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Generalised Anxiety Disorder, Panic
Disorder, Phobias, OCD and PTSD
The are numerous
disorders described in
the DSM.
 One category are
anxiety disorders.
 ANXIETY is a state of
emotinal arousal
associated with
feelings of
apprehension, worry
or uneasiness that
something is wrong or
something bad is
about to happen.


Three basic elements
of anxiety are:



1. Feelings of tension,
apprehension, dread
and an expectation of
not being able to cope.
2. Behavioural responses
such as avoidance of a
feared situation.
3. Phsiological responses
including muscle
tension, increased heart
rate and bllod pressure,
rapid breathing, dry
mouth, nausea,
diarrhoea and dizziness.
 Anxiety
is a normal
part of our lives.
 It is an adaptive
response.
 It can prompt us to
have a medical
check-up and
study hard for an
exam.
 Anxiety
should not
become so severe
that is imparis
performance.
 It can become a
source of extreme
distress and can
indicate an anxiety
disorder.



These are the most
frequently experienced
and diagnosed of all the
mental disorders.
Anxiety disorders are
characterised by chronic
feelings of tension,
distress, nervousness and
apprehension or fear
about the future, with a
negative effect.
It interferes with their
ability to function
normally in everyday life.

5 Types of Anxiety
Disorders





Generalised anxiety disorder
Panic disorder
Phobias
Obsessive Compulsive
Disorder (OCD)
Post Traumatic Stress
Disorder (PTSD)

28 year old Cassandra has been worried about 
her health, job and marriage. She has always
worried about things, but over the past 8
months she has become nervous and tense.
This heightened anxiety began after an
argument with a co-worker whom she believe
to be taking credit for her work. Since the
argument, she has been unable to stand up to
this person. She worries constantly about the
quality of her work and this if she makes a
mistake, she will lose her job. She has began
to lie awake at night, preoccupied with
thoughts about how to deal with her difficult

work colleague, the future, how she will get
another job if she is sacked, and whether her
husband is faithful. She has visited her doctor
a number of times in the past 8 months for
various problems including severe stomach
cramps, diarrhoea , chest pain and shortness of 
breath, which she felt sure were signs of a
serious physical illness. The doctor has
repeatedly assured her that she does not have
any major physical illness.
People with GAD worry
constantly about the
possibility of problems
occurring, such as
something happening to
themselves or their family,
financial difficulties,
health problems, or
concerns with work or
personal relationships.
They experience extreme
symptoms frequently,
their worrying is irrational
and are often unable to
control their anxiety.
Affects women more than
men at a 2:1 ratio.

3 main forms of
treatment:



Cognitive behaviour
therapy (CBT)
Relaxation therapy
Medication
CBT aims to change
the irrational and
unrealistic beliefs,
attitudes and
expectations people
often have.
 They are taught to
change their negative
thoughts into more
rational thoughts.
 Relaxation skills are
also taught to keep
their anxiety under
control.

 Panic
disorder
involves recurring,
unexpected attacks
of anxiety in
situations where
people would not
normally be afraid.
 People who suffer
from panic attacks
feel fear,
apprehension or
even terror.
A
diagnosis of panic
disorder involves
the experience of
dysfunctional
changes in thinking
and behaviour as a
result of the attacks
for a period of a
month or more.
 Panic
disorder is
often accompanied
by agoraphobia.
 It is the fear of
being in a place
from which it may
be difficult to
escape or where it
may be difficult to
get help in the
event of a panic
attack.
 Agoraphobics
are
often afraid to
leave their homes
and travel to public
places.
 It can become so
severe that they are
afraid to walk
outside the door of
their home for fear
of a panic attack.
 Medication

Antidepressants
prescribed by
psychiatrists can
reduce or stop panic
attacks, but not treat
the anxiety.
 CBT
 Relaxation
techniques

Slow breathing
technique


Phobias are excessive or
unreasonable fears
directed to a particular
object, situation or
event, which cause
significant distress or
interfere with everyday
functioning.
Most phobias can be
kept to a manageable
level as long as the
course of their phobia is
avoided.



Many people with
phobias are aware that
their fears are excessive
and unreasonable, but
may not know how they
started.
Most phobias are
classified under the DSM
category called specific
phobias.
A specific phobia is an
extreme and persistent
fear of a specific object
or situation.
 According
to the
DSM, a pattern of
thoughts, feelings
and behaviours will
be classified as a
specific phobia only
if the excessive and
unreasonable fear
of the specific
object or situation
has persisted for at
least 6 months.
 DSM
identifies 2
other categories:
Social Phobia
 Agoraphobia

 Social
phobia is an
irrational fear of
social or
performance
situations in which
embarrassment may
occur.


Most people do not seek
treatment for their
phobias, as they learn to
avoid the object or
situation that triggers
their anxiety.
However, some phobias
require treatment as the
phobia interferes with
their everyday life.


Specific phobias can be
treated effectively with
CBT.
Systematic desensitisation


A phobic person is taught to
replace their fear response
to the specific stimulus that
triggers that fear response
with a relaxed response.
Modelling

The client observes while
the mental health
professional confronts and
successfully deals with the
feared object or situation.
PTSD is a severe
psychological reaction
to an intensely
traumatic event that
was harmful or life
threatening either to
the person or to
others.
 It lasts at least 1
month after the
event.
 Some events are:
assault, rape, armed
robbery, etc.


The DSM describes 3
main groups of
symptoms associated
with PTSD



Intrusive symptoms
Avoidance symptoms
Hyperarousal symptoms

Involve continual
intrusion of the
traumatic event into
the thoughts of the
PTSD sufferer, as they
relive the traumatic
event in their mind.
Distressing memories
 Distressing dreams
 Acting or feeling as if
the traumatic event is
happening again
 Intense psychological
distress
 Physiological
reactions such as
sweating and heart
racing when reminded
of the event.

 Involves
attempts to
block out
unpleasant
memories and
feelings associated
with the trauma.
 Symptoms
include:
Efforts to avoid
thoughts, feelings or
conversations
 Efforts to avoid
activities, places,
people
 Inability to recall an
important aspect of
the event
 Feelings of
detachment from
others

 PTSD
sufferers can
also feel like they
are constantly in
danger.
 Symptoms




include:
Difficulty falling or
staying asleep
Irritability or
outbursts of anger
Difficulty
concentrating
Hypervigilance for
signs of danger
CBT
 Relaxation training
 SBT
 Stress management
strategies
 Rap groups:


Meeting with others to
share thoughts feelings
& experiences to
develop a greater
understanding of one’s
personal responses and
to offer support to each
other.