| Anxiety Disorders - Page Two |
| Generalized Anxiety Disorder (GAD) Generalized anxiety disorder is diagnosed after six or more months of chronic worry and anxiety which is also associated with multiple physical symptoms. These symptoms include: Being unable to relax, trembling, twitching, muscle tension, headaches, irritability, sweating, hot flashes, fatigue, sleep disturbance, difficulty concentrating, light headedness, being easily startled. People will GAD usually anticipate disaster and a lot of the worrying is about everyday thing such as health, money, family, relationships and work or school performance. A key feature however is that the worrying must be excessive. GAD can range hugely in severity with mild GAD hardly impairing function and not restricting people in social or work situations, to very severe GAD which can make it difficult to carry out even the most ordinary of daily activities. To be diagnosed with GAD though, it is necessary that some impairment in social, occupational, or other areas of important functioning, due to the anxiety must be seen. Occasional panic attacks are common in the course of generalized anxiety disorder. |
| Obsessive-Compulsive Disorder (OCD) Obsessions are recurrent, intrusive thoughts, impulses or images that are seen as inappropriate, grotesque or forbidden. The contents of obsessions which elicit severe anxiety and marked distress, are quite unlike the thoughts that the person usually has. Obsessions are perceived as uncontrollable, and a sufferer often fears that he or she will lose control and act upon the thoughts or impulses. Common obsessions include fear of contamination with germs or bodily fluids, doubts (such as the worry that something important has been overlooked or that the sufferer has unknowingly inflicted harm on someone), order and symmetry, and loss of control of violent or sexual impulses. Compulsions are repetitive behaviours or mental acts that reduce the anxiety that accompanies an obsession or "prevent" some dreaded event from happening. Compulsions include cleaning or washing, checking, arranging or organizing, collecting or hoarding, as well as mental rituals such as counting, repeating and praying. Compulsive rituals take long periods of time to complete, often hours and can eventually completely take over life, occupying a significant amount of time during each day. OCD is now widely recognised however and treatment, given time, is usually very successful. |
| Acute And Post-Traumatic Stress Disorders Acute stress disorder refers to anxiety and behavioural disturbances that develop within the first month after exposure to an extreme trauma. The symptoms of acute stress disorder usually begin during or shortly after the trauma. Extreme traumatic events include rape or another severe physical assault, near death experiences in accidents, witnessing a murder or other severe violent crime and being involved in war or combat. The event can be a single event or a repeated experience. Dissociation is a critical feature of acute stress disorder. Dissociation is characterized by a perceived detachment of the mind from the emotional state or the body. A sense of the world as a dreamlike and unreal place and poor memory of the specific events also occur. A more severe form of this is known as dissociative amnesia. Other features of an acute stress disorder include symptoms of generalized anxiety and hyper arousal, avoidance of situations or stimuli which provoke memories of the trauma, and persistent, intrusive recollections of the event via flashbacks, dreams, or recurrent thoughts and visual images. If these symptoms persist for more than one month and are associated with functional impairment and distress for the sufferer, post-traumatic stress disorder should be the given diagnosis. Decreased self esteem, loss of sustained beliefs about people and society, hopelessness, a sense of being permanently damaged, and difficulties in previously established relationships also generally come with PTSD. About 50% of PTSD cases will go within 6 months, while the remainder will stay, often for years and can dominate the sufferer's life. I will go into more detail about PTSD in relation to child abuse, or other abuse at a later date in my abuse and trauma section. |
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| What Treatments Are Available For Anxiety Disorders? Anxiety disorders generally respond very well to treatment and usually people receiving treatment will eventually experience significant relief from their symptoms. Each persons anxiety disorder has it's own unique characteristics, but generally most anxiety disorders respond well to two types of treatment: medication and psychotherapy. The treatments can be used either alone or in combination. Although not cures, both treatments are effective in relieving the symptoms of anxiety disorders, thus enabling individuals to live healthier lives. |
| Behavioral Therapy Behavioral therapy involves using techniques to reduce or stop the undesired behaviour associated with anxiety disorders. For example, one approach involves training patients in relaxation and deep breathing techniques to counteract the agitation and hyperventilation that accompany certain anxiety disorders. |
| Cognitive Therapy Cognitive therapy involves understanding how a persons thoughts contribute to the symptoms of anxiety disorders. A person can then change those thought patterns to reduce the likelihood of occurrence and intensity of the anxiety reaction. The patients increased cognitive awareness is often combined with behavioral techniques to help the individual gradually confront and tolerate fearful situations in a controlled, safe environment. |
| Beta-Blockers Beta Blockers are normally used to treat heart conditions but can also be effective in the treatment of anxiety disorders. They lessen the physical effects of anxiety, such as a pounding heart, shaking and sweating. They dont stop the thoughts of anxiety but with the physical effects having less of an impact, the actual anxiety can be significantly reduced. If a persons headaches/migraines are brought on/made worse by anxiety beta blockers can also decrease the likelihood of this happening. The two most commonly used in anxiety treatment are: Atenolol (tenormin) Propranolol (inderal) |
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| Selective Serotonin Reuptake Inhibitors - (SSRI's) SSRI's are anti-depressants, but are also commonly used to treat panic disorder, OCD, PTSD and social phobia. They usually have very few side effects. SSRI's commonly used are: Fluoxetine (prozac) Sertraline (zoloft) Flufoxamine (luvox) Paroxetine (paxil) Citalopram (celexa) Venafalaxine (effexor) is a drug similar to SSRI's and is useful for treating Generalized anxiety disorder. |
| Tricyclics Tricyclic anti-depressants are often used to treat people with co-occuring anxiety and depression. They cause more side-effects than SSRI's however and are sometimes not well tolerated. Clomipramine (anafranil) is used to treat OCD Imipramine (tofranil) is used to treat panic disorder and GAD |
| Benzodiazepines Benzodiazepines are sedatives, but when used in small doses they can relive anxiety quickly, with minimal drowsiness. However they can only be used for short periods of time becasue of risk of dependance and also the body becomes tolerant to them, so increasing amounts are needed to get the same effect. Sometimes withdrawal symptoms occur when the drug is stopped. Generally the benefits of short term use, outweigh the disadvantages, and a person can take them safely. Examples of benzodiazepines include: Diazepam (valium) Lorazepam (ativan) Clonazepam (klonopin) Alprazolam (xanax) Chlordiazepoxide (librium) |
| Other Anti-Anxiety Drugs Buspirone (BuSpar) is an anxiolytic. It is similar to benziodiazepines but it carries no risk of dependance and is less of a sedative. It also has a less immediate effect, and has to be taken for at least 2 weeks before the anti-anxiety effect kicks in. It is quite a new drug, but has very positive reports from those taking it. |
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