Anxiety Disorders Conditions - Essay Example

Anxiety Disorders The term anxiety disorders (AD) embraces a number of conditions which all look similar in some ways but have their own characteristics. They are all collected under the term anxiety disorders because of their one common symptom of extreme anxiety. Understanding the different facets of anxiety disorders is important to the diagnosis and treatment of these disorders because of the debilitating effects these disorders can have on one’s life. This paper will address the many different anxiety disorders- looking specifically at the understanding the characteristics of the different disorders, the prevalence, the causes and symptoms and ways in which they are treated. An additional interesting aspect of anxiety disorders is the co-morbidity since anxiety disorders hardly seem to be present by themselves in the client. Anxiety disorders have been associated with depression and physical illnesses. Defining anxiety disorders is not straightforward. It is important to note that though there are several specific anxiety disorders, they overlap in their characteristics. The anxiety disorders discussed here will include- panic disorder (PD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobia or also called social anxiety disorder (SAD), generalized anxiety disorder (GAD) and specific phobias. As Siegfried (2006) explains, “anxiety is a generic term encompassing many disorders that all feature symptoms of anxiety, although the symptomatology may be very different”. The National Institute of Mental Health (n.d.) describes each disorder. Panic disorder “is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness or dizziness”. Obsessive-compulsion disorder is different in its symptoms. This disorder causes the person to have “persistent upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce” (NIMH). PTSD usually develops as a result of a trauma that the person may have experienced or witnessed. According to NIMH “people with PTSD may startle easily, become emotionally numb (especially in relation to people they used to be close to), lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive or even become violent”. People with social phobias or social anxiety disorder “become overwhelmingly anxious and excessively self-conscious in everyday social situations”. People who suffer from these social phobias constantly feel as if they are being judged by others and they have a persistent fear of doing something that may embarrass them. Some of the more common specific phobias include fear of heights, escalators, water, flying, closed spaces and spiders. GAD causes worrying excessively about a variety of everyday problems. The National Institute for Mental Health estimates that anxiety disorders “affect about 40 million American adults age 18 and older (about 18%) in a given year”; with more specific figures for panic disorder affects about 6 million Americans and OCD which affects approximately 2.2 million American adults. PTSD is another prevalent disorder with figures of 7.7 million Americans being affected and social phobias affect about 15 million Americans. Causes or origins of anxiety disorder also vary. There may be a genetic component to the onset of anxiety disorders, but this has not been proven conclusively. In addition, Starcevic and Berle (2006) suggested a cognitive component to the occurrence of anxiety disorders. They suggested one construct called anxiety sensitivity that may be specific to some extent to panic disorders and another construct pathological worry for GAD and intolerance of uncertainty for GAD and OCD. They concluded that “there may be a general cognitive predisposition to all anxiety disorders, rather than a specific cognitive risk for specific anxiety disorders” (p.58).The age of onset or occurrence of anxiety disorders is also of importance. The young adult stage of life has been suggested as the most common period for anxiety and anxiety-related disorders and that they were less prevalent in later life. However Krasucki et al (1998) challenge this notion. They reviewed data from a number of studies and found that “phobic disorder, OCD and PD all have their greatest prevalence in younger life”. They go on to suggest that the reports of occurrence of these disorders in later life may be affected by the fact that older people are less likely to disclose anxiety symptoms and that ageing changes the elements that make up the anxiety syndromes. As indicated different anxiety disorders have different specific symptoms but the symptoms are in some way related to excessive fear. As NIMH describes, “people having panic attacks sometimes believe they are having heart attacks, losing their minds or on the verge of death”. People with social phobias can be affected so intensely that their life is affected. Some of the outward symptoms include profuse sweating, nausea and difficulty talking. GAD can lead to difficulty concentrating, relaxing and sleeping. Physical symptoms have also been associated with anxiety disorders. Harter et al (2003) indicate that studies have shown a high rate of medical illness among patients especially with PD and GAD. According to these authors, “panic is more likely to have angina, mitral valve prolapse, idiopathic cardiomyopathy, labile hypertension, respiratory illness, migraine headaches, peptic ulcer disease, diabetes mellitus or thyroid disease”. They warn however that the relationship between anxiety disorders and medical illness is complex especially since some illnesses on their own can cause anxiety in a patient. A combination of medication or drug therapy and psychotherapy is usually recommended to treat anxiety disorders. However the treatment is complicated by the diagnosis. Anxiety disorders are commonly co morbid with other mood disorders particularly major depressive disorders. Kasper (2006) state that up to 70% of patients with SAD show co morbidity with depression, for GAD the figure is 42% and 65% for PTSD. The difficulty with diagnosis results in a difficulty with treatment. Baldwin (2004) also expresses concern about the accuracy of diagnosis due to the complication with depression and other symptoms. He showed that antidepressant SSRIs, in particular escitalopram, have been well documented as effective treatments for anxiety disorders. However he too states that “patients with PD, SAD and GAD are frequently undertreated, and that physicians are not always fully aware of the medication available for the successful treatment of these disorders” (p.34). Cognitive behavioral therapy has had some success for treating anxiety disorders. Dynamic psychotherapy and behavior-based treatments such as anxiety-management training have also been reported as successful by Tyrer and Baldwin (2006). They reviewed fourteen studies of psychological treatment in GAD and found that the results compared favorably with drug treatment. Cognitive behavioral therapy showed more positive results than the other types of psychotherapy. The effects of anxiety disorders on quality of life have been greatly studied. Surveys of patients with OCD show that there is a great reduction in the quality of life. Mogotsi et al (2000) report that in one study “ two-thirds of the individuals surveyed had experienced difficulty with family relationships, socializing and the ability to work and study, 92% had lowered self-esteem and more than 12% had attempted suicide”. (p.275). Another study found that “participants with PD self-reported poorer physical and emotional health than those with no disorder, had higher rates of treatment-seeking than did those with any other psychiatric disorder, and were significantly more likely than persons with depression and those without a psychiatric disorder to be receiving welfare or disability payments” (276). Anxiety disorders can affect anyone regardless of age, gender, or social background. The thin line between these disorders is significant. There are differences yet they all seem similar and it is understandable how this can pose a challenge in accurate diagnosis. The close connection with depression also contributes to the challenge. The extent of the effects on a person’s day to day life underlines the need for such diagnosis and proper treatment. References Baldwin, David. “Anxiety Disorders: Does One Treatment Fit All?” International Journal of Psychiatry in Clinical Practice. 8 (2004):31-35 Harter, Martin, Conway, Kevin P., Merikangas, Kathleen R. “Associations Between Anxiety Disorders and Physical Illness”. European Archives of Psychiatry and Clinical Neuroscience. 253 (2003):31-320 Kasper, Siegfried “Anxiety Disorders: Under-diagnosed and Insufficiently Treated”. International Journal of Psychiatry in Clinical Practice. 10. (2006):3-9 Krasucki, Christopher, Howard, Robert and Mann, Anthony. “The Relationship Between Anxiety Disorders and Age”. International Journal of Geriatric Psychiatry. 13. (1998):79-99 Mogotsi, Modise, Kamina, Debra and Stein, Dan J. “Quality Of Life In Anxiety Disorders”. Harvard Review of Psychiatry. 8. 6. (2000):273-282 National Institutes of Health. National Institute of Mental Health. “Anxiety Disorders”. NIH Publication No. 06-3879. n.d. June 23, 2009 < http://www. Nimh.nih.gov/health/publications/anxiety-disorders/nimhanxiety.pdf> Starcevic, Vladan. and Berle, David. “Cognitive Specificity Of Anxiety Disorders: A Review Of Selected Components”. Depression and Anxiety. 23. (2006):51-61 Tyrer, Peter. and Baldwin, David. “Generalized Anxiety Disorders”. Lancet 368. 9553:2156-2166 Read More