In this post I will talk about the most common anxiety disorders: phobias, panic disorder, generalised anxiety disorder and probably the most well-known one, OCD (obsessive compulsive disorder). I have included several videos with case studies which should make everything even clearer - and hopefully slightly more entertaining!
I will present a brief description, population prevalence, causes and treatments for each disorder.
I will present a brief description, population prevalence, causes and treatments for each disorder.
Phobias
Phobias are irrational, unreasonable fears of a specific object or situation. A person does recognise that the fears is unreasonable, however can not prevent it from occurring. The way phobia sufferers cope with them is by avoiding the stimuli as much as they can. In order to be diagnosed with phobia, the symptoms should be persistently present for at least 6 months. It is more common in women than men, and the risk of developing a phobia increases if there is a family history of phobias. It can also develop due to a fear conditioning (for example, threat of a punishment as part of a discipline in childhood).
Treatment
Exposure therapy has proven to be quite effective in getting rid of phobias. There are three techniques which can be used separately or together, depending on the case.
a) Systematic desensitisation. This therapy involves gradual exposure of a patient to a stimuli which evokes a sense of fear. For example, if it is dogs, a therapist might start with having a dog in the corner of a room where therapy takes place and gradually progress to approaching and handling it, to prove the object is safe to be around with.
b) Modelling. This technique means letting a patient see someone else handling stimuli, thus seeing it does not pose a danger.
c) Virtual reality. This technique has many advantages over the traditional exposure therapy. Firstly, patients might be more willing to participate knowing they would have to face their phobias not in a physical way. Secondly, sometimes it is difficult to get physical exposure to certain stimuli, for example if it is the sea or some particular animals.
Below is a video showing a guy with a phobia of dogs who is undergoing an Exposure therapy. Initially it seems quite funny, but think about how embarrassing it must be for this guy to have this fear..
Treatment
Exposure therapy has proven to be quite effective in getting rid of phobias. There are three techniques which can be used separately or together, depending on the case.
a) Systematic desensitisation. This therapy involves gradual exposure of a patient to a stimuli which evokes a sense of fear. For example, if it is dogs, a therapist might start with having a dog in the corner of a room where therapy takes place and gradually progress to approaching and handling it, to prove the object is safe to be around with.
b) Modelling. This technique means letting a patient see someone else handling stimuli, thus seeing it does not pose a danger.
c) Virtual reality. This technique has many advantages over the traditional exposure therapy. Firstly, patients might be more willing to participate knowing they would have to face their phobias not in a physical way. Secondly, sometimes it is difficult to get physical exposure to certain stimuli, for example if it is the sea or some particular animals.
Below is a video showing a guy with a phobia of dogs who is undergoing an Exposure therapy. Initially it seems quite funny, but think about how embarrassing it must be for this guy to have this fear..
Panic Disorder
Panic disorder is characterised by a recurrent and unexpected panic attacks (not due to drugs or medicine), followed by months of anxiety about having another attack or consequences of a previous one. Panic attack can be described as a discrete period of intense fear which reaches their peak in about 10 minutes. During the attack, four main symptoms develop: fear of dying, shaking, nausea and pounding heart.
Agoraphobia is often present in patients with a panic disorder. It is characterised by a fear of places which may be difficult to escape in case of a sudden panic attack, which would cause embarrassment. Patients with agoraphobia avoid such places/situations due to their worry that they might have a panic attack in there.
Panic disorder is prevalent in 5% of population, and is twice as common in women than men; also, 80-90% of agoraphobia sufferers are women. Panic disorder is often comorbid with other disorders such as phobias, substance use etc.
A person may develop strong associations with certain objects or situations which produce panic attacks. At first, a panic attack may coincide with a neutral cue/situation. As a consequence, the cue is no longer neutral, but is associated with a panic attack. In this case, a person is likely to engage in safety behaviour: certain techniques they employ to deal with panic. Such behaviours further reinforce the association, strengthening it.
Twin studies showed that panic disorder has a heritability of 33-43%, (33-43% of variance can be contributed to genes).
Treatment
Panic disorder is treated either pharmacologically or with behavioural therapies. Behavioural therapy is similar to those used in phobias, and is more effective than drugs. Moreover, it is actually less effective when is employed together with drug therapy.
Below is a bit bizarre video which nevertheless very clearly explains panic disorder.
Agoraphobia is often present in patients with a panic disorder. It is characterised by a fear of places which may be difficult to escape in case of a sudden panic attack, which would cause embarrassment. Patients with agoraphobia avoid such places/situations due to their worry that they might have a panic attack in there.
Panic disorder is prevalent in 5% of population, and is twice as common in women than men; also, 80-90% of agoraphobia sufferers are women. Panic disorder is often comorbid with other disorders such as phobias, substance use etc.
A person may develop strong associations with certain objects or situations which produce panic attacks. At first, a panic attack may coincide with a neutral cue/situation. As a consequence, the cue is no longer neutral, but is associated with a panic attack. In this case, a person is likely to engage in safety behaviour: certain techniques they employ to deal with panic. Such behaviours further reinforce the association, strengthening it.
Twin studies showed that panic disorder has a heritability of 33-43%, (33-43% of variance can be contributed to genes).
Treatment
Panic disorder is treated either pharmacologically or with behavioural therapies. Behavioural therapy is similar to those used in phobias, and is more effective than drugs. Moreover, it is actually less effective when is employed together with drug therapy.
Below is a bit bizarre video which nevertheless very clearly explains panic disorder.
Generalised Anxiety Disorder
Generalised Anxiety Disorder (GAD) is characterised by long periods of uncontrolled and unreasonable worry, which a person can't stop. It can be associated with irritability, impaired sleep and restlessness. A study showed that 5.7% of a population suffer from GAD at some point in their lives, and that 3% of population has the disorder at any 1 year period. It is twice as common in women as men and is comorbid with other anxiety disorders.
According to twin studies, 15-20% of variance is due to genes. It has also been found that those suffering from GAD have lower brain levels of serotonin and GABA ('calming' neurotransmitter) and higher levels of cortisol (hormone released in response to stress).
Treatment
Pharmacological treatment includes prescribing benzodiazepines. These are drugs which boost the effect of GABA neurotransmitters, which 'calm down' the brain.
Cognitive behavioural therapy aims to make a patient as calm and relaxed as possible. It often uses relaxation exercises (e.g. muscle relaxation, meditation); therapist also aims to reduce distorted concepts and information that the patients have about the world.
According to twin studies, 15-20% of variance is due to genes. It has also been found that those suffering from GAD have lower brain levels of serotonin and GABA ('calming' neurotransmitter) and higher levels of cortisol (hormone released in response to stress).
Treatment
Pharmacological treatment includes prescribing benzodiazepines. These are drugs which boost the effect of GABA neurotransmitters, which 'calm down' the brain.
Cognitive behavioural therapy aims to make a patient as calm and relaxed as possible. It often uses relaxation exercises (e.g. muscle relaxation, meditation); therapist also aims to reduce distorted concepts and information that the patients have about the world.
Obsessive Compulsive Disorder
OCD involves presence of compulsions or/and obsessions. Obsessions are recurrent and persistent thoughts which occur despite attempts to stop them. Those having obsessions normally do realise they are the products of their own mind, however struggle to get rid of them. Compulsions are persistent behaviours which a person feels (s)he has to perform as a reaction to their obsession. Again, a person normally realises it is irrational, however not performing a compulsive behaviour leads to a severe discomfort and anxiety.
Approximately 2.5% of population suffers from OCD at some point in life, with a 1 year prevalence of 1.6%. In more than 90% of cases obsessions co-occur with compulsions.
Those with OCD typically perform more poorly on Stop-signal tasks, demonstrating difficulty inhibiting a behaviour (i.e. stopping yourself from doing something). CT scans also showed that they have a less dense gray matter in frontal lobe areas, which control behaviour inhibition.
Treatment
Behavioural therapy is similar to that employed with phobia sufferers: patients get gradually exposed to anxiety provoking stimuli and are forced not to perform a compulsive behaviour. This way they slowly realise that there are no negative consequences in doing so. Medications are sometimes used, however the relapse rate is very high once drug taking is stopped.
Below you will find a very short video presenting two cases of people suffering from OCD.
Approximately 2.5% of population suffers from OCD at some point in life, with a 1 year prevalence of 1.6%. In more than 90% of cases obsessions co-occur with compulsions.
Those with OCD typically perform more poorly on Stop-signal tasks, demonstrating difficulty inhibiting a behaviour (i.e. stopping yourself from doing something). CT scans also showed that they have a less dense gray matter in frontal lobe areas, which control behaviour inhibition.
Treatment
Behavioural therapy is similar to that employed with phobia sufferers: patients get gradually exposed to anxiety provoking stimuli and are forced not to perform a compulsive behaviour. This way they slowly realise that there are no negative consequences in doing so. Medications are sometimes used, however the relapse rate is very high once drug taking is stopped.
Below you will find a very short video presenting two cases of people suffering from OCD.