Anxiety Disorders: Diagnosis and Treatment

Introduction

Anxiety is a state of involuntary alarm as a response to a sense of danger or threat. Among the notable anxiety disorders include fear, anxiety, worry, panic attacks, phobias, and GAD.

Fear

Fear is the immediate state of alarm as a response to any threat to the well-being of an individual.

Symptoms

The symptoms of fear include muscle tension, increased respiration, and perspiration.

Diagnosis

The diagnosis involves physical and medical examination. Physical examination includes obtaining the patient’s history and conducting an interview to evaluate the patient’s experiences. The medical examination involves laboratory tests such as liver functions, urinalysis, complete blood count, and the measurement of TSH levels (American Psychiatric Association, 2015).

Frequency

Fear is a common phenomenon in the human population. Instances of extreme fear last for a few hours and end when the perceived threat is eliminated. However, frequent incidences of fear result in a disorder that should be subjected to treatment.

Course and Outcome

Fear is common and is characterized by obsessions and compulsions as a result of persistent thoughts and repetitive or rigid behaviors. The outcome of frequent fear is the development of other disorders such as panic and phobia attacks.

Causes

Fear is caused by an obsession with ideas, images, and impulses that occupy an individual’s consciousness. When the obsession grows into a repetitive pattern of behavior, the victim may become excessively unreasonable and distressed. In extreme cases, it might interfere with the physical and mental functionality of the patient.

Treatments

Biological and cognitive therapies can be used to treat fear. The biological therapies include the use of serotonin antidepressants such as Prozac, Anafranil, and Luvox. Cognitive therapy involves training on how to overcome fears through practical exposure while the patient observes (Oltmanns & Emery, 2015).

Anxiety

Symptoms

The symptoms of an anxiety disorder include increased jumpiness, vigilance, and the startle response to the slightest stimulation. Other symptoms are sleep disorder, irritability, slowed body functionality, and anger outbursts.

Diagnosis

A diagnosis of anxiety disorder is done by a therapist using the DSM-IV-TR manual (American Psychiatric Association, 2015). This guideline outlines the criteria for observing and making reports. A diagnosis of anxiety begins with observing the patient’s history followed by a short interview to capture patients’ experiences related to this disorder.

Frequency

The frequency of anxiety disorder varies with age, gender, and environment. However, most anxiety disorders do not last for more than six months.

Course and Outcome

Anxiety is a medical condition that occurs due to mental health challenges. Though often mild and can be treated through simple therapy, an extreme case might result in more complex disorders such as panic attacks (Pine, Rothbaum, & Ressler, 2015).

Causes

The causes of anxiety include poor coping skills, limited social support, and bad experiences. Other causes include an unresolved painful past experience, especially during childhood or adolescent stage. Anxiety is also caused by some medications.

Treatments

Anxiety can be treated through medical and cognitive therapy methods. The medical treatment option involves the prescription of antidepressant drugs. Cognitive therapy involves training a patient on practical ways of overcoming anxiety.

Worry

Worry is an anxiety disorder that occurs as a result of a perceived or actual threat of a dangerous event or activity. This disorder is characterized by poor coordination to different thought patterns and responses to external stimuli.

Symptoms

The symptoms of worry include uneasiness, heart palpitation, shortness of breath, sleep disorders, and tense muscles or dizziness.

Diagnosis

The diagnosis involves an examination of a patient’s history, a direct interview to establish experiences that could be related to the symptoms, and running tests to rule out potential illnesses that are not related to worry (Pine et al., 2015).

Frequency

The frequency of worry is dependent on the existence of an internal or external trigger. This means that worry disorder is likely to be more frequent in an individual with a painful unresolved past than a person living in a supportive environment.

Course and Outcome

Worry disorder is a complex mental ailment that is characterized by poor coordination between thought patterns and response to the activity or event perceived as threatening to an individual. For instance, worry disorder may result in poor response to different stimuli in the form of being unreasonable and aggressive. In extreme cases, worry disorder might develop into panic attacks or GAD (American Psychiatric Association, 2015).

Causes

The causes of worry stem from a series of changes in the physical and social environment of a person. Other causes include prolonged realistic anxiety from actual or perceived danger, painful memories, and general fear of the unknown. In the extreme, worry disorder results from unresolved painful past experiences that an individual is afraid might recur.

Treatments

Worry can be treated through medication by prescribing antidepressants such as Prozac and Lexapro. However, mild worry can be treated using weak Alprazolams such as Xanax. Another treatment is through psychotherapy. For instance, cognitive therapy could be used to counsel the patient on effective ways of responding to worry, such as confrontation and positive response (Pine et al., 2015). As a result, the patient will be in a position to change and activate healthy thought patterns that can minimize the triggers of worry.

Panic Attacks

A panic attack is an extreme reaction that can affect any individual when faced with a sudden threat. Panic attacks are short bouts and periodic events that pass quickly when the threat is gone. However, there are individuals who experience repeated panic attacks without any reason.

Symptoms

The symptoms of panic attacks include muscle tension, increased respiration, and perspiration. Another symptom is excessive worry.

Diagnosis

A therapist might carry out a physical examination through an interview to capture the patients’ personal experiences against the DSM-5 standards. Another diagnosis is running blood tests to confirm that the suspected panic attack is not another ailment in the body organs (American Psychiatric Association, 2015).

Frequency

The frequency of fear attacks for most people is in hours after the threat is eliminated. However, those who suffer from panic disorders experience frequent attacks that they are not able to control. The condition often develops in adolescence and early adulthood.

Course and Outcome

Panic attacks affect at least 3% of the US population every year and up to 5% in an individual’s lifetime. Women are more exposed to panic attacks than men in the ratio of 2:1 (Oltmanns & Emery, 2015). A panic attack may develop into a panic disorder when the frequency increases.

Causes

The causes of panic attacks include poor coping skills, an overly protective development environment, limited social support, and bad experiences. These events result in anxiety sensitivity.

Treatments

Fear can be treated through biological methods such as the prescription of panic medicine. The most common panic drugs come in the form of antidepressants such as Prozac, Paxil, and Benzodiazepines (Pine et al., 2015). Cognitive therapy could also work for mild cases of panic attacks.

Phobias

Derived from a Greek word meaning fear, a phobia is a condition characterized by unreasonable and persistent fears of specific situations, activities, and objects. This means that patients suffering from a phobia will tend to avoid such activities, objects, or situations associated with fear. There are specific and social phobias.

Symptoms

The symptoms of a phobia include muscle tension, increased respiration, and perspiration.

Diagnosis

There is a diagnosis guideline that should be used alongside a direct interview of the suspected patient to capture personal experiences. The therapist might also use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to relate these experiences to different forms of phobia (American Psychiatric Association, 2015).

Frequency

A phobia is a lifetime condition that can be managed through continuous therapy. Full recovery from a social phobia is easier than specific phobias. For instance, fear of public speaking is a social phobia that can be solved through training on socialization skills to boost self-confidence (American Psychiatric Association, 2015). On the other hand, specific phobias such as fear of height might take a long time to treat.

Course and Outcome

Phobia usually develops at the early childhood and adolescence stages due to exposure to a situation, object, or activity perceived as dangerous. The outcome includes social and specific phobias, especially when the exposure is prolonged. The current data on the occurrence of phobia suggests that the condition is present in most people in a mild state (American Psychiatric Association, 2015).

Causes

Phobia develops as a result of classical conditioning to a fearful event or object. Phobia also occurs through modeling, which involves imitation and observation. Through observation and imitation, an individual may develop a fear towards an activity that is deemed dangerous, whether perceived or real. When such fears are internalized, they become a phobia.

Treatments

The behavioral treatment techniques for phobia are through desensitization, modeling, and flooding. Systematic desensitization involves creating a fear hierarchy, teaching relaxation skills, and pairing relaxation sessions with the feared objects or activities. Flooding treatment involves forcing the patient to be exposed to feared situations or objects (American Psychiatric Association, 2015). Lastly, the modeling treatment involves direct confrontation of the feared situation by a therapist as the patient observes (Pine et al., 2015). Phobias can also be treated through cognitive therapy and antidepressant medication.

Generalized Anxiety Disorder (GAD)

This anxiety disorder is characterized by extreme fear under ordinary occurrences and the constant worry of the unknown. This means that GAD is a state of free-floating anxiety that is not triggered by any known factor.

Symptoms

The symptoms of GAD include easy fatigue, muscle tension, restlessness, irritability, and sometimes sleep disorder (American Psychiatric Association, 2015). The disorder often appears in adolescence or early adulthood stages. At present, the ratio of women to men who are diagnosed is 2:1 (American Psychiatric Association, 2015).

Diagnosis

A diagnosis of GAD can be done through a physical examination aimed at identifying the above symptoms. This can be followed by urine or blood tests to disqualify other ailments (American Psychiatric Association, 2015).

Frequency

The condition often lasts from between one to six months, depending on the time of detection of and effectiveness of different therapies and treatment programs.

Course and Outcome

GAD condition is likely to develop in individuals facing dangerous social conditions. This means that the rate of GAD is highest within the SES groups (American Psychiatric Association, 2015). In the US, recent research suggests that GAD is highest in the African American population at 6% as compared to 3.1% among White Americans (Pine et al., 2015).

Causes

The causes of GAD include prolonged realistic anxiety from actual or perceived danger, neurotic anxiety due to limited expression of ID impulses, painful memories, and general fear of the unknown (Pine et al., 2015).

Treatments

GAD can be treated through psychodynamic therapies such as applying similar techniques for addressing dysfunction. For instance, encouraging free association, proactive therapeutic interpretation of resistance, and transference are important tools. Another treatment is concentrating focus on control of ID instead of fear and object-relations therapy (Oltmanns & Emery, 2015).

OCD

OCD is a state of extreme tension as a result of an obsession with activities or objects deemed as harmful (Pine et al., 2015).

Symptoms

The symptoms of OCD include muscle tension, increased respiration, and perspiration.

Diagnosis

The diagnosis involves physical and medical examination using the DCM-5 manual (American Psychiatric Association, 2015).

Frequency

The condition might last between 1 and 6 months, depending on the intervention applied.

Course and Outcome

OCD is characterized by obsessions and compulsions as a result of persistent thoughts and repetitive or rigid behaviors and might result in the development of disorders such as panic and phobia attacks.

Causes

OCD is caused by mania with ideas, images, and impulses that occupy an individual’s consciousness.

Treatments

The first treatment is cognitive therapy through altering the maladaptive assumptions and explaining to a patient the negative impacts of OCD on well-being. The second form of treatment is biological through use of anti-anxiety drugs such as Benzodiazepines, relaxation training, and biofeedback (Pine et al., 2015).

References

American Psychiatric Association. (2015). Anxiety disorders: DSM-5® selections. Washington, DC: American Psychiatric Pub.

Oltmanns, T. F., & Emery, R. E. (2015). Abnormal psychology (8th ed.). Upper Saddle River, NJ: Prentice Hall, Div. of Pearson Education.

Pine, D., Rothbaum, B., & Ressler, K. (2015). Anxiety disorders: Translational perspectives on diagnosis and treatment. London, UK: Oxford University Press.