Anxiety Disorders. GAD: Generalized anxiety disorder. Panic disorder. Phobias. OCD: Obsessive- compulsive disorder

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Cathleen Tate
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1 Anxiety Disorders GAD: Generalized anxiety disorder Panic disorder Phobias OCD: Obsessive- compulsive disorder PTSD: Post- stress disorder clay- hunt- act- bill- signing- ceremony/ /

GAD: Generalized Anxiety Disorder Emo5onal- cogni5ve symptoms include worrying, having anxious feelings and thoughts about many subjects, and some@mes free- floa@ng anxiety with no

2 GAD: Generalized Anxiety Disorder Emo5onal- cogni5ve symptoms include worrying, having anxious feelings and thoughts about many subjects, and free- anxiety with no aaachment to any subject. Anxious interferes with Physical symptoms include autonomic arousal, trembling, and sleep

Panic Disorder: I m Dying A panic a>ack is not just an anxiety aaack. It may include: many minutes of intense dread or terror. chest pains, choking, numbness, or other frightening physical sensa@ons.

3 Panic Disorder: I m Dying A panic a>ack is not just an anxiety aaack. It may include: many minutes of intense dread or terror. chest pains, choking, numbness, or other frightening physical sensa@ons. Pa@ents may feel certain that it s a heart aaack. a feeling of a need to escape. Panic disorder refers to repeated and unexpected panic aaacks, as well as a fear of the next aaack, and a change in behavior to avoid panic aaacks.

Specific Phobia A specific phobia is more than just a strong

onal, intense desire to avoid the some object or situa.on.

4 Specific Phobia A specific phobia is more than just a strong fear or dislike. A specific phobia is diagnosed when there is an uncontrollable, irra.onal, intense desire to avoid the some object or situa.on. Even an image of the object can trigger a reac@on- - GET IT AWAY FROM ME!!! - - the uncontrollable, irra.onal, intense desire to avoid the object of the phobia.

5 Some Fears and Phobias What trends are evident here? Which varies more, fear or phobias? What does this imply? Agoraphobia is the avoidance of situa4ons in which one will fear having a panic a7ack, especially a situa@on in which it is difficult to get help, and from which it difficult to escape. Some Other Phobias Social phobia refers to an intense fear of being watched and judged by others. It is visible as a fear of public appearances in which embarrassment or humilia@on is possible, such as public speaking, ea@ng, or performing.

6 Obsessive- Compulsive Disorder [OCD] Obsessions are intense, unwanted worries, ideas, and images that repeatedly pop up in the mind. A compulsion is a repeatedly strong feeling of needing to carry out an ac@on, even though it doesn t feel like it makes sense. When is it a disorder? Distress: when you are deeply frustrated with not being able to control the behaviors or Dysfunc@on: when and mental energy spent on these thoughts and behaviors interfere with everyday life

Common OCD Behaviors Percentage of children and adolescents with OCD repor@ng these obsessions or compulsions: Common

7 Common OCD Behaviors Percentage of children and adolescents with OCD these obsessions or compulsions: Common paaern: RECHECKING Although you know that you ve already made sure the door is locked, you feel you must check again. And again.

Post- Trauma5c Stress Disorder [PTSD] About 10 to 35 percent of people who experience trauma not only have burned- in memories, but also four weeks to a life@me of: repeated

8 Post- Trauma5c Stress Disorder [PTSD] About 10 to 35 percent of people who experience trauma not only have burned- in memories, but also four weeks to a life@me of: repeated intrusive recall of those memories. nightmares and other re- experiencing. social withdrawal or phobic avoidance. jumpy anxiety or hypervigilance. insomnia or sleep problems.

9 Which People get PTSD? Those with less control in the Those more frequently Those with brain differences Those who have less resiliency Those who get re- Resilience and Post- Trauma5c Growth Resilience/recovery acer trauma may include: some lingering, but not overwhelming, stress. finding strengths in yourself. finding with others. finding hope. seeing the trauma as a challenge that can be overcome. seeing yourself as a survivor.

10 Understanding Anxiety Disorders: Explana.ons from Different Perspec.ves Psychodynamic/ Freudian: repressed impulses Classical condi5oning: overgeneralizing a condi@oned response Operant condi5oning: rewarding avoidance Observa5onal learning: worrying like mom Cogni5ve appraisals: uncertainty is danger Evolu5onary: surviving by avoiding danger

11 Understanding Anxiety Disorders: Freudian/Psychodynamic Perspec5ve Sigmund Freud felt that anxiety stems from repressed childhood impulses, socially inappropriate desires, and conflicts. We repress/bury these issues in the unconscious mind, but they come up, as anxiety.

12 Classical Condi5oning and Anxiety In the experiment by John B. Watson and Rosalie Rayner in 1920, LiAle Albert learned to feel fear around a rabbit because he had been condi@oned to associate the bunny with a loud scary noise. Some@mes, such a condi@oned response becomes overgeneralized. We may begin to fear all animals, everything fluffy, and any loca@on where we had seen those, or even fear that those items could appear soon along with the noise. The result is a phobia or generalized anxiety. Operant Condi5oning and Anxiety We may feel anxious in a situa@on and make a decision to leave. This makes us feel beaer and our anxious avoidance was just reinforced. If we know we have locked a door but feel anxious and compelled to re- check, rechecking will help us temporarily feel beaer. The result is an increase in anxious thoughts and behaviors.

13 Observa5onal Learning and Anxiety Experiments with humans and monkeys show that anxiety can be acquired through observa5onal learning. If you see someone else avoiding or fearing some object or creature, you might pick up that fear and adopt it even acer the original scared person is not around. In this way, fears get passed down in families.

Cogni5on and Anxiety Cogni5on includes worried thoughts, as well as interpreta@ons, appraisals, beliefs, predic@ons, and rumina@ons.

14 Cogni5on and Anxiety Cogni5on includes worried thoughts, as well as appraisals, beliefs, and Cogni5on includes mental habits such as hypervigilance (persistently watching out for danger). This accompanies anxiety in PTSD. In anxiety disorders, such cogni5ons appear repeatedly and make anxiety worse.

15 Examples of Cogni5ons that can Worsen Anxiety: Cogni5ve errors, such as believing that we can predict that bad events will happen Irra5onal beliefs, such as bad things don t happen to good people, so if I was hurt, I must be bad Mistaken appraisals, such as seeing aches as diseases, noises as dangers, and strangers as threats Misinterpreta5ons of facial expressions and ac@ons of others, such as thinking they re talking about me

16 Biology and Anxiety: An Evolu5onary Perspec5ve 1. Human phobic objects: Snakes Heights Closed spaces Darkness 2. Similar but non- phobic objects: Fish Low places Open spaces Bright light 3. Dangerous yet non- phobic subjects: We are likely to become about, but not phobic about: Guns Electric wiring Cars psychologists believe that ancestors prone to fear the items on list #1 were less likely to die before reproducing. There has not for the innate fear of list #3 (the gun list) to spread in the

17 Biology and Anxiety: Genes Studies show that twins, even raised separately, develop similar phobias (more similar than two unrelated people). Some people seem to have an inborn high- strung temperament, while others are more easygoing. Temperament may be encoded in our genes. Genes and Neurotransmi>ers Genes regulate levels of neurotransmiaers. People with anxiety have problems with a gene associated with levels of serotonin, a neurotransmi7er involved in regula4ng sleep and mood. People with anxiety also have a gene that triggers high levels of glutamate, an excitatory neurotransmi7er involved in the brain s alarm centers.

Biology and Anxiety: The Brain Trauma@c experiences can burn fear circuits into the amygdala;

Anxiety disorders include overarousal of brain areas involved in impulse control and habitual

18 Biology and Anxiety: The Brain experiences can burn fear circuits into the amygdala; these circuits are later triggered and Anxiety disorders include overarousal of brain areas involved in impulse control and habitual behaviors. The OCD brain shows extra in the ACC, which monitors our and checks for errors. ACC = anterior cingulate gyrus

Post-Traumatic Stress Disorder [PTSD]

Post-Traumatic Stress Disorder [PTSD] About 10 to 35 percent of people who experience trauma not only have burned-in memories, but also four weeks to a lifetime of: repeated intrusive recall of those memories.