Anxiety Disorders

Mr. Ibrahim Rawhi Ayasreh

RN, MSN, CNS

Anxiety Disorders

Anxiety : is an emotional response (e.g., apprehension, tension, uneasiness) to anticipation of danger, the source of which is largely unknown or unrecognized. Anxiety may be regarded as pathologic when it interferes with effectiveness in living, achievement of desired goals or satisfaction, or reasonable emotional comfort

Anxiety Disorders

Anxiety can be considered abnormal or pathological if:

1. It is out of proportion to the situation that is creating it.

2. The anxiety interferes with social, occupational, or other important areas of functioning

Anxiety Disorders

Panic: a sudden overwhelming feeling of terror or impending doom. This most severe form of emotional anxiety is usually accompanied by behavioral, cognitive, and physiological signs and symptoms considered to be outside the expected range of normalcy

Panic Disorder

This disorder is characterized by recurrent panic attacks, the onset of which is unpredictable, and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort.

The symptoms come on unexpectedly; that is, they do not occur

immediately before or on exposure to a situation that usually causes anxiety (as in specific phobia).

They are not triggered by situations in which the person is the focus of others’ attention (as in social phobia). Organic factors in the role of etiology have been ruled out

Panic Disorder At least four of the following symptoms must be present to identify the presence of a panic

attack: - Palpitations, pounding heart, or accelerated heart rate - Sweating - Trembling or shaking - Sensations of shortness of breath or smothering - Feeling of choking - Chest pain or discomfort - Nausea or abdominal distress - Feeling dizzy, unsteady, lightheaded, or faint - Derealization (feelings of unreality) or depersonalization (being detached from oneself) - Fear of losing control or going crazy - Fear of dying - Paresthesias (numbness or tingling sensations) - Chills or hot flashes

Panic Disorder with Agoraphobia

Panic disorder with agoraphobia is characterized by the symptoms described for panic disorder. In addition, the individual experiences a fear of being in places or situations from which escape might be difficult (or embarrassing) or in which help might not be available in the event that a panic attack should occur

Generalized Anxiety Disorder

Generalized anxiety disorder is characterized by chronic, unrealistic, and excessive anxiety and worry. The symptoms have existed for 6 months or longer and cannot be attributed to specific organic factors, such as caffeine intoxication or hyperthyroidism.

Generalized Anxiety Disorder

The DSM-IV-TR identifies the following symptoms associated with generalized anxiety disorder:

- Excessive anxiety and worry about a number of events that the individual finds difficult to control - Restlessness or feeling keyed up or on edge - Being easily fatigued - Difficulty concentrating or mind “going blank” - Irritability - Muscle tension - Sleep disturbance (difficulty falling or staying asleep,or restless unsatisfying sleep)

Phobia

Fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immediate anxiety response or panic attack even though the subject recognizes that the fear is excessive or unreasonable. The phobic stimulus is avoided or endured with marked distress.

Agoraphobia Without History of Panic Disorder

In this disorder, there is a fear of being in places or situations from which escape might be difficult, or in which help might not be available if a limited-symptom attack or panic-like symptoms.

Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years.

It is diagnosed more commonly in women than in men. In extreme cases the individual is unable to leave his or her

home without being accompanied by a friend or relative.

Social phobia

is an excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others.

In some instances, the fear may be very defined, such as the fear of speaking or eating in a public place, fear of using a public restroom, or fear of writing in the presence of others.

In other cases, the social phobia may involve general social situations, such as saying things or answering questions in a manner that would provoke laughter on the part of others

Specific phobia

The essential feature of this disorder is a marked, persistent, and excessive or unreasonable fear when in the presence of, or when anticipating an encounter with, a specific object or situation.

The phobic person may be no more (or less) anxious than anyone else until exposed to the phobic object or situation. Exposure to the phobic stimulus produces overwhelming symptoms of panic, including palpitations, sweating, dizziness, and difficulty breathing.

Obsessive–Compulsive Disorder

Obsessions is unwanted, intrusive, persistent ideas, thoughts, impulses, or images that cause marked anxiety or distress. The most common ones include repeated thoughts about contamination, repeated doubts, a need to have things in a particular order, aggressive or horrific impulses, and sexual imagery.

Compulsions is unwanted repetitive behavior patterns or mental acts (e.g., praying, counting, repeating words silently) that are intended to reduce anxiety, not to provide pleasure or gratification.

Posttraumatic Stress Disorder