Download anxiety - Dr Adelbert Scholtz

ANXIETY DISORDERS
Symptoms, Causes and Treatment
PRESENTED BY
Adelbert Scholtz
[counselling psychologist & retired pastor]
ONLY IMAGINATION?
• Why do people become anxious?
• Why do people get panic attacks?
• Is it attention-seeking? Only imagination?
World Health Organisation:
REAL DISEASES
F 40 Phobic anxiety disorders
F 40.0 Agoraphobia
F 40.1 Social phobias
F 40.2 Specific (isolated) phobias
F 41 Other anxiety disorders
F 41.0 Panic disorder [episodic paroxysmal
anxiety]
F 41.1 Generalized anxiety disorder
F 41.2 Mixed anxiety and depressive disorder
SYMPTOMS
ICD-10: F 40
• Phobic anxiety disorders
A group of disorders in which anxiety
is evoked only, or predominantly, in
certain well-defined situations that are
not currently dangerous. As a result these situations
are characteristically avoided or endured with dread.
The patient's concern may be focused on individual
symptoms like palpitations or feeling faint and is often
associated with secondary fears of dying, losing
control, or going mad. Contemplating entry to the
phobic situation usually generates anticipatory
anxiety. Phobic anxiety and depression often coexist.
ICD-10: F 40.0
• Agoraphobia
A fairly well-defined cluster of phobias
embracing fears of leaving home,
entering shops, crowds and public places, or
travelling alone in trains, buses or planes. Panic
disorder is a frequent feature of both present and
past episodes. Depressive and obsessional
symptoms and social phobias are also commonly
present as subsidiary features. Avoidance of the
phobic situation is often prominent, and some
agoraphobics experience little anxiety because
they are able to avoid their phobic situations.
ICD-10: F 40.1
• Social phobias
Fear of scrutiny by other people leading to avoidance
of social situations. More pervasive social phobias are
usually associated with low self-esteem and fear of
criticism. They may present as a complaint of
blushing, hand tremor, nausea, or
urgency of micturition, the patient
sometimes being convinced that
one of these secondary
manifestations of their anxiety is
the primary problem. Symptoms
may progress to panic attacks.
ICD-10: F 40.2
• Specific (isolated) phobias
Phobias restricted to highly specific situations
such as proximity to particular animals,
heights, thunder, darkness, flying, closed
spaces, urinating or defecating in public
toilets, eating certain foods,
dentistry, or the sight of
blood or injury. Though the
triggering situation is discrete,
contact with it can evoke
panic as in agoraphobia or
social phobia.
ICD-10: F 41
• Other anxiety disorders
Disorders in which manifestation of anxiety is
the major symptom and is not restricted to
any particular environmental situation.
Depressive and obsessional
symptoms, and even some
elements of phobic anxiety,
may also be present, provided
that they are clearly
secondary or less severe.
ICD-10: F 41.0
• Panic disorder [episodic
paroxysmal anxiety]
The essential feature is recurrent
attacks of severe anxiety (panic), which are not
restricted to any particular situation or set of
circumstances and are therefore unpredictable.
As with other anxiety disorders, the dominant
symptoms include sudden onset of palpitations,
chest pain, choking sensations, dizziness, and
feelings of unreality (depersonalization or
derealization). There is often also a secondary
fear of dying, losing control, or going mad.
ICD-10: F 41.1
• Generalized anxiety disorder
Anxiety that is generalized and persistent but not
restricted to, or even strongly predominating in, any
particular environmental circumstances (i.e. it is "freefloating"). The dominant symptoms are variable but
include complaints of persistent nervousness,
trembling, muscular tensions,
sweating, lightheadedness,
palpitations, dizziness, and
epigastric discomfort. Fears
that the patient or a relative
will shortly become ill or have
an accident are often
expressed.
ICD-10: F 41.2
• Mixed anxiety and depressive disorder
This category should be used when
symptoms of anxiety and depression
are both present, but neither is clearly
predominant, and neither type of
symptom is present to the extent that
justifies a diagnosis if considered
separately.
When both anxiety and depressive symptoms are
present and severe enough to justify individual
diagnoses, both diagnoses should be recorded
and this category should not be used.
CAUSES
FEAR
• A normal human
condition/emotion
• Babies are born with a
fear instinct
• Survival value
• May become excessive,
irrational & pathological
CONTEMPORARY LIFE
• Our lives are being ruled by gangsters,
burglars, rapists & drug dealers
• The result: over-protected children &
fearful adults
PHOBIAS
• Excessive and unrealistic fears
• Greek: φόβος (phobos) = fear
PHOBIAS: CAUSES
• Some people more
vulnerable than others
• Trigger: rude shock or
traumatic experience
• Fear imprinted on the
brain – a network of
neurons is fixed
• Brain chemistry
NEURONS &
NEUROTRANSMITTERS
Brain cells
(neurons) form
networks and
communicate by
means of
chemicals called
neurotransmitters
BRAIN CHEMISTRY
• Phobias, anxiety & panic attacks often
accompanied by lack of neurotransmitters
• GABA, Serotonin & Dopamine
(responsible for feelings
of security, self-confidence
& excitement)
ANXIETY & PANIC ATTACK
• Often connected to
phobias, agoraphobia
or social phobia
• Often accompanied by
depression
PANIC ATTACKS: CAUSES
•
•
•
•
Lack of certain neurotransmitters
Overdose of stress
Hyper-ventilation
May be due to medical
condition (e.g. asthma,
heart problems)
SOCIAL PHOBIA
• Excessive fear of people &
social situations
• Blush or sweat
• Dizziness or nausea
• Dry mouth
• Difficulty talking - stutter and
stammer
• Stomach pain
• Heart palpitations and trembling
• Paralyzing panic attack
SOCIAL PHOBIA: CAUSES
• Inherited tendency
• Trigger: embarrasment or humiliation in public
• Results: social isolation, no life partner, cannot
work with people
& depression
AGORAPHOBIA
• Greek: άγορά (agora) = market square
• Excessive fear of open spaces & being away from
home
• May loose self-control in public
• Helplessness when among other people
• Fear of being hedged in
• Light-headedness or
dizziness
• Headaches
• Beating heart
• Nausea
• Sweatiness
• Panic attacks
AGORAPHOBIA: CAUSES
• Inherited tendency
• Trigger: traumatic experience
• People with chemical dependency more
amenable
AGORAPHOBIA - RESULTS
• Social isolation
• Cannot work outside home or go shopping
• Dependent upon
others
XENOPHOBIA
• Fear of or bias
towards strangers &
aliens
• Not a real phobia
HOMOPHOBIA
• Bias towards gay
people
• Not a real phobia
TREATMENT
MEDICATION
• Medical practitioners often prescribe
antidepressants
• Not always effective
• Take long to work (if at all)
• Don’t solve any problems
• Side-effects
PHOBIAS: TREATMENT
•
•
•
•
•
•
Goal: removal of symptoms,
slaying the monsters
Behaviour therapy: flooding,
gradual exposure, progressive
desentization
Group therapy
Hypnosis
Emotional Freedom Technique
Exercise
Nutritional supplements
AGORAPHOBIA: TREATMENT
•
•
•
•
•
•
Psychologist has to visit home of sufferer
Behaviour therapy
Hypnosis
Exercise
Emotional Freedom
Technique
Nutritional
supplements
ANXIETY ATTACK: TREATMENT
•
•
•
•
•
•
Relaxation exercises
Behaviour therapy
Exercise
Hypnosis
Emotional Freedom
Nutritional Supplements
Technique
THE BENEFIT OF EXERCISE
•
•
•
•
•
Relaxation
Pain management
Secretes endorphins
Health improves
Self-confidence
improves
PANIC ATTACK: SELF-HELP
• Breathe into paper
bag to counter
hyper-ventilation
• Deliberate
relaxation exercises
EAT HEALTHY
• Lots of fruit and fresh
veggies
• Provide fibre
• Enough water
• Avoid fat, oil, sugar,
alcohol & caffeine
• Supplement vitamins,
minerals & Omega-3
fatty acids
• Amino acids (GABA, 5-HTP)
YOUR SPIRITUAL NEEDS
• Phobic, anxious and panicky people feel
powerless
• Faith in God may
restore power
TRUST IN GOD
Ps 27:1 The LORD
is my light and my
salvation; whom shall
I fear? The LORD is
the strength of my
life; of whom shall I
be afraid?
GET A CLEAR CONSCIENCE
• Unresolved guilt may cause depression,
fears, anxiety & panic
• Read Ps 103
• You may forgive
yourself – no
need to punish
yourself
GOD MADE MAN TO BE HAPPY
Gen 1:27 – 41 God created man in his own
image. In God`s image he created him; male
and female he created them. God blessed
them. (….) God saw everything that he had
made, and,
behold, it was
very good.
GOD MADE MAN TO BE HAPPY
Eccl 11:9 Rejoice, young man, in your youth,
and let your heart cheer you in the days of your
youth, and walk in the ways of your heart, and
in the sight of your
eyes; but know
that for all these
things God will
bring you into
judgment.
SEEK HELP!
• Join a support group
• Consult a mental
health practitioner
SERENITY IS POSSIBLE