Anxiety disorder

a term covering several different forms of a type of mental illness of abnormal and pathological

fear and anxiety

Generalized anxiety disorder

chronic disorder characterized by long-lasting anxiety that is not focused on any one object or situation.

criteria

A. A period of at least six months with prominent tension, worry and feelings of apprehension, about every-day events and problems.B. At least four symptoms out of the following list of items must be present, of which at least one from items (1) to (4).

Autonomic arousal symptoms Palpitations or pounding heart, or accelerated heart rate.Sweating .

Trembling or shaking.Dry mouth (not due to medication or dehydration).

Symptoms concerning chest and abdomenDifficulty breathing.Feeling of choking.Chest pain or discomfort.

Nausea or abdominal distress (e.g. churning in stomach).

Symptoms concerning brain and mind Feeling dizzy, unsteady, faint or light-headed. Feelings that objects are unreal (derealization), or that one's self is distant or

"not really here" (depersonalization) .Fear of losing control, going crazy, or passing

out .Fear of dying.

General symptomsHot flushes or cold chills.Numbness or tingling sensations.

Symptoms of tensionMuscle tension or aches and pains.Restlessness and inability to relax.

Feeling keyed up, or on edge, or of mental tension.

A sensation of a lump in the throat, or difficulty with swallowing.

Other non-specific symptomsExaggerated response to minor surprises or being startledDifficulty in concentrating, or mind going blank, because of worrying or anxiety.Persistent irritability.Difficulty getting to sleep because of worrying.

C. The disorder does not meet the criteria for panic disorder (F41.0), phobic anxiety disorders (F40.-), obsessive-compulsive disorder (F42.-) or hypochondriacal disorder (F45.2).D. Most commonly used exclusion criteria: not sustained by a physical disorder, such as hyperthyroidism, an organic mental disorder (F0) or psychoactive substance-related disorder (F1), such as excess consumption of amphetamine-like substances, or withdrawal from benzodiazepines.

Treatment

Cognitive behavioral therapyBenzodiazepinesSSRIs

Panic disorder

an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioral changes lasting at least a month and of ongoing worry about the implications or concern about having other attacks

Panic disorder

Panic attacks cannot be predicted, therefore an individual may become stressed, anxious or worried wondering when the next panic attack will occur

Because of the intense symptoms that accompany panic disorder, it may be mistaken for a life-threatening physical illness such as a heart attack. This misconception often aggravates or triggers future attacks (some are called Anticipatory Attacks). People frequently go to hospital emergency rooms when they are having panic attacks, and extensive medical tests may be performed to rule out these other conditions, thus creating further anxiety. There are three types of panic attacks: unexpected, situationally bounded and situationally predisposed

Signs and symptoms

Panic disorder sufferers usually have a series of intense episodes of extreme anxiety during panic attacks. These attacks typically last about ten minutes, and can be as short-lived as 1–5 minutes, but can last twenty minutes to more than an hour, or until helpful intervention is made,

rapid heartbeat, perspiration, dizziness, dyspnea, trembling

Signs and symptoms

uncontrollable fear such as: the fear of losing control and going crazy, the fear of dying and hyperventilationOther symptoms are sweating, a sensation of choking, chest pain, nausea, numbness or tingling, chills or hot flashes, faintness and some sense of altered reality

Diagnosis

unexpected, recurrent panic attacks, followed in at least one instance by at least a month of a significant and related behavior change, a persistent concern of more attacks, or a worry about the attack's consequences. There are two types, one with and one without agoraphobia. Diagnosis is excluded by attacks due to a drug or medical condition, or by panic attacks that are better accounted for by other mental disorders

Treatment

PsychotherapyMedicationAntidepressants SSRIs, MAOIs, tricyclic Anti-antidepressantsAnti-anxiety drugs benzodiazepines

Phobia

persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed

Social phobia

fears other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others, such as eating in public. Overcoming social phobia is often very difficult without the help of therapy or support groups

Specific phobias

fear of a single specific panic trigger such as spiders, snakes, dogs, water, heights, flying, catching a specific illness

Claustrophobia

the fear of having no escape and being closed in small spaces or rooms (opposite: claustrophilia). It is typically classified as an anxiety disorder and often results in panic attack, and can be the result of many situations or stimuli, including elevators crowded to capacity, windowless rooms, and even tight-necked clothing

Agoraphobia

a generalized fear of leaving home or a small familiar 'safe' area, and of possible panic attacks that might follow.

Treatments

Cognitive behavioral therapyEye Movement Desensitization and Reprocessing

Hypnotherapy

Agoraphobia

Agoraphobia is a condition where the sufferer becomes anxious in environments that are unfamiliar or where he or she perceives that they have little control.

Posttraumatic stress disorder

severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,

overwhelming the individual's ability to cope.

Signs and symptoms

Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal—such as difficulty falling or staying asleep, anger, and hypervigilance.

Diagnosis

A: Exposure to a traumatic eventB: Persistent re-experiencingC: Persistent avoidance and emotional numbingD: Persistent symptoms of increased arousal not present beforeE: Duration of symptoms for more than 1 monthF: Significant impairment

Management

Preventive TreatmentsPsychological debriefingRisk Targeted InterventionsPsychobiological TreatmentsStepped Collaborative Care

Psychotherapeutic interventionseye movement desensitization and reprocessingcognitive behavioral therapy

Management

Behavioral and Cognitive Behavioral therapyInterpersonal psychotherapyMedicationAlpha-adrenergic antagonistsAnti- convulsants, mood stabilizersAntipsychoticsBeta blockersBenzodiazepinesGlucocorticoidsHeterocyclic / Tricyclic anti-depressants anti-depressantsSSRIs