Fear- A state where a person feels a strong sense of dread towards a specific object/event

Stress- Physical, emotional, psychological, social or spiritual reaction from a situation/event/condition stimulated in a person

 

Depression & anxiety 

  • Close association
  • Presence of both is often associated with reduced efficacy of treatment
  • Presence of both associated with higher rates of suicide

 

 

Anxiety

− A state where a person feels a strong sense of dread, without having a specific reason

− A state in which a person has feelings of uneasiness

 

Signs & Symptoms

Autonomic Symptoms  Physical Symptoms  Psychological Symptoms 

Tachycardia  Tremor  Insomnia

Sweating  Muscular aches Irritability

Dizziness  Difficulty swallowing  rasily startled

Hot/cold spells  ‘Lump’ in throat Inability to relax

Frequency of micturition  Restlessness  Poor concentration

Diarrhoea/nausea  Fatigue  Feeling tense

Paraesthesia (pins & needles) Distractibility  Reduced sense of humour

 

 

 

Generalised Anxiety Disorder

  • A condition where people tend to worry about many things over long periods of time
  • Associated with physical symptoms: muscle tension, sleeplessness, irritability, restlessness   Diagnosis requires 6 months of symptoms most days

 

Treatments- 

− Cognitive behavioural therapy (CBT)

− Relaxation therapy and deep breathing exercises

− Self-help groups, journaling and healthy living

− Medication- short term during high periods of stress: o Anti-depressants most common

o Anxiolytics- short term relief from physical symptoms

 

Panic Attacks 

  • Sudden, severe, uncontrollable anxiety
  • Thoughts of dread and fear
  • Symptoms include: palpitations, chest pain, tachycardia, sweats, shakes, difficulty breathing, nausea, dizziness, depersonalisation, derealisation, fear of losing control, weakness/tingling in limbs, chills Treatments-

− Avoid recreational drugs

− Psychological treatments most effective: o Psychoeducation about anxiety  o Cognitive behavioural therapy (CBT)  o Relaxation and slow breathing training  o rxposure therapy

 

 

Phobias 

  • Irrational fear that’s out of proportion to actual threat
  • 3 main types:
    • Agoraphobia (e.g. not wanting to leave the house, being scared of confined spaces)
    • Social phobia (e.g. not wanting to leave the house, not wanting to interact with others) Ø Specific phobias (e.g. fear of spiders, snakes, moths, heights etc)

 

  • Generally anxiety and fearfulness only occurs in presence of object of fear

 

Treatments-

− Usually given by specialists

− Cognitive behaviour therapy and/or psychotherapy to re-structure habitual thinking patterns

− Gradual supported exposure to the object of fear − Antidepressants are used

 

Obsessive-Compulsive Disorder (OCD)

  • Obsessive thoughts that cause anxiety and distress
  • Distress is ‘managed’ or responded to with rituals/behaviours (compulsions)
  • Inability to carry out behaviour/ritual, increases person’s anxiety
  • Person recognises rituals as inappropriate or excessive- (they’re aware and acknowledge their illness)

 

Treatments- 

− Reassurance very important- people often express concerns ‘they’re going crazy’

− Specialist treatment- from clinical psychologists

− Antidepressant medication used- especially when co-morbid depression is present

 

Acute Stress Reaction & Post Traumatic Stress Disorder (PTSD)

  • Acute stress disorder is normally time-limited and resolves without intervention (hours or days)
  • PTSD is emotional stress as a result from a near death experience or surviving types of trauma
  • rxperience of feeling dazed, reduced level of consciousness, agitation, withdrawal and anxiety symptoms

 

  • PTSD prevalence is 6.4%

 

Treatments- − Specialist treatment  

− Psycho-therapy  

− Occasional medications  

− Focus on resolving thoughts and emotions triggers by the trauma  

 

− rxploration of trauma & guilt, self-blame, coping mechanisms  

− CBT, desensitisation, family therapy

− Medications- antidepressants