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Understanding and Eliminating Anxiety and Panic Attacks

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Todd McPherson

on 8 December 2013

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Transcript of Understanding and Eliminating Anxiety and Panic Attacks

Keep Calm, and Breathe
Todd McPherson: Psychologist
Understanding and Eliminating Anxiety and Panic Attacks
Anxiety disorders:
Most common form of "mental illness."
Affect approximately one in every five people.
Anxiety disorders include:
Panic attacks
Obsessive compulsive behaviours
Social anxiety
Generalized anxiety disorder
Perfectionism and excessive health worries are also forms of anxiety.
You are not alone
Everybody worries. It is normal to think and rethink things that are important to us or to wonder what will happen if we make certain choices.
Worry can be part of problem solving. It is a mental process.
Why Worry?
What is Anxiety?
Anxiety is worry, but with physiological effects (tense muscles, rapid breathing and rapid heartbeat) and negative emotions like dread, helplessness and fear.

Anxiety involves worrying thoughts, uncomfortable feelings and physiological arousal.
What's Normal Anxiety?
Anxiety is a typical response to a situation where we are concerned about our safety, our performance or how others perceive us.
Feeling anxious before giving a public presentation, writing an exam or bungee jumping would be normal.
When is Anxiety a Problem?
Anxiety becomes a problem when it interferes with normal living.
When you worry about how much you're worrying.
When you can't stop worrying.
When you worry about things that others don't.
When you are not doing things you want to do.
When you start to think it's not normal.
When you believe you shouldn't be worried, but still are.
When anxiety often keeps you awake.
When you start to do things you don't want to do.
Specific Phobia
Obsessive-Compulsive Disorder
Social Anxiety Disorder
Generalized Anxiety Disorder
Panic Disorder
Anxiety Disorders
Extreme anxiety and fear of a specific object or situation.
Extreme avoidance.
Symptoms are disruptive to everyday life (such as quitting a great job because you have to use an elevator).

5% of the population
2-4 times more likely in women.
Specific Phobia
A persistent fear of one or more social or performance situations where you might be exposed to unfamiliar people or possible scrutiny by others.

Fearing you will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.

Prevalence of around 8-15%
Equally common in men and women
Social Anxiety Disorder (Social Phobia)
A persistent fear of one or more social or performance situations where you will be exposed to unfamiliar people or to possible scrutiny by others.

Fearing you will act in a way that will be embarrassing and humiliating.
Obsessive-Compulsive Disorder
A combination of both obsessions and compulsions.

Recurring and persistent thoughts that are intrusive and cause distress.
You try to stop these thoughts.
You know they are in your own head.

Repetitive behaviour you feel you must perform.
These behaviours are an attempt to reduce distress from the thoughts.

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.

3% prevalence
Generalized Anxiety Disorder
Excessive anxiety about many things.
Difficult to control the worry.
The worry causes some of the following:
Restlessness or agitation
Being easily tired
Difficulty concentrating or mind going blank
Muscle tension
Sleep disturbance

Prevalence, around 6%
Panic Attack
A short period of intense fear and a sense of impending doom, with physical symptoms:
Chest pain or tightness
Chills or hot flushes
Derealization (feelings of unreality) or depersonalization (being detached from oneself)
Fear of losing control
Feeling dizzy, unsteady, lightheaded, or faint
Feeling of choking
Nausea or abdominal distress
Palpitations or tachycardia
Sensations of shortness of breath or smothering
Trembling or shaking
Panic Disorder
Persistent fear of having more panic attacks.
Worry about the implications of the attack or its consequences.
A significant change in behavior.

Twice as common in women as men
Prevalence: Men: 0.5-1.5%, Women: 1-3%
Agoraphobia often comes as a consequence of panic attacks.
Fear of being in places or situations from which escape might be difficult (or embarrassing) or in which help might not be available if something happens.
The situations are typically avoided or require the presence of a companion.
Can be the result of a traumatic event.
Usually the result of irrational or "faulty" thinking.
Maintained by this kind of thinking.
Anxiety often begins when our body unexpectedly experiences the physical symptoms of anxiety.
To understand these symptoms, we often blame our surroundings or situation:
It's too crowded and suffocating here.
Maybe I have a disease.
I might embarrass myself.
People are thinking negatively about me.
Maybe I've forgotten something.

Can be related to sleeplessness.
This can lead to anxiety when we are in that situation in the future.

This is especially true for panic attacks.
Anxiety can also begin with anxious thoughts that become so extreme that they provoke the physiological symptoms of anxiety.
Physiological symptoms and thoughts work together to increase anxiety.
This can be made worse by our behaviours.
Doing things to avoid anxiety usually leads to increased anxiety.
This complex combination of thoughts, physiological symptoms and behaviours is what keeps anxiety in our lives.
Anxiety and anxiety disorders respond extremely well to therapy/counselling.
Cognitive-Behavioural Therapy
CBT focuses on helping clients change their thoughts and actions to overcome anxiety and eliminate it from their lives.

Most effective form of therapy.
Various medications are helpful in reducing anxious feelings and some of the distress of anxiety.
Anti-Anxiety Drugs (Tranquilizers / Benzodiazepines)
Work on the central nervous system to calm and relax within thirty minutes to an hour.
Most widely presecribed.
Slow down brain activity.
May lead to addiction.
These include certain selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and the newer atypical antidepressants.
4-6 weeks to take effect.
Withdrawal can be an issue.
Buspirone and Beta-Blockers
Buspirone is are slow acting but has fewer side effects.
Best for GAD, not so effective with other anxieties.

Beta-blockers help control the physiological symptoms and can be taken prior to an anxiety-provoking event to help control "nerves."
Doesn't reduce emotional part of worry.
Best Treatment
Diaphragmatic breathing is one of the most immediate and helpful tools in fighting anxiety.

It helps to reduce the physiological symptoms of arousal caused by anxiety.
Medication alone does not cure anxiety or treat the underlying causes.

Can be considered an aid to making changes in thinking and behaving.

Should be used with therapy to treat the underlying problem.

Therapy alone
eliminate anxiety.
I don't sleep well one night.
Next night I worry I won't sleep, so I get more anxious, and don't sleep. The following night I'm even more anxious about not sleeping and less likely to sleep.
I have a presentation to deliver for work. I start to worry about it so much I get strong physical symptoms and feel like I cannot give the presentation.
You need to break the cycle by controlling your body, controlling your thoughts and controlling your behaviours.
Relaxation exercises.
Breathing control.
Attentional control.
Feeling distress is normal.
Physiological symptoms don't indicate a problem.
Challenge illogical thoughts.
Be easier on yourself.
Don't cooperate with the anxiety.
Do what makes you feel strong and in control, even if it's uncomfortable.
Many people don't know they're suffering from anxiety, they believe they have a medical problem.
Childhood Anxiety
Many children experience intense anxiety, but it may be unrecognised and attributed to "bad behaviour."

It is very important for children to receive treatment.

Approximately 5% to 10% of children have anxiety disorders.
Separation anxiety
Refusal to go to school
Difficulty sleeping
Refusal to sleep alone
Selective mutism
Refusal to sleep over
Frequent stomachaches or nausea
Todd McPherson

Phone: 8637750
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