ANXIETY.ppt

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1、ANXIETY,Galina Gerasimova Raeanne Perri Marisa Sevilla Joe Shen Grace Velasquez,Overview,What is Anxiety? What are the different types of anxiety disorders? What are the causes? What are the symptoms? What are the treatments? Professional Resources available.,Definition of Anxiety,Anxiety is a feeli

2、ng of apprehension or fear. The source of this uneasiness is not always known or recognized, which can add to the distress you feel. Anxiety disorders are a group of psychiatric conditions that involve excessive anxiety.,Anxiety Facts,Most common mental illness in the U.S. with 19 million of the adu

3、lt (ages 18-54) U.S. population affected. Anxiety disorders cost more than $42 billion a year. More than $22 billion are associated with the repeated use of healthcare services, as those with anxiety disorders seek relief for symptoms that mimic physical illnesses.Anxiety is highly treatable (up to

4、90% of cases), but only one-third of those who suffer from it receive treatmentPeople with an anxiety disorder are three-to-five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers.Depression often accompanies anxiety disord

5、ers,2003 Anxiety Disorders Association of America,Types of Anxiety Disorders,Panic Disorder Obsessive-Compulsive Disorder Post-Traumatic Stress Disorder Phobias Generalized Anxiety Disorder,Panic Disorder,The abrupt onset of an episode of intense fear or discomfort, which peaks in approximately 10 m

6、inutes, and includes at least four of the following symptoms:,A feeling of imminent danger or doomThe need to escapePalpitationsSweatingTremblingShortness of breath or a smothering feeling A feeling of choking Chest pain or discomfort,Nausea or abdominal discomfortDizziness or lightheadednessA sense

7、 of things being unreal, depersonalizationA fear of losing control or “going crazy“ A fear of dying Tingling sensations Chills or hot flushes,Panic Disorder,There are three types of Panic Attacks:1. Unexpected - the attack “comes out of the blue“ without warning and for no discernable reason. 2. Sit

8、uational - situations in which an individual always has an attack, for example, upon entering a tunnel. 3. Situationally Predisposed - situations in which an individual is likely to have a Panic Attack, but does not always have one. An example of this would be an individual who sometimes has attacks

9、 while driving.,Obsessive-Compulsive Disorder,Characterized by uncontrollable obsessions and compulsions which the sufferer usually recognizes as being excessive or unreasonable. Obsessions are recurring thoughts or impulses that are intrusive or inappropriate and cause the sufferer anxiety: Thought

10、s about contamination, for example, when an individual fears coming into contact with dirt, germs or “unclean“ objects; Persistent doubts, for example, whether or not one has turned off the iron or stove, locked the door or turned on the answering machine; Extreme need for orderliness; Aggressive im

11、pulses or thoughts, for example, being overcome with the urge to yell fire in a crowded theater,Obsessive-Compulsive Disorder,Compulsions are repetitive behaviors or rituals performed by the OCD sufferer, performance of these rituals neutralize the anxiety caused by obsessive thoughts, relief is onl

12、y temporary. Cleaning. Repeatedly washing their hands, showering, or constantly cleaning their home; Checking. Individuals may check several or even hundreds of times to make sure that stoves are turned off and doors are locked; Repeating. Some repeat a name, phrase or action over and over; Slowness

13、. Some individuals may take an excessively slow and methodical approach to daily activities, they may spend hours organizing and arranging objects; Hoarding. Hoarders are unable to throw away useless items, such as old newspapers, junk mail, even broken appliancesIn order for OCD to be diagnosed, th

14、e obsessions and/or compulsions must take up a considerable amount of the sufferers time, at least one hour every day, and interfere with normal routines .,Post-Traumatic Stress Disorder,Exposure to traumas such as a serious accident, a natural disaster, or criminal assault can result in PTSD. When

15、the aftermath of a traumatic experience interferes with normal functioning, the person may be suffering from PTSD. Symptoms of PTSD are: Reexperiencing the event, which can take the form of intrusive thoughts and recollections, or recurrent dreams; Avoidance behavior in which the sufferer avoids act

16、ivities, situations, people,and/or conversations which he/she associates with the trauma; A general numbness and loss of interest in surroundings; Hypersensitivity, including: inability to sleep, anxious feelings, overactive startle response, hypervigilance, irritability and outbursts of anger.,Soci

17、al Phobia/Anxiety,Social anxiety disorder, also known as social phobia, is an intense fear of social situations. This fear arises when the individual believes that they may be judged, scrutinized or humiliated by others. Individuals with the disorder are acutely aware of the physical signs of their

18、anxiety and fear that others will notice, judge them, and think poorly of them. In extreme cases this intense uneasiness can progress into a full blown panic attack.,Social Phobia/Anxiety,Common anxiety provoking social situations include: public speaking talking with people in authority dating and

19、developing close relationships making a phone call or answering the phone interviewing attending and participating in class speaking with strangers meeting new people eating, drinking, or writing in public using public bathrooms driving shopping,Generalized Anxiety Disorder,Excessive uncontrollable

20、worry about everyday things. This constant worry affects daily functioning and can cause physical symptoms. GAD can occur with other anxiety disorders, depressive disorders, or substance abuse.,Generalized Anxiety Disorder,The focus of GAD worry can shift, usually focusing on issues like job, financ

21、es, health of both self and family; but it can also include more mundane issues such as, chores, car repairs and being late for appointments. The intensity, duration and frequency of the worry are disproportionate to the issue,Specific Disorder Facts,Generalized Anxiety Disorder Women are twice as l

22、ikely to be afflicted than men. Very likely to exist along with other disorders. Obsessive Compulsive Disorder It is equally common among men and women. One third of afflicted adults had their first symptoms in childhood. Panic Disorder Women are twice as likely to be afflicted than men. Occurs with

23、 major depression in very high rates.,2003 Anxiety Disorders Association of America,Specific Disorder Facts,Posttraumatic Stress Disorder Women are more likely to be afflicted than men. Rape is the most likely trigger of PTSD, 65% of men and 45.9% of women who are raped will develop the disorder. Ch

24、ildhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD. Social Anxiety Disorder It is equally common among men and women. Specific Phobia affects Women are twice as likely to be afflicted as men,2003 Anxiety Disorders Association of America,Anxiety Statistics,Anxiety D

25、isorders One-Year Prevalence (Adults),Recent Studies,Freedom From Fear conducted a survey among 410 attendees during National Anxiety Disorders Screening Day on May 7, 2003. The results : An increase in physical aches and pains is directly attributed to anxiety disorders and depression60%) of the re

26、spondents with undiagnosed medical conditions said that on days when they feel anxious or depressed, there is a moderate (41%) to severe (19%) change in their physical symptoms or aches and pains. These physical symptoms or aches and pains include backaches (13%), vague aches and pains (14%), headac

27、hes (14%), digestive pain (11%) and dizziness (8%). 50% of respondents with diagnosed medical conditions, such as arthritis, migraines, diabetes, heart and respiratory diseases, reported that on days when they feel anxious or depressed, there is a moderate (38%) to severe (12%) change in their physi

28、cal symptoms or aches and pains.,Common Causes,There is no one cause for anxiety disorders. Several factors can play a role Genetics Brain biochemistry Overactive “fight or flight“ response Can be caused by too much stress Life circumstances Personality People who have low self-esteem and poor copin

29、g skills may be more prone Certain drugs, both recreational and medicinal, can lead to symptoms of anxiety due to either side effects or withdrawal from the drug. In very rare cases, a tumor of the adrenal gland (pheochromocytoma) may be the cause of anxiety.,Symptoms of Anxiety,Anxiety is an emotio

30、n often accompanied by various physical symptoms, including: Twitching or trembling Muscle tension Headaches Sweating Dry mouth Difficulty swallowing Abdominal pain (may be the only symptom of stress especially in a child),Additional Symptoms of Anxiety,Sometimes other symptoms accompany anxiety: Di

31、zziness Rapid or irregular heart rate Rapid breathing Diarrhea or frequent need to urinate Fatigue Irritability, including loss of your temper Sleeping difficulties and nightmares Decreased concentration Sexual problems,Physical Reaction to Anxiety,Auditory and Visual Stimuli: sights and sounds are

32、processed first by the thalamus, which filters the incoming cues and shunts them either directly to the amygdala or to the other parts of the cortex.Olfactory and tactile stimuli: Smells and touch sensations Bypass the thalamus altogether, Taking a shortcut directly to the Amygdala. Smells, therefor

33、e, Often evoke stronger memories Or feelings than do sights or Sounds.,Physical Reaction to Anxiety,Thalamus: The hub for sights and sounds, The thalamus breaks down Incoming visual ques by size, Shape and color, and auditory Cues, by volume and Dissonance, and then signals The appropriate part of t

34、he Cortex.Cortex: It gives raw sights and sounds meanings, enabling the brain to become conscious of what it Is seeing or hearing. One region, the prefrontal cortex, may be vital to turning off the anxiety response once a threat has passed.,Physical Reaction to Anxiety,Amygdala: emotional core of th

35、e brain, the amygdala has the primary role of triggering the fear response. information that passes through the amygdala is tagged with emotional significance.Bed Nucleus of Stria Terminalis: unlike the Amygdala, which sets off an immediate burst of fear, the BNST perpetuates the fear response, caus

36、ing the longer term unease typical of anxiety.,Physical Reaction to Anxiety,Locus Ceruleus: It receives signals from the amygdala and is responsible for initiating many of the classic anxiety responses: rapid heartbeat, increased blood pressure, sweating and pupil dilation.Hippocampus: This is the m

37、emory center, vital to storing the raw information coming in from the senses along with the emotional baggage attached to the data during their trip through the amygdala.,Social Effects of Anxiety,Depression Not as involved with family and friends the way you used to be Lowered quality of relationsh

38、ips Low energy Lack of motivation to do the things you once looked forward to doing Unable to convey the person that you are Fear and avoidance of situations where previous attacks occurred,Allopathic Treatments,Medications (Drug Therapy): Behavioral Therapy Cognitive Behavioral Therapy Psychodynami

39、c Psychotherapy,Alternative Treatments,Acupuncture Aromatherapy Breathing Exercises Exercise Meditation Nutrition and Diet Therapy Vitamins Self Love,Medications,Buspirone: shown to be effective but usually takes 3-4 weeks, particularly useful in elderly patients Benzodiazepines: include Xanax and V

40、alium, act rapidly and successfully but can be addictive and loses effectiveness over time Side Effects: dizziness, headaches, nausea, impaired memory,Behavioral and Cognitive Therapy,Teaches patient to react differently to situations and bodily sensations that trigger anxiety Teaches patient to und

41、erstand how thinking patterns that contribute to symptoms Patients learn that by changing how they perceive feelings of anxiety, the less likely they are to have them Examples: Hyperventilating, writing down list of top fears and doing one of them once a week, spinning in a chair until dizzy; after

42、awhile patients learned to cope with the negative feelings associated with them and replace them with positive ones,Psychodynamic Psychotherapy,Psychodynamic therapy is a general name for therapeutic approaches which try to get the patient to bring to the surface their true feelings, so that they ca

43、n experience them and understand them. Psychodynamic Psychotherapy uses the basic assumption that everyone has feelings held in the subconscious which are too painful to be faced. We then come up with defenses (such as denial) to protect us knowing about these painful feelings. Psychodynamic psychot

44、herapy assumes that these defenses have gone wrong and are causing more harm than good, making you seek help. It tries to subdue them, with the intention that once you are aware of what is really going on in your mind the feelings will not be as painful. Takes an extremely long time and is labor int

45、ensive,Acupuncture,Caused by the imbalance of chi coming about by keeping emotions in for too long Emotion effects the chi to move in an abnormal way: when fearful it goes to the floor, when angry the neck and shoulders tighten Redirects the chi into a balanced flow, releases tension in the muscles,

46、 increases flow of blood, lymph, and nerve impulses to affected areas Takes 10-12 weekly sessions,Aromatherapy,Calming Effect: vanilla, orange blossom, rose, chamomile, and lavender Reducing Stress: Lavender, sandalwood, and nutmeg Uplifting Oils: Bergamot, geranium, juniper, and lavender Essential

47、Oil Combination: 3 parts lavender, 2 parts bergamot, and 1 part sandalwood,Exercise,Benefits: symbolic meaning of the activity, the distraction from worries, mastery of a sport, effects on self image, biochemical and physiological changes associated with exercise, symbolic meaning of the sport Helps

48、 by expelling negative emotions and adrenaline out of your body in order to enter a more relaxed, calm state to deal with issues and conflicts,Meditation,Cultivates calmness to create a sense of control over life Practice: Sit quietly in a position comfortable to you and take a few deep breaths to r

49、elax your muscles, next choose a calming phrase (such as “om” or that with great significance to you), silently repeat the word or phrase for 20 minutes,Nutrition and Diet Therapy,Foods to Eat: whole grains, bananas, asparagus, garlic, brown rice, green and leafy veggies, soy products, yogurt Foods

50、to Avoid: coffee, alcohol, sugar, strong spices, highly acidic foods, foods with white flour Keep a diary of the foods you eat and your anxiety attacks; after awhile you may be able to see a correlation East small, frequent meals,Vitamins,B-Vitamins stabilize the bodys lactate levels which cause anx

51、iety attacks (B-6, B-1, B-3) Calcium (a natural tranquilizer) and magnesium relax the nervous system; taken in combination before bed improves sleep Vitamin C taken in large doses also has a tranquilizing effect Potassium helps with proper functioning of adrenal glands Zinc has a calming effect on the nervous system,