My Anxiety Convinces Me

That Everyone Hates Me

(attached article)
 Facts & Statistics
Most common mental illness in the U.S.
– Anxiety disorders affect over 18% of the U.S.
population
Can be comorbid with depression or
substance abuse
– Nearly one-half of those diagnosed with an
anxiety disorder are also diagnosed with
depression.
Most people with one anxiety disorder
also have a related disorder
Normal vs. Problem Anxiety
Reasonable Excessive
Productive Disruptive
Manageable Uncontrollable
Mobilizing Paralyzing
Specific Pervasive
Time-limited Chronic
Age-matched Age-mismatched
Fears vs. Phobias
• Remember the 4 D’s of
disorders:
1. Deviation (from the norm)
2. Disruption
3. Distress
4. Duration
Anxiety in the DSM-V
Anxiety in the DSM-V
Anxiety in the DSM-V
 Most Common Types
Type # of Adult % of U.S.
Sufferers Pop.
1. Specific Phobias 19 million 8.7%

2. Social Phobia 15 million 6.8%

3. PTSD 7.7 million 3.5%
4. GAD 6.8 million 3.1%
5. Panic Disorder 6 million 2.7%
6. OCD 2.2 million 1-3%
“All Fears are the Same Fear”
Irrational fears that
cause someone to
avoid some object,
activity, or situation.
 Specific Phobias
• Persistent fear and avoidance
of specific objects or situations
• The person does recognize that
the fear is excessive or
unreasonable, but can’t help it
• Typically begin in childhood
(median age of onset is age 7)
 Specific Phobia Subtypes
Animal type: Dogs, insects, mice, etc.
Most common specific phobia
Situational type: Flying, bridges, etc.
Natural environment type: Storms,
heights, water, etc.
Blood-Injection-Injury type: Seeing
or giving blood, invasive medical
procedures
Other: Clowns, feet, marriage, etc.
 10 Most Common Specific
Phobias
Acrophobia: Trypanophobia:
heights injection or needles
Claustrophobia: Astraphobia:
enclosed spaces thunder & lightning
Nyctophobia: the Nosophobia: having
a disease
dark
Mysophobia: germs
Ophidiophobia:
snakes Triskaidekaphobia:
the number 13
Arachnophobia: Source: www.about.com
spiders
Other Interesting Phobias
Androphobia: Fear of men
Gynophobia: Fear of women
Gamophobia: Fear of marriage
Lockiophobia: Fear of childbirth
Thanatophobia: Fear of death
 Social Phobia
• Also called Social Anxiety
Disorder
• Persistent fear of scrutiny by
others or of doing something
humiliating or embarrassing
• Tend to avoid social situations
• Begins in childhood or
adolescence (around age 13)
• Excessive anxiety, worry, & tension occurring
more days than not for at least 6 months
• The person finds it difficult to control the worry
• The anxiety and worry are associated with 3 or
more of the following symptoms:
1. Restlessness or feeling keyed up or on edge
(tense, jittery, racing heart, perspiration, twitching
eyelids)
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle tension
6. Sleep Disturbance
 Panic Disorder
• Both 1 and 2 are present
1. Recurrent, unexpected panic attacks
2. At least one of the attacks has been followed
by 1 or more months of 1 or more of the
following
a. Persistent concern about having additional
attacks
b. Worry about the implications of the attack or its
consequences
c. Significant change in behavior related to the
attacks
 A Look at Panic Disorder
• Common factor: Panic
disorder can develop after
major life transitions
• E.g. Going to college
Obsessions Compulsions
• Unwanted, • Ritualistic behaviors
repetitive irrational or mental acts that
thoughts that cause the person feels
anxiety or distress driven to perform in
• Not simply response to an
excessive worries obsession.
about real-life • Aimed at preventing
problems. or reducing distress
or preventing some
dreaded event or
situation.
 Typical Obsessions
Doubts (e.g. Did I turn off the stove?
Did I lock the door? Did I hurt
someone?)
Worry that one has become dirty or
contaminated
NOT just excessive worries about
real-life problems
 Typical Compulsions
Excessive washing Ordering/
Repeating arranging
Checking Reassurance
seeking
Doing & then
undoing things Hoarding (now
own category in
Touching
DSM-V)
Counting
 Other OCD Statistics
The median age of onset is 19, with
25 percent of cases occurring by age
14. One-third of affected adults first
experienced symptoms in childhood.

Equally common among males and

females.
 Do you or anyone you
know have obsessive
thoughts or conduct
compulsive behaviors?
Living w/ OCD
Neil Hilborn – “OCD”
 PTSD
The person has been exposed to a
traumatic event and has experienced 4 or
more weeks of 1 or more of the following
symptoms:

1. Haunting memories or flashbacks

2. Nightmares
3. Social withdrawal
4. Sleep problems
5. Jumpy anxiety
 PTSD
• Can occur in people who have
experienced or witnessed a natural
disaster, serious accident, terrorist attack,
sudden death of a loved one, war, violent
personal assault such as rape, or other
life-threatening events.
• 67% of people exposed to mass violence
have been shown to develop PTSD, a
higher rate than those exposed to natural
disasters or other types of traumatic
events.
 Warm-Up
Take out your Anxiety & Related Disorders
notes. Answer the following:
1. What is the difference between Specific
Phobias and Social Phobias?
2. What are the major symptoms of GAD?
How long do they have to last for to be
diagnosed with GAD?
3. In relation to OCD, how are obsessions
and compulsions different AND related?
Fight or Flight Freeze Response
 An over-active frontal lobe

• The anterior
cingulate cortex
(monitors our
actions and
checks for errors)

Hyperactive in an OCD patient.

3) Observational
Learning

• Wild monkeys transmit

their fear of snakes to their
watchful offspring
• Human parents similarly
transmit fears to their kids
 Cognitive Perspective
• Dysfunctional & irrational ways
of thinking
• GAD & unrealistically high
standards for own behavior
• Panic disorder: Heightened,
intense focus on potential threats
Psychodynamic Perspective
• Anxiety stems from
unresolved, unconscious
conflicts from childhood
• Id vs. superego
• Basic anxiety develops
during childhood &
continues (Karen Horney)
Psychodynamic take on OCD

• Fixation in the anal stage

• Compulsions = attempts to
keep those impulses
repressed (exaggerated
defense mechanisms)
 Anxiety Disorders
Cultural Variations
Fear, Anxiety, and Anxiety Disorders exist in
all cultures
Prevalence rates vary, but are generally the
most common mental illness in all countries
Fear stimulus and content of anxiety differ
greatly between cultures
 Dhat (India), Jiryan (India), Sukra
Prameha (Sri Lanka), & Shen-k’uei
(China)
Severe anxiety, panic symptoms, somatic
complaints, hypochondriachal symptoms
associated with the discharge of semen
Excessive semen loss is feared because
of the belief that it represents the loss of
one’s vital essence and can thereby be
life threatening
 Koro (South and Southeast
Asia)
Sudden and intense anxiety that one’s
genitalia will recede into the body and
possibly cause death
Can occur in epidemics
 Taijin Kyofusho (Japan)
An intense fear that one’s body, its parts,
or its functions (sweating, body odor, facial
expressions, etc.) displease, embarrass,
or are offensive to other people
Similar to the DSM’s Social Phobia