Anxiety Disorders

Question 1

How does anxiety affect us?

Answer 1

Anxiety is a common emotion that everyone feels, but for some, it can become debilitating and impacts things in their life.

Question 2

Psychoanalytic viewpoint of anxiety:

Answer 2

Freud argues that we should be able to control anxiety to be able to live a normal, happy life. When we can’t control it, or don’t want to, Freud calls it “neurotic anxiety”. There isn’t much research to back this idea, but it is still plausible.

Question 3

Humanistic viewpoint of anxiety:

Answer 3

Humanistic sees it as a result of acting the way we believe others want us to act rather than acting for ourselves, leading to stress.

Question 4

Biological viewpoint of anxiety:

Answer 4

GABA neurotransmitters normally regulate anxiety. When not enough GABA is being produced, we get overly anxious and cannot control the emotion.

Question 5

What does statistics say about anxiety disorders?

Answer 5

Current estimates are about 20% of the current adult population experience an anxiety disorder in a given year. While they are common, about 60% of individuals who experience an anxiety disorder do not receive treatment. It’s also not uncommon for those with anxiety disorders to experience other disorders (most commonly depression, sometimes other anxiety disorders, mood disorders, etc.)

Question 6

What are comorbid disorders?

Answer 6

Disorders that occur at the same time and have to be treated at the same time.

Question 7

What are drugs used to treat anxiety?

Answer 7

Benzodiazepines (anti-anxiety drugs) are commonly used. The most common drug to treat anxiety is Xanax.

Question 8

What are the pros and cons about using Xanax?

Answer 8

Pros: It’s an affective drug without many side affects.
Cons: The biggest side affect is that it’s highly addictive, and could lead to possible physiological dependence.
This drug is given in small doses, but because of the lack of education around it, it’s prescribed “as-needed”, which can lead to addiction.

Question 9

What are common anxiety disorders?

Answer 9

Generalized anxiety disorder (GAD), panic disorder, and phobia disorders.

Question 10

What is an obsessive-compulsive disorder?

Answer 10

A disorder characterized by a pattern of compulsive or driven repetitive behaviors associated with significant personal distress or impaired functioning in meeting demands of daily life.

Question 11

What are common obsessive-compulsive and related disorders?

Answer 11

OCD, body dysmorphic disorder, and hoarding disorder.

Question 12

What is generalized anxiety disorder (GAD)?

Answer 12

GAD is described as “free floating anxiety”. The individual has an excessive worry about anything & everything, and they’re in a constant state of anxiety or worry not tied to a specific thing or fear-based aspect.

Question 13

What are symptoms of GAD?

Answer 13

Restlessness, easily fatigued, irritability, muscle tension, and/or sleep disturbances.

Question 14

What does statistics say about GAD?

Answer 14

About 4% of the population per year gets diagnosed. This disorder usually shows up at early adolescence, and the recurring outcome is that women experience it more than men by 2:1.

Question 15

Treatment for GAD:

Answer 15

The major forms of treatment for GAD are psychiatric drugs and CBT. Cognitive-behavioral therapists use a combination of relaxation skill training, substituting intrusive, worrisome thoughts for salming, adaptive thoughts, and learning skills of decatastrophizing. CBT is notably more affective amongst clients than drugs, as it has similar effects, but there are less dropout rates.

Question 16

What is panic disorder?

Answer 16

An anxiety disorder characterized by sporadic and reoccuring panic attacks.

Question 17

What is a panic attack?

Answer 17

Periodic, short bursts of panic that occur suddenly, reaches a peak, and then passes. These are longer in duration than what individuals experience as mere “panic”. Individuals in a panic attack believe they’re going to go crazy, lose control, or die.

Question 18

When can panic attacks lead to panic disorder?

Answer 18

When it happens so often and for no good reason, this can lead to a disorder. Individuals believe they are the only ones that can handle it, so they start anticipating it. This starts to become their whole focus that they never experience it again. More often than not, the initial reason for a panic attack is rational - it becomes an issue after the fact.

Question 19

What does statistics say about panic disorders?

Answer 19

Women outnumber men 2:1, and luckily, most with panic disorder are in treatment. Panic disorder is also associated with agoraphobia (but you can have either without the other).

Question 20

Biological viewpoint on panic disorder:

Answer 20

A panic circuit in the brain, most specifically “locus coeruleus”, is rich in neurons that contain norepinephrine. A disconnect between certain GABA neurotransmitters, along with an imbalance of norepinephrine, leads to excessive panic.

Question 21

CBT model on panic disorder:

Answer 21

While biological factors are a part of the cause, individuals who are prone to panic attacks also have high levels of anxiety and are more prone to misinterpret these sensations (like experiencing “extreme” panic) and feeling physiologically aroused.

Question 22

Drug treatment for panic disorder:

Answer 22

Antidepressant medications work much better in treatment than antianxiety medications, since norepinephrine is a drug contained within the class of “depressants”. This doesn’t mean that the individual with panic disorder ALSO has depression.

Question 23

Therapeutic treatment for panic disorder:

Answer 23

In therapy, it’s not as helpful to find the cause of the panic disorders, but moreso working with the thought process and associations made by the individual. The goal is to correct the misinterpretation of panic attacks and sensations and experiences associated with it. Exposure therapy and “biological challenges” (put them in situations that trigger those intense physiological reactions while under supervision and using skills to cope with it) are the most common and effective methods.

Question 24

What is a phobia disorder?

Answer 24

An anxiety disorder characterized by persistent unreasonable fear of living things, objects, or situations that usually impacts one’s quality of life and prevents one from completing daily tasks. The fear is much more intense, magnified, and persistent.

Question 25

What are the 3 main types of phobia disorders?

Answer 25

Social anxiety disorder (SAD), agoraphobia, and specific phobia.

Question 26

What is social anxiety disorder (SAD)?

Answer 26

A phobia disorder stemming from the fear of being judged or watched by others. It is characterized by severe, persistent and irrational fear of social or performance situations in which scrutiny by others and embarrassment may occur. Individuals judge themselves harshly and overthink situations.

Question 27

What does statistics say about SAD?

Answer 27

About 60% of individuals with SAD are women, and the disorder usually begins in childhood. Only 30% receive some sort of treatment due to not wanting to deal or talk about their issues for fear of being judged.

Question 28

CBT model on SAD:

Answer 28

Individuals believe in a group of social beliefs and expectations that consistently work against them. Examples of this include unrealistically high social standards, views themselves as unattractive and socially unskilled, and the belief that they have no control over their feelings of anxiety. Because of these beliefs, they anticipate that social disasters are going to occur, so they engage in social avoidance behaviors.

Question 29

Treatment for SAD:

Answer 29

There are 2 things individuals with SAD work on in therapy: overwhelming social fear & social skills (self-esteem, how to interpret situations, confidence, etc.). Antidepressants (ex: lexapro) are used, since this is a different kind of anxiety disorder, similar to panic disorder.

Question 30

What is agoraphobia?

Answer 30

A phobia disorder stemming from the fear of being in a situation where escape might be difficult. It's most commonly manifested as not leaving the house, but this isn't always the case. They feel safer at home since they can control it, and avoid social situations as a result.

Question 31

What does statistics say about agoraphobia?

Answer 31

Agoraphobia affects 2% of the population, with women outnumbering men 2:1. More often than not, it's tied with a panic disorder.

Question 32

Treatment for agoraphobia:

Answer 32

Exposure therapy, focusing on gradual transitions and modeling. Studies show that more agoraphobic people who get exposure therapy are able to overcome their fears easier or quicker.

Question 33

What is specific phobia?

Answer 33

The persistent fear of an object or situation. When approached with said object or situation, they expeirence immediate and intense fear. The phobia prevents one from performing daily tasks and everyday activities, and the avoidance reinforces the fear.

Question 34

What are the most common types of phobias?

Answer 34

A specific animal or insect (butterflies, cats, flies, dogs, snakes, spiders), heights, enclosed spaces, thunderstorms, and blood.

Question 35

What does statistics say about specific phobia?

Answer 35

Specific phobia affects about 10% of the population, with women outnumbering men 2:1, and most don't get treated. Individuals usually have more than one phobia.

Question 36

CBT model on specific phobia:

Answer 36

The CBT model focuses on 2 different approaches: classical conditioning (neutral stimuli elicits fear during traumatic event) and the environmental factor (if one's parents are afraid of germs, there's a chance one may grow up to be afraid of germs as well).

Question 37

Behavioral-evolutionary perspective on specific phobia:

Answer 37

Humans had a predisposition to develop fears and pass them on, which is likely what helped us survive compared to other species. We are more prepared to acquire phobias around certain objects and situations, but not others. Less common phobias appear from specific survival situations, possibly with some sort of trauma.

Question 38

Therapeutic treatments for specific phobia:

Answer 38

Exposure therapy is the most effective. Gradually exposing the client to a situation is the most common form used to achieve systematic desensitization. Relaxation techniques and anxiety hierarchies are helpful for this form. Modeling (the therapist shows the client how to properly react to fear) and flooding (put client in an intense situation with their fear) are other forms of exposure therapy, but flooding can be the most problematic, as the therapist has to be careful not to retraumatize the client.

Question 39

What are obsessions and compulsions?

Answer 39

Obsession is a thought or action that the individual is unable to control. Common themes include dirt or contamination, violence or aggression, orderliness, religion, or sexuality. Compulsions are repetitive behaviors that the person feels compelled to perform. These are voluntary behaviors, and are seen as rituals or experiences. These include observable and nonobservable behaviors (such as counting).

Question 40

What are common misconceptions about OCD?

Answer 40

Individuals who suffer from OCD or similar disorders completely and rationally understand that their obsessions and compulsions are irrational. However, if they don't do it, they believe something terrible may happen. This is what drives the disorder.

Question 41

What are symptoms of body dysmorphic disorder?

Answer 41

Individuals are preoccupied with an imagined or exaggerated physical defect in their appearance, such as wrinkles, spots, facial blemishes, or specific body parts or features that are socially deemed "incorrect" or "ugly", leading individuals to believe they themselves are ugly or disfigured.

Question 42

What are symptoms of hoarding disorder?

Answer 42

Extreme difficulty discarding stacks of unnecessary and seemingly useless possessions, which results in personal distress or in creating so much clutter that it makes a person's home unsafe to walk through or nearly uninhabitable.

Question 43

Psychoanalytic viewpoint on OCD:

Answer 43

Obsessions represent leakage of unconscious urges or impulses into consciousness, and compulsions are acts that help keep these impulses repressed. For example, obsessive thoughts about contamination by dirt or germs may represent the threatened emergence of unconscious infantile wishes to soil oneself and play with feces. The compulsion (in this case, cleanliness rituals) helps keep such wishes at bay. This viewpoint is largely speculative, mainly due to the difficulty of tests to determine the existence of unconscious impulses and conflicts.

Question 44

Biological viewpoint on OCD:

Answer 44

Vulnerability to OCD is influenced by genetic factors. The actions of certain genes involved in regulating neurotransmitter functioning lead to overarousal of a "worry circuit" in the brain, which is a neural network that signals danger in response to perceived threats. Another possibility is abnormalities or disruptions in brain circuits that normally serve to perform repetitive behaviors.

Question 45

Treatment for OCD:

Answer 45

Exposure with response prevention (ERP) therapy has proved most useful, with repeated and prolonged exposure to stimuli or situations that evoke obsessive thoughts, and preventing the compulsive behavior or ritual from occurring.