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Anxiety Disorders

Anxiety Disorders. What is anxiety?. A normal response to demands placed upon us. A warning sign. A motivator. Physical sx-heart palpitations, pounding heart, sweating, trembling, shaking, shortness of breath, etc. Worry or fear-of a specific event, object, situation or in general.

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Anxiety Disorders

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  1. Anxiety Disorders

  2. What is anxiety? • A normal response to demands placed upon us. • A warning sign. • A motivator. • Physical sx-heart palpitations, pounding heart, sweating, trembling, shaking, shortness of breath, etc. • Worry or fear-of a specific event, object, situation or in general.

  3. At what point does it become a disorder?

  4. Distinguishing substance-related anxiety from primary anxiety • Anxiety-inducing substances • How can you determine which substances cause sx of anxiety? • How are intoxication and withdrawal relevant? • What about prescription meds? • Antipsychotics and antidepressants • Medical conditions can also cause anxiety

  5. Consider the rules for distinguishing substance-induced from primary anxiety. • Look at the whole of the client’s experience. • Do they experience isolated sx of anxiety? • Are there specific situations in which the sx occur? • What psychosocial stressors or traumas have they experienced?

  6. Anxiety Disorders • Panic Attack • Panic Disorder • Agoraphobia • Specific Phobia • Social Phobia • Obsessive-Compulsive Disorder • Posttraumatic Stress Disorder • Acute Stress Disorder • Generalized Anxiety Disorder • Anxiety Disorder Due to a General Medical Condition • Substance-Induced Anxiety Disorder • Anxiety Disorder NOS

  7. PTSD Small group discussionBased on reading of pg. 408-416 • What are the symptoms of PTSD? What questions do you have about them? • Discuss your assigned section of the reading • Prepare a poster for a poster session highlighting key points from the reading and your discussion. • Questions?

  8. PTSD Symptomotology • Exposure to trauma • Persistent re-experiencing of the trauma • Persistent avoidance of stimuli • Persistent increased arousal • Duration 1 month+ • Clinically significant distress • Specifiers: acute or chronic=<3 mos, >3 mos • With delayed onset…6 months after event

  9. PTSD-Key issues • Co-occurs very frequently with SUD. • Sometimes individual is self-medicating. • Substance abuse/dep can also lead to additional stressors. • Pharmacotherapy • Sertraline (zoloft) is approved for ptsd • Benzodiazepines may be used but are problematic • Anticonvulsants or antipsychotics may be used

  10. Strategies, Tx and Tools • During assessment, screen for ptsd but avoid details of trauma. • Avoid confrontation and coercion. • Establish safety-in tx and in general. • Triggers may occur in group setting. • Deal with crisis. • Refer for integrated tx. • Exposure treatment • CBT • Seeking Safety

  11. Small groups case scenarios

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