This document discusses different types of anxiety disorders including generalized anxiety disorder, social phobia, panic disorder, agoraphobia, specific phobias, post-traumatic stress disorder, and obsessive-compulsive disorder. It describes the symptoms, causes, and common treatments for each disorder which typically involve medication, cognitive behavioral therapy, and exposure therapy.

1. Anxiety
Disorder

2. What is Anxiety?
• Anxiety is an emotion characterized by feelings of
tension, worried thoughts and physical changes like
increased blood pressure. People
with anxiety disorders usually have recurring
intrusive thoughts or concerns. They may avoid
certain situations out of worry.

3. Types of Anxiety Disorder
1. Generalized Anxiety Disorder (GAD)
2. Social Phobia
3. Panic Disorder
4. Agoraphobia
5. Phobias
6. Post-Traumatic Stress Disorder (PTSD)
7. Obsessive-Compulsive Disorder (OCD)

4. 1. Generalized Anxiety Disorder
• A person feels anxious on most days,
worrying about lots of different things, over a
period of six months or more.

5. Symptoms
• Excessive, ongoing worry and tension
• An unrealistic view of problems
• Restlessness or a feeling of being "edgy"
• Irritability
• Muscle tension
• Headaches
• Sweating

6. • Difficulty concentrating
• Nausea
• The need to go to the bathroom frequently
• Tiredness
• Trouble falling or staying asleep
• Trembling
• Being easily startled

7. What Causes GAD?
• Genetics
• Brain Chemistry
• Environmental Factors

8. How Is GAD Treated?
• Medication: Drugs are available to treat GAD and may be
especially helpful for people whose anxiety is interfering
with daily functioning. The drugs most often used to treat
GAD in the short-term (since they can be addictive, are
sedating, and can interfere with memory and attention)
are from a class of drugs called benzodiazepines. These
medications are sometimes also referred to as sedative-
hypnotics or "minor tranquilizers" because they can
remove intense feelings of acute anxiety. They work by
decreasing the physical symptoms of anxiety, such as
muscle tension and restlessness.

9. • Cognitive-Behavioral Therapy: People suffering from
anxiety disorders often participate in this type of
therapy, in which you learn to recognize and change
thought patterns and behaviors that lead to anxious
feelings. This type of therapy helps limit distorted
thinking by looking at worries more realistically.

10. 2. Social Phobia
• Many people suffer from what's known as "social
phobia," or an irrational fear of social situations.
Some degree of social phobia is normal. Small
degrees of shyness in public places, or discomfort
while public speaking, are natural in most people,
and do not imply an anxiety problem.
A phobia is a type of anxiety disorder, usually
defined as a persistent fear of an object or situation
the affected person will go to great lengths to avoid,
typically disproportional to the actual danger posed.

11. • But when that fear disrupts your life, you may be
suffering from social phobia. Social phobia is
when the shyness is intense and the idea of
socializing or speaking with the public, strangers,
authority figures, or possibly even your friends
causes you noticeable anxiety and fear.

12. • People with social phobia view public situations as
being potentially painful and distressing, living with a
constant fear of being judged, observed, remarked
upon, or avoided. Those with social phobia also often
have an irrational fear of doing something stupid or
embarrassing.

13. What makes this more than just shyness is when those fears cause you
to avoid healthy socializing situations altogether. Those with social phobia
often live with two or more of the following issues:
• Feeling hopeless or fearful within unfamiliar people or in unfamiliar
situations.
• Obsession over being watched, observed, or judged by strangers.
• Experiencing overwhelming anxiety in any social situation with
difficulty coping.
• Severe fear of public speaking – beyond what one would consider
"normal"
• Anxiousness about the idea of social situations, even when not in
one.
• Intense issues meeting new people or voicing up when you need
to speak.

14. Emotional Symptoms of Social
Anxiety Disorder / Social Phobia
• Excessive self-consciousness and anxiety in
everyday social situations
• Intense worry for days, weeks, or even months
before an upcoming social situation
• Extreme fear of being watched or judged by others,
especially people you don’t know
• Fear that you’ll act in ways that that will embarrass or
humiliate yourself
• Fear that others will notice that you’re nervous

15. Physical Symptoms of Social Anxiety
Disorder / Social Phobia
• Red face, or blushing
• Shortness of breath
• Upset stomach, nausea (i.e. butterflies)
• Trembling or shaking (including shaky voice)
• Racing heart or tightness in chest
• Sweating or hot flashes
• Feeling dizzy or faint

16. Behavioral Symptoms of Social
Anxiety Disorder / Social Phobia
• Avoiding social situations to a degree that limits your
activities or disrupts your life.
• Staying quiet or hiding in the background in order to
escape notice and embarrassment.
• A need to always bring a buddy along with you
wherever you go.
• Drinking before social situations in order to soothe
your nerves.

17. Treatment
• Exposure Therapy: In this treatment, patients are
gradually exposed to their feared situations repeatedly,
until the situation no longer triggers the fear response.
This can be done via “imaginable exposure” - i.e.
imagining confronting the feared situation in one’s mind,
or via “in vivo exposure” - confronting the feared situation
in real life. Often, treatment plans combine the two
techniques. Exposure is most effective when it is done
frequently and lasts for long enough for the fear to
decrease. In fact, in certain situations, exposure-based
treatment has been shown to work in as little as one,
longer session.

18. • Cognitive Therapy: In this kind of treatment, people
learn to identify their anxious thoughts and replace
them with more realistic thoughts. For example,
someone with a fear of driving is shown evidence
that driving is, indeed, usually not dangerous.
However, cognitive therapy alone is usually not an
appropriate choice for people with specific phobias,
as most individuals with phobias recognize that their
fears are irrational.

19. • Relaxation: Relaxation techniques - such as
breathing retraining and exercise - can help
individuals cope for effectively with the stresses and
physical reactions related to their specific phobias.

20. • Medication: There is little research on the use of
medication and specific phobias. However, some
people with situational-type phobias (i.e. flying) do
note some benefit in taking anti-anxiety medications
(i.e. Ativan) or serotonin reuptake inhibiters (i.e.
Paxil) before confronting the feared situation.

21. 3. Panic Disorder
• Panic disorder is a debilitating anxiety disorder that
is very different from GAD. Panic disorder is not
about "panicking." It's not about getting very worried
because you might lose your job or a lion is about to
attack you in the jungle. That type of panic is normal.

22. • Panic disorder is when you experience severe
feelings of doom that cause both mental and physical
symptoms that can be so intense that some people
become hospitalized, worried that something is
dangerously wrong with their health.
Panic disorder is characterized by two things:
• Panic attacks.
• Fear of getting panic attacks.

23. Panic attacks are intense physical and mental
sensations that can triggered by stress, anxiety, or by
nothing at all. They often involve mental distress, but
are most well-known by their physical symptoms,
including:
• Rapid heartbeat (heart palpitations or irregular/fast
paced heart rhythms).
• Excessive sweating or hot/cold flashes.
• Tingling sensations, numbness, or weakness in the
body.

24. • Depersonalization (feeling like you're outside yourself).
• Trouble breathing or feeling as though you've had a deep
breath.
• Lightheadedness or dizziness.
• Chest pain or stomach pain.
• Digestive problems and/or discomfort.

25. Symptoms
• Shortness of breath or hyperventilation
• Heart palpitations or a racing heart
• Chest pain or discomfort
• Trembling or shaking
• Choking feeling
• Feeling unreal or detached from your surroundings
• Sweating
• Nausea or upset stomach
• Feeling dizzy, light-headed, or faint
• Numbness or tingling sensations
• Hot or cold flashes
• Fear of dying, losing control, or going crazy

26. Treatment
• Cognitive Behavioral Therapy is generally viewed as
the most effective form of treatment for panic attacks,
panic disorder, and agoraphobia. Cognitive
behavioral therapy focuses on the thinking patterns
and behaviors that are sustaining or triggering the
panic attacks. It helps you look at your fears in a
more realistic light.

27. • In Exposure Therapy for panic disorder, you are
exposed to the physical sensations of panic in a safe
and controlled environment, giving you the
opportunity to learn healthier ways of coping. You
may be asked to hyperventilate, shake your head
from side to side, or hold your breath. These different
exercises cause sensations similar to the symptoms
of panic. With each exposure, you become less
afraid of these internal bodily sensations and feel a
greater sense of control over your panic.

28. Medication Treatment
• Antidepressants. It takes several weeks before they
begin to work, so you have to take them
continuously, not just during a panic attack.
• Benzodiazepines. These are anti-anxiety drugs that
act very quickly (usually within 30 minutes to an
hour). Taking them during a panic attack provides
rapid relief of symptoms. However, benzodiazepines
are highly addictive and have serious withdrawal
symptoms, so they should be used with caution.

29. 4. Agoraphobia
• Agoraphobia is the fear of going out in public, either
the fear of open spaces or the fear of being in
unfamiliar places. Many people with agoraphobia
either never leave their home, or do anything they
can to avoid travelling anywhere other than their
home and office. Some people can go to the grocery
store or other familiar places, but otherwise
experience intense, nearly debilitating fear anywhere
else.

30. • Many people (although not all) that have
agoraphobia also have panic disorder. That's
because for many, agoraphobia is often caused by
panic attacks. People experience panic attacks in
public places, so they start to avoid more and more
places in order to avoid panic attacks until they are
afraid to go outside.
• Some people experience agoraphobia after traumatic
events as well.

31. Agoraphobia is more common for adults. Many also
fear losing control (both psychologically and physically),
causing them to avoid social situations. Not everyone
living with agoraphobia spends all their time in their
home. In fact, some of the more common symptoms
include:
• Obsessive fear of socializing with groups of people,
regardless of whether or not you know them.

32. • Severe stress or anxiety whenever you're in an environment
other than your home, or an environment where you're not in
control.
• Feelings of tension and stress even during regular activities,
such as going to the store, talking with strangers, or even just
stepping outdoors.
• Preoccupation with how to protect yourself or find safety in the
event that some type of trouble occurs, even with little reason
to believe trouble will occur.
• Finding that your own fears are keeping you prisoner,
preventing you from going out and living life because of that
fear.

33. Symptoms
• Afraid of leaving their home for extended periods of
time
• Afraid of being alone in the social situation
• Afraid of losing control in a public place
• Afraid of being in places where it would be difficult to
escape, such as a car or elevator
• Detached or estranged from others
• Anxious or agitated

34. What Causes Agoraphobia?
• Depression
• Other phobias, such as claustrophobia and social
phobia
• Another type of anxiety disorder, such as generalized
anxiety disorder or obsessive compulsive disorder
• A history of physical or sexual abuse
• A substance abuse problem
• A family history of agoraphobia

35. Treatment
• Psychotherapy, also known as talk therapy, involves
meeting with a therapist or other mental health
professional on a regular basis. This gives you the
opportunity to talk about your fears and any issues
that may be contributing to your fears.
Psychotherapy is often combined with medications
for optimum effectiveness. It’s generally a short-term
treatment that can be stopped once you’re able to
cope with your fears and anxiety.

36. • Cognitive Behavioral Therapy (CBT) is the most
common form of psychotherapy used to treat people
with agoraphobia. CBT can help you understand the
distorted feelings and views associated with
agoraphobia. It can also teach you how to work
through stressful situations by replacing the distorted
thoughts with healthy thoughts, allowing you to
regain a sense of control in your life.

37. • Exposure Therapy can also help you overcome your
fears. In this type of therapy, you’re gently and slowly
exposed to the situations or places you fear. This
may make your fear diminish over time.

38. Medications
• Selective serotonin reuptake inhibitors, such as
paroxetine (Paxil) or fluoxetine (Prozac)
• Selective serotonin and norepinephrine reuptake
inhibitors, such as venlafaxine (Effexor) or duloxetine
(Cymbalta)
• Tricyclic antidepressants, such as amitriptyline
(Elavil) or nortriptyline (Pamelor)
• Anti-anxiety medications, such as alprazolam
(Xanax) or clonazepam (Klonopin)

39. 5. Specific Phobia
• A specific phobia is any kind of anxiety disorder that
amounts to an unreasonable or irrational fear related
to exposure to specific objects or situations. As a
result, the affected person tends to actively avoid
direct contact with the objects or situations and,
in severe cases, any mention or depiction of them.

40. Symptoms
• A feeling of imminent danger or doom
• The need to escape
• Heart palpitations
• Sweating
• Trembling
• Shortness of breath or a smothering feeling
• A feeling of choking

41. • Chest pain or discomfort
• Nausea or abdominal discomfort
• Feeling faint, dizzy or lightheaded
• A sense of things being unreal, depersonalization
• A fear of losing control or “going crazy”
• A fear of dying
• Tingling sensation
• Chills or heat flush

42. Treatment
• Cognitive-Behavioral Therapy (CBT) can work for
those with specific phobia. Weekly treatment with
homework assignments usually succeeds in 12 to16
sessions. First the therapist helps the patient
understand incorrect assumptions and then gradually
exposes him or her to the phobia source.
• Secondly comes exposure, or confronting the feared
situation.

43. 6. Post Traumatic Stress Disorder (PTSD)
• As a human being, there are always risks that put
your life in danger. Most people are lucky enough to
avoid these dangers and live a nice and safe life. But
in some cases, you may experience a life trauma –
either physically or emotionally – and this can cause
an anxiety problem known as post-traumatic stress
disorder.

44. • PTSD affects people both psychologically and
physically. In most cases, the person with PTSD is
the one that experienced the traumatic event, but it's
possible to get PTSD by simply witnessing an event
or injury, or even simply discovering that someone
close to you dealt with a traumatic event.

45. Symptoms
Reliving the Trauma, which consists of:
• flashbacks, in which it feels as if the event is
occurring over and over
• intrusive, vivid memories of the event
• frequent nightmares about the event
• mental or physical discomfort when reminded of the
event

46. Avoidance, which includes:
• emotional apathy
• detachment from or lack of interest in daily activities
• amnesia (memory loss) about the actual event
• inability to express feelings
• avoidance of people or situations that are reminders
of the event

47. Increased Arousal, which is characterized by:
• difficulty concentrating
• startling easily
• exaggerated response to startling events
• constantly feeling on guard (hypervigilance)
• irritability or bouts of anger
• difficulty falling or staying asleep

48. Treatment
• Cognitive Behavioral (“talk”) Therapy to encourage
you to remember the event and express your
feelings about it. This can help desensitize you to the
trauma and reduce your symptoms.
• A support group where you can discuss your feelings
with other PTSD sufferers. This will help you realize
that your symptoms are not unusual and that you are
not alone.

49. Medications
• Antidepressants
• Anti-anxiety drugs
• Sleep aids to decrease the frequency of intrusive and
frightening thoughts and allow you to get some rest.

50. 7. Obsessive Compulsive Disorder (OCD)
• Obsessive compulsive disorder, or OCD, can be a
very destructive anxiety disorder. Those with OCD
often exhibit behaviors and fears that are not only
confusing to those around you – they may be
confusing to the person with OCD as well.

51. What Causes Obsessive-Compulsive Disorder?
• Biological Causes — OCD may be caused by genetic
abnormalities. People with OCD often have a close
relative that has the disorder.
• Environmental Causes — OCD may develop as a
result of behaviors that have been learned over time.
• Insufficient Levels of Serotonin — OCD may occur if
levels of serotonin in your brain decrease. Serotonin
is a chemical that can help you regulate emotions.

52. Symptoms
• A fear of germs, illness, or disease
• A fear of hurting oneself or others
• Violent thoughts of a sexual nature
• A fear that you will lose things that are important to
you
• A focus on preciseness and order
• A focus on superstitions
• Strict devotion to religious beliefs

53. Compulsions are behaviors and while behavior will vary
for each person with OCD, there are some common
compulsions. These include:
• Checking and rechecking tasks that have already
been completed
• Continually calling friends and family to see if they
are safe
• Counting or repeating words
• Excessive cleaning or washing
• Ordering things
• Excessive praying
• Accumulating trash that has no value or worth

54. Treatment
Drugs and Medication
• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

55. Therapy
• Your doctor may also recommend therapy to help
you learn to cope with your symptoms. Cognitive
behavioral therapy (CBT) has been shown to reduce
obsessions and compulsions in patients with OCD.
When combined with medication, CBT can enhance
treatment success.