SL Psychology/Anxiety Disorders

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This article will address the symptoms and theories about anxiety disorders

Anxiety disorders have different causes which can be unique to the individual. The anxiety disorder may be present from childhood and worsen in times of high stress, or there may be a triggering event like a parent dying or a spouse leaving. Scientists have developed several theories as to why these anxiety disorders have appeared. Biologists believe that genetics and evolution play a part in the development. They believe that genetics predispose a person to having such a disorder. This belief is supported by studies with twins and other relatives. There is a high rate of monozygotic (identical) twins both having an anxiety disorder, dizygotic (fraternal) twins have a much lower rate of concordance. Also people’s whose mother, father, or sibling has had a panic attack are ten times more likely to experience a panic attack than those who do not have a relative with panic attacks. Phobias can be good for evolutionary reasons and can help survival. Snakes, heights and dark are dangerous and have been around for thousands of years. They are subjects of common phobias. However, guns and cars are also dangerous and detrimental to survival, but they are modern, and are not common human phobias. There are several types of anxiety disorders which include phobias, Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Panic Disorder, Post-Traumatic Stress Disorder (PTSD).

Generalized Anxiety Disorder

Affects women twice as much as men. The person affected by GAD experiences fear, anxiety, or worry over an unspecified event or object. They do not know what is causing the anxiety. The Diagnostic and Statistical Manual IV (DSM IV) states that the diagnosis of GAD involves:

Excessive, and difficult to control, worry and anxiety.
Significant distress and distress.
Worry occurring more days than not for at least 6 months.
Worry not involving another disorder (e.g. depression).

Other symptoms may also be shown such as:

restlessness and irritability,
muscle tension, rapid physical fatigue, and sleep disturbance,
concentration problems.

Phobias

The person suffering from a phobia has a strong and irrational fear of something or some event. Their reaction to the feared object/situation is disproportionate to the danger the object/situation poses. The fear they feel includes the expectation of impending harm, release of adrenaline and activation of the nervous system, feelings of dread, terror, and panic, and fleeing or freezing (fight or flight). The symptoms of a phobic disorder are sometimes obvious enough to make diagnosis easy. For example, a phobia of wasps is visible when someone is physically and mentally scared of wasps - yet social phobia is harder to diagnose as it often links with insecurity complexes, claustrophobia, agoraphobia and many other psychological problems.

Persistent fear of a specific situation out of proportion to the reality of the danger.
Compelling desire to avoid and escape the situation.
Recognition that the fear is unreasonably excessive.
Symptoms not due to another disorder.

Phobics may also perceive their disorder to be beyond their control and wish to be rid of it; however, with one exception, the phobic’s everyday functioning is unimpaired. Although there are many types of phobias, e.g. heights, enclosed places, or strangers/foreigners, they fall into three categories: Agoraphobia – involves fear of places of assembly, crowds, and open spaces and is the most prevalent of all phobias and occurs most often in women in early adulthood. Social phobias – involve fear of being observed doing something humiliating, generally beginning in adolescence. Problems such as reluctancy to talk to people, fear of talking to people on the phone, being unable to cope in situations where you don't know people, can often be a sign of social anxiety or social phobia. Specific phobias – three subtypes: 1) fear of animals (e.g. spiders, rats, and snakes), 2) fear inanimate objects (darkness, heights, enclosed spaces), 3) fear of illness (injury, death, disease).

OCD

OCD is a debilitating disorder that does not seem to favor men or women. At least five of the nine criteria listed in the DSM IV must be met for OCD to be diagnosed. These criteria include:

Either obsession or compulsion must be experienced.
- Obsessions are defined by the DSM IV as:
  - recurrent and persistent ideas, thoughts, impulses, or images that are experienced, at least initially, as intrusive and senseless, e.g., a parent's having repeated impulses to kill a loved child, a religious person's having recurrent blasphemous thoughts
  - the person attempts to ignore or suppress such thoughts or impulses or to neutralize them with some other thought or action
  - the person recognizes that the obsessions are the product of his or her own mind, not imposed from without (as in thought insertion)
- Compulsions are defined in the DSM IV as:
  - repetitive, purposeful, and intentional behaviors that are performed in response to an obsession, or according to certain rules or in a stereotyped fashion
  - the behavior is designed to neutralize or to prevent discomfort or some dreaded event or situation; however, either the activity is not connected in a realistic way with what it is designed to neutralize or prevent, or it is clearly excessive
  - the person recognizes that his or her behavior is excessive or unreasonable (this may not be true for young children; it may no longer be true for people whose obsessions have evolved into overvalued ideas)
  - B. The obsessions or compulsions cause marked distress, are time-consuming (take more than an hour a day), or significantly interfere with the person's normal routine, occupational functioning, or usual social activities or relationships with others.

Jeffery Shwartz believes that the obsessions and compulsions are products of what he calls "brain lock." He describes this as the same neurons being fired over and over again in the same pattern, which causes the persistent thoughts and actions. He finds that the best treatment of OCD is what is known as Cognitive-behavioral therapy. In this therapy, the patient completes the Four Step Regimen of relabeling, reattributing, refocusing, and revaluing. By completing these four steps, the patient has trained him- or herself to overcome some of his or her obsessions and compulsions.

Panic Disorder

A panic attack is very disruptive to the sufferers life - and chronic suffering of panic attacks is known as Panic Disorder. It can be brought on by facing a phobia, high stress environments or a situation where the sufferer is unsure or nervous. The symptoms are cross-cultural, but the immediate causes are limited by the culture, such as driving a car - cars are not in every culture. The sufferer may experience:

restlessness and irritability
muscle tension, rapid physical fatigue and sleep disturbances
concentration problems
heart palpitations, cold sweats, nausea
irregular breathing, dizziness and in severe cases, Hypoxia.

According to the DSM IV, diagnosis of a panic attack includes:

a discrete period of intense fear or discomfort, reaching a peak within 10 minutes
at least four of the thirteen symptoms listed in the DSM IV occur rapidly.

PTSD

PTSD is a very common disorder affecting veterans and victims of violent crime. The DSM IV states that diagnosis of PTSD involves:

exposure to a traumatic event that was responded to with fear, helplessness, or horror
and the prevalence of the following symptoms for at least one month:
- the traumatic event is persistently re-lived through flashbacks, dreams, intrusive memories, etc.
- persistent avoidance of stimuli associated with the trauma
- numbing of general responsiveness
- persistent symptoms of increased arousal, such as difficulty sleeping, anger outbursts, exaggerated startle response, difficulty concentrating.

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