Anxiety and OCD

Normal Anxiety

Helps and individuals be alert and think more clearly

Acute (state) Anxiety

Temporary heightened apprehension, tension, nervousness, worry

Chronic (trait) Anxiety

• Long-lasting condition part of the individual's personality over time​

• Response to state anxiety more debilitating​

• Trouble performing at work, in relationships, with immune system​

  • becomes a habit

Separation Anxiety

Excessive fear or anxiety resulting from separation from a home or loved one

• Developmentally inappropriate

• Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures ​

• Persistent refusal to go out, away from home, to school, to work, or elsewhere because of fear or separation​

Separation Anxiety Sx

• Reluctant to leave who they are attached to

• Nightmares

• Physical manifestations of distress

• Can be somatic or refusal to partake in certain activities

  • Dx in childhood or adolescence

Selective Mutism

Consistent failure in speaking during social situations where speaking is expected/required

• Interferes with educational and occupational achievements or social communication

• Not due to lack of knowledge, they speak when comfortable

• Must be present for 1 month

Phobia

Experiencing marked fear and anxiety upon exposure to a specific object or situation.

• Must be excessive in patient's culture, out of proportion to actual danger, and cause patient significant impairment, distress for at least 6 months​

Examples of phobias include:

• Animals

• Nature

• Heights

• Inoculations 

• Blood

• Agoraphobia

Agoraphobia

Marked fear or anxiety about situations in which escape could be difficult or help not immediately accessible, leading to avoidance or enduring with distress (e.g. being in a crowd

• Typically in two or more of the following spaces: public transportation, open spaces, shops/theaters/cinemas, standing in line or being in a crowd, being outside the home alone​

Social Anxiety (social phobia)

Marked fear or anxiety about social situations where there is potential for embarrassment or scrutiny by others​

• Types of situations that trigger anxiety​

  • Interaction​

  • Observation​

  • Performance ​

• Cultural differences may occur​

Thoughts ruminate on being embarrassed, humiliated, rejected, or offending others.

Panic Disorder

Experiencing distinct and extreme periods of physiologic and psychologic hyperarousal.

• Usually unexpected and occurs for no apparent reason  

• Panic attacks may be an aspect or any anxiety disorder

Generally occurs between adolescence and the mid 30s ​

Panic Disorder Requirements

• Recurrent, unexpected panic attacks followed with at least one month of: ​

• Persistent concern about having additional panic attacks or their consequences ​

AND/ OR​

• Significant changes in behavior related to the attacks

Panic Attack

Not a disorder, but occur as a result of anxiety or mental health disorders. Last for a discrete period of time and involve intense fear, discomfort, or a sense of impending doom

• Increased risk for suicide

Panic Attack Sx

• Palpitations, increased HR

• Sweating

• Trembling or shaking

• SOB

• Sensation of choking

• Chest pain or discomfort

• Dizziness, faint, lightheaded

• Chills or hot flashes

• Abd. cramping or nausea

• Paresthesia

• Derealization or depersonalization

• Fear of loss of control

• Impending doom

Need at last 4 of these Sx

Generalized Anxiety Disorder

Excessive worry in two or more domains (e.g., family, health, finances, school, work) more days than not

• Over a period of three months​

One or more of the following behaviors:​

• Avoidance of activities with possible negative outcomes​

• Time and effort preparing for activities with possible negative outcomes​

• Procrastination in behavior, decision making due to worries​

• Repeatedly seeking reassurance due to worries

Generalized Anxiety Disorder Sx

• Excessive anxiety and worry

• Sleep disturbances

• Muscle tension

• Irritability

• Inability of concentration

• Fatigue

• Restlessness

Obsessive Compulsive Disorder

Recurring obsessions and compulsions so persistent that they take an unreasonable amount of time (for example, more than one hour each day) or cause significant distress or impairment​

• Cleaning

• Washing hands

• Ordering or counting objects or behaviors

• Taboo or forbidden thoughts

Obsession

Recurrent, persistent thoughts, urges, or images causing significant distress​

Fear of

• Causing harm or being harmed

• Contamination and illness

• Making mistakes

• Losing things

Compulsions

Repetitive behaviors or mental acts the individual feels driven to perform​

• Washing hands and cleaning

• Counting and checking

• Ordering or arranging

• Requesting or demanding assurances

• Extreme hoarding or saving

• Praying

• Counting

• Repetition of words

Body Dysmorphic Disorder

Experiencing a persistent preoccupation with perceived defects or flaws on one’s physical appearance.

• Excessive grooming​

• Mirror checking​

• Reassurance seeking​

• Comparing appearance to that of others​

• Skin picking

• Eating - possible eating disorder

Hoarding

Continued difficulty discarding or parting with possessions due to perceived need to save items​

• Distress associated with discarding items​

• Living spaces may be unfit for use.​

• Symptoms emerge in childhood but are not debilitating until mid-30s.​

Trichotillomania

Demonstrating a pattern of ritualized behavior defined by serially and intentionally pulling out one’s hair.

• Behaviors are triggered by boredom and/or anxiety

• Results of behavior reduce tension, lead to form of gratification, and pleasure or a sense of relief

Excoriation disorder

Demonstrating a pattern of behavior defined by the recurrent picking at one’s skin, resulting in lesions.

• Physical manifestations commonly found on hands, face, arms, or multiple body sites

• May pick pimples, scabs, or previous picked areas of skin

• Use of picking with fingers, tweezers, rubbing

• Extensive time daily is spent picking

• Often client attempts to cover with clothing or makeup