Major Anxiety Disorders

Hello and welcome back to

module three anxiety disorders. This is lecture two

major anxiety disorders. In the first lecture we considered anxiety

in general what it is and how it can be helpful to us in moderate amounts and

harmful to us and extremely high amounts. In this lecture we're going to look at

specific ways that excessive anxiety causes problems for people. First, it's important to note that there are many more types of anxiety disorders than we can cover in this course. We're going to talk about the major, most common ones. It is also important to note that we will

not be able to discuss the major anxiety disorders in a great deal of depth. Rather, this lecture providesan introduction to and overview of the major anxiety disorders. The first we will consider is generalized anxiety disorder or GAD. People with GAD experience what is often referred to as free floating anxiety and almost constant feeling of anxiety that

is not attached to any one thing or situation. People with GAD worry continuously

about a variety of minor issues. They feel chronically tense and

on edge, possibly irritable, and they typically struggle with insomnia and

physical fatigue. People with GAD are unable to

control their constant worry and free floating anxiety. And this causes significant distress as

well as impairment in their ability to participate effectively

in their daily lives. GAD is very common in the US and Europe, where it has been found to occur twice as often in women as in men. US population surveys have

found that in any given year 4% of the population experiences GAD. Lifetime prevalence of this disorder is estimated at 6%. GAD can be found in both adults and

Children, although it most commonly occurs in adults 45 older. It is particularly common among older people between the ages of 65 and 80.

Next, let's look at panic disorder,

recall from our introductory lecture that panic refers to an intense fear response

in the absence of any immediate threat. Panic disorder is diagnosed when

people experience severe and unexpected or uncured panic episodes. During these episodes,people feel convinced they are dying or losing physical control of their bodies. They may feel they're about to lose consciousness or that they are having a heart attack or

a stroke. These panic episodes are so

overwhelming and distressing that people develop an intense

dread of experiencing another one. In fact, in order to be diagnosed with

panic disorder, a person must experience significant anxiety over the possibility

of having a future panic episode. Often, this anticipatory anxiety is so intense that people change their behavior and begin to avoid places and situations they feel they will be unable

to escape in the event of a panic episode. At times this avoidance

behavior becomes so extreme that people severely

limit their daily activities. Some even get to the point that

they stopped leaving their homes. When this extreme avoidance behavior

occurs, it is referred to as agoraphobia. Panic disorder can occur with or

without agoraphobia. Panic disorder is fairly common. US research indicates that in any given

year, about 2.7% of the population struggles with this disorder and

that lifetime prevalence is about 4.7%. About 2/3 of the people

diagnosed are women. Panic disorder tends to

develop an early adult life. Most cases are diagnosed

between the ages of 20 and 40.

Specific phobias are somewhat

similar to panic disorder and that they involve

an intense panic reaction. In the case of this disorder however,

the panic reaction is expected or cued by a specific object or situation. When a person with a specific phobia is confronted with the feared object or situation. They respond with an intense irrational fear or panic reaction and

an overwhelming desire to escape. People who struggle with specific

phobias feel a strong desire to avoid the situation or

object that causes their panic response. Sometimes they're able to successfully

engage in this avoidance without experiencing a negative

impact on their lives. For instance, a person with a phobia for

snakes may choose to live in a part of the world that's too cold for

snakes to live in. On the other hand, someone with a phobia of heights may

experience a negative impact to their professional success if they limit

themselves to working on the ground floor. While many or

even most people have specific fears, these fears do not rise to

the level of specific phobias. In order to be diagnosed with a specific

phobia disorder, a person must experience an intense overwhelming fear

reaction to an object or situation. The fear must be far out of proportion

to the actual danger it represents. They must either avoid the situation or

object or endure it while experiencing

intense distress. The fear reaction must

persist over time and it must cause them distress or

impairment in their daily lives. So, even if you're afraid of spiders or

feel uneasy riding in elevators, you do not have a specific phobia

unless all of those criteria are met. Specific phobias are among the most

common of the anxiety disorders. In the US, research indicates that 8.7% of the population experiences a specific

phobia at some point in the year. While lifetime prevalence

is estimated at 12.5%. As with other anxiety disorders, the large majority of people diagnosed with specific phobias are women. Specific phobias tend to develop at a much

younger age than other anxiety disorders, with the typical age of

onset being seven years.

Next, we're going to talk

about social anxiety disorder. People with social anxiety disorder

feel overwhelming anxiety when faced with situations in which they

must interact with other people. Their anxiety involves worry about

being watched and evaluated and making a mistake or

doing something embarrassing or humiliating that causes rejection or

ridicule from other people. Sometimes social anxiety

disorder is very specific and involves engaging in a particular

activity in the presence of others, such as making a speech or

acting or singing. This is often referred to

as performance anxiety. However, the anxiety may relate to

a specific situation that's unrelated to performance, such as eating or

signing a check in front of other people. Others with social anxiety disorder have

a more broad generalized worry that they will embarrass themselves in some obvious

way when interacting with others. As you can imagine, social anxiety

disorder significantly impacts the lives of people who struggle with it. They may avoid all social situations and as a result feel extremely isolated and

they may even be unable to carry out required responsibilities

of their daily lives and jobs. US research indicates that in any

given year 8% of the population experiences social anxiety disorder

with a lifetime prevalence of 13%. As we've seen consistently, the majority

of those who struggle with it are women. Like specific phobias,

social anxiety disorder tends to occur early in life,

with the typical age of onset being 13.

The last disorder we will

discuss in this lecture is obsessive compulsive disorder or OCD. It's very important to note that according to the current US diagnostic rules, OCD is no longer categorized

as an anxiety disorder. Nonetheless, it is characterized by

extremely high levels of anxiety. So we are including it in our

discussion of anxiety disorders. Obsessions are recurrent thoughts,

impulses or images that are unwanted by

the person experiencing them. Obsessions cause a great deal of distress

and anxiety that becomes so overwhelming. The person then engages in

compulsions which are repetitive, rigid, time consuming behaviors or

mental acts that are designed to neutralize the anxiety

created by the obsession. People with OCD are usually aware that

both the content of their obsessive thoughts as well as their compulsive

behavior are not reasonable or rational. In fact, the recognition of the irrational

nature of their struggle often leads to even more intense distress and

anxiety. Both the obsessions and the compulsions are experienced as being

beyond their control and they cannot stop. Common patterns or themes can be observed

among people who struggle with OCD. Obsessions often involved

thoughts of contamination, orderliness, violence or

aggression, religion or sexuality. Compulsions corresponding to these

themes may present is repetitive, hand washing, cleaning,

checking, ordering. Or other mental or

behavioral rituals that are performed in order to neutralize the anxiety

created by the obsessive thoughts. A pattern is present in OCD in which

the compulsion does in fact neutralize the anxiety created by the obsession for

a very short period of time. Inevitably, the obsession returns

often stronger than before and so the person must again engage in

the compulsions in an effort to rid themselves of their distress. As this pattern continues, it's common for

the person's distress to become more severe and for them to spend more and more

time engaging in compulsive behaviors. It's common for people with OCD to

experience significant impairment in various areas of their lives. Because of their severe anxiety and

distress and the increasingly long periods of time they spend

engaged in the compulsive behavior. US research indicates that OCD is less

common than the major anxiety disorders. With 1% of the population experiencing

this disorder in any given year, with a lifetime prevalence

of 1.6% to 2.3%. Unlike the anxiety

disorders we've discussed, OCD is equally common in women and men. Age of onset ranges from childhood through the mid 30s.