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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
Anxiety Facts
Most common mental illness in the U.S. with 19 million of the adult
(ages 18-54) U.S. population affected.
Anxiety disorders cost more than $42 billion a year.
More than $22 billion are associated with the repeated use of healthcare
services, as those with anxiety disorders seek relief for symptoms that
mimic physical illnesses.
Anxiety is highly treatable (up to 90% of cases), but only one-third of
those who suffer from it receive treatment
People with an anxiety disorder are three-to-five times more likely to go
to the doctor and six times more likely to be hospitalized for psychiatric
disorders than non-sufferers.
Depression often accompanies anxiety disorders
Types of Anxiety Disorders
Panic Disorder
Obsessive-Compulsive Disorder
Post-Traumatic Stress Disorder
Generalized Anxiety Disorder
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
The need to escape
Shortness of breath or a smothering
• Chest pain or discomfort
• Nausea or abdominal discomfort
• Dizziness or lightheadedness
•A fear of losing control or "going crazy"
• A fear of dying
• Tingling sensations
• Chills or hot flushes
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.
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
– Extreme need for orderliness;
– Aggressive impulses or thoughts, for example, being overcome
with the urge to yell 'fire' in a crowded theater
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 .
Post-Traumatic Stress Disorder
• Exposure to traumas such as a serious accident, a natural
disaster, or criminal assault can result in PTSD. When the
aftermath of a traumatic experience interferes with normal
functioning, the person may be suffering from PTSD.
• Symptoms of PTSD are:
– Reexperiencing the event, which can take the form of intrusive thoughts
and recollections, or recurrent dreams;
– Avoidance behavior in which the sufferer avoids activities, situations,
people,and/or conversations which he/she associates with the trauma;
– A general numbness and loss of interest in surroundings;
– Hypersensitivity, including: inability to sleep, anxious feelings, overactive
startle response, hypervigilance, irritability and outbursts of anger.
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.
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
attending and participating in class
speaking with strangers
meeting new people
eating, drinking, or writing in public
using public bathrooms
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.
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
• The intensity, duration and frequency of the
worry are disproportionate to the issue
Specific Disorder Facts
• Generalized Anxiety Disorder
– Women are twice as likely to be afflicted than men.
– Very likely to exist along with other disorders.
• Obsessive Compulsive Disorder
– It is equally common among men and women.
– One third of afflicted adults had their first symptoms in childhood.
• Panic Disorder
– Women are twice as likely to be afflicted than men.
– Occurs with major depression in very high rates.
2003 Anxiety Disorders Association of America
Specific Disorder Facts
• Posttraumatic Stress Disorder
– Women are more likely to be afflicted than men.
– Rape is the most likely trigger of PTSD, 65% of men and 45.9% of
women who are raped will develop the disorder.
– Childhood sexual abuse is a strong predictor of lifetime likelihood
for developing PTSD.
• Social Anxiety Disorder
– It is equally common among men and women.
• Specific Phobia affects
– Women are twice as likely to be afflicted as men
2003 Anxiety Disorders Association of America
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.
Symptoms of Anxiety
Anxiety is an emotion often accompanied by
various physical symptoms, including:
Twitching or trembling
Muscle tension
Dry mouth
Difficulty swallowing
Abdominal pain (may be the only symptom of stress
especially in a child)
Additional Symptoms of Anxiety
Sometimes other symptoms accompany
Rapid or irregular heart rate
Rapid breathing
Diarrhea or frequent need to urinate
Irritability, including loss of your temper
Sleeping difficulties and nightmares
Decreased concentration
Sexual problems
Physical Reaction to Anxiety
Auditory and Visual Stimuli:
sights and sounds are processed
first by the thalamus, which filters
the incoming cues and shunts
them either directly to the
amygdala or to the other parts of
the cortex.
Olfactory and tactile stimuli:
Smells and touch sensations
Bypass the thalamus altogether,
Taking a shortcut directly to the
Amygdala. Smells, therefore,
Often evoke stronger memories
Or feelings than do sights or
Physical Reaction to Anxiety
The hub for sights and sounds,
The thalamus breaks down
Incoming visual cues by size,
Shape and color, and auditory
Cues, by volume and
Dissonance, and then signals
The appropriate part of the
It gives raw sights and sounds
meanings, enabling the brain
to become conscious of what it
Is seeing or hearing. One
region, the prefrontal cortex,
may be vital to turning off the
anxiety response once a threat
has passed.
Physical Reaction to Anxiety
emotional core of the brain, the
amygdala has the primary role
of triggering the fear response.
information that passes through
the amygdala is tagged with
emotional significance.
Bed Nucleus of Stria Terminalis:
unlike the Amygdala, which sets
off an immediate burst of fear,
the BNST perpetuates the fear
response, causing the longer
term unease typical of
Physical Reaction to Anxiety
Locus Ceruleus:
It receives signals from the
amygdala and is responsible
for initiating many of the
classic anxiety responses:
rapid heartbeat, increased
blood pressure, sweating and
pupil dilation.
This is the memory center,
vital to storing the raw
information coming in from
the senses along with the
emotional baggage attached
to the data during their trip
through the amygdala.
The End