Category: Anxiety Disorder

Commonly anxiety is caused through environmental factors such as personal relationships, school, job, or financial predicament can contribute greatly to anxiety disorders. Anxiety plagues the mind by a constant state of worry, dread, and fear. This eventually would lead to domination over one’s thought processes to the extent that it starts to interfere with daily functioning such as work, school, social activities, and relationships. These frequent overwhelming feelings can lead one to drug use, alcohol use, eating disorders, or even self-mutilation as a means of release from these feelings of distress, in turn significantly putting the individual’s health at great risk in several ways.

Types of Anxiety

Anxiety can be diagnosed in three Anxiety disorders are in part grouped together based on their shared symptoms. However, many people experience a range of symptoms across the spectrum of disorders. Anxiety symptoms that begin to interfere with normal activities in life and relationships could point to an anxiety disorder.

Generalized anxiety disorder (GAD): Generally most common amongst anxiety disorders. GAD refers to the feeling of excessive worry about many different things. Usually, these issues relate to things like work, safety, or family, and are usually much more serious compared to other forms and more likely to interfere with your personal life. GAD signs include the difficulty of doing tasks on a daily basis. This may also result in the person taking drugs and may cause them to experience physical problems.

Social anxiety: meaning that one may have an intense fear of social situations such as public speaking. It is an intense, recurrent fear that others will be watching and judging. This fear can have an effect on your job, education, and other daily activities.

Specific phobias: Specific phobias are an overwhelming and unreasonable fear of objects or situations that pose little real danger but provokes anxiety and avoidance. Meaning they are anxious about specific situations such as having an injection.

Panic disorders: causing one to have intense and overwhelming uncontrollable feelings of anxiety combined with many physical symptoms. Panic attacks are intense overwhelming and are usually uncontrollable intense feelings of anxiety.

Signs and symptoms

The symptoms of anxiety conditions are sometimes not all that obvious as they often develop slowly over time and, given we all experience some anxiety at various points in our lives, it can be hard to know how much is too much. While each anxiety condition has its own unique features, there are some common symptoms including:

Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up and edgy. Typically symptoms of panic disorders.

Psychological: excessive fear, worry, catastrophizing, or obsessive thinking, feeling intense fear of situations that involve social situations. Usually symptoms of social anxiety.

Behavioral: avoidance of situations that make you feel anxious which can impact on study, work, or social life, excessive fear (specific phobias).

Prevalence higher in women than men- At least one in seven women report experiencing an anxiety-related condition. According to research, anxiety disorders are far more common among women, who were twice as likely to be affected than men. This can be due to some mood changes and depressed feelings that occur with normal hormonal changes. Other biological factors, inherited traits, and personal life circumstances and experiences are associated with a higher risk of anxiety. Here’s what contributes to anxiety in women. Dramatic hormonal changes occur during pregnancy, and these can affect mood. Work overload. Often women work outside the home and still handle home responsibilities. Many women deal with the challenges of single parenthood, such as working multiple jobs to make ends meet. Also, women may be caring for their children while also caring for sick or older family members. Sexual or physical abuse. Women who were emotionally, physically, or sexually abused as children or adults are more likely to experience anxiety at some point in their lives than those who weren’t abused. Women are more likely than men to experience sexual abuse.

Affecting Aboriginal Torres Strait Islander (ATSI)- According to the Australian Indigenous Health info net page, one in three Aboriginal and Torres Strait Islander adults have experienced high levels of psychological distress (anxiety). Aboriginal and Torres Strait Islander people are nearly twice as likely to die by suicide. These alarming trends show that mental illness within the ATSI population is significantly high and is increasing. This could be due to many also experience disadvantages in the form of unemployment, poverty, isolation, trauma, discrimination, trouble with the law, and alcohol and substance abuse.

Youth-Beyond blue: One in fourteen young Australians (6.9%) aged 4-17 experienced an anxiety disorder in 2015. This is equivalent to approximately 278,000 young people. Affecting youth- An increase in the trend of mental illness disorders for adolescents can be due to numerous factors. One of the main factors could be stress. An individual could experience stress through school. According to the World Health Organization, research suggests factors that can contribute to stress during adolescence include a desire for greater autonomy, pressure to conform with peers, exploration of sexual identity, and increased access to and use of technology. Stress is caused by many factors within adolescence leading to more stress within individuals increasing the anxiety rate within young people.

Risk factors and protective behaviors

Risk factors: Risk factors are those behaviors that increase the chance of developing a mental illness. Modifiable determinants are those that can be changed or controlled so they have a different level of influence on our health. Non-modifiable determinants are determinants that cannot be changed or altered examples include Genetics, Environmental.

Mental health problems and illnesses may arise from a wide range of factors, and they have the potential to affect anyone. Anxiety tends to have a significant life event that negatively impacts an individual. Anxiety is linked with substance abuse such as alcohol consumption and illicit drug use. Factors of heredity (non-modifiable) can also lead to the development of a mental illness. A major risk factor related to mental health is stigma, as many people feel embarrassed or are less likely to seek care and help for a physical illness. Other risk factors that may lead to the diagnosis of anxiety are:

Trauma (non-modifiable) can increase an individual’s chance of developing a mental health condition, such as depression, anxiety, or post-traumatic stress disorder (PTSD). A traumatic event is an incident that causes physical, emotional, spiritual, or psychological harm. An individual who has experienced trauma may cause them to feel a sense of distress/worry. This can lead to more frequent behavioral and psychological symptoms of anxiety such as excessive fear/worry or even a racing heart rate. This is due to the fear of a past traumatic event recurring, leading to the individual experiencing symptoms of anxiety causing him/her to be more prone to the illness. Trauma can stimulate many types of anxiety such as Generalised anxiety disorder, specific disorder, or even social anxiety.

A build-up of stressful situations (modifiable) such as school and conflict that brings about a lot of stress may trigger this disorder. Feeling stressed can be triggered by an event that makes you feel frustrated or nervous. According to the department of health the highest rate of anxiety was within the 16-24 age group. This can be due to environmental factors such as school, work, university, etc.

Drugs or illicit substances (modifiable) can cause or worsen one’s mental illness. According to a study done by SANE illicit drugs cause a condition called drug-induced Psychosis. Abuse of illicit substances will increase the tendency of Psychosis leading to a high chance of a mental illness such as anxiety, being triggered for a lifetime long. Using illicit substances can also make the symptoms of mental illnesses worse and make treatment less effective. The exploitation of illicit substances can cause symptoms of anxiety increases the chance of the diagnosis of the mental illness.

People with other mental health (modifiable) conditions such as depression can also develop anxiety. This could be due to the fact of the individual has poor mental health. For example, if someone has depression symptoms of poor mental health can include isolation from society (friends, peers) resulting in him/her being more prone to other mental illnesses such as anxiety (social anxiety).

Protective factors

Protective behaviors aim to improve the mental health of Australian individuals and communities. Due to the high prevalence rate and severe impacts of anxiety, governments, communities, and schools have made efforts to recognize and support those with or at risk of poor mental health. For instance, school curriculums include mental health problems through mandatory PDHPE lessons to ensure the youth is educated about the risk factors of anxiety or any mental illness. Other common protective behaviors that can be taken are:

Consistent home/family routine to prevent any situations where the individual wouldn’t stress on new situations where they wouldn’t know how to react. Studies suggest that a strong relationship with an individual’s family decreases the chance of being diagnosed with mental illnesses such as anxiety or depression. Ensuring a stable and strong relationship with family and friends is an important protective factor, as they as a family can act as a vital support network to the individual.

High social support allows individuals to have support in stressful situations that may bring about anxiety. This can also prevent social anxiety as social support may give a sense of comfort to the person.

Consistent physical activity brings about constant happiness to outweigh the stress, as, through exercise, endorphins are released to bring about these moods. Frequent physical activity can reduce stress symptoms and also could help an individual recover from a mental illness.

High self-esteem helps one feel good about themselves in several situations, preventing stressful moods and thoughts. High self-esteem can lead to fewer symptoms of anxiety.

Good problem-solving skills, allowing the individual to know how to react in many situations, preventing them from falling into instances where they don’t know what to do, which can cause one to feel stressed, worsening the anxiety.

Sociocultural: Refers to the way society perceives and stigmatizes mental health as perhaps one of the most significant risk factors. Families, media, religion, culture, and peers can impact an individual’s chances of developing anxiety in several ways. An example of the family can be the personality of a mother might be one that is usually anxious about many things. This could be a tendency a child could take on as they grow up, leading to an increase in anxiety from many things, increasing the likelihood of becoming anxious. However family, could also positively impact and individually as it can be important for their wellness and outcomes, but it also improves the mental health of individual family members and the family as a unit. Peers can positively impact an individual by reducing the possibility of getting this mental illness. Having a supportive group of friends by people supporting an individual through stressful times and helping them through hardships, decreasing the chance of anxiety in this situation. Peers can also negatively impact an individual by introducing the individual to illicit substances through peer pressure. This exposes the person to a risk factor of illicit substances. Media can educate individuals about what a healthy lifestyle is. It can teach people the risk factors of mental illnesses, decreasing the chances of diagnosis of a mental illness. Social Media also can cause a mental illness as it can lead to low self-esteem, making someone feel not as or good enough. This can be analyzed through the 60% of people using social media reported that it has impacted their self-esteem in a negative way. Religion and culture influence many things in one’s life, and the likelihood of developing a mental illness is one of them. Religions have certain beliefs and boundaries that must be followed in the same way as culture, where traditions can influence decisions to do many things, and this can also affect them in many ways. Religion can positively impact an individual as it can give people something to believe in, gives them a sense of meaning, and usually offers a group of people a bond over similar beliefs. Both factors can have a significant positive effect on mental health. Research suggests that religiosity decreases suicide, alcohol, and drug use. This can decrease the chance of social anxiety as an individual can connect with others through similar beliefs. Religion also reduces the chances of participating in risk factors as in religions the consumption of illicit substances is prohibited. Distance from religion can negatively impact the individual. If one suffers from forms of religious and spiritual difficulties, this could have an impact on their relationship with their religion. It affects the person emotionally and morally, as the individual does not feel any relation to his or her values, impacting his or her social health, which, in effect, may increase the chances of developing mental disorders such as depression and anxiety.

Socioeconomic

Socioeconomic refers to society-related economic factors. The socioeconomic factors that determine health include employment, education, and income. Education plays a vital role in the likelihood of an individual falling into any mental health condition in many ways. If the individual was not taught the effects of stress and a lack of sleep, then that person will feel there is no problem in participating in such harmful activities, not knowing the effects, therefore increasing the chance of developing anxiety as both a lack of sleep and stress are risk factors of anxiety. Employment is another determinant that affects the chance of an individual developing many types of different mental illnesses. Employment affects an individual in many ways such as family relationships and other aspects of health. Income is another factor that can determine one’s chance of developing mental illness. Income varies for many people and is very important to have in modern-day society to be able to survive a healthy lifestyle in every aspect.

Environmental Determinants

An individual’s geographical location significantly impacts one’s health. In many ways, geographical location can affect the chances of developing mental health issues and illnesses. This can be due to people living in rural and remote areas have less access to health care and support for mental health. People in rural/remote areas may also be susceptible to developing a mental illness such as anxiety, due to other factors such as isolation. Another way environmental sustainability may impact one’s health is through the lack of access to technology. Technology is a big part of modern-day society and is vital to have for many uses such as education, location help, etc. If a person does not have access to this then it can affect their health in negative ways. Technology can help an individual develop personal skills by educating themself, this can be done through reading online. Technology allows an individual to be aware of risk factors of mental illness decreasing the chance of the diagnosis of a mental illness.

Groups at risk

Aboriginal and Torres Strait Islander people (ATSI): are at risk due to aboriginal and Torres strait islanders usually coming from a low socioeconomic background. Indigenous Australians are nearly three times more likely to be psychologically distressed than non-Indigenous Australians, suggesting a high rate of poor mental health within the population. ATSI people are more likely to have behavioral risk factors present in their lifestyle than other Australians. For example the increasing rate of smoking among, risky alcohol consumption, illicit substance use. Due to the high rates of risk behaviors individuals within the ATSI population are more prone to mental illnesses than non-indigenous people. Another factor putting the ATSI population at risk is the majority living in rural areas. This disadvantages them as most people living in remote/rural come from low SES. Living in remote areas increases an individual’s behavior to interact with risk behaviors such as consumption of illicit substances.

Socioeconomically disadvantaged people (low SES) tend to be most at risk of mental illnesses. People from low SES appear to be less informed about factors affecting health. Smoking prevalence tends to fall as SES rises. Meaning that the lower the SES status the individual is the more chance of smoking. According to smokenet.gov, the use of tobacco use can trigger common anxiety symptoms. Some regular smokers believe smoking eases anxiety and they report this is a reason they continue to smoke. However, that’s because smoking relieves their nicotine withdrawal symptoms. This relief is only temporary and symptoms of anxiety are likely to return and the cycle will continue. When an individual is ‘hooked’ on the use of tobacco, constant anxiety symptoms will be affecting the individual as the urge to smoke. A low SES status could also have other factors putting them at risk of mental illnesses such as unstable employment, or those who live in substandard housing are more likely to suffer from anxiety, mood disorders, and increased substance abuse. A low SES can impact an individual’s diet as they might not be able to afford a healthy diet, resulting in an unhealthy diet. Poorer diets tend to be linked to poor mental health as they can worsen anxiety symptoms.

People who have experienced trauma (eg. Major accidents) are likely to experience a mental illness disorder such as anxiety due to the fear/worry of an individual’s past traumatic event recurring.

Males- in particular those aged 16-25 due to the high rates of smoking and use of illicit substances. Younger males tend to take more risks, increasing the chance of drug usage. Stressful situations are common within this age group as individuals may be coming from age leading them to make life decisions such as studying in university or being financially stable as an adult.

Prevalence is higher in women than men due to a range of factors such as hormonal changes, workload or even past traumatic events. At least one in seven women (15.7%) report experiencing an anxiety-related condition. A study done by the anxiety and depression association suggests that women are more sensitive to low levels of corticotropin-releasing factor (CRF), a hormone that organizes stress responses in mammals, making them twice as vulnerable as men to stress-related disorders.

Introduction

Menopause is the final menstrual period, representing the loss of ovarian follicular function. The menopause starts after 12 months without a menstrual period. Most women have their natural menopause in their 40s or 50s. (1)

Symptoms of menopause vary from one woman to another. As physical symptoms arising, mental health is also affected during menopause. Phycological symptoms include depression, anxiety, and a decreased sense of well-being (1).

There is little attention regarding anxiety symptoms experienced by menopausal women though such symptoms have a considerable impact on life. Siegel et al. revealed that a rather poor amount of literature addresses this issue (2).

Diagnosis

Anxiety disorders manifest excessive fear or anxiety, which is different from ordinary nervousness or anxiousness. There are six types of anxiety disorders in general, including generalized anxiety disorder, panic disorder, phobias, agoraphobia, social anxiety disorder, and separation anxiety disorder (3). For general diagnosis, it starts with a physical examination to exclude symptoms caused by the physical problem (3). After that, mental health professionals need a psychological evaluation to validate a diagnosis and potential complications. At last, mental health professionals need to complete matching patients’ symptoms with diagnostic criteria. Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria is widely used across the world (4).

Many tools are used to screen anxiety disorders in menopausal women, such as Greene Climacteric Scale (GCS), Women’s Health Questionnaire (WHQ), Menopause-Specific Quality of Life, The Menopause Rating Scale (MRS), The Midlife Women’s Symptom Index (MSI), and Everyday Complaint Checklist. GCS is extensively used both clinically and academically for its coverage of psychological, somatic, and vasomotor symptoms with 21 items (5).

Women in menopause have more intensive anxiety symptoms regarding similar issue than they are not in menopause. As Bremer et al. reported, although the severity of anxiety is individualized, most women tend to share similar symptoms including “short of breath”, “weakness”, “feeling a sense of loss of control”, “waking up between 2 and 3 am with heart racing” . The anxiety experience of women in menopause is unique. Bremer et al. further pointed out DSM-5 criteria may not be suitable for the unique diagnosis. (6)

Prevalence

World Health Organization reported an estimation of 1.2 billion women worldwide to be menopausal by the year 2030. 1.5 million women in Australia experienced distinct menopause symptoms each year (7). A population-based assessment found that 86% of Australian women in their mid-life did consultations with doctors for solutions of menopausal symptoms (8). An early study in 2001 also showed that 51% of women aged between 40 and 55 years old reporting anxiety symptoms in last fortnight or at the moment (9) while another study in 2004 showed that 25% of mid-life women suffering from frequently occurred anxiety symptoms (10).

Risk Factors

One of the major triggers of mental disorder is the change of steroid hormones level. Stressful life events in menopausal transitions also contribute to phycological symptoms (11). The risk of relapse during menopause exists for women with mental disorder history (12). However, those who have no history of anxiety can suffer the increased risk of having high levels of anxiety during and even after menopausal transition (13). Ethnics remain with the result conducted in 2018 that European and Latin American women are at a higher prevalence of mood changes comparing with women of other ethnicities (14). Although education background has low relevance with menopausal anxiety, the ability to pay for psychotropic medications is significantly relate to a high level of menopausal anxiety (13).

Burden

It was estimated in 2017 that the mean annual per-patient direct cost for treatment of symptoms associated with menopause is $248 in the US apart from prescription medication cost. For anxiety disorder, the annual per-patient cost was $46. (15)

A reduction of mental and physical quality-of-life scores appeared among the menopausal population. Menopausal symptoms in certain degree deteriorate relationships, decrease working productivity, and affect economic outcomes (16). Up to 40% of women described a reduction of performance in work due to menopausal symptoms. They are also likely to share emotion burden of embarrassment for their symptoms (17).

Consequences

The neglection or mismanagement of anxiety disorders in menopausal women can cause serious consequences. It was indicated that mental disorders in menopausal transition could develop dementia afterward (18). Anxiety-related symptoms as sleep disturbances can increase the risk of cardiovascular disease and carotid atherosclerosis among mid-life women (19).

Management and Treatment

Psychotherapy is recommended by specialists for treating mild phycological symptoms while pharmacologic treatment is often required for moderate to severe symptoms. For handling stress commonly occur at midlife, nonpharmacologic methods should be considered. The importance of education is highlighted in official guidelines (1) for health providers.

Hormone-based therapies appeared to be more effective than other treatments that target to single symptom each time. Nevertheless, hormone-base therapies cannot be adopted to certain groups of women.

Complementary and alternative medicine usage can be adopted as well for women who are interested. The study showed that the diet of increased phytoestrogens could help reduce symptoms. The herbal product can be advised for the efficacy of menopausal depression (1). It was demonstrated that kava, a kind of herb might reduce anxiety. Acupuncture can be quite helpful to improve sleep quality.

Discussion

Women play vital roles in families and societies. Accordingly, menopause is a life stage inevitable for all women. Unique anxiety symptoms arise during menopausal transitions, which can have significant and long-lasting impacts on individual and society. Anxiety disorders in menopause need to be recognized and acknowledged. Also, women in menopause need to be characterized treated with care.

In the UK, government officials conducted prospective work regarding the support for women in menopausal transitions. The Equality Act 2010 urges employers to support their female employees. Business in the Community has produced a free toolkit aim to educate business owners to support women at menopause. The faculty of Occupational Medicine published guidelines in 2016 entitled “Guidance on menopause and the workplace” to help women tackle troublesome menopausal symptoms with clear instructions based on works by the European Menopause and Andropause Society. (20)

As it was suggested earlier, helping women overcome obstacles regarding menopause required attention and support from the interior and exterior environment. Women themselves need education and awareness of menopause and related anxiety disorders before the actual menopausal transition starts. On the other hand, policies should be made while family care should be attended during menopause. The menopause-friendly working environment needs to be established.

Based on the considerable rate of anxiety disorders among mid-life women in menopause, Strengths-based recovery model can be advocated for cost-effectiveness.

Reference

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Your palms are sweaty, your heart is racing, your knees are weak, and yet you stand there in front of everyone while they just blatantly stare at you. The sweat building up on your forehead drips into your eyes. You stutter, trying desperately to remember what you are supposed to speak about. Nothing comes to mind and you can’t read the blurred words faded across the paper shaking in your hands. You walk off the stage with your knees feeling like they could collapse beneath you. Everyone comforts you and tells you it’s a normal feeling, and that it happens to everyone. But, this isn’t your first time, and it won’t be your last. Today, many teenagers are facing events in their life that they shouldn’t have to deal with, such as feeling overwhelmed when talking in front of others. Stress consumes them every single day and soon they will begin to develop anxiety. Anxiety is becoming more common and it’s becoming a huge problem in our society. It feels like you can’t keep up with everything going on in your life. There are many types of anxiety, such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), or even phobia. Anxiety is classified as a disorder when a person stresses over something that most others wouldn’t stress about, or when an event occurs and there is constant stress or panic afterward (Lombardo, 2018 p.7). Anxiety is a growing disorder amongst teenagers because of compounded stress.

Everyone has anxiety, but it can become chronic to the point where it becomes an illness. Iorizzo claims that if you have anxiety, “You may experience fear, panic, nightmares, sickness, headache, tense muscles, shortness of breath, or it may be hard for you to sleep” (2014, p. 10). It is actually good for you to have anxiety, but the prolonging of it is unhealthy. Iorizzo also says, “Anxiety is the body’s natural response to danger” (2014, p. 4). Anxiety can help you to maintain focus. It tells your brain that you need to be worried about a test so that it’s easier for you to study and not forget about it. It also gives you energy, motivation, and purpose. Matt Abrahams says, “I don’t think we can ever truly overcome our anxiety, nor would we want to. Anxiety is actually helpful. It gives us energy, helps us focus, tells us what we’re doing is important, but we must manage it, so it doesn’t manage us” (2018). Some people will go see a doctor or therapist to help them, but usually, that is not the case. People who don’t get help will overwork themselves, not get enough sleep, and overall will not live a happy life. Only 36.9% of people with anxiety decide to get medical help (About ADAA facts, 2018). When stress compounds someone’s life to the point they feel helpless, it turns into an anxiety disorder and they need to get help.

There are many types of anxiety with differences in each case. Some of them are generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). GAD is a common type of anxiety and can be a mixture of some of the other forms of anxiety. When you have generalized anxiety, you mostly panic constantly about different situations and feel stressed out all of the time. SAD is a disorder that occurs when you are around people. It may be a large group setting, or it could even be talking to a friend. It usually begins in young adults and starts to develop when they are in middle school. According to Lombardo, “People with SAD are afraid of drawing attention to themselves, being at an event with others, speaking in public, being embarrassed, or even criticized” (2018, p. 17). A phobia is whenever you are scared of a specific thing, such as spiders, heights, or small spaces. It is said that women are more likely to have a phobia (About ADAA facts, 2018). OCD and PTSD are both disorders that are usually acquired over time. If you have OCD, everything around you has to be perfect. Everything must be clean, organized, and not overwhelming. When in a scary situation, a person may experience PTSD (Lombardo, 2018, p. 10). It is a very common disorder for people who have experienced war, rape, and violence. People who have PTSD are always on high alert in public, stay away from big crowds, and do not handle loud noises well.

To put it into perspective, it is said that anxiety is now the largest issue among our teens, not depression (Nutt, 2018). Teenagers are pressured with multiple things and they build up quickly. In 2017, it was recorded that the number of teens sent to the hospital for an anxiety disorder had doubled since 2007 (Gunn, 2018). Some common stress factors are schoolwork, college, getting a job, fitting in, sports, clubs, and trying to plan out their future. These are normal things to have anxiety about, but the prolonging of it is not good for them. Iorizzo says, “Researchers believe that common mental disorders in adults first emerge in childhood and adolescence” (2014, p. 15). Everyone is taught competitiveness at a very young age. Although competitiveness is very good, it has been carried to an extreme. Parents are putting the message in their kids’ heads that they should always win, and that they should be upset whenever they don’t. Kids should be rewarded for always trying their best and having fun, yet they are criticized for not winning.

One of the largest components of a teenager’s anxiety is the atmosphere in a school or classroom. Nutt states, “Classroom pressures are putting kids in the state of mind that they need to always win and beat others to achieve in life” (2018). Students are fighting to be valedictorian, salutatorian, best athlete, or just to maintain a good GPA. Teens go home with lots of homework and have multiple tests per week. It is hard for a student to be completely focused when they might have a bad home life, are working, or playing sports. When a student has anxiety, it will be hard for them to pay attention in their classes (Seema & Vankatesh, 2017, p. 435). If a student is worried about studying for a huge test they have on Friday morning, they may not have an exemplary amount of time to be able to do their math homework the night before. This results in them staying up late to finish both and being too tired to focus on the test or any other class. There are too many standards for our teenagers today. A study was done on the association of gender and different school systems in regular teenagers aged 16-18. In the study conducted by Seema and Vanketash, “Neither gender nor school type revealed statistically significant differences in the manifestation of social phobia” (2017, p. 437). This shows that certain schools do not have more standards than others. It also proves that even though a male would be perceived to not have anxiety, that it is just as common as it would be for a female.

Mood disorder is an umbrella term used by both DSM and ICD classification. A mood disorder is any type of psychiatric illness that affects your mood. These disorders could be depressive disorders, manic or major, bipolar disorders, seasonal affective disorder, along with new modern terms such as Disruptive mood dysregulation disorder. All these disorders can be categorised by the symptomatic mood changes someone who suffers with them may experience. Most of these disorders will make the patient feel low in mood, fatigued, irritable and the feeling of helplessness. These disorders also cause emotional turmoil, showing emotions by exhibiting crying, anxiety, fear, and even anger. Due to these disorders affecting a person’s mood they can also have the opposite effect. If you suffer from a manic disorder such as manic depression or bipolar, you can experience extreme ‘highs’. In which someone may become hyper, extremely happy or the feeling of which you could burst. However with this comes extreme crashes after such events which usually plunge people into the darkest spaces of their emotions and moods. Mood disorders once diagnosed, are usually treated with medication, as often the disorders affecting your mood are caused by a chemical imbalance within your brain. This can cause an imbalance of serotonin and dopamine within your brain which creates the feeling of joy, and balances your moods.

There are many different disorders and mental health conditions that affect your personality. According to ICD classification personality disorders are classed into prominent personality traits. These are regularly used to separate the severity of the disorder, ranging from mild to serve. ICD classifieds disorders such as schizophrenia depending on how it affects the patients everyday life and relationships. Personality disorders in all classifications affect your personality or cause you to have multiple personalities. This means the same person may present differently within seconds depending on which side or which personality comes out. Personality disorders are often linked with psychosis and hearing voices.

DSM classification related disorders slightly differently and happens to be the more modern way of identifying them. For instance these disorders are often separated into ten identities: paranoid, schizoid,schizotypal, antisocial, borderline, narcissistic, historic, obsessive compulsive, dependant, avoidant. These also may also be used within another umbrella section of DSM which links disorders into whether it was caused from illness, medical condition side effects and also unspecified which could be any disorder that does not fit any or all criteria. Much like ICD this is manly used to develop the severity of disorder. EG: borderline personality disorder under borderline as it presents mild symptoms of a more complex multiple personality disorders or DID (Dissociative Identity Disorder).

Anxiety disorders

Anxiety disorders are simply a pronounced feeling of worry or anxiousness that does not go away easily, even worrying over simple tasks. This disorder can often make the patient feel physically ill with symptoms classified in both DSM and ICD of anxiousness along with physical nausea, sweating, a tight chest, hyperventilating and panic attacks. In both classifications anxiety disorders range from anxiety, feeling concerned or overly worried for a long period of time, DSM states 6months, to Obsessive compulsive disorder. Compulsive disorders can come under a range of mental health diagnosis due to the range of symptoms. Within anxiety, someone with OCD may feel anxious about not completing a task or urge and the feeling that something bad may happen if it is not complete. This often produces symptoms of anxiety and can create a lot of stress on the patient. For example someone with OCD may believe if they do not repeat a pattern by tapping a wall a certain way their family may die. OCD sufferers genuinely believe this and with in both DSM and ICD being unable to act upon an OCD urge is described as a wave of anxiousness, worry and dread.

Psychotic disorders

The classification within Psychotic disorders in ICD and DSM differ greatly. There are a lot of challenges from both classifications. ICD separates psychotic disorders into separate groups and sub groups. Such as the variation of types/ severity of schizophrenia, such as paranoid, catatonic, simple and otherwise. DSM on the other hand has removed this type of division and categorises via symptoms and attributes. Such as someone suffering acute schizophrenic tendencies. There is also a difference in how short psychotic disorders, or psychotic breaks are labelled. In DSM short lived psychotic disorders such as postpartum psychosis is labelled as ‘brief psychotic disorder’ (BPD) meanwhile in ICD it is labelled under acute and transient psychotic disorders (ATPDs). This gives the impression that under DSM BPD experiences are short lived and the patient may recover quickly. The word transient in ICD diagnosis imposes that it may occur again and has periods of subsidence before psychosis reoccurs. ICD focuses mostly on schizophrenic episodes and psychotic hallucinations. Focusing many of the umbrella terms over schizophrenic episodes, whether long or short. DSM uses the phrases psychotic episodes, and focuses more on the fact someone is diagnosed through symptoms and the length of time they are displayed. Meaning someone showing symptoms of psychosis, would be deemed as having episodes, labelled with a phrase such as psychotic tendencies, rather than being diagnosed with a labelled disorder. DSM does have a much more varied diagnosis platform than ICD. However it is not as simple and up front, it seems to refuse many labels and does not appear to often give a general diagnosis that ICD-10 would. ICD-10 in particular appears to be the classification of choice for many psychiatrists and case studies.

Substance-related disorders

Substance-related disorders or substance use disorders, is used to describe a wide variety of disorders from addiction to psychotic disorders caused by substance abuse. DSM and ICD both describe substance use disorders differently and categorise them separately. DSM categorises substance disorders as taking the substance in larger amounts and for longer than you are meant to, trying to stop using the substance but failing too, spending a lot of time using, sourcing and recovering from the substance. DSM also focuses largely on addiction. And uses the term addiction to categorise Substance disorders. DSM impresses that substance related disorders such as psychotic illnesses are all a result of abusing drugs or alcohol. Therefore the idea behind the DSM category is without being addicted you would not become mentally ill. This even suggested that some people are predisposed to become addicted to things therefore vulnerable to being diagnosed with related mental health complications. ICD on the other hand is a much more in depth categorisation. ICD suggests that drugs and alcohol are ‘psychoactive’. Individuals who take these psychoactive drugs are at high risk of psychotic disorders, of which using ICD are greatly self diagnosed, with evidence for diagnosis having to be collected and trusted from the patient. Along with this blood and urine samples may be taken, and third party accounts to clarify the substance being abused. ICD also has a class system for substance disorders, ranging from F10-F19. These include substance abuse of alcohol, abuse of caffeine and stimulants, mental health complications of tobacco, uses of psychoactive drugs and so on. This means the diagnosis and treatment of a disorder will come under one of these classes, meaning treatment is more targeted towards one drug in particular.

Eating disorders

There is a range of eating disorder diagnosis within mental Health. ICD recognises Eating Disorders as a behavioural disorders. ICD believes and demonstrates within diagnosis that eating disorders such as anorexia nervosa, bulimia, purging and binging, all stem from a mismanagement of food or childhood trauma related to food. ICD recognises that this behaviour could be learnt from role models and parents. Anorexia (typical and nervosa) is characterised through deliberate weight loss. Although depending on how long the disorder has gone on for some do not even realize they have it or are purposefully doing it. Anorexia is normally seen by victims losing weight as a diet plan but then becoming obsessive. Many people hear voices in their heads or suffer from body dysmorphia where they see their body as very different or overweight to what it actually looks like. ICD categorizes eating disorders similarly with other ‘behavioural’ based disorders and illnesses such as insomnia and sexual disorders. DSM also categories similarly, stating eating disorders can stem from environmental, biological or trauma. However DSM also places some disorders in a Not otherwise specified category. DSM establishes similar diagnosis such as anorexia and bulimia but it believes in a further more wide spread category where someone may suffer from multiple symptoms or not fit fully into a treatment programme. Teh ‘NOS’ is the biggest area of the diagnosis category according to DSM, where patients either suffer from a bad relationship with food through mental health, working, habit or other issues. It also includes those who simply suffer from multiple eating disorders that then becomes one None specified disorder.

Cognitive disorders

The definition of cognitive disorders or neurocognitive disorders as they are also known, is quite similar according to ICD and DSM. Both categories see cognitive disorders as mental health disorders that affect physical cognitive ability along with memory and brain function. An example found in both DSM and Icd is dementia. Labelled as a cognitive disorder, dementia affects memory, perception and in some forms such as vascular there can come a point where it effects abilities such as mobility and swallowing. DSM recognises that other disorders such as anxiety and mood disorders can affect memory and function but unlike ICD that does not mean they come under cognitive disorders, and believe that only disease that purley attacks brain function can be labeled as cognitive.

Generalised anxiety disorder (GAD) is a serious, debilitating condition which affects around 5% of the UK’s population, therefore it is vital that the advice given by health care professionals to help cope with this disorder is accessible to all those who require it. Currently, once an individual is diagnosed with GAD, the main recommended treatment is cognitive behavioural therapy (CBT) to help control their anxiety levels as it is regarded as one of the most effective treatments. However, the lengthy waiting times to access this therapy are extremely concerning and they are having a detrimental effect on patients. Therefore, changes need to be made so that those who need CBT can access it within 28 days of requesting it as this will ensure that individuals are receiving the support that they need to cope with their disorder.

The psychological therapy of CBT is one of the first line of treatments recommended by the NHS (2018) to those diagnosed with GAD. Medication such as the antidepressant SSRIs are also often offered. Generally, CBT is preferred over pharmacological treatments by patients to manage their anxiety, as it is considered one of the most effective treatments by psychologists and does not have distressing side effects like medication. Also, because after completion, patients can still apply the skills learnt to their daily lives which significantly decreases the chance of symptoms returning. Therefore, CBT has longer lasting benefits compared to medication. This personal view article will focus on how even though those with GAD are often advised to go through CBT to help them cope, this treatment is not suitable for everyone and not as accessible as it should be due to long waiting times ,which in my opinion lowers the effectiveness of this advice.

CBT for individuals with GAD entails around 12 to 15 weekly sessions(NHS, 2018). Therefore, in comparison to medication this is a time-consuming treatment and requires extra work outside of sessions to be effective. I think CBT is then not always the most suitable way to cope with GAD for those with hectic lifestyles. For example, a working parent could be put off by the commitment required as they would struggle to make time for it. Such individuals are likely to opt for SSRIs instead, especially because improvement is often seen quicker and less time and effort is needed.

I first came across the problem of lengthy waiting times when a close friend was diagnosed with GAD. I was shocked and saddened to see her have to wait 8 months until her first CBT session. She believed this was due to being a low priority case and even though I understand that cases should be seen to in order of priority, I believe an 8 month wait is unacceptable. Especially, because this debilitating disorder was affecting so many aspects of her life, there were days where she struggled to leave the house. Whilst waiting, her symptoms became increasingly worse and it was extremely difficult to see her struggle and still not receive the help she needed to cope with her anxiety. When her CBT eventually started, her therapist cancelled on multiple occasions for higher priority cases, sometimes 4 weeks would pass in between sessions which inevitably made progression difficult.

Given my friends experience, I was intrigued to see how common this problem was because if it is a prominent issue it lowers the accessibility of CBT and decreases the effectiveness of this coping method. I found that long waiting times were sadly a common occurrence. One survey showed that 10% of those who required therapies such as CBT had been waiting for more than a year and more than 50% had been waiting for over 3 months (Mind, 2013).The British Medical Association (2018) also reported concerning waiting times: they found that 3,700 individuals waited for over 6 months to receive psychological therapies in 2017. I understand these lengthy waiting times are due to the increasing awareness of mental health leading to more people seeking help, which is undoubtedly a positive thing. However, health care professionals are struggling to cope with this demand due to a lack of funding.

Timely access to CBT for those with GAD is vital to ensure that they can receive the help they require. Lengthy waiting times can cause substantial damage because whilst individuals are waiting their symptoms often intensify and there is the risk of this resulting in a mental health crisis. I witnessed how this affected my friend, it led to her giving up her job as she felt she could no longer cope, this was devastating to see. The long waiting time and multiple cancellations resulted in her switching to private CBT as she felt let down by the service the NHS had provided. This had a significant financial impact on her, but she saw no other option as her condition was deteriorating daily. Private CBT is around £40- £100 per session(NHS, 2019), many individuals are unable to afford this, no matter how desperate they are. Therefore, it is imperative that more is done to improve how accessible CBT is on the NHS, so everyone in society has the same opportunities to access the help they need to cope with their anxiety.

The Health and Social Care Act 2012 states that mental health should be equal to physical health. For this to be achieved it is vital that psychological treatments should be as accessible as physical treatments, especially with regards to waiting times. Therefore, I strongly and passionately believe that the NHS should provide CBT to all those with GAD that require it within 28 days of the initial request, which is equivalent to the standard waiting time for physical health problems. This should be every individuals’ right. Unfortunately, currently this is not the case. I do recognise that waiting times have improved recently, but they are still nowhere near the level they should be and I believe more needs to be done. This is because research shows how even today, despite increased funding, a large proportion of individuals are still waiting far too long to access CBT. This is having a detrimental effect to patients’ quality of life, which is unacceptable.

To conclude, the effectiveness of CBT as a method to help those with GAD cope and the benefits it has over other treatments is undeniable. However, we should not forget that even though CBT is often the recommended first line of treatment, it is not always the most suitable option for everyone due to it being time consuming and requiring the patient to put work in too. Furthermore, those who cannot afford private CBT are currently stuck in long queues whilst their symptoms worsen. Therefore, I believe crucial changes need to be made through reducing waiting times, so this treatment is more accessible to all those who require it. This will ensure that CBT is an effective coping mechanism for anxiety for everyone and not just those who can afford private therapy.

In general, when it comes to the biological aspect of anxiety there is still more to learn and examine. For example, there should be more studies that focus on the environment and other risk factors. Even though some risk factors indicate one specific sex there should be more for both sexes. Basic and clinical studies are also needed to review the role of testosterone during fear extinction.

The research about the adult female and male Long-Evans rats showed how imported the gondola hormones are for the females (Zimmerberg and Farley, 1992). The research was well performed with many important factors that could have an effect on anxiety. The research had two experiments with two different results. The first experiment focused on natural behavior without any kind of treatment. The second experiment included two treatments that showed a different result than the first one. The gonadal hormones for female rats showed to have a big effect on their behavior, compared to the male rats. Rats’ sex hormones can be compared and analyzed with human sex hormones. But the study does not talk about the relationship between these two. In future studies, this study can be used to compare and draw parallels between humans’ sex hormones and rats.

One of the studies that were included in the result shows that women had more severe physical symptoms in panic disorder compared to men ( Sheik & Klein, 2002). But the study does not explain the reason behind the outcome. The study also had participants who either were diagnosed with a Panic disorder or those who only had a panic attack but did not meet the criteria for PD. This makes it difficult to draw a conclusion if panic disorder differs between the two sexes.

In another study included in the results, the authors believe that PTSD symptoms for women are more emotional rather than physical as it is for the male gender (Murphy & Ghazali, 2018). This study focused mainly on adolescents between the ages of 15 and 19 who had just gone through a natural disaster. The result clearly showed the relationship between PTSD symptoms and sex differences, as the female gender had more symptoms such as guilt, bad memory, negative emotional state while the male gender had aggression, self-destructive behavior, and Physiological cue reactivity.

In another study, the authors show that the symptoms of PTSD are different between males and females (Hu & Zheng, 2017). The symptoms that characterize the female gender were lack of concentration, a sense of guilt, and flashbacks. The study also mentions the background factors that can cause different symptoms, for example, traumatic events. The authors indicate that females and males often experience different types of trauma. Males experience traumatic events such as accidents, natural disasters, and military combat, whereas woman tends to experience more incidents of sexual abuse and sexual assault. This may be one of the reasons why the symptoms between them look different.

Having an anxiety disorder can lead to serious complications in the life of a person, it can; increase the risk of depression, take away time and focus from other activities, impair the ability to perform tasks quickly and efficiently due to difficulty in concentration. It can also lead to or worsen some physical health conditions like headaches and migraines, heart-health issues, sleep problems and insomnia, chronic pain, and illness. Anxiety disorder often occurs along with other mental health problems like phobias, depression, substance abuse, and suicidal thoughts.

Panic Disorder

According to the American Psychiatric Association, panic disorder involves “repeated unexpected panic attacks (e.g. heart palpitations, sweating, trembling) followed by at least one month of persistent concern about having another panic attack.” A panic attack is a sudden surge of fear or anxiety which triggers severe physical reactions in situations where others would not be afraid, for no obvious or particular reason.

Recurrent panic attacks are usually manifested by these symptoms, fear of inability to escape from fearful situations, fear of losing control or dying, dizziness, tachycardia, nausea, chest pain or discomfort, sweating, tremors, palpitation, chills, shortness of breath, abdominal cramps, sense of impending doom or danger. One of the worst things about the panic disorder is the debilitating fear that another one will occur.

The exact cause for panic disorder is not known, but certain factors may play a role like major stress and genetics. Panic attacks may begin suddenly but over time they may be discovered that they are triggered by certain situations. Eventually, panic attacks may cause or lead to complications like avoidance of social situations, alcohol or substance misuse, problems at work or school, financial problems, development of specific phobias, and increased risk of suicide or suicidal thoughts. A person with panic disorder may feel ashamed or discouraged because he or she is unable to perform the required everyday activities.

Acute stress disorder

Acute stress disorder (ASD) can occur after someone has witnessed, experienced, or was confronted with an event or events that involved actual or threatened death or injury, or a threat to the physical integrity of self or others. This disorder habitually occurs within one month of the traumatic event, disturbing memories of the event cause an emotional reaction and a sense of reliving the event.

It is usually characterized by restlessness, difficulty concentrating or sleeping, feelings of tension and numbness, exaggerated startle response, leading the person to avoid situations or instances that may cause recollections of the traumatic event, and intense emotional reaction or absence of emotional responsiveness.

Acute stress disorder is very similar to posttraumatic stress disorder, having the following psychological symptoms, hypervigilance, irritable mood, a sense of physical displacement, recurrent involuntary flashback or nightmares of the event, and generalized low mood. Many people with ASD recover without any treatment, there are however a variety of methods for combating this situation including psychotherapy and medication.

Phobias

A phobia is a type of anxiety disorder that causes an individual to experience extreme and irrational fear about a situation, place, object, or living creature. Phobias involve a persistent fear of clearly discernible and circumscribed objects or situations. A phobia is essentially an irrational, unrealistic, or exaggerated fear of a specific activity, object, or situation that actually presents little to no danger. The individual will experience intense distress when faced with the source of their phobia, this can easily prevent them from functioning normally and may even lead to panic attacks.

The word “phobia” is often used to refer to a particular fear with a specific trigger, there are however three types of phobia recognized by the American Psychiatric Association, these are

1. Specific phobia: This is an intense and irrational fear of a specific trigger, specific phobias are also known as simple phobias as they can be linked to an identifiable cause that may not occur in the everyday life of an individual, such as spiders, snakes, heights, etc. these may be easily avoided and are therefore not likely to affect day to day living in a significant way;
2. Agoraphobia: This is a fear of situations that it would be difficult to escape from if the person in question were to experience extreme panic, such as being in an elevator or on public transport. It is commonly misunderstood to be a fear of open spaces but the term may also apply to being confined in a small space. Individuals with agoraphobia have an increased risk of susceptibility to panic disorder;
3. Social phobia or social anxiety: this is a profound fear of public humiliation or being judged by others in a social situation.

There are 5 subtypes of specific phobia; the natural environment type, such as fear of heights or storms; the situational type, such as fear of elevators or enclosed places, public transportation; animal types such as fear of spiders, mice, or cockroaches; blood-injection-injury type, such as fear of seeing blood or receiving an injection; and another type, such as fear of vomiting or choking.

In instances of an extreme phobia the person goes out of his way to avoid the object of his fear, unfortunately, avoidance only serves to strengthen the phobia. Phobias are characterized by sweating, dizziness, muscle tension, a need to escape, and avoidance of the object of fear.

A person affected by a phobia will experience symptoms like uncontrollable anxiety when exposed to the source of fear, inability to function properly when exposed to the trigger, avoidance of the source of fear at all costs, an acknowledgment that the fear is irrational, exaggerated, and unreasonable, combined with an inability to control these feelings. The above symptoms may result in the following physical effects; accelerated heartbeat, trembling, chest pains or tightness, dry mouth, confusion and disorientation, dizziness, sweating, nausea, or headaches, and a feeling of anxiety can be produced merely by thinking about the subject of the phobia.

In 2013, there were over 8 million cases of anxiety in the UK, with women being almost twice as likely as men to develop an anxiety disorder. This can come in many forms, from post-traumatic stress disorder (PTSD), to obsessive compulsive disorder (OCD) and generalised anxiety disorder (GAD). However, while there are many psychological treatments available for these patients, it can be argued that there is not enough evidence to support the use of such therapy over other treatments such as medication. In this essay I am going to outline different anxiety disorders and review certain psychological therapies for them, and then evaluate their effectiveness in treating the patient.

Perhaps one of the most common anxiety disorders, GAD is estimated to affect up to 5% of the UK’s population. Those affected suffer from insistent and perpetual worrying about numerous different things, which could include family, relationships or financial concerns. It is diagnosed when a person experiences uncontrollable worrying on more days than not for a period of at least six months. While several different psychological treatments can be suggested for patients, one of the most common is Cognitive Behavioural Therapy (CBT). This form of psychotherapy focuses on how a patient’s inner thoughts, feelings and beliefs shapes their behaviour, and aims to introduce coping skills to help deal with different concerns or problems. It is widely recognised amongst psychologists as a treatment not only for adults with anxiety disorders, but children and adolescents as well.

Despite the recognition CBT receives, psychologists have still aimed to provide sufficient evidence for its ‘relative efficacy versus non-CBT active treatments’ and it’s long-term effects. In 2015, Anthony C James et al (1) sought to review the effectiveness of CBT for children and adolescents compared to non-CBT treatments as well as medication. Data was reviewed from several search engines including the Cochrane Central Register of Controlled Trials (CENTRAL) and all participants were selected if they met the criteria of the Diagnostic and Statistical Manual (DSM) or the International Classification of Diseases (ICD) for an anxiety diagnosis (excluding phobias, OCD, PTSD and elective mutism). Forty-one studies were eventually selected; on average 13.1 CBT sessions were given to the patients. These were delivered in various formats including group or individual therapy and involved helping the child to recognise feelings of anxiety and develop coping skills. The review showed that CBT was superior to waiting list controls (i.e. no therapy), however there was limited support for the use of CBT instead of medication. The authors also note that there is uncertainty as to whether younger patients benefit from this therapy, as they need ‘a certain level of cognitive maturity to participate in the treatment’ (Kendall, 1990) (2). While the appropriate age for the use of CBT is left ambiguous in this review, other research suggests that it can be effective from the age of 9 onwards (Kendall PC, Flannery-Schroeder E, Panichelli-Mindel SM et al, 1997) (3). Using a sample of 94 children ranging from 9 to 13 years old who all had a primary anxiety disorder, the authors found that at the end of a 16 week treatment program, 32 children (53%) no longer met diagnostic criteria for their primary anxiety disorder compared with 2 children (6%) in the control group. Those that received CBT who still met their criteria reported better preparedness for dreaded situations and improved over time on multiple anxiety and depression scales. This study is important as it provides strong support for the use of CBT among children and adolescents, especially with its strong sample which can easily be generalised to the target population. It also presents evidence for the long-lasting effects of this treatment with its 1 year follow up.

It could be suggested that from the research I have highlighted so far there is only evidence for CBT being useful in more Western cultures; but this is not the case. A preliminary study in Japan (Ishikawa, S., 2012) (4) comparable to that of Kendall et al’s showed that after treatment of CBT that was modelled after intervention programs developed in Western cultures, similar outcomes were found to other studies that had been conducted before. Of the 33 children and adolescents who participated in the study, 20 of them no longer met criteria for their principal anxiety disorders three months following treatment, and 16 were free from all anxiety disorders.

Exposure therapies are another type of psychological treatment for anxiety disorders. They are most often used to treat severe phobias or PTSD, and they are intended to help the patient take control of their fear or trauma. It must be done very carefully so as not to retraumatise the participant, so part of the treatment involves pairing the stimulus with relaxation techniques such as controlled breathing or imagery exercises. Exposure therapy comes in two main forms – systematic desensitisation and flooding; the patient discusses which option would be most suitable for them with their therapist. Systematic desensitisation focuses around the patient creating a ‘hierarchy of fears’ (a list of the most distressing thing related to their phobia down to the least distressing) and then slowly working their way through this list from the bottom upwards until they feel they can use their knowledge of relaxation techniques to overcome their phobia. Flooding is effectively the opposite of this – the patient confronts all their fears at once and uses their newly-learned coping strategies to gradually calm down from their arousal state.

Upon reviewing the available research into the effectiveness of systematic desensitisation, it appears there is limited evidence in support of the use of this treatment on its own. Aside from the original study from which the therapy was developed (Wolpe, J., 1958) (5) – which claimed to have achieved the recovery of 188 out of 210 neurotic cases in an average of 34.8 sessions – there has been little more significant evidence to suggest the efficacy of systematic desensitisation without the support of another kind of therapy. In an article titled ‘Treatment of Phobic Patients by Systematic Desensitisation’ (Friedman, D.E.I., & Trevor Silverstone, J., 1967) (6), the authors observed: “Wolpe’s (1961) results were impressive: he reported striking improvement in 90% of his patients. Less striking successes have been reported by other workers”. Hence the authors felt the need to test the treatments effectiveness alongside the use of intravenous methohexitone sodium (‘Brietal’) in small doses to produce relaxation and to counter anxiety. Participants underwent the process of systematic desensitisation, and at any time they experienced anxiety they received an injection of the Brietal, the effects of which last for approximately only 5 minutes. At the end of the treatment period all patients were assessed to have significantly improved, and 5 were judged to be ‘symptom-free’. However, at a follow-up session 6 months after the end of treatment, one patient had relapsed completely while another 3 were ‘not as well as they had been at the end of treatment’. Despite this, the authors also report some cases of great improvement: ‘Patient no. 20, for example, had originally presented with severe cancerophobia which involved avoidance of any possible mention of the word cancer or tumour and which eventually led to complete suppression of all television and radio programmes in her house for fear of her inadvertently hearing or seeing the word cancer. After a 7-week course of treatment she was completely untroubled by any fear of cancer whatsoever’. The results from this study are inconclusive; while the authors clearly state there are some improvements, the long-lasting effects of this treatment do not provide strong evidence for its use. Another study (Lazarus, A.A., 1961) (7) that focused on group therapy of phobic disorders by systematic desensitization showed similar results, with 5 of the 18 patients considered to have ‘failed’ the treatment after not passing the symptomatic criteria for the study. This would suggest that there is only a 72% chance of this type of treatment working. However, there is not sufficient evidence as to how effective systematic desensitisation is in treating anxiety disorders due to the low sample sizes of the studies and the relative sensitive nature of the experimental method.

Evidence in support of flooding is far more widely available; research tends to be in case study format due to the specific nature of phobias. It is most commonly given to patients for a specific severe phobia, and in most cases only lasts one or two sessions. One study (Yule, W., Sacks, B. & Hersov, L., 1974) (8) describes the use of flooding treatment in an 11-year-old (‘Bill’) with a phobia of loud noises after unsuccessful systematic desensitisation treatment. The treatment took place over two sessions and focused on the boy’s fear of balloons (specifically the loud noise made when they burst). It involved taking Bill into a confined room which was filled with balloons, and gradually getting him to burst them himself. 25 months after the flooding session, Bill was no longer phobic of the noises which had once scared him. He was reported to be much happier and tended to socialise more at school. Another study (Sreenivasan, U. , Manogha, S. N. and Jain, V. K., 1979) (9) focuses on an eleven-year-old girl, Colleen, who’s fear of dogs had become so bad she had become house-bound most of the time. Again, after initial use of systematic desensitisation (which was unsuccessful), a trial of flooding was deemed to be the most suitable treatment. Six sessions of flooding took place over 10 days – these involved Colleen sitting in a room with a dog taken off the lead. For the first session, Colleen was obviously apprehensive for several hours before, and when the dog was first introduced, she began crying and begging for the dog to be put back on its lead. By the sixth session, she held the dog on her lap and even took it for a walk. At the beginning of treatment, Colleen’s anxiety level was rated at 5 – after the six sessions, it was down to one, and remained that way when she was seen at follow-up sessions 12 and 24 weeks later.

From this evidence, it is clear that flooding tends to be more successful than systematic desensitisation. It appears that flooding can be extremely useful in curing specific phobias, but there is limited evidence to support it’s use for other anxiety disorders such as PTSD, for example. There is also a lack of modern research into the effectiveness of both flooding and systematic desensitisation, which questions the generalisability of this type of therapy in the present day. While the two case studies I reviewed show strong support for the use of flooding, there is not enough sufficient evidence to categorically support it’s use. On the other hand, the use of CBT has been shown to be very effective in helping anxiety disorders in children and adolescents, however research supporting its use in adults is harder to come across. Nevertheless, I would still say there is enough strong evidence to support its use in treating anxiety disorders.

The first purpose for social anxiousness sickness consists of genetics. To begin with, social anxiousness ailment is a common kind of anxiousness disorder. A character with social intellectual sickness feels signs and symptoms of hysteria or state of affairs in fine or all situations, like meeting new people, dating, being on employment, answering a query in class, or having to discuss with a cashier in a store. Doing each day matters in front of people, such as eating or consuming in front of others moreover reasons anxiousness or fear. The hassle that human beings with social intellectual ailment have in social stipulations is so strong that they ride it is previously their workable to alter. As a result, it receives in the way of going to work, attending school, or doing each and everyday things.

People with social anxiousness ailment can also additionally in addition concerned about these and specific matters for weeks previously than they happen. Sometimes, they end up staying away from areas or matters to do the place they matter on they may additionally have to do something that will embarrass them. Some human beings with the ailment do not have anxiousness in social stipulations and then once more have frequent performance anxiousness instead. They experience bodily symptoms and signs and symptoms and signs and symptoms of hysteria in prerequisites like giving a speech, taking part in sports activities thing to do things to do games, or dancing or taking a section in an instrument on stage.

Social anxiety disorder in many instances starts off evolving all through formative years in human beings who are extremely shy, Social anxiousness disease is common; suggests that about 7 share of Americans are affected. Without treatment, social mental disorders can close for several years or a lifetime and prevent a man or lady from reaching his or her full potential. Social mental sickness now and once more runs in families, alternatively no man or girl is aware of pointless to say why some family contributors have it while others don’t. Researchers have placed that infinite parts of the Genius consist of difficulty and anxiety. Some researchers skinny that misreading other’s behavior might additionally play a function in inflicting or worsening social anxiety. For example, you will assume that human beings are staring or frowning at you as shortly as they without a doubt do not appear to be.

Researchers at the Institute of Human Genetics at the University of Bonn in Germany recently determined that a chosen serotonin transporter gene referred to as “SLC6A4” is strongly correlated with someone’s odds of struggling with social anxiousness disorder. Until now, genetic seem up on social anxiety sickness (SAD) have been rare. According to the researchers, “This is the largest affiliation stumble on out about so a strategy into social phobia”. For this study, the German researchers genotyped 321 contributors with SAD and 804 controls except phobia. Then, they administered a single-marker comparison to spot a quantitative affiliation between SAD and avoidance behaviors. Their penalties furnish proof that the serotonin transporter gene SLC6A4 is commonly correlated with anxiety-related traits. Anxiety problems tend to run in families. However, it isn’t sincerely clear how a lot of this may additionally moreover in addition be due to genetics and how an excellent deal is due to realized behavior.

This paper will cover the numerous areas mainly talked about ranging from definition to treatment and will be covered in either what society has to say along with medical professionals’ input. Information gathered was very similar however there were differences in treatment based on the event that causes Anxiety. This paper will strongly examine what the best forms of sings and symptoms, diagnosis and treatment are for everyday individuals that aren’t well experienced in the medical field.

In the article “America really is in the midst of a rising anxiety epidemic” we see how anxiety rates for Americans is rising and some statistics to show what is happening provided by author Peter Dockrill.

In today’s society the number of individuals that are being diagnosed with anxiety has increased 36 percent in the US from 2016 and 2017(Dockrill, Peter 2018) meanwhile the age of individuals affected is getting younger and younger. Dockrill also mentions that people in the US main concerns that causes them to be anxious is health, safety and financial status, and if we look at what people I general care about those three things will always be in the top 5 it just how we think now, is it bad not necessarily if anything it is good to worry about that if you didn’t then you might have a problem but people are stressing about it a lot more than previous years.

Dockrill goes into further depth about those three, and the one that stood out and outweighs the other two was health and how a survey that was taken place 68 percent reported feeling extreme or somewhat anxious when this topic was brought up in their survey. Following in second was Safety with 67 percent felt extreme or somewhat anxious, finally third was financial with 65 percent reported felt extreme or somewhat anxious (Dockrill, Peter 2018). Increases in in anxiety was common in both men and women and was gathered, by people from different race/ethnicities along with ages.

Millennials scored higher in being more anxious than people born in the baby boomer section. However, when comparing the two side by side the baby boomers were not far off only by 7 percent in the financial aspect which is very close when comparing the other two factors which where 21 percent for health and 18 percent for safety.

In the article “Illness Anxiety Disorder” Dr. Joel E Dimsdale discusses the three main parts of IAD (Illness Anxiety Disorder). Identifying, diagnosing and treatment, First to better understand what IAD is, previously called hypochondriasis or health anxiety is defined as worrying excessively that you are or may become seriously ill (Joel E Dimsdale,2019). This seems straight forward however anxiety alone is more of a general term defined as feelings of tension, worried thoughts or even increased blood pressure about something that could happen rather than IAD is more along the lines of they are anxious they are going to get sick, physically or mentally these are the symptoms patients may have, if they do their main concern is about what possible implications there is rather than the symptoms alone. (e.g., looking in the mirror at their throat, checking their skin for marks, sores or lesions).

What tends to happen is people become so preoccupied with the thought that they are or could possibly become or be ill which is an indicator, now this doesn’t mean for sure they are going to develop IAD but it is a good indication and should be monitored from there on. Other signs/symptoms are social interactions are limited by either lack of detailed responses mainly closed ended with no room for a follow up. And or always visiting doctors or physicians frequently which makes up majority of the people diagnosed about 84 percent meanwhile the other 16 percent rarely seek medical care (Dimsdale, 2019). In order in for an individual to be diagnosed with IAD and any other disorder listed in the DSM 5, there has to be an occurrence time of at least 6 months of consistent evidence that a person is demonstrating the symptoms of IAD and or any disorder listed in the DSM 5 (DSM-5, 2019).

What brings a lot of attention to people in society and has been a controversial topic for a couple years now, is the rate of increasing reports of mental illness more so IAD really accurate as in people genuinely have it either being hereditary or people developing it because of the increased number of cases reported and subconsciously “having it”. Now it is in no one’s right to judge if someone is mentally ill other than people of qualified education and/or trained individuals, if we look back and compare statistics over 20 years ago e.g. in 1982-83 there were 189,517 total reports of people visiting hospitals in Canada with related reasons to mental illness for both sexes, 34,256 individuals ended up in a psychiatric hospital being diagnosed with a mental disorder (Stats Canada, 1996). In 2017 645,898 people visited a hospital in Canada claiming to have a mental health illness 505,390 were diagnosed from DSM-5 that is more than 10 times the amount of people willingly going to seek help (Stats Canada, 2018).

More facts about IAD, Illness Anxiety Disorder is a long-term illness that could fluctuate in severity, some factors are age and amount of stress. What seems to limit us in finding a cure that accommodates everyone is how different every individual is ranging in severity of their illness. Another point that limits us is not everyone is very well trained in dealing with people with mental illness. E.g. for those who have tried to help someone in crisis and failed the result is typically escalating the situation by using trigger words that could set that person off and cause them to put either themselves or others life in danger.

In order to completely understand IAD and its true effects on the individual, it is crucial to conduct studies that examine all aspects of IAD. This includes a start to finish case as in detailed evidence over months at a time to fully understand how and why illness’s like this occur ad what causes them. As each day goes on mental illness becomes more prevalent in Canadian and American lives, it is important to examine the impact of IAD directly and indirectly.