ANXIETY DISORDERS

PRESENTED BY NATASHA ISHFAQFINAL YEAR MBBS

WHAT IS ANXIETY?

Anxiety is feeling of worry, nervousness or unease about something with an uncertain outcome.

In psychiatry it is defined as a nervous disorder marked by excessive uneasiness and apprehension typically with compulsive behavior or panic attacks.

WHEN DOES ANXIETY BECOMES A DISORDER ?

• Anxiety is a normal human response to objects, situation or events that are threatening.

• Anxiety becomes a disorder when out of proportion or when it significantly interferes with life.

ANXIETY DISORDERS

• These are characterized by the emotion of anxiety, worrisome thoughts, avoidance behavior and the somatic symptoms of autonomic arousal.

• Anxiety may be stress related and phobic anxiety may follow an unpleasant incident.

• Patients with anxiety often also have depression.

SYMPTOMS OF ANXIETY DISORDER1) PSYCHOLOGICAL :-

Apprehension ( an alarm or fear that something bad or unpleasant will

happen)

Irritability

Worry

Fear of impending disaster

Poor concentration

Depersonalization ( a state in which ones thoughts and feelings seem

unreal or not to belong to oneself )

SYMPTOMS… (Contd…)

2)SOMATIC

Palpitations

Fatigue

Tremor

Dizziness

Sweating

Diarrhea

SYMPTOMS (Contd..)

Frequent desire to pass urine

Chest painInitial insomnia

Breathlessness

Headache

CLASSIFICATION OF ANXIETY DISORDERS

PHOBIC ANXIETY DISORDER

PANIC DISORDER GENERALIZED ANXIETY DISORDER

OCCURRENCE Situational Paroxysmal Persistent

BEHAVIOUR Avoidance Escape Agitation

COGNITIONS Fear of situation Fear of symptoms Worry

SYMPTOMS On exposure Episodic Persistent

PHOBIC ANXIETY DISORDER

• A phobia is an irrational ,abnormal or excessive fear of an object or situation, which leads to avoidance of it ,even when a person thinks about that situation he becomes anxious. ( such as excessive fear of dying in an air crash leading to avoidance of flying).

PHOBIC ANXIETY DISORDER

• AGORAPHOBIA ( means “open space” ) A generalized phobia of going out alone or

being in crowded places is called AGORAPHOBIA.Agoraphobia can be severely disabling; some people

with this disorder have stayed inside their homes for years, afraid to venture outside where they might have a panic attack in public.

AGORAPHOBIA

PANIC ANXIETY DISORDER

• Panic disorder describes repeated attacks of severe anxiety, which are not restricted to any particular situation or circumstances.

• Somatic symptoms such as chest pain, palpitations, and paraesthesiae in lips and fingers are common.

• The symptoms in part due to involuntary over-breathing (hyperventilation).

PANIC ANXIETY DISORDER (Contd..)

• Patients often fear they are suffering from a serious illness such as a heart attack or stroke, and may therefore seek emergency medical attention.

• Panic disorder is often associated with agoraphobia..

GENERALISED ANXIETY DISORDER

• The primary characteristics of generalized anxiety disorder are excessive anxiety and worry, difficulty in controlling these symptoms and clinically significant signs of distress and disruption of their lives.

• Somatic symptoms of muscle tension and bowel disturbance often lead to a medical presentation.

SOCIAL ANXIETY DISORDER

• A disorder characterized by excessive fear of being exposed to the scrutiny of other people that leads to avoidance of social situations in which the person is called on to perform.

• Examples include • Public speaking • Talking to authority figures• Talking to a group of people or an individual

SOCIAL ANXIETY DISORDER

• Eating in public• Any performance based situation With such situations ,people can often

experience many uncomfortable physical symptoms of anxiety e.g. a rapid heart beat.

SOCIAL ANXIETY DISORDER

•

MANAGEMENT OF ANXIETY DISORDERS

1) PSYCHOLOGICAL TREATMENT Explanation and Reassurance are

essential ,especially when patients fear they have a serious medical condition.

Specific treatment may be needed. Treatments include relaxation, graded exposure (desensitization ) to feared situations for phobic disorders.

MANAGEMENT Contd…

2) DRUG TEATMENT :- ANTIDEPRESSANTS are the drugs of

choice. BENZODIAZEPINES are useful in the short term but long term use can lead to dependence. A B-BLOCKER such as PROPRANOLOL can help when somatic symptoms are prominent.

MANAGEMENT

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TAKE HOME MESSAGE

HOPE YOU HAVE ENJOYED LEARNING ANXIETY