Anxiety Disorders

What is fear?

Focused physiological reaction, typically in response to a particular stimulus

What is anxiety?

Emotional and physiological reaction to a stressor (real or perceived); may or may not have a focus

What is phobia?

Fear that causes avoidance of feared stimulus along with social and occupational impacts

What is a panic attack?

Sudden “rush” of fear (tachycardia, sweating, shaking) that often feels “out of the blue” → peaks in about 10 minutes, typically lasts for 20-30 minutes

What is Generalized Anxiety Disorder (GAD?)

Characterized by excessive worry across many different areas/topics

• Own/others’ health

• World events

• Work/school

What do individuals with Generalized Anxiety Disorder talk about/face?

• Not being able to “turn off” their worry

• Worry is uncontrollable and diffuse in severe cases

  • Often interferes with sleep

  • Can impact social/occupational function - “paralyzed” by worry

What is Social Anxiety Disorder?

Fear of being in a social situation where one would be negatively evaluated

How can Social Anxiety Disorder affect your quality of life?

• Can be occupational (e.g., public speaking) and/or social (going to parties)

• In severe cases, can significantly impact social and occupational functioning

What is Specific Phobia?

Significant, extreme fear associated with a specific situation or stimulus

What are some examples of specific phobia?

Typically involves avoidance of feared stimulus

Can impact social and occupational functioning

• Heights

• Water

• Dogs

• Snakes

• Spiders

• Darkness

• Flying

• Needles

What is Agoraphobia?

Fear of having a panic attack in a place where escape is not possible; the key is fear of having a panic attack in an unsafe place

Agoraphobia can present on a spectrum. How?

Mild (sitting on the aisle) to severe (not leaving home)

What is Post-Traumatic Stress Disorder (PTSD)?

• Occurs after experiencing or witnessing a traumatic event(s)

• Hypervigilance (autonomic arousal, scanning the environment, easily startled)

• Re-experiencing the trauma

  • Flashbacks when awake, and/or

  • Nightmares when asleep

• Can significantly impact social and occupational functioning

• Can impact dental treatment (e.g., physical and/or sexual assault victims

What is Acute Stress Disorder?

Symptoms of PTSD within 6 months of trauma occurring

What are obsessions in Obsessive-Compulsive Disorder (OCD)?

Recurrent and persistent thoughts, images, urges that are intrusive and unwanted; cause significant distress

What are compulsions in Obsessive-Compulsive Disorder (OCD)?

Repetitive behaviors or mental acts the individual feels driven to perform In response to an obsession (may include behaviors like hand-washing, ordering, checking) and/or mental acts like counting, repeating silently, praying

How can OCD impact one’s life?

• The obsessions/compulsions are time-consuming and/or cause clinically significant distress

• NOT the same as “double-checking” the lock on a door or that the stove is off

Dental anxiety is also called

• Dental fear

• Dental phobia

• Odontophobia

How can dental anxiety show up?

• Can manifest as increased muscle tension, tachycardia, sweating, shaking; crying or anger

• In severe cases: can impact social and occupational functioning

If a person with dental anxiety avoids their care, what can that lead to?

Deteroiration of dental health —> pain —> embarrassment —> avoid social, occupational situations

What are some methods for treating anxiety disorders in general?

• Pharmacotherapy

• Psychotherapy

What is pharmacotherapy for treating anxiety disorders?

1. Benzodiazepines (alprazolam, diazepam)

2. Beta-adrenergic receptor antagonist (beta-blockers like propranolol)

3. Selective Serotonin Reuptake Inhibitors (SSRIs)- less common in acute settings

4. Nitrous Oxide in dental setting

What are some psychotherapies for treating anxiety disorders?

1. Cognitive-behavioral therapy

2. Systematic desensitization

3. Flooding