Submitted to

Ma’am Qurat-al-Ain
Submitted by
Urooj Zafar
2014

Department of Psychology
F.G. Degree College for Women, Abid Majeed Road Rawalpindi
Topic
Anxiety Disorders
Definition
Anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or
terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic
interfere with daily activities, are difficult to control, are out of proportion to the actual danger
and can last a long time. You may avoid places or situations to prevent these feelings.

Cause
Family history: People who have a history of mental health issues in the family may usually
have problems with anxiety. For instance, OCD can be passed down in a family.
Stressful events: Stress at the workplace, loss of a loved one, or troubled relationships, can also
trigger symptoms of anxiety.
Health issues: Ailments such as thyroid problems, asthma, diabetes or a heart disease can also
cause anxiety. People suffering from depression can also develop symptoms of anxiety disorders.
For instance, someone who has been suffering from depression for a long period, may start to
under-perform at work. This can then lead to work-related stress which could trigger anxiety.
Substance use: People who are heavy users of drugs, alcohol and other substances, develop
anxiety problems when the effects of the substance begin to wear off (in withdrawal).
Personality factors: Sometimes, people with certain personality traits such as perfectionists or
people who like to be in control, develop anxiety-related issues.

Symptoms
 Feeling nervous, restless or tense
 Having an increased heart rate
 Breathing rapidly (hyperventilation)
 Sweating
 Trembling
 Feeling weak or tired
 Trouble concentrating or thinking about anything other than the present worry
 Having trouble sleeping
 Experiencing gastrointestinal (GI) problems
 Having difficulty controlling worry
 Having the urge to avoid things that trigger anxiety
Neural Mechanism
Processing of long-term memory is a vital role of the hippocampus. An increased level of
amygdala activation indirectly causes the secretion of stress hormones which directly interacts
with the hippocampus. Researchers have discovered that continuous exposure of an individual to
stress hormones adversely affects the development of nerve cells in the hippocampus region of
the brain.

Types of anxiety disorders

1. Panic Disorder
A panic attack is a brief episode of intense anxiety, which causes the physical sensations
of fear. Panic disorder is an anxiety disorder where you regularly have sudden attacks of
panic or fear
o Symptoms
People with panic disorder suffer from panic attacks that are uncontrollable and include a
range of physical symptoms such as dizziness, shortness of breath and excessive
perspiration. During these episodes, they also report psychological symptoms (thoughts)
like experiencing a sense of impending doom and feelings such as ‘I am going to die’ or
‘I will go crazy’.
o Causes
t's not known what causes panic attacks or panic disorder, but these factors may play a
role:
a. Genetics
b. Major stress
c. Temperament that is more sensitive to stress or prone to negative emotions
d. Certain changes in the way parts of your brain function. The amygdala is the
primary part of the brain that is activated during a panic attack.
o Treatment
 practice breathing exercises every day to help prevent panic attacks and relieve
them when they happen
 practice regular exercise, especially aerobic exercise, to help you to manage stress
levels, release tension, improve your mood and boost confidence
 eat regular meals to stabilize your blood sugar levels
 avoid caffeine, alcohol and smoking – these can make panic attacks worse
 try a panic support groups to get useful advice about how to manage your attacks
– your GP can put you in touch with groups in your area
 try cognitive behavioral therapy (CBT) to identify and change the negative
thought patterns that are feeding your panic attacks
2. Obsessive-Compulsive Disorder
OCD symptoms include obsessions, compulsions, or both. An obsession is an uncontrollable
thought or fear that causes stress. A compulsion is a ritual or action that someone repeats a
lot. Compulsions may offer some relief, but only for a little while.
People with OCD have constant thoughts and fears that trigger anxiety. They relieve this
anxiety by performing certain actions repetitively. For instance, a person with a fear of germs
and contamination will repetitively wash his or her hands, and the vessels at home.
o Symptoms
 Fear of contamination or dirt.
 Doubting and having difficulty tolerating uncertainty.
 Needing things orderly and symmetrical.
 Aggressive or horrific thoughts about losing control and harming yourself
or others.
 Unwanted thoughts, including aggression, or sexual or religious subjects.
o Causes
The cause of obsessive-compulsive disorder isn't fully understood. Main theories
include:
 Biology. OCD may be a result of changes in your body's own natural
chemistry or brain functions.
 Genetics. OCD may have a genetic component, but specific genes have
yet to be identified.
 Learning. Obsessive fears and compulsive behaviors can be learned from
watching family members or gradually learned over time.
o Treatment
There's no sure way to prevent obsessive-compulsive disorder. However, getting
treatment as soon as possible may help prevent OCD from worsening and
disrupting activities and your daily routine.
3. Generalized Anxiety Disorder
People suffering from GAD experience excessive anxiety and worry about various events
and situations. They have difficulty in controlling anxiety and worry, along with
restlessness and 'feeling keyed up or on edge' all the time. Such people are not worried
about anything in particular and there is no specific trigger.
o Symptoms
 Persistent worrying or anxiety about a number of areas that are out of
proportion to the impact of the events
 Overthinking plans and solutions to all possible worst-case outcomes
 Perceiving situations and events as threatening, even when they aren't
 Difficulty handling uncertainty
 Indecisiveness and fear of making the wrong decision
 Inability to set aside or let go of a worry
 Inability to relax, feeling restless, and feeling keyed up or on edge
 Difficulty concentrating, or the feeling that your mind "goes blank.
o Causes
As with many mental health conditions, the cause of generalized anxiety disorder
likely arises from a complex interaction of biological and environmental factors,
which may include:
 Differences in brain chemistry and function: Apart from the aberrant
functioning of the VLPFC, the relationship between the prefrontal region
and the amygdale, when altered, also results in symptoms of GAD. The
main activity of VLPFC is inhibition.
  Genetics
 Differences in the way threats are perceived
 Development and personality
o Treatment
 Get help early. Anxiety, like many other mental health conditions, can be harder
to treat if you wait.
 Keep a journal. Keeping track of your personal life can help you and your mental
health professional identify what's causing you stress and what seems to help you
feel better.
 Prioritize issues in your life. You can reduce anxiety by carefully managing your
time and energy.
 Avoid unhealthy substance use. Alcohol and drug use and even nicotine or
caffeine use can cause or worsen anxiety. If you're addicted to any of these
substances, quitting can make you anxious. If you can't quit on your own, see
your doctor or find a treatment program or support group to help you.
4. Post Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who
have experienced a shocking, scary, or dangerous event. It is natural to feel afraid during
and after a traumatic situation. Fear is a part of the body's “fight-or-flight” response,
which helps us avoid or respond to potential danger.
Symptoms:
Post-traumatic stress disorder symptoms may start within one month of a traumatic event,
but sometimes symptoms may not appear until years after the event. These symptoms
cause significant problems in social or work situations and in relationships. They can also
interfere with your ability to go about your normal daily tasks.
PTSD symptoms are generally grouped into four types: intrusive memories, avoidance,
negative changes in thinking and mood, and changes in physical and emotional reactions.
Symptoms can vary over time or vary from person to person.
Intrusive memories: Symptoms of intrusive memories may include:
 Recurrent, unwanted distressing memories of the traumatic event
 Reliving the traumatic event as if it were happening again (flashbacks)
 Upsetting dreams or nightmares about the traumatic event
 Severe emotional distress or physical reactions to something that reminds you of
the traumatic event
Avoidance: Symptoms of avoidance may include:
 Trying to avoid thinking or talking about the traumatic event
 Avoiding places, activities or people that remind you of the traumatic event
Symptoms of negative changes in thinking and mood may include:
 Negative thoughts about yourself, other people or the world
 Hopelessness about the future
  Memory problems, including not remembering important aspects of the
traumatic event
 Difficulty maintaining close relationships
 Feeling detached from family and friends
 Lack of interest in activities you once enjoyed
 Difficulty experiencing positive emotional
 Feeling emotionally numb
 Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions may include:
 Being easily startled or frightened
 Always being on guard for danger
 Self-destructive behavior, such as drinking too much or driving too fast
 Trouble sleeping
 Trouble concentrating
 Irritability, angry outbursts or aggressive behavior
o Causes
You can develop post-traumatic stress disorder when you go through, see or learn about an
event involving actual or threatened death, serious injury or sexual violation.
 Stressful experiences, including the amount and severity of trauma you've gone through
in your life
 Inherited mental health risks, such as a family history of anxiety and depression
 Inherited features of your personality — often called your temperament
 The way your brain PTSD include hippocampus, amygdala, and medial prefrontal cortex.
Cortisol and norepinephrine are two neurochemical systems that are critical in the stress
response regulates the chemicals and hormones your body releases in response to stress.
o Prevention
After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being
unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt — all are
common reactions to trauma. Getting timely help and support may prevent normal stress
reactions from getting worse and developing into PTSD. This may mean turning to family and
friends who will listen and offer comfort. It may mean seeking out a mental health professional
for a brief course of therapy. Some people may also find it helpful to turn to their faith
community. Support from others also may help prevent you from turning to unhealthy coping
methods, such as misuse of alcohol or drugs.

5. Social Phobias/Social Anxiety Disorder

People with social anxiety disorder fear social and performance-related situations where they
may be subject to the scrutiny of others. They have an intense fear that something they do or say
will lead to their humiliation or embarrassment. These people are unable to handle everyday
situations such as making small talk or even eating in public.
 o Symptoms
 Intense fear of interacting or talking with strangers
 Fear that others will notice that you look anxious
 Avoidance of doing things or speaking to people out of fear of embarrassment
 Avoidance of situations where you might be the center of attention
o Causes
Like many other mental health conditions, social anxiety disorder likely arises from a
complex interaction of biological and environmental factors. Possible causes include:
Inherited traits. Anxiety disorders tend to run in families. However, it isn't entirely clear
how much of this may be due to genetics and how much is due to learned behavior.
Brain structure. A structure in the brain called the amygdala may play a role in
controlling the fear response. People who have an overactive amygdala may have a
heightened fear response, causing increased anxiety in social situations.
Environment. Social anxiety disorder may be a learned behavior — some people may
develop significant anxiety after an unpleasant or embarrassing social situation. Also,
there may be an association between social anxiety disorder and parents who either
model anxious behavior in social situations or are more controlling or overprotective of
their children.
o treatments for social anxiety
cognitive behavioral therapy (CBT) with a therapist, which is therapy that helps you identify
negative thought patterns and behaviours, and change them; this can be done with just you and a
therapist, in a group or with your parents or carers guided self-help, which involves working
through a CBT-based workbook or online course with regular support from a therapist
antidepressant medicines, usually a type of medicine called a selective serotonin reuptake
inhibitor (SSRI), such as escitalopram or sertraline; these are usually not used to treat children
and young people.

6. Specific Phobias
Phobias are unsubstantiated fears and people with phobias go to great lengths to avoid the
object or situation that triggers their anxiety. Their fears could range from flying in
airplanes, being in crowded places, to harmless things such as spiders and high-rise
buildings
o Symptoms
 Situations, such as airplanes, driving, enclosed spaces or going to school.
 Nature, such as thunderstorms, heights or the dark.
 Animals or insects, such as dogs, snakes or spiders.
 Blood, shots or injuries, such as needles, accidents or medical procedures.
 Others, such as choking, throwing up, loud noises or clowns.
o Causes
Bad experiences. Many phobias start because of a bad experience or panic attack related
to a specific object or situation. Sometimes even seeing or hearing about a bad experience
can be enough to trigger a phobia.
 Genetics or learned behavior. There may be a link between your specific phobia and the
phobia or anxiety of your parents. This could be due to a blend of genetics and learned
behaviors.
Brain function and structure. Those with specific phobias trigger certain parts of the
brain, while a person without these phobias does not have the same response in the brain.
Also, a person with a specific phobia can have a different brain structure than a person
without that specific phobia.
o Treatment
 The best treatment for specific phobias is a form of therapy called exposure
therapy. Sometimes your health care professional also may recommend other
therapies or medicine. Knowing the cause of a phobia is less important than
focusing on how to treat the avoidance behavior that has developed over time.
 Cognitive behavioral therapy (CBT). CBT involves gradual exposure combined
with other ways to learn how to view and cope with the feared object or situation
differently. You learn how to challenge your worries and put up with
uncomfortable feelings. CBT helps you learn how to create a sense of mastery and
confidence with your thoughts and feelings rather than feeling overcome by them.
 Medicines: Generally, exposure therapy successfully treats specific phobias. But
sometimes medicines can reduce the anxiety and panic symptoms you feel from
thinking about or being exposed to the object or situation you fear. Medicines may
be used during treatment at first or for short-term use in specific, occasionally
encountered situations, such as flying on an airplane, public speaking or going
through an MRI procedure.
References:
https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961