Category: Anxiety Disorders

Generalized Anxiety Disorder

Generalized Anxiety Disorder

Psychiatry

Generalized Anxiety Disorder

Diagnostic Criteria

A) Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

B) The individual finds it difficult to control the worry.

C) The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):

Note: Only one item is required in children.

  1. Restlessness or feeling keyed up or on edge.
  2. Being easily fatigued.
  3. Difficulty concentrating or mind going blank.
  4. Irritability.
  5. Muscle tension.
  6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).

D) The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

E) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).

F) The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dimorphic disorder, having a serious illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).

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Agoraphobia

Agoraphobia

Psychiatry

Agoraphobia

Diagnostic Criteria

A) Marked  fear or anxiety about two (or more) of the following five situations:

  1. Using public transportation (e.g., automobiles, buses, trains, ships, planes).
  2. Being in open spaces (e.g., parking lots, marketplaces, bridges).
  3. Being in enclosed places (e.g., shops, theaters, cinemas).
  4. Standing in line or being a crowd.
  5. Being outside of the home alone.

B)The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e.g., fear of falling in the elderly; fear of incontinence).

C) The agoraphobic situations almost always provoke fear or anxiety.

D)The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.

E)The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context.

F) The fear, anxiety, or avoidance is persistent, typically for 6 months or more.

G)The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

H)  If another medical condition (e.g., inflammatory bowel disease, Parkinson’s disease) is present, the fear, anxiety, or avoidance is clearly excessive.

I)  The  fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder-for example , the symptoms are  not confined to specific phobia, situational  type; do not involve only social situations (as in social anxiety disorder); and are not related exclusively to obsessions (as in obsessive-compulsive disorder), perceived defects or flaws in physical appearance (as in body dimorphic disorder), reminders of  traumatic events (as in posttraumatic stress disorder), or fear of separation (as in separation anxiety 

Note:   Agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder and agoraphobia, both diagnoses should be assigned.

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Phobias

Phobias

Psychiatry

Phobias

Phobias are among the most common off all psychiatric disorders. Specific phobias affects 5-10 % of the general population and social phobia affects about 3 %.

A. What are phobias?

Phobias are marked and persistent fear that is excessive or unreasonable which is triggered by the presence or anticipation of a specific object or situation. Exposure to the situation cause intense anxiety and distress. People with phobias avoid the anxiety provoking situation.

There are many kinds of phobias

  1. Blood phobia: runs in the family
  2. Phobias for heights
  3. Phobias for lifts, escalators
  4. Phobias for flying in aircraft
  5. Phobias for enclosed places ETCSocial anxiety disorder or
  6. social phobia is one of the most common psychiatric disorder with a life time prevalence off 12 %. It is more common among women than men but both men and women equally seek help for the problem.

B. What are the symptoms of social Phobia?

There are definite criteria to diagnose social phobia

Some of the symptoms are

  1. A marked and persistent fear of social situations in which person is exposed to unfamiliar people or to possible scrutiny by others.
  2. Fear that he or she will act in way that will be humiliating or embarrassing.
  3. Exposure to the feared social situation provokes anxiety.
  4. The person recognizes that the fear is excessive or unreasonable.
  5. Avoiding the feared social situation.
  6. Impaired socio –occupational functioning.
    Duration of above symptoms should at least be for 6 mont

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Panic Disorder

Panic Disorder

Psychiatry

Panic Disorder

Panic disorder occurs in 1-3 % of the population. It is twice as more common in women as men. It can exist with other psychiatry disorders.

A. What are symptoms of panic attacks?

There are definite criteria for diagnosing panic disorder.

Some of the symptoms are

  1. Palpitations ( pounding heart)
  2. Sweating , tremors
  3. Shortness of breadth
  4. Feeling of choking
  5. Nausea, abdominal distress
  6. Light head, dizzy
  7. Fear that you are losing control
  8. Fear that you might die
  9. Tingling sensation in the limbs
  10. Anticipating another attack

Each attack lasts for a few minutes and patient is worried that he might get another attack again. Above symptoms come in episodes with patient avoiding situations which might trigger an episode and restricting their lifestyle.

Many patients fear that they may die and go to hospitals repeatedly.

B. Causes of panic attacks?

Panic disorder is caused by a number of factors

  1. Certain chemicals can trigger off panic attacks.
  2. Genetics: Panic disorder can run in families.
  3. Psychological reasons: Patients with panic disorder tend to catastrophise normal body symptoms there by leading the body to trigger of chemicals which cause symptoms of panic attacks.
  4. Panic attack like symptoms can also occur with physical problems like hyperthyroidism.
  5. Symptoms can also occur as side effects to medications taken for other conditions.

C. What is the treatment for Panic disorder?

Panic disorder can be treated with medications and Cognitive Behaviour therapy

  1. Medications are very effective in treating symptoms of Panic disorder. Numerous medications like SSRI, benzodiazepine and older antidepressants can be used to treat panic disorder.
  2. Cognitive Behaviour is very effective in treating panic disorder. It requires the patient to be motivated and brave to work through the problem. It is used along with medications and at times alone to treat panic disorder.
    The response to medication and CBT is good for panic disorder and patients do well after treatment. It is advisable to seek treatment earlier rather than later.

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