Anxiety Disorders

Anxiety is appropriate as a part of the fight or flight response, but becomes abnormal when it's out of proportion to the stressful situation, persists after the situation has ended, or occurs for no apparent reason. Anxiety disorder includes Generalized Anxiety disorder, Phobia, Panic disorder, OCD, and PTSD.

It presents with:

• Psychological - Poor concentration, Irritability, Derealisation, Depersonalisation

• Motor - Restlessness, Fidgeting

• Neuromuscular - Tremor, Tension headache, Dizziness

• GI - Dry mouth, Nausea, Indigestion

• Chest - Hyperventilation, Chest pain/tightness, Palpitations, Sweating, Shaking

Management:

• CBT

• B-blockers for symptomatic relief

• SSRIs, MAOIs, TCAs, Antipsychotics

Types:

Generalised Anxiety Disorder is a generalised, persistent worry about everyday event and problems. Its risk factors include low socioeconomic status, and childhood maltreatment.

Panic Disorder is characterised by recurrent attacks of severe anxiety that isn’t restricted to any particular situation or set of circumstances, therefore is unpredictable.

Agoraphobia is the fear of places/situations that make you feel trapped, helpless or embarrassed e.g. large crowds, enclosed spaces. This leads to one becoming housebound, and avoiding certain situations.

Social Anxiety Disorder is the fear of criticism by others, leading to avoidance of social situations. It can be precipitated by stressful/humiliating experiences, death of a parent, separation, and chronic stress.

OCD is characterised by:

• Obsession - Repetitive, senseless thoughts/behaviours that the pt recognises as irrational but feels they’re unable to resist

• Compulsion - Repetitive behaviours and mental acts to neutralise obsessions and reduce emotional distress

Specific Phobia is the excessive, unreasonable fear caused by the presence/thought of a specific object or situation. It's considered abnormal when it interferes with daily life.