1 / 21

ANXIETY DISORDERS

ANXIETY DISORDERS. Dr David Schaefer. History Normal anxiety: - evolutionary - alerting signal - interpersonal Pathological: - most common - selective attention - Yerkes Dobson. Classification. Generalised anxiety disorder

acton
Download Presentation

ANXIETY DISORDERS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ANXIETY DISORDERS • Dr David Schaefer

  2. History • Normal anxiety: - evolutionary - alerting signal - interpersonal Pathological: - most common - selective attention - Yerkes Dobson

  3. Classification • Generalised anxiety disorder • Panic disorder • Agorophobia • Specific phobia • Social phobia • OCD • PTSD • Substance induced anxiety disorder

  4. Panic Attack • Discrete period of intense fear/discomfort • Starts suddenly, peaks at 10 mins • Palpitations • Sweating • Trembling/shaking • SOB/choaking • Chest pain • Nausea • Dizzy/fainting • Derealization/detached • Fear losing control ,dying • Paraesthsia, chills

  5. Panic Disorder • Recurrent unexpected panic attacks • Worry about additional panic attacks • Worry about consequences • Behavioural change

  6. Treatment Panic Disorder • Emergency- Benzos • First line- SSRI (delayed effect) • 2nd line- MAOI - Mirtazepine - TCA- imipramine, clomip - Venlafaxine - Epilim

  7. Panic Disorder-Therapy • Psychoeducation • Cognitive- ‘false alarm’ • Relaxation- muscular, imagery • Breathing

  8. Obsessive Compulsive Disorder • Obsessions- recurrent intrusive thoughts, impulses, images. Recognise thoughts are their own • Compulsions- repetitive behaviours/mental acts in response to obsession or rule. Include: - handwashing, ordering, checking,praying, repeating words, counting Compulsion aimed at reducing stress/preventing event

  9. Treatment OCD • SSRI or Clomipramine • Add Neuroleptic • Citalopram and Clomipramine • Mirtazepine and SSRI

  10. Therapy OCD • Exposure • CBT

  11. Obsessive Compulsive Related Disorders • OCD • Body Dysmorphic Disorder • Hoarding Disorder (new to DSM V) • Trichotillomania • Excoriation (skin picking) • Substance induced • Obsessional jealousy

  12. PTSD • Exposure to traumatic event • Reexperienced: Recurrent recollections Dreams Flashbacks Avoidance Emotional numbing/detachment Hyperarousal- sleep, irritability,startle reflex

  13. Treament PTSD • SSRI • Add neuroleptic • Mirtazepine • Venlafaxine • ? CMZ, clonidine, lamictin, Epilim • ? Benzos

  14. Therapy PTSD • Cognitive- world unsafe • Exposure therapy- conditioned fear response • Eye Movement Desensitisation and Reprocessing • Behavioural- breathing, progressive muscular relaxation

  15. Specific Phobia • Marked fear specific object/situation • Exposure provokes anxietyb response • Avoidance • Realises fear unreasonable • Treatment- exposure therapy - ?B-blockers

  16. Social Anxiety Disorder • Fear of social/performance situations • Fears humiliation/embarrassment • Exposure causes anxiety • Avoidance • Anxious anticipation • Blushing • Treatment- emergency- Benzos • -1st line- SSRI - B-blocker- performance - Buspirone - Venlafaxine - Epilim

  17. Therapy SAD • CBT- mind reading • Exposure therapy

  18. Generalised Anxiety Disorder • Excessive anxiety and worry • Unable to control worry • Symptoms- restlesness - fatigue - poor concentration - irritability - muscular tension - insomnia • Common- prevalence 5-8% • women>men - Many seek help other specialities

  19. Treatment GAD • Benzos?- sort-term 2-4 weeks • Stessum • SSRI- start low dose • Mirtazepine • Venlafaxine • B-blockers • ?neuroleptics

  20. Therapy GAD • Psycho-education • CBT • Exercise • Relaxation

  21. Summary • Common Disorders • Often Missed • High comorbidity • Often missed • Treatment medication and therapy

More Related