MANAGING ANXIETY DISORDERS

MANAGING ANXIETY DISORDERS –

DR. ANGELA LYKINS, PH.D., HSPP

LICENSED CLINICAL PSYCHOLOGIST

HEALTH SERVICE PROVIDER IN PSYCHOLOGY

OBJECTIVES

• LIST POTENTIAL CAUSES OF ANXIETY

• ADDRESS SYMPTOMS AND CHARACTERISTICS

• UNDERSTAND PREVALENCE RATES

• DISCUSS POTENTIAL TECHNIQUES

• IDENTIFY ASSESSMENTS AND RESOURCES

WHAT IS AN ANXIETY DISORDER? DIAGNOSTIC AND STATISTICAL MANUAL, 5TH EDITION

A) PERSISTENT FEARB) EXPOSURE TO THE FEAR PROVOKES ANXIETYC) THE PERSON KNOWS THE FEAR IS UNREASONABLED) THE FEARED SITUATIONS ARE AVOIDEDE) ANXIETY INTERFERES SIGNIFICANTLY WITH DAILY LIFE F) THE FEAR, ANXIETY, OR AVOIDANCE IS PERSISTENT, TYPICALLY LASTING 6 OR MORE MONTHS G) THE FEAR OR ANXIETY IS NOT DUE TO DIRECT PHYSIOLOGICAL EFFECTS

MANY COMPLICATED

TERMS

WHERE DO WE BEGIN?

CAUSES OF ANXIETY DISORDERS: NEUROBIOLOGICAL

DYSREGULATION OF AUTONOMIC NERVOUS SYSTEM

SENSORY INTEGRATION

ABNORMAL CARDIOVASCULAR AND ELECTRODERMAL RESPONSES

GENETIC TEMPERAMENT OF FAMILY

CAUSES OF ANXIETY DISORDERS: STRUCTURAL ABNORMALITIES

ABNORMALITIES OF SEROTONIN AND DOPAMINE

METABOLIC DEFICITS IN FRONT CORTEX

STRUCTURE ABNORMALITIES IN AMYGDALA AND HIPPOCAMPUS; LIMBIC SYSTEM AS A WHOLE

LIMBIC SYSTEM: PREFRONTAL CORTEX

CAUSES OF ANXIETY DISORDERS: ENVIRONMENTAL

TRAUMA/BULLYING

MULTIPLE HOMES TRANSITIONS

STRESSFUL WORK AND

SOCIAL SITUATIONS

ILLNESSSTRICT

ROUTINES AND LACK OF CHOICE

SERVICE PROVIDERS

FROM DIFFERENT

DISCIPLINES AND AGENCIES

COMMON TYPES OF ANXIETY DISORDERS

GENERALIZED ANXIETY DISORDER (GAD)


PANIC DISORDER


OBSESSIVE COMPULSIVE DISORDER


PHOBIA


SOCIAL ANXIETY DISORDER


POSTTRAUMATIC STRESS DISORDER


GENERALIZED ANXIETY DISORDER (GAD)PANIC DISORDEROBSESSIVE COMPULSIVE DISORDER

PHOBIASOCIAL ANXIETY DISORDERPOSTTRAUMATIC STRESS DISORDER (PTSD)

SYMPTOMSEXCESSIVE WORRY

RESTLESSNESS FATIGUE

DIFFICULTY CONCENTR

ATINGIRRITABI

LITY

MUSCLE TENSIO

N

HEART PALPITATIO

NS

ACCELERATED HEART

RATESWEATI

NG TREMBLI

NGPHOBIA

SHYPERVIGILAN

CE

PANIC ATTACK

S

OBSESSIVE

THOUGHTS

COMPULSIVE

BEHAVIORS

SCREAMING YELLING FLAPPING

ROCKING

SLEEP DISTURBAN

CESWITHDRA

WAL

AGGRESSION

INTERRUPTING

REPETITIVE

QUESTIONS

SELF-INJURIO

US BEHAVIO

RS

????

HOW DO WE RECOGNIZE SYMPTOMS IN

OURSELVES AND WITH OTHERS?

PREVALENCE• STATISTICS: MOST COMMON MENTAL HEALTH

DIAGNOSIS IN THE U.S. (PER NATIONAL INSTITUTE OF MENTAL HEALTH-NIMH).

• OF THE 40 MILLION PEOPLE DIAGNOSED WITH ANXIETY DISORDER

A) ALMOST 7 MILLION SUFFER FROM GAD

B) ALMOST 14 MILLION SUFFER FROM SOCIAL ANXIETY DIOSRDER

C) ALMOST 7 MILLION AFFECTED BY PTSD

D) ALMOST 13 MILLION EXPERIENCE COMORBID DX OF DEPRESSION

COMORBIDITY

POTENTIAL TECHNIQUES• PSYCHOTHERAPY: COGNITIVE BEHAVIORAL THERAPY

• TELL YOURSELF: “IT’S OK TO FEEL ANXIOUS”

• WILLINGNESS: CHOOSING AND ACCEPTING TO FEEL WHAT YOU ARE EXPERIENCING IN THE MOMENT

• WHY DO YOU WANT TO BEAT ANXIETY? TALK OUT LOUD

• MINDFULNESS: PRESENT MOMENT HEADSPACE OR STOP, BREATHE & THINK – 10 MINUTES A DAY

• ACCEPTANCE AND COMMITMENT THERAPY (ACT)

• GROUNDING (ANXIETY, FLASHBACKS, PTSD, IMPROVING MENTAL HEALTH) – PARASYMPATHETIC RESPONSE COUNTERACTS THE FEAR RESPONSE

• SELF-REGULATION ACTIVITIES (BREATHING TECHNIQUES)

• SHARING DAILY A MISTAKE YOU MADE (AT DINNER TABLE, JOURNAL, SOCIAL MEDIA)

COGNITIVEBEHAVIORAL THERAPY

POTENTIAL TECHNIQUES: BEHAVIORAL• LIFE STYLE

• REDUCE STIMULI (LIGHTING, CLUTTER, NOISE, TEMPERATURE)

• REDUCE TRANSITIONS

• SKILL BUILDING

• PROVIDE ACTIVITIES TO ENGAGE WITH OTHERS

• TEACH CAREGIVERS TECHNIQUES TO IMPROVE COMMUNICATION SKILLS

• REDIRECTION

• POSITIVELY REINFORCE FOR DESIRED BEHAVIORS

POTENTIAL TECHNIQUES : PHARMACOTHERAPY

SELECTIVE SEROTONIN REUPTAKE INHIBITORS

(SSRI): PROZAC, CELEXA,

LEXAPRO, ZOLOFT, PAXIL,

LUVOX

SEROTONIN NOREPINEPHRIN

E REUPTAKE INHIBITORS

(SNRI): PRISTIQ, CYMBALTA, EFFEXOR

BENZODIAZEPINE: XANAX,

KLONOPIN, VALIUM

POSSIBLE SIDE

EFFECTS

ASSESSMENTS/RESOURCES• SELF-REPORT & INFORMANT REPORT: GLASGOW

ANXIETY SCALE

• PHQ-9 (PATIENT HEALTH QUESTIONNAIRE) – USED BY HEALTH CARE PROFESSIONALS

• MASS (MOOD AND ANXIETY SEMI-STRUCTURED INTERVIEW) –USED BY HEALTH CARE PROFESSIONALS

• ADAMS (ANXIETY, DEPRESSION, AND MOOD SCALE) – USED BY HEALTH CARE PROFESSIONALS

• THE FEAR SURVEY

LOTS OF WORK TO BE DONE

REFERENCES• ADDRESSING ANXIETY IN INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, DR. JULIE STECK, CRG, JUNE 2016

• ANXIETY AND INTELLECTUAL DISABILITY, MOLLY FAULKNER, PH.D., CNP, LISW UNIVERSITY OF NEW MEXICO, MARCH 2015

• ANXIETY, DEPRESSION AND MOOD SCALE, AJ ESBENSEN , J ROJAHN , MG AMAN,S RUEDRICH , 2003

• THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; 5TH EDITION, PUBLISHED BY AMERICAN PSYCHIATRIC ASSOCIATION, 2013

• GLASGOW ANXIETY SCALE FOR PEOPLE WITH AN INTELLECTUAL DISABILITY (GAS-ID), BLACKWELL PUBLISHING 2003

• INDIANA FAMILY & SOCIAL SERVICES ADMINISTRATION

• MENTAL HEALTH ISSUES FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, KAREN TOTO, LMFT, JANUARY 2017

• THE MOOD AND ANXIETY SEMI-STRUCTURED INTERVIEW, CHARLOT, DEUTSCH, HUNT, FLETCHER, & MCILVANE, 2007

• PATIENT HEALTH QUESTIONNAIRE-9, EDUCATIONAL GRANTS FOR DRS SPITZER, WILLIAMS AND KROENKE

CONTACT INFORMATION

DR. ANGELA LYKINS

LYKINS COUNSELING CLINIC

4221 N BROADWAY AVENUE

MUNCIE, IN 47303

765-282-7150

[email protected]

MANAGING ANXIETY DISORDERS

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