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Patrick McGee & Associates
Psychologists, Counselling Sydney

ANXIETY DISORDERS, counselling Sydney & About Counselling Solutions

There are various types of anxiety disorders. Anxiety can become very serious if left untreated. It's important to realize that they can also be accompanied by depression, eating disorders, substance abuse or another anxiety disorder, compounding the problem. There are several types of anxiety disorders. They include:

Social Anxiety Disorder (SAD)

SAD is the most common of the anxiety disorders, with with 1:4 people afflicted by it. It is characterized by a persistent fear of social or performance situations.

In social situations people with SAD become very nervous. They feel that people are looking at them, that they're not saying the right things, or they don't look right. These afflicted with SAD can become very shy and begin to avoid social situations. As a result, they don't have as many friends as they could. It also affects their ability to perform at work because many jobs involve speaking in front of other people or being in group meetings where you are expected to make a contribution.

Generalised Anxiety

If you often feel anxious without reason and your worries disrupt your daily life, you may have generalized anxiety disorder (GAD).

Generalized anxiety disorder causes excessive or unrealistic anxiety and worry about life circumstances, usually without a readily identifiable cause.

Post-traumatic stress disorder (PTSD)

PTSD is a reaction to a terrifying event that keeps returning in frightening, intrusive memories. The traumatic event could be something you see or something that happens to you directly. PTSD produces an intense fear and a sense of helplessness. People with this disorder can become detached and emotionally numb. They may feel guilt for surviving. The survivors wonder, why me? They also often have problems sleeping.

Excessive: Generalised Anxiety Disorder

Like social anxiety, a certain amount of worry is normal and useful. If we worry about a possible future event it can help us to prepare for it. However, in some people worry gets out of hand. When this happens, people spend a substantial proportion of their time worrying, without ever really resolving the issues they are worrying about. Despite trying hard to stop the worry, people find that it recurs incessantly, and becomes very difficult to control. The kinds of issues people tend to worry about are:

• Work and/or school
• Health
• Finances
• Minor matters such as punctuality
• Safety, including terrorism, car accidents, plane crashes etc
• Social and interpersonal issue

These worries typically involve persistent "what if?" thoughts, such as:

"What if I mess this up?"
"What if I fail this exam / get the sack?"
"What if I get a fatal disease?"
"What if my children / parents get ill / have an accident?"
"What if I can't keep up the mortgage payments?"

The anxiety associated with such worries often creates ongoing feelings of tension, agitation, irritability, fatigue, sleep disturbance, and/or difficulty concentrating. Sometimes the worrying thoughts can be so persistent that they interfere with productivity and performance at work or school, and get in the way of enjoying everyday life.

Treatment

With effective treatment, people can reduce their worrying to more manageable and normal levels, and reduce its impact on their lives.

Psychological intervention

Generally, intervention starts with interpersonal therapy, this treatment involves receiving help from a mental health professional through a combination of talking and listening.

The psychologist will employ cognitive behavior therapy to examine distorted thinking that lead to psychological problems.

During cognitive behavior therapy, a therapist helps you identify distorted thoughts and beliefs that trigger psychological stress, fear or depression. You learn to replace negative thoughts with more positive, realistic perceptions, and you learn ways to view and cope with life events differently. Generally a short-term treatment, cognitive behavior therapy emphasizes learning to develop a sense of mastery and control over your thoughts and feelings.  

PANIC DISORDER

People with panic disorder have recurrent, unexpected feelings of extreme fear and dread that strike for no apparent reason, causing their heart to race, rapid breathing, sweating, and shakiness. These "attacks" can send people to the hospital believing they are having a heart attack.
A panic attack often begins abruptly, peaks within 10 minutes and lasts about half an hour. But panic attacks have many variations. They may last hours or, on rare occasions, up to a day. You may feel fatigued and worn out after a panic attack subsides.

Signs and symptoms may include:

• Rapid heart rate
• Sweating
• Trembling
• Shortness of breath
• Chills
• Hot flashes
• Nausea
• Abdominal cramping

• Chest pain
• Headache
• Dizziness
• Faintness
• Tightness in your throat
• Trouble swallowing
• A sense of impending death

Other health problems — such as an impending heart attack, an overactive thyroid gland (hyperthyroidism) or drug withdrawal — can cause similar signs and symptoms.
People who experience panic attacks often are affected by other mental health conditions, including depression, fear of public places (agoraphobia) and social phobia.
 
Treatment

Treatment for panic attacks and panic disorder is very effective. The outlook is good if you seek help, and most people are eventually able to resume everyday activities. Treatment may involve:

Cognitive behavior therapy. During sessions with your psychologist, you learn to better understand your panic attacks and how to deal with them. In the cognitive part of the therapy, you learn to recognize things that trigger your panic attacks or make them worse. The behavioral part of the therapy involves learning ways of coping with anxiety, such as using breathing and relaxation techniques. If you're avoiding common situations because of fear of panic attacks, behavior therapy can help you overcome this avoidance, which may be limiting the quality of your life.

OBSESSIVE-COMPULSIVE DISORDER (OCD)

People who suffer from OCD become trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to stop. If severe and left untreated, OCD can destroy a person's capacity to function at work, at school, or even in the home.

Obsessive-compulsive disorder symptoms include both obsessions and compulsions. OCD symptoms can be severe and time-consuming. For instance, someone may repeatedly wash their hands as a result of feeling that his or her hands have become contaminated by germs (an obsession), may spend hours washing them each day, (a compulsion). The focus on constant hand washing may  effect their daily functioning, sothat they accomplish little else.

Obsessions
OCD obsessions are repeated, persistent, intrusive ideas, thoughts, images or impulses that you experience involuntarily and that appear to be senseless. These obsessions typically intrude when you're trying to think of or do other things.

Typical OCD obsessions revolve around:

• Fear of contamination or dirt
• Repeated doubts
• Having things orderly and symmetrical
• Aggressive or horrific impulses
• Sexual image

OCD symptoms involving obsessions may include:

• Fear of being contaminated by shaking hands or by touching objects others have touched
• Doubts that you've locked the door or turned off the stove
• Repeated thoughts that you've hurt someone in a traffic accident
• Intense distress when objects aren't orderly, lined up properly or facing the right way
• Images of hurting your child
• Impulses to shout obscenities in inappropriate situations
• Avoidance of situations that can trigger obsessions, such as shaking hands
• Replaying pornographic images in your mind
• Dermatitis because of frequent hand washing
• Skin lesions because of picking at the skin
• Hair loss or bald spots because of hair pulling

Compulsions

Compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety or distress related to your obsessions. For instance, if you believe you ran over someone in your car, you may return to the scene over and over because you just can't shake your doubts. You may even make up rules or rituals to follow that help control the anxiety you feel when having obsessive thoughts.

Typical compulsions revolve around:

OCD symptoms involving compulsions may include:

Treatment
Obsessive-compulsive disorder treatment can sometimes be difficult, and it may not offer a cure. However, OCD treatment can help you bring symptoms under control so that they don't rule your daily life.

Psychological intervention: Cognitive behavior therapy has been shown to be the most effective form of therapy for OCD in both children and adults. Cognitive behavior therapy involves retraining your thought patterns and routines so that compulsive behaviors are no longer necessary. One approach in particular is called exposure and response prevention. This therapy involves gradually exposing you to a feared object or obsession, such as dirt, and teaching you healthy ways to deal with it. Learning the techniques and new thought patterns takes effort and practice, but it's worth it. Most people with obsessive-compulsive disorder show improvement of signs and symptoms with cognitive behavior therapy.

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