Anxiety Disorders Dr. Ameena S. Mu min, LPC Counseling Services- Nestor Hall 010 Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older (18.1% of U.S. population)
Objectives To increase knowledge and awareness of Anxiety Disorders. To increase knowledge and awareness of treatments provided.
Let s do a Relaxation Technique!
Anxiety as a Normal and an Abnormal Response Some amount of anxiety is normal and is associated with optimal levels of functioning. Only when anxiety begins to interfere with social or occupational functioning is it considered abnormal.
What are Anxiety Disorders? Anxiety disorders are the most common class of mental disorders affecting nearly 1 in 5 adults in the U.S. (Kessler et al., 2005).
Common Types of Anxiety Disorders Phobias Generalized Anxiety Panic Disorder Obsessive Compulsive Disorder Post-traumatic Stress Disorder
What are Phobias? Irrational fear of certain objects or situations Specific/Simple Phobias- Fear of specific objects or situations such as: flying, elevators, heights Social Phobias- Fear of being judged or embarrassed Fear of speaking in public or meeting new people Agoraphobia- being trapped in places or situations such as: Being in a crowd without any escape Approximately 15 million American adults age 18 and over, or about 6.8 percent of people in this age group in a given year, have social phobia (Kessler et al, 2005).
People w/phobias often are: Overcome with feelings of terror when..there is no actual threat to their health or safety or when they encounter their feared object or situation Heart racing; Difficulty breathing; trembling and sweating Determined to avoid their fear..even though it may disrupt their daily life. Drive only on little-used roads Leave home only to go to work Refuse a promotion because it involves traveling or meeting new people
What is Generalized Anxiety? Constant worry that the worst will happen lasting 6 months or longer. The worry is out of proportion to the actual situation. Feeling overly anxious about routine situations Going to school/work Paying bills Doing chores Health Car problems Appointments
People with Generalized Anxiety Trouble Concentrating Dizziness Fatigue Feeling out of breath Frequent urination Irritability Restlessness Muscle Tension Headaches Sleep Problems often Experience: Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have GAD in a given year (Kessler et al, 2005).
What is a Panic Disorder? Unexpected attacks of fear (panic attacks) and the constant fear of having these attacks. Panic Attack-racing heart, sweating, shortness of breath, chest pain, dizziness, feeling detached from oneself, fear of losing control. Panic Disorder: experiencing recurring panic attacks for at least 1 month Persistently worried about possible future panic attacks-and associated panic experience. Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder (Kessler et al, 2005; US Census, 2005)
Panic Disorder cont Co-existing disorders Depression Substance Abuse Agoraphobia
What is Obsessive Compulsive Disorder (OCD)? OCD is characterized by repetitive, intrusive, irrational and unwanted thoughts (obsessions) and/or rituals that seem impossible to control (compulsions). Some people with OCD have specific compulsions (e.g., counting, arranging, cleaning) that they must perform multiple times each day. To momentarily release their anxiety that something bad might happen to themselves or to someone they love. OCD is the least common anxiety disorder but can be very disabling.
Obsession (Thoughts) Obsessive thoughts are: Recurrent impulses and images that are experienced as intrusive, unwanted, and inappropriate. Fear of contamination Need for symmetry or exactness Safety issues
Compulsion (Behavior) Compulsive Behaviors are: Repetitive behaviors or mental acts that one feels driven to perform in order to reduce or relieve anxiety. Washing Checking Repeating Ordering Counting Hoarding Touching things over and over again
Obsessions & Compulsions Repeated unwanted thoughts like: Fear of getting sick from germs or dirt Doubt about having done something (locked doors) Repeated actions aimed at relieving anxiety: Washing hands Checking doors A person with OCD knows that his or her obsessions and/or compulsions are not rational.
What causes OCD? Biology: OCD may be a result of changes in your body's own natural chemistry or brain functions. OCD also may have a genetic component, but specific genes have yet to be identified. Environment: OCD may stem from behavior-related habits that you learned over time. Insufficient levels of serotonin: one of your brain's chemical messengers. Medication to boost the neurochemical serotonin People with OCD who take medications that improve the action of serotonin often have fewer OCD symptoms.
What is Post-Traumatic Stress Disorder (PTSD)? When people experience or witness a traumatic event such as natural disasters or extreme violence: Car accident Sexual Assault War Mugging or Robbery Family Violence Terrorists attacks Mass shootings Natural Disasters (Tsunami, Hurricane, Tornado)
Symptoms of PTSD Recurrent Dreams Flashbacks Intrusive memories Hypervigilence Exaggerated startle response Intense psychological distress at exposure to internal or external cues.
Response to PTSD Symptoms Avoid thoughts, feelings, or conversations associated with the trauma Avoid activities, places, or people cause recollection of the trauma Inability to recall important aspects of the trauma Diminished interest or participation in significant activities Feeling of detachment or estrangement from others Restricted range of affect (e.g., unable to have loving feelings) Sense of foreshortened future
Culture and Anxiety The demand for culturally competent practices and service systems is a pervasive mental health care theme. Culture affects effective assessment, diagnosis, and treatment of mental illness because it exerts great influence on how people define themselves (U.S. Department of Health & Human Services).
First things First! Working Definition Culture Culture is whatever it is that one has to know or believe in, in order to operate in a manner acceptable to its members (Ward-Goodenough, 1981). Culture is a multidimensional concept that encompasses the collective realities of a group of people (Lee & Ramsey, 2006). Socioeconomic Status Gender Disability Mental health and/or physical disability Interracial Families; Intercultural Families Ethnicity Faith Tradition
FACTORS SUCH AS CULTURE, RACE, ETHNICITY, GENDER AND AGE CAN SIGNIFICANTLY INFLUENCE OVERALL HEALTH, AS WELL AS HEALTH CARE ATTITUDES AND ACCESS, AND RESPONSES TO TREATMENT. (NIMH, 2012)
Gender and Anxiety Women had have higher rates of lifetime diagnosis for each of the anxiety disorders except for social anxiety disorder which showed no gender difference in prevalence. Women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extent also among Hispanic women. Results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men. McLean et al., (2011). Journal of Psychiatric Research
Race/Ethnicity and Anxiety There is a higher prevalence among Blacks than Whites of phobic disorders including agoraphobia and social phobia. (Journal of the National Medical Association) African Americans are often misdiagnosed due to cultural differences of the clinician; differences in the way symptoms are described versus documented. Age at immigration appears to affect the onset of mental disorders such as anxiety in Asian Americans. Reports also indicate that ½ of all Asian Americans and Pacific Islanders have difficulty accessing mental health services because of economic barriers, social and cultural differences and language disparities (APA,2012). Studies have shown that older Hispanic adults and youth are especially vulnerable to the stresses of immigration and acculturation. Hispanic/ Latino youth also have been found to be at risk for higher levels of emotional distress because of the pressures to rapidly adopt the values of their new culture as well as inequality, poverty, and discrimination.
Treatment of Anxiety Disorders Cognitive Behavioral Therapy (CBT) Learning to replace anxious thoughts & actions with positive rational ones Other Types of Psychotherapy Can also help you resolve conflicts associated with anxiety. Medication May be used w/other forms of treatment to help reduce symptoms of anxiety disorders Lifestyle Changes A healthy lifestyle can help you manage stress. Changes in nutrition, exercise, and in alcohol/drug use.
Help is available Campus and Local Community Resources available on back table
Review Common Types of Anxiety Disorders Phobias Generalized Anxiety Panic Disorder Obsessive Compulsive Disorder Post-traumatic Stress Disorder Culture and Anxiety Treatment
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