Anxiety is normal. It helps us get out of harm’s way and prepare for important events.It warns us when we need to take action. Butif you have anxiety that is persistent, irrational, and overwhelming and interferes with daily activities, you may have an anxiety disorder.

“Anxiety is a normal human emotion which is

triggered when we perceive threats of

harm.”

• The term “anxiety disorders” refers to – Panic disorder,– Generalized anxiety disorder (GAD),– Obsessive-compulsive dis- order (OCD),– Posttraumatic stress disorder (PTSD),– Social anxiety disorder, – And specific phobias.

PANIC DISORDER

What is panic disorder?

• Panic disorder is an anxiety disorder characterized by recurring panic attacks, causing a series of intense episodes of extreme anxiety during panic attacks.

• Panic attacks may change behavior and function at home, school, or work. People with the disorder often worry about the effects of their panic attacks.

• Panic attacks cannot be predicted. At least in the early stages of the disorder, there is no trigger that starts the attack. Recalling a past attack may trigger panic attacks.

When assessing a patient for panic disorder, check for the presence of these symptoms: • Recurrent, unexpected panic attacks—a discrete period of intense fear or discomfort with 4 or

more of the following symptoms: • Racing or pounding heartbeat• Chest pains or discomfort • Shortness of breath, sensation of smothering or feeling of choking • Nausea or abdominal distress • Sweating, flushes or chills • Dizziness • Tingling or numbness • Trembling or shaking • Fear of losing control or going crazy • Fear of dying • Feelings of unreality or depersonalization • Symptoms typically develop abruptly and reach a peak within 10 minutes • 1 month or more of persistent concern about having another attack OR • worry about the implications or consequences of panic OR a significant behavioral change related

to the attacks or fear of future attacks

Panic Disorder with Agoraphobia includes the above AND: • there is anxiety about being in situations in which escape is difficult or help may not be available if

a panic attack occurs AND; • those situations are avoided or endured with marked distress.

Exams and test

• Many people with panic disorder first seek treatment in the emergency room. This is because the panic attack often feels like a heart attack.

• The health care provider will perform a physical exam and a mental health assessment.

• Blood tests will be done. Other medical disorders must be ruled out before panic disorder can be diagnosed. Disorders related to substance use will be considered because symptoms can resemble panic attacks.

Consider the use of a rating scale, such as the Panic Disorder Severity Scale, to establish a baseline and to monitor progress: Panic Disorder Severity Scale (PDSS)

Treatment

The goal of treatment is to help you function well during everyday life. Using both medicines and talk therapy works best.

Types of medicines used to treat panic disorder:

• Antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) are most often prescribed for panic disorder.

• Sedatives are medicines that relax you. These may be used for a short time. There is a risk of becoming dependent on these medicines.

Talk therapy (cognitive-behavioral therapy, or CBT) helps you understand your behaviors and how to change them. During therapy you will learn how to:

• Understand and control distorted views of life stressors, such as other people's behavior or life events.

• Recognize and replace thoughts that cause panic and decrease the sense of helplessness.

• Manage stress and relax when symptoms occur.• Imagine the things that cause the anxiety, starting

with the least fearful. Practice in real-life situations to help you overcome your fears.

GENERALIZED ANXIETY DISORDER (GAD)

What is GAD ?

All of us worry about things like health, money, or family problems. But people with GAD are extremely worried about these and many other things, even when there is little or no reason to worry about them.

Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable and often irrational

worry, that is, apprehensive expectation about events or activities.

• In a given year, approximately 6.8 million American adults and two percent of European adults experience GAD.

• GAD is seen in women twice as much as men.• GAD is also common in individuals with a history of

substance abuse and a family history of the disorder.

• GAD is the most common cause of disability in the workplace in the United States.

Sign and symptoms of GADA person with GAD may: • Worry very much about everyday things • Have trouble controlling their constant worries• Know that they worry much more than they should • Not be able to relax• Have a hard time concentrating• Be easily startled• Have trouble falling asleep or staying asleep Feel tired all the time• Have headaches, muscle aches, stomach aches, or unexplained pains• Have a hard time swallowing• Tremble or twitch• Be irritable, sweat a lot, and feel light-headed or out of breath• Have to go to the bathroom a lot.These symptoms must be consistent and ongoing, persisting at least six months, for a formal diagnosis of GAD.

Standardized rating scales such as GAD-7 can be used to assess severity of generalized anxiety disorder symptoms.

Score 5–9 Mild anxiety 10–14 Moderate anxiety 15–21 Severe anxiety

Treatment

Treatment of GAD may involve psychological therapy, drug therapy or a combination of both. Psychological and drug therapies are equally effective in the treatment of GAD. However the relapse rate for psychological therapies may be lower.

Psychological therapies for generalised anxiety disorder

– Cognitive behavioural therapy (CBT) is the most widely used and may be useful for some patients with GAD

– Cognitif behavioral therapy (CBT) is a psychological method of treatment for GAD that involves a therapist working with the patient to understand how thoughts and feeling influence behaviour.

– Components of Cognitive Behavioral Therapy (CBT) for GAD includes psychoeducation, self-monitoring, stimulus control techniques, relaxation, self-control desensitization, cognitive restructuring, worry exposure, worry behavior modification, and problem-solving.

DRUG THERAPIESFOR GENERALISED ANXIETY DISORDER

The following may also help reduce the number or severity of panic attacks:• Not drinking alcohol• Eating at regular times• Getting plenty of exercise • Getting enough sleep• Reducing or avoiding caffeine, certain cold

medicines, and stimulants

Thank you. .