GAD 1/2

Anxiety Disorders Overview

  • Anxiety disorders encompass various specific disorders.

  • Obsessive Compulsive Disorder (OCD) is categorized under this umbrella but will be discussed individually.

Generalized Anxiety Disorder (GAD)

  • GAD is characterized by uncontrollable excessive worry, which persists for more days than not for at least six months.

    • Definition: Uncontrollable, excessive worry that lasts more than six months and occurs most days.

    • Example: Worrying about finding a parking spot at a new location without cause.

    • Symptoms:

      • Chronic Fatigue: Resultant from constant high anxiety levels.

      • Difficulty Concentrating: Overwhelming number of worries disrupts focus.

      • Muscle Tension: Physical tension due to constant worry (e.g., shoulders raised).

      • Irritability: Increased focus on worries can lead to irritability.

      • Restlessness: Inability to concentrate on immediate surroundings due to anxiety.

Panic Disorder

  • Defined as having sudden episodes of intense fear, often referred to as panic attacks, occurring without real danger.

    • Duration: Panic attacks typically last 5 to 30 minutes, average range is between 5 to 10 minutes.

    • Symptoms include:

      • Feeling of Doom: Intense feeling of impending disaster.

      • Physical Symptoms:

        • Heart Palpitations: Racing heart rate.

        • Shortness of Breath: Difficulty breathing.

        • Nausea: Physical discomfort often felt during the attack.

        • Chest Pain: A sensation as though an elephant is sitting on the chest.

        • Chills/Hot Flashes: Sudden temperature changes.

        • Numbness or Tingling: Sensation resembling needles in the skin.

      • Depersonalization: Feeling detached from oneself, akin to observing oneself from outside the body.

Separation Anxiety Disorder

  • Usually emerges in children but can affect individuals at any age, concerning fear of separation from home or loved ones.

    • Normal Development: Separation anxiety is typical in infants and toddlers but usually resolves by age three.

    • Symptoms:

      • Excessive distress when anticipating or experiencing separation.

      • Refusing to be away from home or loved ones (e.g., unable to go to the store).

      • Physical complaints such as headaches or stomachaches when faced with separation.

      • Repeated nightmares involving separation.

Phobias

  • Phobias are characterized by strong, irrational, excessive fears of an object or situation.

    • Individuals recognize their fear is irrational yet feel powerless to control it.

    • Symptoms include immediate anxiety or panic when faced with feared object/situation.

    • Examples of Common Phobias: fear of flying, enclosed spaces, public places, animals (dogs, snakes, spiders).

    • Treatment Approach:

      • Exposure Therapy: Gradual, controlled exposure to feared objects or situations to reduce anxiety.

      • Desensitization: Similar to exposure but includes a systematic approach to facing fear (e.g., starting from image viewing to actual contact).

      • Flooding: Immediate exposure to most intense fears, though can be traumatic.

Social Anxiety Disorder (Social Phobia)

  • Intense, persistent fear of being judged negatively in social situations.

    • Signs and Symptoms:

      • Fear of public speaking or any performance.

      • Avoidance of social gatherings or common activities (dating, work conversations).

      • Extreme worry about embarrassing oneself.

    • Difference from General Shyness: Social anxiety significantly impairs functioning because of a deep fear of judgment.

Obsessive-Compulsive Disorder (OCD)

  • OCD involves unwanted, intrusive thoughts (obsessions) that lead to compulsive behaviors aimed at relieving anxiety ( compulsions).

    • Symptoms:

      • Time Consuming Rituals: Such as washing hands excessively, counting, organization (e.g., spices).

      • Hoarding: Difficulty in discarding possessions leading to extreme stress.

      • Body Dysmorphic Disorder: Preoccupation with perceived flaws.

Treatment for Anxiety Disorders

  • Psychotherapy: Talk therapy involving behavioral interventions.

    • Medications:

      • SSRIs (e.g., Paxil, Zoloft, Prozac) for long-term depression and anxiety management.

      • Benzodiazepines (e.g., Xanax, Klonopin) for short-term rapid relief during panic attacks.

    • Behavioral Therapies:

      • Relaxation Techniques: To relieve tension.

      • Modeling: Demonstrating proper behavior for the patient to mimic.

      • Systematic Desensitization & Flooding: Gradual or immediate exposure to anxieties.

      • Response Prevention: Preventing compulsive behavior to decrease associated anxiety.

      • Thought Stopping: Mentally saying "stop" when intrusive thoughts arise to diminish their intensity.

Trauma and Stress-Related Disorders

Acute Stress Disorder and PTSD

  • Acute Stress Disorder: Symptoms after a trauma lasting from three days to one month.

    • Symptoms impact memory, emotional response, and social functionality.

    • Can develop into PTSD if symptoms persist beyond a month.

  • Post-Traumatic Stress Disorder (PTSD): Symptoms that can linger for years, resulting from significant trauma.

    • Symptoms include re-experiencing the traumatic event, avoidance behaviors, negative thoughts, and mood alterations.

Adjustment Disorder

  • Triggered By: Significant stressor resulting in emotional distress or dysfunctional behaviors.

    • Symptoms typically arise within three months of the triggering event, such as family changes, loss, or major life shifts.

    • Symptoms persist for less than six months after the stressor has ended.

Dissociative Disorders

  • Protective response of the brain from trauma, often observed in child abuse survivors.

    • Examples:

      • Depersonalization/Derealization Disorder: Feeling detached from oneself and surroundings.

      • Dissociative Amnesia: Inability to recall specific personal information related to trauma.

      • Dissociative Identity Disorder: Presence of two or more distinct identities or personality states.

  • Nursing Care: Includes grounding techniques, SSRIs, and careful management of information related to trauma to avoid further stress.

Bipolar Disorder

  • Characterized by episodes of mania and depression.

    • Individuals must experience both phases for diagnosis.

    • Manic Episode: Increased mood, heightened energy, rapid speech (often jumpy in subjects).

    • Depressive Episode: Decreased energy, sadness, loss of interest in activities.

    • There are varying types:

      • Bipolar I: At least one manic episode.

      • Bipolar II: Hypomania accompanied by major depression.

      • Cyclothymic Disorder: Episodes of hypomania and depression over the long term.

This guide provides an in-depth overview of various anxiety disorders, their symptoms, treatments, and related mental health conditions. Students should study each disorder thoroughly, understanding its distinct features and managerial approaches.