Friday, 19 September 2014

Anxiety Disorders (Part 1)


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Both positive and negetive

Anxiety: diffuse, vague and very unpleasant feeling of fear and apprehension. They worry a lot, puticularly about unknown dangers.  Physical and psychological symptoms-

Physical- rapid heart rate, shortness of breath, diarrhea, loss of appetite, fainting, dizziness, sweating, sleeplessness, frequent urination, tremors.

Psychological- possible future events fear, catastrophic interpretations of past, feeling uncertainity and helpless, overly sensitive to threatening cues.







Earlier called neurosis.

Individual is abnormally anxious either generally or specific situation, but still has adequate contact with reality and rarely need institutionalization.

Major catagories:


Generalized Anxiety disorder

Prolonged, vague, unexplained, but intense fears that does not seem to be attached to any purticular object. Anxious for minor, or even when no stimuli present.

Symptoms-
1.      Worry and apprehensive feelings about feature.
2.      Hypervigilance- hyper aroused state
3.      Motor tension- not relaxed
4.      Autonomic Reactivity- symathetic and parasympathetic nervous system working overtime

Clinical Features:

1.      Excessive anxiety and worry occuring for atleast 6 months and affecting many areas of person’s life (no medication)

2.     Inability to control worry

3.      Three or more symptoms (DSM IV TR)

(a)    Restlessness, feeling on edge
(b)   Being easily fatigued
(c)    Difficulty in concentration
(d)   Irritablity
(e)    Muscle tension
(f)    Sleep disturbance

4.      Considerable distress or impairment in social, occupational, and other important areas of life.

3% have GAD. More in women. May long along 20 years(protracted). Starts at late teens and early 20s

Amyglada and neurotransmitters

Cognitively and psychodynamically Oriented psychotherapy.



Panic Disorder

Abrupt surge of intense anxiety rising to a peak, which is cued by either the presence of, thought of a purticular stimuli or that comes without obvious cues and is spontaneous and unpredictable.  Not persistant like phobia. Stressful life events like new job, marriage, can trigger. Also intense fear of having another attack.  Worry over the implications and consequences of having panic attacks

Symptoms:

 During normal fuctioning and comes unanticipated. It is recurring. Victims fear that they will die, go crazy, or do something uncontrolled, and report variety of psycho sensory symptoms.

Anticipatory Anxiety:  Have intense fear of having attacks again and hence avoid all area where they could possivly have an attack

Constant worry of health and more prone to suicidal tendencies.

Clinical features:

Recurrent, Unexpected panick attacks and atleast 1 month of persistant concern having them. Attacks charecterizes-
(a)    Shortness of breath
(b)   Dizziness, Unsteadyness, or faintness
(c)    Trembling, shaking, or sweating
(d)   Heart palpitation, or racing heart rate
(e)    Choking, nausea, or stomach pain
(f)    Numbness or tingling
(g)   Chest pain or discomfort
(h)   A sense of strangeness, or being detached from oneself or one’s surrounding
(i)     Fear of going crazy, losing control or dying
Length- few seconds to  days.

Comparison of panic disorder and GAD-
1.      
Panic disorder have early onset
2.      Role of heredity more in Panic Disoreder
3.      Ratio of women:men greater in PD.
4.      Alchaholism more in PD
5.      Unusually more depressed are PDs
 

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