Course Psychology

Lesson Number 53

Lesson Title Anxiety Disorders

Author Ilanna S. Mandel

Development State

Date October 19, 2008

IIC-2.3 Describe the a. Explaining why one person would be curious and another situational cues and individual anxious in the same situation characteristics giving rise to b. Discussing why one person responds to stereotyping without curiosity and anxiety. anxiety and another person responds with anxiety VA-1.1 Distinguish the common characteristics of abnormal behavior. VA-1.2 Cite examples of abnormal behavior. VA-1.3 Relate judgments of abnormality to contexts in which those judgments occur. a. Listing criteria that distinguish normal from disordered behavior a. Describing observable symptoms of abnormal behavior

c. Describing some abnormal behaviors specific to particular contexts or circumstances


Prepare Phase

Do you know anyone who is constantly plagued by worries and even suffers from panic attacks? Or, have you known someone who obsessively does things like washing their hands twenty or thirty times a day? Have you ever met someone who has to stop what they’re doing because they think they’re having a heart attack but it’s really a panic attack? These are all forms of anxiety disorders. While anxiety is a common fact of every day life for millions of people for logical reasons such as financial problems, an impending divorce, an upcoming final exam or other practical problems, some people live in a constant state of anxiety and can’t seem to get out of it. Today we’re going to explore anxiety disorders and learn why some people fall into panic or anxiety while others stay calm and patient. In the meantime: do you know anyone who suffers regularly from any of these symptoms?

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Feelings of panic, fear and uneasiness Uncontrollable, obsessive thoughts Repeated thoughts or flashbacks of traumatic experiences Nightmares Ritualistic behaviors, such as repeated hand washing Problems sleeping Cold or sweaty hands and/or feet Shortness of breath Palpitations An inability to be still and calm Dry mouth Numbness or tingling in the hands or feet Nausea Muscle tension Dizziness

Do any of the reactions in the photograph below resonate with you?

Do you ever feel like pushing this button?

Do you sometimes walk around feeling like this?

Anxiety disorders affect millions of people and these disorders can make life extremely unpleasant and even cause people to fall into depression. Lesson Expectations Explain why one person would be curious and another anxious in the same situation

Discuss why one person responds to stereotyping without anxiety and another person responds with anxiety List criteria that distinguish normal from disordered behavior Describe observable symptoms of abnormal behavior Describe some abnormal behaviors specific to particular contexts or circumstances Key Terms Anxiety is a physiological and psychological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create the painful feelings that are typically recognized as uneasiness, apprehension, or worry. Anxiety is a normal reaction to stress. It may help a person to deal with a difficult situation, for example at work or at school, by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder. Anxiety disorders are the most common psychiatric illnesses affecting children and adults. Anxiety disorders may develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events. An estimated 40 million adult Americans suffer from anxiety disorders. Anxiety disorders are highly treatable, yet only about one-third of those suffering from an anxiety disorder receive treatment. Generalized Anxiety Disorder (GAD). Generalized anxiety disorder is characterized by excessive, unrealistic worry that lasts six months or more; in adults, the anxiety may focus on issues such as health, money, or career. In addition to chronic worry, GAD symptoms include trembling, muscular aches, insomnia, abdominal upsets, dizziness, and irritability. Obsessive-Compulsive Disorder (OCD). People suffering from OCD are plagued by persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears; typical obsessions include worry about being contaminated or fears of behaving improperly or acting violently. The obsessions may lead to performing a ritual or routine (compulsions), such as washing hands, repeating phrases, or hoarding, to relieve the anxiety caused by the obsession. Panic Disorder. People with panic disorder suffer severe attacks of panic, which may make them feel as if they are having a heart attack or can't breathe, for no apparent reason. Symptoms include heart palpitations, chest pain or discomfort, sweating, trembling, tingling sensations, feeling of choking, fear of dying, fear of losing control, and feelings of unreality. Panic disorder often occurs with agoraphobia, in which people are afraid of having a panic attack in a place from which escape would be difficult, so they avoid these places.

Posttraumatic Stress Disorder (PTSD). Posttraumatic stress disorder can follow an exposure to a traumatic event such as a sexual or physical assault, witnessing a death, the unexpected death of a loved one, or natural disaster. Three main symptoms are associated with PTSD: "reliving" of the traumatic event through flashbacks or nightmares; avoidance behaviors (avoiding places related to the trauma) and emotional numbing (detachment from others); and physiological arousal such difficulty sleeping, irritability, or poor concentration. Social Anxiety Disorder (Social Phobia). Social anxiety disorder is also called social phobia. It is characterized by extreme anxiety about being judged by others or behaving in a way that might cause embarrassment or ridicule. This intense anxiety may lead to avoidance behavior. Physical symptoms associated with this disorder include heart palpitations, faintness, blushing, and profuse sweating. Specific Phobias. People with specific phobias suffer from an intense fear reaction to a specific object or situation (examples: spiders, dogs, heights). The level of fear is usually inappropriate to the situation and it is recognized by the sufferer as being irrational. This inordinate fear can lead to the avoidance of common, everyday situations. Agoraphobia - is an anxiety disorder, often precipitated by the fear of having a panic attack in a setting from which there is no easy means of escape. As a result, sufferers of agoraphobia may avoid public and/or unfamiliar places. In severe cases, the sufferer may become confined to his or her home, experiencing difficulty traveling from this "safe place." 2. Deliv er & Pr actice P hase

Let’s work with three of the most common of anxiety disorders:
PANIC ATTACKS They’re real and they can debilitate peoples’ lives. What happened to Kerry that caused her to start having panic attacks? What wax the context in which her attacks existed? What did she experience as a result? What were her symptoms? What happened to Kerry’s life? What did Kerry do to start to recover? Watch: Panic Attacks

POST-TRAUMATIC STRESS DISORDER What was the context for PTSD developing in Jenny? What was the behavior that caused Jenny to develop PTSD? How did Jenny react? What were her behaviors as a result? What were her symptoms? Why did Jenny come to believe she was ‘mad’? What helped Jenny to start her recovery? Watch: PTSD OBSESSIVE-COMPULSIVE DISORDER What are some of the symptoms of OCD? What are some of the things that people do when they have OCD? What distinguishes Craig’s behavior from ‘normal’ behavior? What was he doing that distinguished his abnormal behavior? How does OCD manifest itself with Sherry? What does Sherry think about disease in general? What does it say about Sherry that she knows this is not ‘logical’? Watch Obsessive-Compulsive Disorder: Now, let’s see what you’ve learned: – Standard Pack 2 Quadrant Practice The Four Quadrants are as follows: Panic Disorder Generalized Anxiety Disorder Obsessive-Compulsive Disorder

Post-Traumatic Stress Disorder The RIGHT HAND SIDE CHOICES with their answers are: Follows a traumatic event or assault (PTSD) Avoidance behaviors (PTSD) Characterized by excessive unrealistic worry (GAD) Often accompanied by muscles aches, pains and insomnia (GAD) People with this suffer with consistent, recurring thoughts (OCD) People with this often perform repetitive ritualistic behavior (OCD) People with this often fear they’re choking or dying from a heart attack (Panic Disorder) People with this also suffer what is known as agoraphobia (Panic Disorder) NORMAL VERSUS ABNORMAL BEHAVIOR Over the centuries the notions of ‘normal’ and ‘abnormal’ have radically changed. For example, people with epilepsy were once considered ‘mad’ because it was a greatly misunderstood condition. We now know that epilepsy is a neurological condition that can be treated with medication. As we discussed in our lesson on “Stress and Health”, everyone experiences stress and by the same reasoning, everyone feels anxious at some points in time. Often this is SITUATIONAL ANXIETY. That is, the response is shortterm and will be alleviated when the situation changes. CHRONIC ANXIETY is different. Here is a very good brief list to look at which describes the behaviors that differentiate the ‘normal’ versus ‘abnormal’ blues: Anxiety becomes ‘abnormal’ when it begins to interfere with our daily lives. Here’s a thoughtful 3-minute musical interpretation of anxiety disorders: What kinds of fears do people with anxiety disorders experience? What happens to them as a result – what do they feel – how do their fears manifest in their lives? 3. S ummariz e Phase Explain why one person would be curious and another anxious in the same situation Discuss why one person responds to stereotyping without anxiety and another person responds with anxiety

List criteria that distinguish normal from disordered behavior Describe observable symptoms of abnormal behavior Describe some abnormal behaviors specific to particular contexts or circumstances 4. As sessmen t Phase Assignment – True and False 1. Post-traumatic stress disorder always follows a traumatic or stressful event that the person cannot seem to recover from. a. True b. False 2. Anxiety disorders are considered stressful but not abnormal a.True b. False No, anxiety disorders are classified as abnormal behavior 3. Some of the observable symptoms of panic attacks are the feeling of a heart attack, feeling like one is going to faint and/or feeling that the room is closing in on them. a. True b. False 4. Generalized anxiety disorder is characterized by anxiety that lasts more than three months. a. True b. False GAD is characterized by anxiety that lasts more than six months. 5. Difficulty sleeping, irritability, or poor concentration are all symptoms of generalized anxiety disorder. a. True b. False No, these are symptoms of Post-Traumatic Stress Disorder. 6. The reason why some people respond calmly and others respond with anxiety has as much to do with situations and events as it does our environment. a. True b. False Yes, for example panic attacks are brought on by an event or situation, just as general anxiety can be. The sources of other phobias are not as well known but our social environment can certainly affect our responses to events.

7. Sufferers of agoraphobia may avoid public and/or unfamiliar places but only for a short time until they become comfortable with them. a. True b. False No, these feelings can last for many years unless the person seeks treatment. 8. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder. a. True b. False 9. Ritualistic behaviors such as repetitive hand washing are symptoms of social phobias just as much as they are symptomatic of obsessive-compulsive disorder (OCD). a. True b. False No, these are only symptomatic of OCD and have nothing to do with social phobias. 10. People can suffer from short-term or situational anxiety and recover quickly without treatment or therapy. a. True b. False Yes, for example, the loss of a friend or family member can cause short-term situational anxiety and/or depression which people recover from once they’ve adjusted to the loss in their life. 11. Generalized anxiety disorder has nothing to do with stress. a. True b. False No, this is not true. Extreme stress can actually be the precursor to the onset of GAD. 12. In the video on Kerry and panic attacks, the young girl named Kerry began to suffer from panic attacks as a result of bullying. a. True b. False Yes, this was the traumatic event that caused Kerry to first suffer from panic attacks and eventually change schools. 13. Normal versus abnormal behavior is not only distinguished by what we do but also how often we do it. a. True b. False Yes, the constant repetition of certain behaviors (like hand washing) to the point of being excessive becomes abnormal behavior. 14. People with OCD can develop an unreasonable fear that they will contaminate others.

a. True b. False No, it’s the other way around. They’re fearful that others will contaminate them and so they engage in constant washing rituals to the point that it interferes with heir daily lives. 15. Of all the anxiety disorders, only OCD truly prevents people from living a ‘normal, healthy’ daily routine. a. True b. False No, this isn’t true. Any of these anxiety disorders can and do interfere with peoples’ daily lives to the point that they often cease to function in a healthy way. Extra Assignment A friend of yours has been suffering with a lot of anxiety lately. You’ve noticed that they’re often extremely worried and they’ve had what you would describe as panic attacks? But, are they? Here’s the assignment: 1. Describe your friend’s situation – what are they going through and why 2. What are your friend’s symptoms and how long have they been going on? 3. What do you think your friend is suffering from and why? (Give it a name and explain your choice) This can be written in the form of an essay using quotations 9APA STYLE), or a short story, or a conversation between two people. 5. Additional Resources - Excellent website – A wonderful hour long video on anxiety disorders