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Anxiety and PTSD

What is Anxiety?
Anxiety is an emotion characterized by an unpleasant
state of inner turmoil, often accompanied by nervous
behavior, such as pacing back and forth, somatic
complaints, and rumination.

https://www.youtube.com/watch?v=kyG9HG4kJI4 (On the next Slide)


Video

https://www.youtube.com/watch?v=kyG9HG4kJI4
What Having Anxiety Feels Like
Signs and Symptoms of Anxiety
Feeling nervous, restless or tense
Having a sense of impending danger, panic or doom
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
Types of Anxiety (Anxiety disorder is an umbrella term that
includes different conditions)
Panic Disorder

Generalized Anxiety
Disorder

Social Anxiety Disorder

Specific Phobias

OCD

PTSD

Separation Anxiety
Generalized Anxiety Disorder
Symptoms of Generalized Anxiety Disorder From the DSM-5
The DSM-5 criteria that are used to diagnose GAD are as follows:
1. The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months
and is clearly excessive. Excessive worry means worrying even when there is nothing wrong or in a manner that is disproportionate to the actual risk. This
typically involves spending a high percentage of waking hours worrying about something. The worry may be accompanied by reassurance-seeking from others.
In adults, the worry can be about job responsibilities or performance, ones own health or the health of family members, financial matters, and other everyday,
typical life circumstances. Of note, in children, the worry is more likely to be about their abilities or the quality of their performance (for example, in school).
2. The worry is experienced as very challenging to control. The worry in both adults and children may shift from one topic to another.
3. The anxiety and worry are associated with at least three of the following physical or cognitive symptoms (In children, only one symptom is necessary for a
diagnosis of GAD):
Edginess or restlessness
Tiring easily; more fatigued than usual
Impaired concentration or feeling as though the mind goes blank
Irritability (which may or may not be observable to others)
Increased muscle aches or soreness
Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep)
Many individuals with GAD also experience symptoms such as sweating, nausea, or diarrhea.
The anxiety, worry, or associated symptoms make it hard to carry out day-to-day activities and responsibilities. They may cause problems in
relationships, at work, or in other important areas.
These symptoms are unrelated to any other medical conditions and cannot be explained by the effect of substances including a prescription
medication, alcohol, or recreational drugs.
These symptoms are not better explained by a different mental disorder.
Panic Disorder
How DSM-5 Diagnoses a Panic Disorder
The diagnostic criteria for panic disorder are defined in the DSM-5. It is an anxiety disorder based primarily on the occurrence of panic
attacks, which are recurrent and often unexpected.
In addition, at least one attack is followed by one month or more of the person fearing that they will have more attacks.

This causes them to change their behavior, which often includes avoiding situations that might induce an attack.

It's important to note that a panic disorder diagnosis must rule out other potential causes for the panic attack or what feels like one.

The attacks are not due to the direct physiological effects of a substance (such as drug use or a medication) or a general
medical condition.
The attacks are not better accounted for by another mental disorder. These may include a social phobia or another specific
phobia, obsessive-compulsive disorder, post-traumatic stress disorder, or separation anxiety disorder
Social Anxiety Disorder
The Current DSM-5 Definition:
A. A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible
scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and
humiliating.
B. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally
pre-disposed Panic Attack.
C. The person recognizes that this fear is unreasonable or excessive.
D. The feared situations are avoided or else are endured with intense anxiety and distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the
person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about
having the phobia.
F. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical
condition not better accounted for by another mental disorder
Specific Phobias
Specific phobia is a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.) diagnosis assigned to
individuals who suffer from intense fear or anxiety when exposed to specific objects or situations. A type of anxiety disorder,
specific phobias may present in response to a range of stimuli, from animals to medical procedures.

Phobias are defined as extreme or irrational fears, often persistent, that compel sufferers to avoid the object or situation to
which their fear is connected. A specific phobia relates to a particular stimulus that causes fear, anxiety or avoidance and
results in intense distress for the sufferer.

According to estimates, around 19.2 million adult Americans are afflicted by specific phobias1, with women affected more
often than men at an approximate rate of 2:1. Sufferers will often take measures to avoid the object or situation in question,
although individuals are aware that their fears are usually greater than the threat itself.

Specific phobias fall under the heterogeneous disorders group, having no single universal cause or pattern of development.
Most specific phobias develop during childhood and adolescence, although the disorder may present at any stage, often in
connection with a traumatic experience2. Other factors that may be connected to the onset of specific phobia include
genetic predisposition and familial influence.
Clinical Definition of OCD

OCD
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides clinicians with official definitions of and
criteria for diagnosing mental disorders and dysfunctions. Although not all experts agree on the definitions and criteria set forth in the
DSM-5, it is considered the "gold standard" by most mental health professionals in the United States.
DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (300.3)
A. Presence of obsessions, compulsions, or both:

B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.

C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or
another medical condition.

D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder;
preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair
pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement
disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive
disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in
disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional
preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).
OCD cont.
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and
unwanted, and that in most individuals cause marked anxiety or distress.
2.The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or
action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that
the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2.The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation;
however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or
are clearly excessive.

Note: Young children may not be able to articulate the aims of these behaviors or mental acts.Specify if:
With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or
that they may or may not be true.
With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true.
With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.
Specify if:
Tic-related: The individual has a current or past history of a tic disorder.
Separation Anxiety
A condition that children feel when he/she is separated from home or parents or a
loved one.

Little kids are more likely to have separation anxiety when they go to school, over
to friends houses, other houses and more.

How long separation anxiety lasts can vary, depending on the child and how a
parent respond

If separation anxiety appears out of the blue in an older child, there might be
another problem, like bullying or abuse.
How Anxiety Affects Sleep
The anxiety that characterizes GAD often interferes with the ability to sleep
and leads to insomnia
Your mind keeps racing and makes it tough to sleep
You cant shake the thoughts from your mind
You might not sleep more than 3 to 5 hours a night
Tips to Help with Sleeping when you have
Anxiety
Block out seven to nine hours for a full night of uninterrupted sleep
Establish a regular, relaxing bedtime routine
Never watch TV, use the computer, or pay bills before going to bed
Avoid coffee, chocolate, caffeinated soda, or nicotine in the evening
Make sure your bedroom is cool, dark, and quiet
Use your bedroom for sleeping and relaxing only
Keep worry and stress outside the bedroom
Exercise regularly, but not too close to your bedtime
Get into bed only when you are tired
Avoid looking at the clock
Try not to take naps
Talk to your doctor, if necessary
Celebrities with Anxiety
Emma Stone

Johnny Depp (Panic Disorder)

Kate Moss (Panic Disorder)

Leann Rimes

Oprah Winfrey

Kristen Bell

Royce White-NBA Player


Statistics About Anxiety
*Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States
age 18 and older, or 18.1% of the population every year.Anxiety disorders are highly treatable, yet only 36.9% of
those suffering receive treatment.

*People with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to
be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders.

*Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and
life events.

*Seven out of ten adults say they have trouble sleeping when they have anxiety

https://adaa.org/about-adaa/press-room/facts-statistics
Generalized Anxiety Disorder (GAD) Facts
GAD affects 6.8 million adults, or 3.1% of the U.S. population, yet only 43.2% are receiving treatment.
Women are twice as likely to be affected as men.
Panic Disorder (PD)
PD affects 6 million adults, or 2.7% of the U.S. population.
Women are twice as likely to be affected as men. GAD often co-occurs with major depression.
Social Anxiety Disorder
SAD affects 15 million adults, or 6.8% of the U.S. population.
SAD is equally common among men and women and typically begins around age 13. According to a 2007 ADAA survey, 36% of
people with social anxiety disorder report experiencing symptoms for 10 or more years before seeking help.
Specific Phobias
Specific phobias affect 19 million adults, or 8.7% of the U.S. population.
Women are twice as likely to be affected as men.
Symptoms typically begin in childhood; the average age-of-onset is 7 years old.
Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are closely related to anxiety disorders, which some
may experience at the same time, along with depression.
Obsessive-Compulsive Disorder (OCD)
OCD affects 2.2 million adults, or 1.0% of the U.S. population.
OCD is equally common among men and women.
The average age of onset is 19, with 25 percent of cases occurring by age 14. One-third of affected adults first experienced symptoms
in childhood.
Facts cont.
Posttraumatic Stress Disorder (PTSD)
PTSD affects 7.7 million adults, or 3.5% of the U.S. population.
Women are more likely to be affected than men.
Rape is the most likely trigger of PTSD: 65% of men and 45.9% of women who are raped will develop the disorder.
Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD.
Major Depressive Disorder
The leading cause of disability in the U.S. for ages 15 to 44.3.
MDD affects more than 16.1 million American adults, or about 6.7%of the U.S. population age 18 and older in a given year.
While major depressive disorder can develop at any age, the median age at onset is 32.5 years old.
More prevalent in women than in men.
Persistent depressive disorder, or PDD, (formerly called dysthymia) is a form of depression that usually continues for at least two
years.
Affects approximately 1.5 percent of the U.S. population age 18 and older in a given year. (about 3.3 million American adults). Only
61.7% of adults with MDD are receiving treatment. The average age of onset is 31 years old.
Cycle of Anxiety
Through the Flower
Vicious Flower Model Of
Anxiety
Center=Negative thinking

Pedal One= Uncontrollable

Pedal Two= Dangers

Pedal Three= Positive

Pedal Four= Unhelpful Behaviors

Pedal Five= Attention


Personal Experience

13 Things People Dont Realize You Do Because Of Your


Anxiety
Personal Experience
Janaes Personal Experience with Generalized Anxiety Disorder

-Journey

-Therapy

-Breathing Exercise

- Sleep Exercise
Treatment
Therapy (Types of Therapy)
Cognitive-Behavioral Therapy (CBT)

Breathing techniques (examples on next page)


Grounding Tool (examples on next couple of pages)
Medication
Xanax or Niravam (alprazolam)
Klonopin (clonazepam)
Ativan (lorazepam)
Valium (diazepam)
Exercise
Yoga
Breathing Techniques
Janae will teach the class ways to calm their breathing when they feel their anxiety
is getting bad.

Example One: Belly Breathing

One hand on top of chest and other hand on the stomach


Janae will teach the class the Grounding Tool Technique.

Technique One: When you are out and about (have children as class do it)
5 things you can see
4 things you can touch
3 things you can hear
2 things you smell
1 thing you taste

Technique Two: When you are in Bed (eye closed)


5 things you see
5 things you hear
5 things you feel/touch
Anxiety Activity
PTSD
Definition of PTSD- Post Traumatic Stress Disorder

- is a mental health condition that's triggered by


a terrifying event either experiencing it or
witnessing it.
Signs and Symptoms of PTSD
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.

https://www.youtube.com/watch?v=BEHDQeIRTgs (On the Next Slide)


Video

https://www.youtube.com/watch?v=BEHDQeIRTgs
Causes that Lead to PTSD
Assault
Domestic abuse or intimate partner violence
Prison Stay
Rape
Terrorism
War
Activities that might Lead to
PTSD
Car Crash
Natural Disasters
Civilians in the Midst
of War
Assault
Relationship to Anxiety
PTSD is often accompanied with one or more of the anxiety disorders.
Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that may
develop after witnessing a deeply distressing or disturbing experience, or
after experiencing a serious injury.
Treatment Options
The main treatments for people with PTSD are medications, psychotherapy (talk
therapy), or both.

Cognitive Behavioral Therapy (CBT): This psychiatric therapy technique


encourages the patient to learn the connection between their thoughts, feelings,
and behaviors. This understanding can allow the patient to visualize the
underlying cause of their anxiety.
Medication
The most studied medications for treating PTSD include antidepressants, which
may help control PTSD symptoms such as sadness, worry, anger, and feeling
numb inside.
Psychotherapy
Psychotherapy (sometimes called talk therapy) involves talking with a mental
health professional to treat a mental illness. Psychotherapy can occur one-on-one
or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it
can last longer. Research shows that support from family and friends can be an
important part of recovery.
Sources:
Seligman, M.E.P.; Walker, E.F.; Rosenhan, D.L. Abnormal psychology (4th ed.). New York: W.W. Norton &
Company.[page needed]

Anxiety. (2017, August 16). Retrieved November 01, 2017, from https://www.mayoclinic.org/diseases-
conditions/anxiety/symptoms-causes/syc-20350961

Stress and Anxiety Interfere With Sleep. Anxiety and Depression Association of America, ADAA,
adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/stress-and-anxiety-interfere.

Pendley, J. S. (Ed.). (2016, October). Separation Anxiety. Retrieved November 01, 2017, from
http://kidshealth.org/en/parents/sep-anxiety.html#