15.3

Learning Objective 15.3 a: Know the key terminology related to anxiety, obsessive-compulsive, and depressive disorders.
Learning Objective 15.3 b: Understand the different types of anxiety disorders.
Learning Objective 15.3 c: Understand how anxiety or depressive disorders can be self-perpetuating.
Learning Objective 15.3 d: Apply your knowledge of anxiety, obsessive-compulsive, and depressive disorders in order to identify which behavioral symptoms are associated with each disorder.
Learning Objective 15.3 e: Analyze whether maladaptive aspects of specific phobias might arise from perfectly normal healthy behaviors.

On 03/29/2018, during an NHL game, Robin Lehner, goaltender for the Buffalo Sabres, experiences intense panic.
- This panic occurred despite not being able to identify its specific cause.
- Eventually, Lehner decides to play, leading to severe physical symptoms
- Experienced intense chest pain and blurred vision by the second period.
Following these experiences, he is diagnosed with:
- Bipolar disorder: Characterized by alternating periods of depression and manic energy.
- Anxiety disorder.
- Substance abuse disorder.
Lehner’s treatment involved:
- Spending over two months in a treatment facility in Arizona.
- Focused efforts on overcoming substance abuse and coping with depression and anxiety.
Post-treatment, Lehner received a contract offer from the New York Islanders in 2018.

Numerous athletes and public figures, including Naomi Osaka and Simone Biles, have openly addressed their mental health challenges, signaling a cultural shift toward acknowledging mental illness as common and critical to address.
- Naomi Osaka: Took time off due to anxiety and depression.
- Simone Biles: Withdrew from events during the Tokyo 2020 Olympics for mental health reasons.
- Other celebrities like Ryan Reynolds, Katy Perry, and Megan Thee Stallion have also shared their experiences with mental illness.
The importance of speaking openly about mental health:
- Reduces stigma.
- Encourages those in need to seek help.

Anxiety and mood disorders are prevalent in society.
- 1 in 4 children and adolescents globally experience depression.
- 1 in 5 youth battle an anxiety disorder.

Anxiety disorders are characterized by excessive, irrational, and maladaptive fear or nervousness.
- Commonly co-occur with other disorders like depression, obsessive-compulsive disorders, and substance abuse.
Occasional anxiety is normal, but debilitating anxiety requires intervention.
- Individuals cope by limiting themselves to safer environments or developing rigid habits.
Fight or flight response:
- Physical manifestations may include racing heartbeat, increased respiration, and gastrointestinal distress.
- This response has an evolutionary basis but can become maladaptive in modern society due to chronic stress.

Generalized Anxiety Disorder (GAD):
- Characterized by frequent, elevated anxiety levels without clear sources, leading to unease and varied symptoms:
- Difficulty sleeping, breathing, concentrating.
- Individuals often feel a constant need for control.
- Linked to genetic and environmental factors, exacerbated by significant life stress.
- Imaging studies show that individuals with GAD may have a larger right amygdala.
Panic Disorder:
- Marked by episodes of sudden, intense fear known as panic attacks:
- Symptoms may escalate quickly, typically resolving within 10 minutes.
- Can lead to agoraphobia, where individuals avoid places where panic may occur, limiting social interactions.
Specific Phobias:
- Severe and irrational fears directed at specific objects or situations.
- Two categories:
- Specific Phobias: Fear of specific items or situations (e.g., heights, injections).
- Social Phobias: Fear of judgment in social situations.
- Develop from unpleasant experiences, genetic predispositions, and observational learning.

Phobias can develop without personal experience, evidenced by fear of uncommon events (e.g., shark attacks by those in landlocked regions).
The feedback loop of anxiety leads to more intense phobias over time, termed parasitic processing.

Genetics and behavioral traits contribute to the risk for developing phobias:
- Studies with mice show selective breeding leads to heritable traits related to fear responses.
Observational learning plays a role; witnessing fear can instill similar fears in others.
The biopsychosocial model highlights the interactions between genetic, psychological, and societal influences in the development of phobias.

Characterized by the fear of being judged negatively in social contexts:
- Individuals create routines to avoid exposing themselves to anxiety-inducing situations.
- Examples include avoiding crowded spaces or public speaking opportunities.

OCD was reclassified in DSM-5 TR due to its unique characteristics distinct from general anxiety disorders.
- Involves obsessions (unwanted thoughts) and compulsions (ritualistic behaviors to alleviate anxiety).
- A well-known example: Fears of germs lead to excessive hand washing.

Differences in brain structure (e.g., orbitofrontal cortex) may contribute to OCD symptoms.
Abnormal activity patterns can affect decision-making, movement, and emotional regulation.

Common mood disorders include Major Depression and Bipolar Disorder.
- Affects almost 10% of adults in the US and Canada.
- Rates of depression are higher in women and those in poverty.

Marked by prolonged sadness, feelings of worthlessness, social withdrawal, and cognitive sluggishness:
- Physiological effects include insomnia, lethargy, appetite changes.
- Cognitive burden leads to negative life impacts.
- The pessimistic explanatory style is characteristic, where individuals attribute failures to self and view situations as permanent and pervasive.

Twin studies reveal a genetic risk component.
The diathesis-stress model illustrates how genetic predisposition interacts with stressful life events in developing depression.
Involvement of brain structures (e.g., amygdala, HPA axis) in stress responses contributes to depression symptoms.

Involves extreme mood fluctuations from manic highs to depressive lows:
- Symptoms include racing thoughts and impulsivity during manic episodes, often followed by remorse in the depressive phase.
- Higher suicide rates associated with bipolar disorder compared to major depression.

The second leading cause of death among youth; it is crucial to understand risk factors.
Disproportionately higher rates among males, elderly individuals, and Indigenous communities.
Warning signs can include verbal expressions of despair, withdrawing from usual activities, and giving away belongings.

Indigenous youth face disproportionately high suicide rates often linked to historical and systemic issues.
Enhancing community connections and cultural re-engagement can mitigate risks.
Research indicates a caring and culturally supportive environment lowers suicide rates.

Mental health awareness, particularly regarding anxiety and mood disorders, is crucial for fostering understanding and encouraging help-seeking behaviors. Treatment avenues and support systems, like helplines, significantly assist individuals in crisis.