Ch. 18 Anxiety and Obsessive Compulsive Disorders

Stress

external pressure brought on to the person

Anxiety

Feeling of discomfort, apprehension, or dread from some kind of imminent danger

•Response to the stressor

•Normal to feel anxious

Panic Disorder

•Sudden overwhelming feeling of terror or impending doom

•Most severe state of anxiety because it starts involving behavioral, physical, and cognitive symptoms

•Symptoms include but are not limited to:

•Palpitations

•Sweating

•SOB

•Feeling dizzy

•Detachment 

•attacks are recurrent and unpredictable

•Attacks usually last a few minutes

•Rarely lasts a few hours

•Onset can happen in late 20s

Generalized Anxiety Disorder

•Persistent, unrealistic, and excessive anxiety and worry for at least 6 months

•Difficult to control worrying

•Can begin in childhood or adolescence

Generalized anxiety disorder symptoms

•Restlessness or feeling on edge all the time

•Pacing

•Easily fatigued

•Difficulty concentrating or mind going blank

•Irritability

•Muscle tension

•Sleep disturbance

Social Anxiety Disorder

•Excessive fear of situations where a person might do something embarrassing or be perceived negatively by others

•Onset begins in late childhood and early adolescence

Phobias

•An irrational fear of a specific thing resulting in actively avoiding the feared object

•Specific phobias- specific objects or situations that could cause harm but reaction is over the top

Agoraphobia

•Fear of being in open places due to feeling vulnerable and unable to get help

•Person cannot leave home without being accompanied by someone

•Show support and promote independence

Obsessions

•Intrusive thoughts that are recurrent and stressful

•Person knows the thoughts are irrational but keep acting on it

Compulsions

•intrusive actions that the person HAS to perform to calm down

Obsessive Compulsive Disorder

•Obsessive Compulsive Disorder- Obsessions and/or compulsions are done to the point where it becomes pathological

OCD and hospitalization

New patient is  doing their compulsion»> let them but slowly start to discourage so you do not aggravate them 

PT in treatment being medicated doing compulsion»» stop them as it shows a sign of regression

Trichotillomania

•Hair pulling disorder

•Results in hair loss

•Pulling out hair gives a sense of gratification

Hoarding Disorder

•Persistent difficulties getting rid of an item regardless of how valuable it is

•They'll also keep buying things and hoard them

•It's impossible to walk around the house

Body Dysmorphic Disorder

•Person thinks part of their body is defective to the point where they think about or have multiple surgeries

•Often found in cosmetic or dermatological settings

Interventions for Anxiety Disorders

•Safety

•Low stimuli environment

•Approach them in a calm manner

•Stay with the patient

•Give simple directions

•Teach coping strategies and stressor identification when ready

•Cognitive Behavioral Therapy

•Psychopharmacology

Main Pharm Treatment

-pams and -lams

Non-benzos

• burspirone

• hydroxyzine

Off Label Meds

•SNRIs (specifically Venlafaxine/Effexor)

•Gabapentin (also for pain)

•Antihistamines

•Antihypertensives (specifically Propranolol and Clonidine)