Evaluating the Case for Differential Diagnosis between Anxiety Disorders and Depression - Coursework Example

Evaluating the Case for Differential Diagnosis between Anxiety Disorders and Depression Psychology In May American Psychiatric Association is will launch the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Given that currently some conditions diagnosed as different have almost similar characteristics and symptoms; they should be reconsidered on whether to group them as different conditions or they should be categorized together. This paper discusses two conditions; anxiety and depression that appear to have similar characteristics and symptoms with an aim of justifying whether they should be regrouped together. The study has found that the two are similar in most ways and therefore should be classified in a unique group when the next DSM is being published. Introduction In May 2013, the American Psychiatric Association is expected to launch the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This manual will make revisions on the present diagnostic criteria for psychiatric conditions. This has been necessitated by co-morbidity which is described as a condition of where a patient has two or more diseases concurrently and it is therefore difficult to diagnose one disorder from the other. This implies that in psychiatry, a single diagnosis is inadequate to explain all the symptoms. Conditions currently under review include depression, anxiety, bipolar sand related conditions, dissociative disorders and neuro-cognitive disorder among others. DSM-5 will lead to the regrouping of clinical conditions with some distinct conditions being classified as unique disorders while others will remain separate. In paper aims to discuss whether depression and anxiety should be regrouped as unique disorders or should remain as separate disorders. Anxiety disorders have been classified as the 2nd most common mental disorders which are more frequently misdiagnosed or missed (Casey and Pillay, 2008). Anxious persons are characterized by a form of discriminatory processing which favors encoding of frightening information. On the other hand, a person going through clinical depression is characterized by having low mood, negative personal attitudes, helplessness and hopelessness and high level of sadness (Gilmour and Patten, 2007). An individual is usually advised to go for diagnosis in clinical depression in case the signs and symptoms are prolonged over a period of weeks or months thereby interfering with work. To effectively discuss this, the paper will be based on the similarities and differences between the two conditions. Discussion According to Ungar and Shear (2004), anxiety disorders are the most prevalent psychiatric disorders. Anxiety disorders affect the functioning and quality of life in a similar way as the results of depression disorder and other serious medical disorder. However, not all levels of anxiety are considered as disorders. Ugar and Shear (2004) explain that anxiety is a mechanism that enhances the probability of appropriate response to dangerous situations and assert that certain level of anxiety is normal and even normal. A person having low anxiety may fail to acknowledge and take action on a potentially life threatening situation although anxiety can reach to detrimental levels which leads to maladaptive anxiety. Maladaptive anxiety is described as response to nonthreatening situations or anxiety that is exemplified by intensity and a long duration over the proportion of the challenging situation. Anxiety is categorized into five disorders all having distinct diagnostic procedures. This include generalized anxiety disorder, panic disorder, phobic disorder, obsessive compulsive disorder (OCD) and post traumatic stress disorder (PTSD) (Amir, Kaplan and Kotler, 1996). Anxiety is usually first experienced by an individual during the individual’s childhood years and is majorly caused by physical or psychosocial stressors. Moreover, there has been documented evidence that anxiety is genetic hence predisposing individuals of the same family line to developing the anxiety disorder. After the initial trigger during the younger years of the individual, it predisposes the individual to experiencing anxiety disorders all through his life especially in the presence of the stressors (antecedents). Moreover, anxiety disorders present with the majority of behavioral symptoms of all the mental disorder. This therefore calls for more intricate diagnostic criteria (DSM-IV) of anxiety disorder (Casey & Pillay, 2008). Persons suffering from clinical depression experience low moods, feeling of helplessness and hopelessness, negative attitudes about themselves (Benady, 2002). Moreover, such persons have increased sadness and a person should go for diagnosis in case the symptoms are prolonged may be extending over a period of weeks or months and affect one at their workplace. Depression is an array of affective disorders that include bipolar depression otherwise referred to as manic-depression and uni-polar depression (Benady, 2002). Additionally, a depressed person may be going through a chronic although non-disabling condition known as dysthymia. Depression is an illness of the whole body that can be differentiated based on its intensity, severity, and the duration of time. If not addressed, clinical depression determines how a person’s body feels, affects ones moods what one thinks and how they act (Benady, 2002). Depression has been blamed suicide cases in addition to low productivity at workplace. Depression cannot be linked to a single cause, but usually results from interactions between an individual’s biological inclinations, psychological tendencies mostly those inclined to pessimism, trauma, low self esteem and extended periods of stress. Moreover, persons feeling pressure as a result of being overworked or underpaid are predisposed to become depressed. Other causes of depression are conflicts at the workplace either with the seniors or co-workers (Benady, 2002). It is therefore critical for the diagnosis to be effective and so that the condition can be adequately managed. Patients going through anxiety have distinctive characteristics some of which are similar to patients suffering from depression (Hodges, 2005). Knowledge of these characteristics enhances the diagnosis of anxiety disorder. One characteristic of patients suffering from anxiety disorder is catastrophic thinking. Patients suffering from anxiety disorders mostly become drawn into catastrophic thinking and over-predicting negative consequences of the events. To such a person, an ambiguous situation is interpreted to be the worst happening having the worst possible outcomes (Morgan & Jorm, 2009). For example, catastrophic thoughts may cross an anxious person when someone makes a joke about them and interprets as the truth and starts thinking of how to avenge. This is also experienced by depressed persons who may think of doing something to end their tribulations. A person depressed due to conflicts at workplace with a workmate may thoughts of roughing up the person (Morgan & Jorm, 2009). Moreover, depressed person are get suicidal thoughts when they feel that life is working out as they would wish. Patients suffering from anxiety disorders experience somatic symptoms; where such patients are characterized by outstanding physical symptoms resulting from automatic arousal of the nervous system. Anxious persons also have reduced physical performance given that they are always suspicious of an impeding dangerous situation. Similarly, depressed persons are characterized by reduced physical performance (Zivin et al., 2007). Depression may result from crippling fatigue drastically diminishing the energy of the person. Like anxious people, depressed persons mostly tire fast even when involved in normal activities such as walking, talking or making their beds. Consequently, they tend to shun away from activities requiring much energy (Seligman & Wuyek, 2007). Moreover, such people complain of being tired too be engaged in anything. The most somatic symptoms experienced by both depressed and anxious person include headaches, stomach pain and backaches. People suffering from anxiety disorder like depressed individuals are characterized by having avoidance and escapist behaviors. Such patients avoid physical arousal prevents them from opening up about their symptoms with doctors or their families and friends who may help them out of the situation. In addition, such people always avoid confronting the situations that is causing them fear and stress. Consequently, anxious and depressed persons like to live in an isolated life in both emotionally and physically. They prefer to be indoors rather going to be with friends and when they are in a group they are withdrawn failing to participate in the discussions and activities of the group (McCormick et al., 2005). This is because they like to keep their feelings and thoughts to themselves so that others do not learn how they are feeling. The other shared characteristic witnessed in depression and anxiety is that such persons are moody. This results from negative thinking that such persons engage in. Moreover, depressed anxious persons have low self esteem and confidence due to self loath. Adults suffering from depression are usually sad and withdrawn while teenagers are easily irritable. Both groups of people usually have increased risk of committing suicide. Thoughts of suicide result from panic and depression that preoccupy their lives. Depressed and anxious persons may change appearance since most of their efforts are no longer directed into grooming and personal hygiene. Such people may go for days without taking a shower while their hair remains uncut for months. They are never concerned about the clothes they wear. Moreover, they may lose weight if the conditions are extended for long in addition to insomnia. People going depression and anxiety disorders do not get enough sleep since they spend most of their time thinking of their situations and how they can solve them (Amir, Kaplan, & Kotler, 1996). Anxious and depressed alike lose interest in activities that previously gave them pleasure such as their hobbies and sports. Depressed persons are reported to as lacking interest for things they usually looked forward to engage in. Persons who are severely depressed contemplate of suicide since they lack interest in life. Persons suffering from depression and anxiety mostly experience problems in paying attention and concentrating in a session or activity. In addition, depression causes problems in an individual’s memory and therefore depressed persons have trouble in retaining information (Amir, Kaplan, & Kotler, 1996). However, this is mostly experienced in depression rather than among anxious persons. Signs and symptoms of person suffering from anxiety varies across the population given that different person have unique body make-up. Moreover there are various types of anxiety disorders and the intensity with which a person is affected. This is also the case among individuals among depressed persons (Schulz et al., 2006). Despite the type and intensity of anxiety, the most common symptoms observed among person’s suffering from anxiety can be classified according to the area affected such as physical, emotional and cognitive. Physical symptoms are evident from the patient’s skin, eyes and body weight. Emotional symptoms deal with the moods swings of the patient while cognitive symptoms affect various senses of the patient. The physical symptoms of anxiety mostly visible from the patient’s skin include skin problems where patient can get skin infections and rashes. Moreover, patient suffering from anxiety may experience burning skin sensation and skin sensitivity. Other anxiety symptoms associated with skin are skin numbness and tingling. Patients suffering from anxiety have difficulties falling or remaining asleep. A person suffering from anxiety disorders does not easily fall asleep when they get to bed and when they do so, they may wake up during the night since they are mostly preoccupied with the issues that are causing them anxiety. Additionally, anxious persons have frequent bad dreams and get some feelings in the head that awaken them (Schulz et al., 2006). When awaken by those feelings they are usually panic stricken and most of them will complain to feel worse in the morning although they should have rested throughout the night. Patients suffering from patients may complain of chest discomfort and pains. One may feel as if the chest is trembling or vibrating. In addition, one has difficulties in breathing and therefore they yawn a lot in attempt to catch a breath. They also experience rib cage tightness or may feel like they have a tight band round their ribs (Amir, Kaplan, & Kotler, 1996). The heart beat of an anxious person beats fast and hard and may experience irregular pulse rates such as a skipped beat. Emotional symptoms of anxious persons may include fears, mood swings and unique feelings. Anxious persons have fears on what people think about them. They are mostly concerned about what other persons think about them and because they are always pessimist, they have a fear that other people have a bad image about them. Individuals suffering from anxiety have fear of being trapped in areas with no exit and get a feeling of always being overwhelmed with work. Additionally, they fear to make mistakes, fear to appear in public, are afraid of death and lack of control of a situation. Such persons are also afraid of an imminent doom and fear irrational objects, situations or circumstances. Anxious persons experience increased self awareness, therefore are always trying to working to perfection (Hall & Geher, 2003). The anxiety symptoms mostly associated with head include frequent headaches and pressure in the head. Additionally, a person may get a burning and itchy scalp and light-headedness or dizziness. Other symptoms under this area are loss of hair, head tremors, brain fog, feelings of tooth ache and sharp pains in the face, neck or head. When an anxious person closes their eyes, they may get a feeling as if they are floating or beginning to float in the air (Varela et al., 2007). Symptoms associated with hearing include a feeling like the ears are plugged, rumbling and throbbing sounds in the ears. Furthermore, one may get ringing sounds in the ears, itchy or tricking feelings that are hard to control. Anxiety symptoms associated with the mind range from being afraid of almost everything, get engaged in repetitive in thinking and get a feeling as if one is to go crazy (Hodges, 2005). Anxious persons mostly feel as if they shoulder the whole world alone and get obsessed with some certain sensations. They get it difficult to concentrate and feel overwhelmed by the issues facing them. One should also seek for diagnosis of anxiety disorder in case one feels disoriented, has difficulty in thinking through an issue and forming rational thoughts or following through a conversation. The other symptoms that are seen in most persons suffering from anxiety disorder are associated with a person’s moods. Anxious persons get easily irritable, dramatic mood swings and get stressed. They also lack patience; get a feeling of detachment from friends and family, feel like they are at the edge and sees as if everything is unreal. One may also feel like crying for no specific reason, are apprehensive and always feel like they are under pressure all the times. Some individuals suffering from anxiety disorder may have blurred vision and dry and itchy eyes. They also get flashing lights when their eyes are closed, are sensitive to light and eye tricks where one sees thing that are not there from the corners of their eyes. Anxiety disorders affect a patient’s alimentary canal as depicted by symptoms that are associated with the mouth and stomach. These include; usual metallic taste in the mouth or a feeling as if the mouth and tongue is burning (Amir, Kaplan & Kotler, 1996). One may get a craving for sweets and may preoccupy themselves by chewing gum. Anxiety can lead to constipation, diarrhea and frequent passing of urine. Others lose appetite, get stomach upset, bloating or may nauseate and vomit frequently. Some may find it difficult to pronounce words as their mouths feel as if it is not moving to the right direction. Other symptoms are restlessness, sweating, muscle tension and one gets easily startled. Most of symptoms experienced by persons suffering from anxiety disorder are similar to those experienced by depressed persons. Like anxious persons, depressed persons are prone to mood swings. They are easily irritable where if triggered by a small event or circumstance becomes sad. Some complain of being sad and can cry frequently after slight provocation. Depressed persons lose interest in things that they previously enjoyed participating in. In case of a person whose hobby was basketball, they no longer want to play and married persons find displeasure in sex. This is also experienced by anxious persons and therefore distinguishing between the two disorders is difficult. Depressed persons may lose or gain weight although they are not in a mission to do so. Bovasso (2001) explains that when one gains or loses weight by more than five percent or more within a month, this may be an indicator that they are suffering from depression. Similar to persons suffering from anxiety disorders, depressed persons get sleep problems. To them, falling asleep is usually a struggle and when they do so; they are awakened by thoughts crossing their mind. Moreover, they may also sleep too much as they do not want to wake to face reality. Depressed persons lack energy to get engaged in daily activities because they mostly have a feeling of fatigue. Depressed persons feel worthless and guilt; they feel they have no value to others and therefore they lack self worthy. They also get guilty for things they lack control over. For instance, in case one gets depressed since they do not do well at school, such a person always feels guilty although they have worked hard to improve their grades with no improvement. Due to a feeling of worthlessness in a depressed person, a married person may not be unable to fulfill their partners sexually or provide adequate love to their children. Like an anxious person, depression causes one to get brain fog. A depressed person has difficulties in thinking straight and making rational decisions. Moreover, it is difficult for one to concentrate in class or follow a discussion. Depressed persons also get repetitive thoughts where go over one thought over and over again in their mind. One should seek to be diagnosed on whether they are suffering from depression once they get suicidal thoughts. This is because depressed persons may think of suicide and death despite the fact that they may not work out plans to execute their plans. The physical symptoms of depressed persons are similar to those of people suffering from anxiety disorders. These include muscle ache, frequent head-ache, lose of appetitive and stomach problems. Moreover, depressed persons may have skin associated symptoms such as rushes, skin rushes or skin infections. Conclusion From the study of the characteristics and symptoms of depression and anxiety disorders, I conclude that the two should be classified under a unique category in the next DSM to be launched in May next year. In both conditions, patients go through similar physical characterized where they feel fatigued and get frequent head-aches, stomach–pains and muscle pains. In both conditions patients experience insomnia and may lose or gain weight. Additionally, patients become irritable and easily startled by remote occurrences. Depressed and persons suffering from anxiety disorder become isolated and lack interest in things they previously enjoyed doing. They also become hopeless and restless and pessimist towards life. A person suffering from depression or anxiety disorder has mood swings. In both conditions, patients suffer from cognitive problems where it may be hard to concentrate when in a group, follow discussions or make decisions. 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