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Anxiety Prevalence
More prevalent in women (2:1) |
More prevalent in people under 45 y/o |
More prevalent in divorced/separated people |
More prevalent in people with lower socio-economic status |
Panic Disorder
Onset at ~late 20s |
Recurrent unexpected panic attacks |
Intense physical symptoms |
May last weeks, months or years |
Close morbidity rate to depression |
Women affected 3x more than men |
May be affiliated with stressors |
Generalized Anxiety Disorder
6 months of unrealistic worry and anxiety |
Affects 3% of population |
Associated with Major Depressive Disorder |
Etiology for Panic and GAD
Psychodynamic Theory |
Inability of ego to intervene
id and superego produce anxiety
unable to regulate anxiety and resorts to unconscious mechanisms
ineffective use of defence mechanisms |
Cognitive Theory |
Faulty thinking results in maladaptive behaviours and emotional disorders
Anxiety is maintained by dysfunctional assessment of environment |
Biological Factors |
Genetics
Identical twins: 30%
Close relative: 10-20%
Cholecystokinin production: induce panic attacks
Neuroanatomical
Abnormal levels of blood-lactate
Infusion of Sodium Lactate may precipitate panic attacks
Neurochemical
Norepinephrine: cause anxiety
Serotonin and GABA decrease with panic/anxiety disorders |
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Levels of Anxiety
Normal |
Mild |
- Something is different
- Helps person focus attention to learn, solve problems, etc.
- Perceptual field widens slightly
- Alert, more perceptive
- Able to recognize anxiety
promote motivation and growth |
Moderate |
- Disturbing feeling something is wrong
- nervous and aggitated
- Difficulty concentrating
- Perceptual field narrows a bit
- Diminished cognitive skills |
Severe |
- Perceptual field greatly reduced
- Does not notice external events
attention focused on small part of specific area
- Unaware of anxiety
- Increase Vital Signs |
Panic |
- Focused on defense
- Flight of ideas
- Feels dread and terror |
Specific Phobias
Signs and Symptoms
Anxiety response to object or situation
Avoidance of object/situation
Impairment of daily routine
Acknowledge reaction is unreasonable |
Anxiety may be triggered |
Women 2x as likely to be affected than men |
Not diagnosed as a phobia unless interferes with person's function or causes severe distress
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Separation Anxiety Disorder
Recurrent distress over leaving home or attachment figure |
Excessive worry about the loss of figure |
Refusal to leave home |
Fear of being alone |
Refusal to sleep away from home or figure |
Nightmares with separation theme |
Physical symptoms |
Experience at least three of the above with symptoms lasting 4+ weeks in children/adolescents or 6+ months in adults
Agoraphobia
Panic disorder signs and symptoms |
Fears being in places where escaping is difficult or embarrassing if panic does occur |
Planes, subways, buses, movie theatres, etc. |
May not meet daily commitments (ie. work, grocery shopping, appointments, etc) |
Knows behaviour is extreme |
More common in women than men |
Social Anxiety Disorder
Fear that person might do something embarrassing, or be evaluated negatively by others |
fear of public speaking, public eating, using public washrooms |
Self-medication with alcohol or street drugs to cope |
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