Unit 6: Anxiety Disorders (video)

Question 1

Anxiety Disorders are similar to other mental health disorders in that…

Answer 1

You will experience clients that are experience symptoms that are related to anxiety everywhere you work
-OT’s always work with clients while they are at a point of transition whether they have a new illness, injury, or disability or a transition in life with one of these

Question 2

Anxiety Disorders

Answer 2

Group of classification of disorders whether it be short-term experience related to some event or stressor in life or a long-term issue someone is dealing with

• Incredibly variable
• Defined as a feeling of apprehension, or danger/restlessness whether real or imagined
• Can be an anticipated event, experience, conversation
• Most anxiety is actually normal and can be a motivator (way our nervous system warns us and gives us a higher sense of awareness and ability to process info)

Question 3

Biologically speaking anxiety is…

Answer 3

A protective response and is normal

Question 4

Is the level of anxiety that someone is feeling normal/expected for the situation at hand and can it be resolved quickly once somebody understands that they have the problem-solving capabilities or even just the innate characteristics to be able to handle whatever this unexpected situation is?

Answer 4

• Anxiety becomes a disorder when it becomes people’s experience of this feeling of apprehension or danger when it’s not related to something in particular.
• When there is no real threat of danger, when there is no real threat and this feeling is sustained, people experience signs of restlessness, intention and the sustained feeling is what we call classify then as anxiety disorders.

Question 5

Generalized Anxiety Disorder

Answer 5

An excessive underlying constant feeling of worry, feeling like you’re on the edge, restless, irritable.

• There’s usually some difficulty with sleep and wake cycle, but a generalized anxiety disorder is usually considered more so when this is sustained for a long period of time.
• When you have that sense of apprehension and that difficulty with sleep and wake and those feelings like you’re on the edge all the time and excessive worry about things that it starts to impact your ability to process.
• It starts to impact your ability to function and actually starts to impact occupational performance.

Question 6

Panic Disorder (anxiety)

Answer 6

• The feeling of sudden attacks of terror.
• People actually experiencing panic disorders or panic attacks, experience it and describe it as feeling like a heart attack almost, heart attack symptoms.
• Many times people will go to the emergency room feeling like they are having a heart attack even though it is just a panic attack.
• A feel of losing control, unexpected and intense fear.
• There’s a lot of autonomic symptoms that occur with panic disorder. (increased heart rate, sweating, shortness of breath, numbness and tingling)
• The somatic impact of panic disorder is real.
• When people are having these autonomic symptoms and this increased heart rate and these sorts of things, those are real.
• The manifestation is not from, and the pathology of it is not a dysfunction in any sort of a system, it is a dysfunction in your nervous system that is impacting and creating those somatic symptoms.

Question 7

Phobia (anxiety

Answer 7

• Related to more of an irrational fear of certain objects and situations.
• Have a feeling of real intense fear or anxiety.
• People who have a true phobia when they are exposed to this certain object or situation, have that feeling of panic, have those somatic symptoms that occur that shouldn’t occur during those situations.

Question 8

Agoraphobia (anxiety)

Answer 8

• A little more pervasive and a little more debilitating, which is why it gets to be put on under its own diagnostic category.
• People understand it to be people not wanting to leave their home and people afraid to leave their home.
• It is a fear of situations in which they may not be able to escape, so feeling of safety in home allows them to avoid situations that they may not be able to escape, so it’s actually more of a social anxiety as opposed to a fear of leaving their home.
• It’s actually a fear of where they’re going as opposed to and what could happen as opposed to those types of experiences

Question 9

Factors impacting Anxiety Disorders

Answer 9

• Psychological and genetic factors can influence susceptibility to anxiety, but then it’s also influenced and exacerbated by life experiences.
• Most individuals have experienced anxiety at some point in their lives and you will. Some anxiety is good.
• This is how our nervous system is built in order to send messages to us to be able to protect ourselves effectively.

Question 10

Chronic Exposure to Stress (anxiety)

Answer 10

(or ineffective response to stress)

• Can be considered anxiety disorders
• Can change the nervous system so that somebody would experience more of a generalized anxiety disorder and have those experiences of anxiety more current more frequently in their lives.
• The nervous system decreases serotonin and increases dopaminergic activity bc chronic stress exposure puts strain on the CNS and this imbalance is what causes these somatic symptoms to occur.
• Causes increased heart rate and state of needing to protect ourselves quite frequently for a longer duration of time.

Question 11

Anxiety Disorder Management

Answer 11

-Combo of pharmacological, psychological, and cognitive-behavioral interventions

Question 12

Pharmacological/ Psycological interventions for Anxiety

Answer 12

Come from psychiatrists or medical doctors, but under the supervision of a psychologist or other psychological interventions.

• We often have to change the behavioral patterns in order to sustain long-term effects and change in anxiety disorders.
• Many interventions OT’s use can help support this.
• Antidepressants such as selective serotonin reuptake inhibitors are used frequently to treat anxiety disorders similar pharmacological management to that of other mood disorders.
• We may see that people are experiencing depression as a result of the anxiety, therefore will be on those mood-stabilizing medications.
• However, most likely it is because of the fact that the serotonin, the lack of serotonin in the brain is what is really impacting somebody’s ability to be able to recover from these situations of anxiety more frequently.

Question 13

Cognitive-Behavioral Intervention for Anxiety Disorder

Answer 13

Understanding how to behaviorally change what you’re experiencing and how you’re approaching what you’re experiencing with the anxiety disorder is really how you can begin to manage it yourself.
-So coupled with a neurological stabilizer and a mood stabilizer, like an antidepressant or similar types of medications, cognitive behavioral interventions, changing the way you’re thinking about something, changing the way you’re acting about a situation can really start to empower people with anxiety disorders and help them to manage some of the situations that can exacerbate or elicit some of their traditional anxiety responses.

Question 14

How does anxiety impact occupational performance?

Answer 14

• Impacts sleep-wake cycles and the circadian rhythms, so understanding sleep hygiene, understanding sleep patterns and sleep routines
• Using cognitive-behavioral approaches to help people to reframe what they’re seeing and how they’re processing and what their behaviors are going to help us to be able to help them develop new performance patterns, new performance skills to be more effective.
• Understand how pharmacological supports can help our clients to feel a little more stable in some of those environments can help us to change our approaches to be more specific related to that client.
• We need to understand how these symptoms related to their actual disorder or symptoms related to the side effects of their medication are impacting their ability to do what they want or need to do on a daily basis.
• OTs are going to see people with anxiety disorders, one to three to one to four people experience some type of a mental illness and anxiety being the primary one.

Question 15

Anxiety throughout the lifespan

Answer 15

• May see in NICU with babies up to geriatrics
• Babies themselves may have some sorts of neurological impacts that indicates stress and feelings of stress, but more so you’re going to be dealing with the anxiety and the and the stress of their parents.
• Geriatric population: Home health, inpatient, not just the anxieties of the clients that you’re dealing with but also family and the dynamic of that they’re living within and their social settings and their social context.
• Understand symptomology, how it can manifest, understand you’re dealing with the person who you’re treating and everybody around it to be able to help somebody live the most successful occupational life

Question 16

Mood disorders include:

Answer 16

Depression, Mania, and Bipolar disorder.

Question 17

In 2012, the World Health Organization estimated that major depressive disorder and bipolar disorder were…

Answer 17

Among the leading causes of disability.

Question 18

Occupational therapists contextual nature with Mood DIsorders

Answer 18

• Wouldn’t necessarily be referred to treat this diagnosis, but instead we would encounter people with occupational dysfunctions that are experiencing symptoms related to some of these things.
• They may have a history of some of these disorders and they may have experienced them or could be experiencing them currently.

Question 19

Mood disorders

Answer 19

• A classification of diagnoses and classification of symptoms that are considered some of the most disabling and the most prevalent within illnesses worldwide.
• People can experience mood disorders and have experiences of depression and mania in conjunction with a lot of different other diagnoses.

Question 20

Mood Disorders induced by substance or medication, or specific depression related to a medical illness

Answer 20

Major depressive through depression

Question 21

Specific mood disorders that are inherent to the person, which are an experience of these mood disorders and symptoms related to these mood disorders over a long period of time.

Answer 21

Bipolar disorder, Major depressive disorder,

Question 22

People who are affected by these on a daily basis, as well as some of these experiences within mood disorders, that are included short term or are associated specifically with an event or a period of time in somebody’s life.

Answer 22

Depression and Mania

Question 23

Cause of Mood Disorders

Answer 23

Different from person to person, as well as the type of mood disorder that we’re dealing with.

Question 24

Seasonal Affective DIsorder

Answer 24

• Affected by the actual seasonal changes and the barometric pressures that are involved in different types of environments, and light and dark, and having experiences in their circadian rhythms that are impacting their ability to process the neurotransmitters effectively.
• More specifically associated with short term and very specific times of year.

Question 25

Major Depressive Disorders

Answer 25

• More consistent and systematic throughout everything that they’re experiencing for a long period of time.
• Depressed Mood, Altered sleep pattern (too much or too lil), Feelings of worthlessness or guilt, suicidal thoughts

Question 26

As an OT, we need to understand how these kinds of etiologies, whether it be

Answer 26

• Seasonal, medication, neurological and biological, triggered by a traumatic event, or exposure to chronic stress
• We need to understand how it’s impacting somebody’s occupational performance.

Question 27

Primary Categories of Mood Disorders

Answer 27

Major Depressive Disorder and Bipolar Disorder

Question 28

Bipolar Disorder

Answer 28

• Depression Symptoms: Depressed Mood, Altered sleep pattern (too much or too lil)
• Mania Symptoms: Impulsive/Risky behavior, excessive activity
• Elevated mood may be happy, angry, productive, or violent

Question 29

Medical Treatment for MDD

Answer 29

Selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitor (allow for the brain to have
more access to serotonin, which has been shown to be able to regulate mood a little bit more effectively.)
-If people are experiencing some of these symptoms related to depression or mania, the availability of additional serotonin that’s provided by some of this pharmacological intervention can allow for some of that mood stabilization to happen.

Question 30

More invasive and severe interventions for Depression

Answer 30

• Electroconvulsive therapy and repetitive transcranial magnetic stimulation
• Support some of this availability of serotonin for some support in mood stabilization. are two of these
• Usually, they are a last effort for treatment-resistant types of depression

Question 31

Bipolar Disorder Pharmacology

Answer 31

• Anti-convulsant medications
• Important know that if you see this med, it may not be because they have seizure disorders.
• Understanding the different ways that these are applied by a psychologist, a psychiatrist or a medical physician is important for us to know because of the different side effects that people could experience.
• May also respond well to Electroconvulsive therapy and repetitive transcranial magnetic stimulation

Question 32

How do mood disorders impact occupational performance?

Answer 32

• Changes in patterns, roles, habits, routines.
• Changes in their ability to process information and their performance skills.
• Basic client factor impacts based upon, potentially, the side effects of the medication, not just in the mood disorder itself. Somebody who’s experiencing severe depression, one of the major hallmarks is abnormal sleep patterns. Some of the things that we may be impacting right away are sleep routines, sleep hygiene, those types of things affecting the performance patterns of our clients to have more effective occupational performance.