Anxiety and anxiety related disorder

1. By the end of lecture the student will be able to acquire knowledge about:-
1-DEFINE ANXIETY AND ANXIETY DISORDER
2-Identify PREVALENCE AND EPIDEMIOLOGY
3-List LEVELS OF ANXIETY
4-Enumerate SYMPTOMS OF ANXIETY
5- Discuss CAUSES
6-Discuss DIAGNOSIS OF ANXIETY
7- DISCUSS TREATMENT
8-Discuss COMPLICATION OF ANXIETY
9-IDENTIFY PREVENTION OF ANXIETY
10-List TYPE OF ANXIETY
11-DISCUSS SOCIAL ANXIETY DISORDER
(DEFINITION,CAUSES,SYMPTOM,TREATMENT)
12-DISCUSS POST TRAUMATIC STRESS DISORDER (DEFINITION, RISK
FACTOR, SYMPTOM, TREATMENT)
‫عبدالرسول‬ ‫سحر‬‫بنها‬ ‫جامعة‬

2. -Introduction
-Definition of
Anxiety
Anxiety disorder
-Prevalence of anxiety
-Causes of anxiety
-Level of anxiety
-Symptom of anxiety
-TYPE of anxiety
-Diagnosis of anxiety
-Treatment of anxiety
-Complication of anxiety
-Prevention of anxiety
- Social anxiety disorder (definition, causes, symptom, treatment)
- Post traumatic stress disorder (definition, Risk factor,symptom,treatment)

3.  People often experience a general state of worry or fear
before confronting something challenging such as a test,
examination, recital, or interview. These feelings are easily
justified and considered normal. Anxiety is considered a
problem when symptoms interfere with a person's ability to
sleep or otherwise function. Generally speaking, anxiety
occurs when a reaction is out of proportion with what
might be normally expected in a situation.

4. abnormal and overwhelming
sense of apprehension and fear often marked by
physiological signs (as sweating, tension, and increased
pulse), by doubt concerning the reality and nature of
the threat, and by self-doubt about one's capacity to
cope with it

5.  Often begins early in life(13-18)yrs. old
 Reported more by women than men
 Female: Male 2:1
 Reported more in Western countries ( between 13.6%- 28.8%)
 In Egypt represented 4.75% of population

6.  - Mild, Moderate Severe, and panic
 1. Mild anxiety
 Associated with the tension of everyday life events.
 • Concentrate on the problem
 • Solve problems effectively
 • Little sense of failure
 • Be alert and pay attention to many things
 • Look calm and confident
 • Optimal learning
 • Able to accept that complex excitatory

7. 2. Moderate anxiety
At this level decreases the perception of the environment,
individuals are more focused on the important thing and the
exclusion of anything else.
• No attention is selectively
• The focus of the stimulus increases
• Decreased attention span
• Decreased problem-solving
• Learning takes place by focusing

8. 3. Severe anxiety
.Limited field of perception
• Fragmented thought processes
• It's hard to think
• Poor problem-solving
• Unable to consider the information
• Just watch the threat
• Egocentric
4- Panic Anxiety
This most intense state of anxiety,
- Individual is unable to focus on even one detail within the environment.
- Misperceptions are common,
-a loss of contact with reality may occur.
-The individual may experience hallucinations or delusions.

9.  1 - Environmental and external factors
 Environmental factors that are known to cause several
types of anxiety include:
 - Trauma from events such as abuse, victimization, or
the death of a loved one
 - Stress in a personal relationship, marriage, friendship,
and divorce
 - Stress at work
 - Stress from school
 - Stress about finances and money
 - Stress from a natural disaster
 - Lack of oxygen in high altitude areas

10. 2-Medical factors
Anxiety is associated with medical factors such as anemia,
asthma, infections, and several heart conditions. Some medically-
related causes of anxiety include:
-Stress from a serious medical illness
-Side effects of medication
-Symptoms of a medical illness
-Lack of oxygen from emphysema, or pulmonary embolism (a blood
clot in the lung)
-Substance use and abuse

11. 3-Genetics
It has been suggested by some researchers that a family
history of anxiety increases the likelihood that a person
will develop it. That is, some people may have a genetic
predisposition that gives them a greater chance of
suffering from anxiety disorders.
4-Brain chemistry
Research has shown that people with abnormal levels of
certain neurotransmitters in the brain are more likely to
suffer from generalized anxiety disorder.

12.  -Trembling
 -Churning stomach
 -Nausea
 -Diarrhea
 -Headache
 -Backache
 -Heart palpitations
 -Numbness or "pins and needles" in arms, hands or legs
 -Sweating/flushing
 -Restlessness
 -Easily tired
 -Trouble concentrating
 -Irritability
 -Muscle tension
 -Frequent urination
 -Trouble falling or staying asleep
 -Being easily startled

13.  A psychiatrist, clinical psychologist, or other mental-health
professional is usually enlisted to diagnose anxiety and
identify the causes of it. The physician will take a careful
medical and personal history, perform a physical
examination, and order laboratory tests as needed. There is
no one laboratory test that can be used to diagnose anxiety,
but tests may provide useful information about a medical
condition that may be causing physical illness or other
anxiety symptoms.

14.  Treatments will consist of a combination of psychotherapy, behavioral
therapy, and medications.
 1-Self-treatment
 Learn to replace "negative self-talk" with "coping self-talk." Make a list of
the negative thoughts you have, and write a list of positive, believable
thoughts to replace them. Replace negative thoughts with positive ones.
 Picture you successfully facing and conquering a specific fear.
 Talk with a person who is supportive.
 Meditate.
 Exercise.
 Take a long, warm bath.
 Rest in a dark room.
 2-Counseling
 A standard method of treating anxiety is with psychological counseling.
This can include cognitive-behavioral therapy, psychotherapy, or a
combination of therapies.

15. 3-Cognitive-behavioral therapy
Aims to recognize and change the patient's thinking patterns that are associated
with the anxiety and troublesome feelings. This type of therapy has two main
parts:
-a cognitive part designed to limit distorted thinking and
-a behavioral part designed to change the way people react to the objects or
situations that trigger anxiety.
4-Psychotherapy
Is another type of counseling treatment for anxiety disorders. It consists of talking
with a trained mental health professional, psychiatrist, psychologist, social
worker, or other counselor. Sessions may be used to explore the causes of anxiety
and possible ways to cope with symptoms.

16. 5-Medication
- medicines such as antidepressants,
benzodiazepines, tricyclic's, and beta-
blockers are used to control some of the
physical and mental symptoms.
-Anti-depressants - especially those in the
class of serotonin reuptake inhibitors (SSRI) -
are also commonly used to treat anxiety

17.  1-PREGNANCY
 More likely to have babies with low birth weight
 2-Children and teens
 -Depression
 -Behavioral problems e.g. aggressive
 -Substance abuse
 -Failing in school
 3-Adults
 -Suicide
 -Psychiatrically hospitalized
 -Having low paying jobs

18.  Although anxiety disorders cannot be prevented, there are
ways to reduce your risk and methods to control or lessen
symptoms. Recommendations include:
 -Reducing caffeine, tea, cola, and chocolate consumption.
 -Checking with a doctor or pharmacist before using over-the-
counter or herbal remedies to see if they contain chemicals
that may contribute to anxiety.
 -Exercising regularly.
 -Eating healthy foods.
 -Keeping a regular sleep pattern.
 -Seeking counseling and support after a traumatic or
disturbing experience.
 -Avoiding alcohol, cannabis.

19.  1-Acknoeledge awareness of patient anxiety
 2-Reassure patient and make good patient- nurse relation ship
 3-Maintain calm while interacting with patient
 4-Use simple language
 5-Maintaining a quiet environment
 6-Encourge patient to talk about anxious feeling
 7-Assisst patient in assessing situation realistically and
recognizing factor leading to anxious feeling
 8-Assisst the patient in developing anxiety reducing skill e.g.;
relaxation, deep breathing
 9-Assisst patient in developing problem solving abilities
 10-Instruct the patient in the appropriate use of anti-anxiety
medication

20. A general term for several disorders that cause
nervousness, fear, apprehension, and worrying. These
disorders affect how we feel and behave, and they can
manifest real physical symptoms.

21.  Anxiety disorders can be classified into several more specific
types. The most common are briefly described below.
 1-Generalized Anxiety Disorder (GAD)
 2-Panic Disorder
 3-a Phobia
 4- Social Anxiety Disorder
 5-Obsessive-Compulsive Disorder (OCD)
 6-Post-Traumatic Stress Disorder (PTSD)
 7-Separation Anxiety Disorder

23.  The fear of being judged and evaluated negatively by
other people, leading to Feelings of inadequacy,
inferiority, embarrassment, , and depression

24.  Emotional symptoms of social anxiety disorder / social
phobia
 • Excessive self-consciousness and anxiety in
everyday social situations
 • Intense worry for days, weeks, or even months
before an upcoming social situation
 • Extreme fear of being watched or judged by
others, especially people you don’t know
 • Fear that you’ll act in ways that will embarrass
yourself
 • Fear that others will notice that you’re nervous

25.  • Red face, or blushing
 • Shortness of breath
 • Upset stomach, nausea
 • Racing heart or tightness in chest
 • Sweating or hot flashes
 • Feeling dizzy or faint

26.  • Avoiding social situations to a degree that limits
your activities or disrupts your life
 • Staying quiet or hiding in the background in order
to escape notice and embarrassment
 • A need to always bring a buddy along with you
wherever you go
 • Drinking before social situations in order to
soothe your nerves

27.  We don't really know what causes social anxiety disorder, but it
is likely to involve a combination of factors.
 1-Genes may play a role.
 2- the behavior of parents may have an influence on whether
their child will develop social anxiety disorder.
 People with the disorder have described their parents as:
 • overprotective
 • not affectionate enough
 • constantly criticizing them and worrying they may do
something wrong
 • overemphasizing the importance of manners and grooming
 • exaggerating the danger of approaching strangers

28.  1-Cognitive behavioral therapy(CBT)
 Usually 14 sessions over approximately four months.
 Generally, CBT works by helping you identify unhelpful and
unrealistic beliefs and behavioral patterns. You and your therapist
work together to change your behavior and replace unhelpful
beliefs with more realistic and balanced ones.
 2-Supported self-help
 3-Antidepressants
 Usually an SSRI (selective serotonin reuptake inhibitor), either
instead of or in combination with individual CBT.
 4-Psychotherapy
 Encourage you to face feared social situations outside therapy
sessions. It is normally 25-30 sessions over six to eight months

29. Develop following a traumatic event that threatens your safety or
makes you feel helpless.

30.  • War
 • Natural disasters
 • Car or plane crashes
 • Sudden death of a
loved one
 • Rape
 • Terrorist attacks
 • Childhood neglect

31.  • Previous traumatic
experiences, especially in
early life
 • History of physical
or sexual abuse
 • History of substance
abuse
 • High level of stress
in everyday life
 • Family history of
PTSD or depression
 • Lack of coping skills

32.  1-Symptoms of PTSD
 :-( Re-experiencing the traumatic event)
 • Intrusive, upsetting memories of the event
 • Flashbacks (acting or feeling like the event is
happening again)
 • Nightmares (either of the event or of other frightening
things)
 • Feelings of intense distress when reminded of the
trauma
 • Intense physical reactions to reminders of the event
(e.g. pounding heart, rapid breathing, nausea, muscle
tension, sweating)


33. 2-Symptoms of PTSD: (Avoidance and numbing)
• Avoiding activities, places, thoughts, or feelings that remind you
of the trauma
• Inability to remember important aspects of the trauma
• Loss of interest in activities and life in general
• Feeling detached from others and emotionally numb
• Sense of a limited future (you don’t expect to live a normal life
span, get married, have a career)
3-Symptoms of PTSD: (Increased anxiety and emotional
arousal)
• Difficulty falling or staying asleep
• Irritability or outbursts of anger
• Difficulty concentrating
• Hyper vigilance (on constant “red alert”)

34.  • Cognitive-behavioral therapy.
 Cognitive-behavioral therapy for PTSD and trauma involves
carefully and gradually “exposing” yourself to thoughts,
feelings, and situations that remind you of the trauma.
Therapy also involves identifying upsetting thoughts about
the traumatic event–particularly thoughts that are distorted
and irrational—and replacing them with more balanced
picture.
 • Family therapy.
 • Since PTSD affects both you and those close to you,
family therapy can be especially productive. Family therapy
can help your loved ones understand what you’re going
through. It can also help everyone in the family communicate
better and work through relationship problems caused by
PTSD symptoms.

35. • Is sometimes prescribed to people with PTSD to
relieve secondary symptoms of depression or anxiety.
Antidepressants such as Prozac are the medications
most commonly used for PTSD. While antidepressants
may help you feel less sad, worried, or on edge, they
do not treat the causes of PTSD.

37. It's normal to feel anxious from time to time, especially
if your life is stressful. However excessive, ongoing
anxiety and worry that
interfere with day-to-day activities may be a sign of
generalized anxiety disorder.

38. Generalized anxiety disorder symptoms can vary. They may
include:
Persistent worrying or obsession about small or large
concerns that's out of proportion to the impact of the event
Inability to relax, restlessness, and feeling keyed up or on
edge
Difficulty concentrating, or the feeling that your mind "goes
blank"
Worrying about excessively worrying
Distress about making decisions for fear of making the wrong
decision
Carrying every option in a situation all the way out to its
possible negative conclusion

39. The exact cause of generalized anxiety disorder isn't fully
understood, but it may include:-
Genetics
as well as other risk factors.as:-
Personality. A person whose temperament is timid or
negative or who avoids anything dangerous may be more
prone to generalized anxiety disorder than others are.
Genetics. Generalized anxiety disorder may run in
families.
Being female. Women are diagnosed with generalized
anxiety disorder somewhat more often than men are.

41. Unwanted and intrusive thoughts that they can't seem to
get out of their heads (obsessions), often compelling
them to repeatedly perform ritualistic behaviors and
routines (compulsions) to try and ease their anxiety.

42. The symptoms of OCD, which are the obsessions and compulsions, may
vary.
Common obsessions include:
Fear of dirt or contamination by germs
Fear of causing harm to another
Fear of making a mistake
Fear of thinking evil or sinful thoughts
Need for order, symmetry, or exactness
Common compulsions include:
Repeatedly bathing, showering, or washing hands
Refusing to shake hands or touch doorknobs
Repeatedly checking things, such as locks or stoves
Constant counting, mentally or aloud, while performing routine tasks
Eating foods in a specific order

43.  Although the exact cause of OCD is not fully understood,
studies have shown that a combination of biological and
environmental factors may be involved.
Biological Factors: The brain is a very complex structure. It
contains billions of nerve cells -- called neurons -- that must
communicate and work together for the body to function
normally. Neurons communicate via chemicals called
neurotransmitters that stimulate the flow of information
from one nerve cell to the next. At one time, it was thought
that low levels of the neurotransmitter serotonin were
responsible for the development of OCD. Now, however,
scientists think that OCD arises from problems in the
pathways of the brain that link areas dealing with judgment
and planning with another area that filters messages
involving body movements.

44.  A phobia is an excessive and irrational fear reaction.

45. Phobias can be caused by:-
1- genetic
2-environmental reasons
3-. Children who have a close relative with an anxiety disorder
are at risk for developing a phobia.
4- Distressing events can bring on a phobia.
5- Exposure to confined spaces, extreme temperatures, nearly
drowning, or an animal or insect bite can all be sources of
phobias.
6-development after traumatic brain injuries.
7- Substance abuse and depression also have been connected
to phobias.

46. 3-Specific Phobias
Many people dislike certain situations or objects, but to be a true phobia, the fear must
interfere with your daily life.
Some of the most common are:-
-Gloss phobia: performance anxiety, or the fear of speaking in front of an audience.
-Acrophobia: the fear of heights. With this phobia, you will avoid mountains, bridges,
or the higher floors of buildings.
-Claustrophobia: the fear of enclosed or tight spaces. Severe claustrophobia can be
especially disabling if it prevents you from riding in cars or elevators
-Aviatophobia: the fear of flying. It is estimated that 10 percent of the population
avoids airplane travel because of this phobia.
-Dent phobia: fear of the dentist or dental procedures
-Homophobia: fear of blood or injury. A person with hemophobia may faint when
they come in contact with his or her own or another person’s blood.
-Animal or insect phobias: most common are arachnophobia (fear of spiders)
-cynophobia (fear of dogs), and
-ophidiophobia (fear of snakes).
These often develop out of normal childhood fears, but may be connected with a past
experience like an animal bite.

47. There are more than 100 different phobias recognized by the American
Psychiatric Association (APA). Here are a few of the most common, and
some specific phobias.
1-Agoraphobia
Agoraphobia is a fear about places or situations from which one cannot
escape.
2-Social Phobia
Social phobia is also referred to as “social anxiety disorder.” This is
extreme worry about social situations that can lead to isolation

48. The most common and disabling symptom of a phobia is a panic attack.
Features of a panic attack include:
pounding or racing heart
shortness of breath
rapid speech or inability to speak
dry mouth
upset stomach or nausea
elevated blood pressure
trembling or shaking
chest pain or tightness
choking sensation
dizziness or lightheadedness
profuse sweating
sense of impending doom ‫سحر‬
‫عبدالرسول‬
‫بنها‬ ‫جامعة‬

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