Anxiety is a feeling of apprehension or fear about an unknown situation. There are several types of anxiety disorders including panic disorder, obsessive-compulsive disorder, phobias, and generalized anxiety disorder. Treatment options include medications like buspirone and benzodiazepines, as well as behavioral therapies and cognitive behavioral therapy which teach patients to react differently to anxiety triggers and change negative thinking patterns.

1. ANXIETY

2. Definition of Anxiety
• Anxiety is a feeling of apprehension or fear. The
source of this uneasiness is not always known or
recognized, which can add to the distress you feel.
• Anxiety disorders are a group of psychiatric
conditions that involve excessive anxiety.

3. Types of Anxiety Disorders
• Panic Disorder
• Obsessive-Compulsive Disorder
• Phobias
• Generalized Anxiety Disorder

4. Panic Disorder
• The abrupt onset of an episode of intense fear or
discomfort, which peaks in approximately 10
minutes, and includes at least four of the following
symptoms:
• A feeling of imminent danger or doom • Nausea or abdominal discomfort
• The need to escape • Dizziness or lightheadedness
• Palpitations • A sense of things being unreal,
• Sweating depersonalization
• Trembling • A fear of losing control or "going crazy"
• Shortness of breath or a smothering • A fear of dying
feeling • Tingling sensations
• A feeling of choking • Chills or hot flushes
• Chest pain or discomfort

5. Panic Disorder
There are three types of Panic Attacks:
1. Unexpected - the attack "comes out of the blue" without
warning and for no discernable reason.
2. Situational - situations in which an individual always has an
attack, for example, upon entering a tunnel.
3. Situationally Predisposed - situations in which an individual is
likely to have a Panic Attack, but does not always have one. An
example of this would be an individual who sometimes has
attacks while driving.

6. Obsessive-Compulsive Disorder
Characterized by uncontrollable obsessions and compulsions
which the sufferer usually recognizes as being excessive or
unreasonable.
• Obsessions are recurring thoughts or impulses that are
intrusive or inappropriate and cause the sufferer anxiety:
– Thoughts about contamination, for example, when an individual fears
coming into contact with dirt, germs or "unclean" objects;
– Persistent doubts, for example, whether or not one has turned off the
iron or stove, locked the door or turned on the answering machine;
– Extreme need for orderliness;
– Aggressive impulses or thoughts, for example, being overcome with the
urge to yell 'fire' in a crowded theater

7. Obsessive-Compulsive Disorder
• Compulsions are repetitive behaviors or rituals performed by the OCD
sufferer, performance of these rituals neutralize the anxiety caused by
obsessive thoughts, relief is only temporary.
– Cleaning. Repeatedly washing their hands, showering, or constantly cleaning
their home;
– Checking. Individuals may check several or even hundreds of times to make sure
that stoves are turned off and doors are locked;
– Repeating. Some repeat a name, phrase or action over and over;
– Slowness. Some individuals may take an excessively slow and methodical
approach to daily activities, they may spend hours organizing and arranging
objects;
– Hoarding. Hoarders are unable to throw away useless items, such as old
newspapers, junk mail, even broken appliances
• In order for OCD to be diagnosed, the obsessions and/or compulsions must
take up a considerable amount of the sufferers time, at least one hour every
day, and interfere with normal routines .

8. Social Phobia/Anxiety
• Social anxiety disorder, also known as social phobia, is an
intense fear of social situations. This fear arises when the
individual believes that they may be judged, scrutinized or
humiliated by others.
• Individuals with the disorder are acutely aware of the physical
signs of their anxiety and fear that others will notice, judge
them, and think poorly of them.
• In extreme cases this intense uneasiness can progress into a full
blown panic attack.

9. Social Phobia/Anxiety
• Common anxiety provoking social situations include:
– public speaking
– talking with people in authority
– dating and developing close relationships
– making a phone call or answering the phone
– interviewing
– attending and participating in class
– speaking with strangers
– meeting new people
– eating, drinking, or writing in public
– using public bathrooms
– driving
– shopping

10. Generalized Anxiety Disorder
• Excessive uncontrollable worry about everyday
things. This constant worry affects daily
functioning and can cause physical symptoms.
• GAD can occur with other anxiety
disorders, depressive disorders, or substance
abuse.

11. Generalized Anxiety Disorder
• The focus of GAD worry can shift, usually
focusing on issues like job, finances, health of
both self and family; but it can also include
more mundane issues such as, chores, car
repairs and being late for appointments.
• The intensity, duration and frequency of the
worry are disproportionate to the issue

12. Common Causes
• There is no one cause for anxiety disorders. Several factors can
play a role
– Genetics
– Brain biochemistry
– Overactive "fight or flight" response
• Can be caused by too much stress
– Life circumstances
– Personality
• People who have low self-esteem and poor coping skills may be more prone
• Certain drugs, both recreational and medicinal, can lead to
symptoms of anxiety due to either side effects or withdrawal
from the drug.
• In very rare cases, a tumor of the adrenal gland
(pheochromocytoma) may be the cause of anxiety.

13. Symptoms of Anxiety
Anxiety is an emotion often accompanied by
various physical symptoms, including:
• Twitching or trembling
• Muscle tension
• Headaches
• Sweating
• Dry mouth
• Difficulty swallowing
• Abdominal pain (may be the only symptom of stress
especially in a child)

14. Additional Symptoms of Anxiety
Sometimes other symptoms accompany
anxiety:
• Dizziness
• Rapid or irregular heart rate
• Rapid breathing
• Diarrhea or frequent need to urinate
• Fatigue
• Irritability, including loss of your temper
• Sleeping difficulties and nightmares
• Decreased concentration
• Sexual problems

15. Allopathic Treatments
• Medications (Drug Therapy):
• Behavioral Therapy
• Cognitive Behavioral Therapy
• Psychodynamic Psychotherapy

16. Medications
• Buspirone: shown to be effective but usually takes 3-
4 weeks, particularly useful in elderly patients
• Benzodiazepines: include Xanax and Valium, act
rapidly and successfully but can be addictive and
loses effectiveness over time
• Side Effects: dizziness, headaches, nausea, impaired
memory

17. Behavioral and Cognitive Therapy
• Teaches patient to react differently to situations and bodily
sensations that trigger anxiety
• Teaches patient to understand how thinking patterns that
contribute to symptoms
• Patients learn that by changing how they perceive feelings of
anxiety, the less likely they are to have them
• Examples: Hyperventilating, writing down list of top fears and
doing one of them once a week, spinning in a chair until dizzy;
after awhile patients learned to cope with the negative
feelings associated with them and replace them with positive
ones