anxiety disorder

• Stress is the internal biological and psychological responses to demands placed on an individual.
• Anxiety is a general feeling of apprehension about possible danger, oriented to the future and diffuse, and is an emotion.
• Anxiety has three other components: cognitive (worry chain about car crash), physiological (tense shoulders), and behavioural (reassurance).
• Fear or panic is an emotion that involves activation of the “fight-or-flight” response in the sympathetic nervous system, more oriented to imminent danger in the here and now.
• The three components of panic/fear are cognitive (“I’m going to die”), physiological (increased heart rate), and behavioural (urge to flee/get help).
• Anxiety disorders share commonalities such as unrealistic, irrational fears, anxiety/panic of disabling intensity, avoidance, escape, thought suppression efforts, or safety behaviours, and are highly treatable yet also resistant to extinction.
• Anxiety disorders often begin early in life, are reported more by women than men, and are reported more in Western countries.
• Anxiety disorders are often comorbid both with other anxiety diagnoses and with other disorder groups such as Mood disorders and psychoses.
• The three parts of the brain involved in fear response are the thalamus, amygdala, and hypothalamus, which then instruct the endocrine glands and autonomic nervous system.
• Social Anxiety Disorder is characterized by marked and persistent fear of one or more social or performance situations, concern about behaving in a way that will lead to being judged, scrutinized, embarrassed, or humiliated, and exposure to situations that leads to increased anxiety, a panic attack, or efforts to escape or avoid.
• Social Anxiety Disorder is also characterized by anxious anticipation, anxiety, or avoidance which leads to significant distress or impairment.
• Perceptions of uncontrollability and/or unpredictability may be important factors in the development of social phobias.
• The fear of having a panic attack becomes a problem in itself, possibly leading to agoraphobia.
• Negative cognitions and schema are also a risk factor in the development of social phobias.
• Medications are also an effective treatment for Panic Disorder.
• Social phobias generally involve learned behaviors, such as being bullied or observing isolated parents, and are most likely to occur in people who are genetically or temperamentally at risk.
• Cognitive-Behavioral therapy is an effective treatment for Social Anxiety Disorder.
• Jeff is a socially anxious person who avoids opportunities for advancement at work because he feels intensely anxious in social situations.
• Panic Disorder consists of a pattern of recurring panic attacks, with emotional, physical, cognitive and behavioural components, and the main fear is of losing control, leading to the consequences of dying, going crazy, embarrassment, or not being able to get help.
• The “fight or flight” response is an evolved fear module, while the “feel the fear and do it anyway (or do it differently)” response is a considered response.
• Children with SM often have other fears and social anxieties and may have additional speech and language difficulties.
• Many kids with one anxiety disorder also have another, and they are more likely than average to be depressed, too.
• The anxiety condition usually develops first, and is considered a risk factor for later depression.
• There is a strong correlation between separation anxiety in children and a diagnosis of panic disorder later in life, and between separation and social anxiety disorders.
• Typical anxiolytics, or anti-anxiety medications like the benzodiazepines, are also effective, though they can be habit forming.
• The first-line treatment for the majority of separation anxiety cases is psychotherapy; cognitive behavioral therapy in particular is used with great success on mild to moderate cases.
• Selective mutism (SM) is an anxiety disorder that prevents children speaking in certain social situations, such as school lessons or in public.
• The first-line medication for separation anxiety is one of the SSRIs, or selective serotonin reuptake inhibitor family.
• In more severe cases and with kids who don’t respond well to CBT or other psychotherapeutic approaches, a course of medication may be indicated.
• A child might have a hard time saying goodbye to parents, being alone on one floor of the house, or going to sleep in a darkened room, because she is terrified that something will happen to her or her family.
• Anxiety is defined as a state of intense apprehension, uncertainty, and fear resulting from the anticipation of a threatening event or situation, often to a degree that normal physical and psychological functioning is disrupted.
• The American Psychiatric Association (APA) purports that each of the Anxiety Disorders share features of fear and anxiety.
• Physiological symptoms of anxiety disorders include muscle tension, heart palpitations, sweating, dizziness, or shortness of breath.
• Positive beliefs about worry (Borkovec) and preparation for negative event/outcome will result in increased coping when it occurs are psychological causal factors in Generalized Anxiety Disorder.
• Negative outcomes of worry include catastrophic predictions, engaging in worry, attempts to suppress worry or distract, and worrying about worry.
• Treatment of Generalized Anxiety Disorder includes medication (SSRIs used more for GAD than other anxiety disorders), psychoanalysis, behavioral techniques, and cognitive therapy.
• Anxiolytic Medications (Benzodiazepine) such as Valium and Ativan are used to treat Generalized Anxiety Disorder, targeting physiological symptoms but with side effects and addictiveness.
• Anxiety Disorder Psychological Causal Factors include CBT Models of GAD, uncontrollable/unpredictable events, lack of safety signals, intolerance of uncertainty, attentional bias toward threatening information, biased interpretation of ambiguous information, and superstitious avoidance of catastrophe.
• Generalized Anxiety Disorder is modestly heritable (15 - 20%), often co-occurs with neuroticism, is a shared underlying personality trait with depression, and may involve deficiency in Gamma Aminobutyric Acid (GABA).
• Buspirone is a more recent medication used to treat Generalized Anxiety Disorder, less addictive or sedating but takes several weeks to be effective.