I'm going to show you how to stop having panic
attacks using exposure therapy, coping skills and grounding skills and you can start applying
this to your life. Right now. I'm clinical psychologist Dr. Ali Mattu. Psychology took me from almost flunking out
of high school to becoming an assistant professor at Columbia University. Now I've left academia so I can give away
everything I've learned to you for free. Welcome to the psych show. The first step to stopping panic attacks is
to understand what exactly is happening when someone has a panic attack.
They experience a sudden rise in at least
four of these symptoms. It's normal to feel the sensations when we're
in a real dangerous situation like an animal's chasing us or before an important event, like
a presentation for school or work. But what's so scary about panic attacks is
the sensations can feel like they're coming out of nowhere. Your mind is an association machine. It connects things together, ice cream and
a beautiful summer's day movies in popcorn and email from your boss and stress. All of this happens automatically it happens
without you even realizing it through a process called classical conditioning. This is the stuff Ivan Pavlov was working
on when he got dogs to salivate when they heard a metronome, sometimes weird things
get associated together.
And for some reason, your mind has associated
normal physical sensations of anxiety with a real sense of danger. Maybe you were really sick one day and had
difficulty breathing or you were driving across a bridge and there was a lot more traffic
than usual and you felt stuck and unsafe or you were using a drug and had a really bad
experience with it. There are so many ways in which your mind
You can experience those physical sensations of panic and why it might associate those
sensations with danger. If you avoid going to certain places because
you're afraid you might panic or you might do something really embarrassing. You might also have agoraphobia. This gets us to step two exposure therapy. It doesn't matter too much how these associations
formed, what matters is they exist now. So we have to understand what is it that you're
afraid might happen? When you panic, I want you to take a moment
and write that down, write down what it is you're afraid might happen when you panic.
Maybe you're afraid that the panic attack
will end. Maybe you're afraid of having a heart attack,
or something really embarrassing happening, like fainting or making a fool of yourself
or the ambulance and all these people being called Your rescue when it was a panic attack
and not a heart attack. Or maybe you're afraid of losing control of
hurting yourself hurting someone else of losing your mind, or maybe even dying. I wish I could tell you to not worry about
this stuff. But you've already tried that and it hasn't
worked. You can't out think panic attacks, these associations
have been formed. And the only way we can break them apart is
by gaining new experiences and that is where exposure therapy comes in. Before I introduce you to exposure therapy
exercises, there's a couple things you need to know first, these exercises require you
to get physically active.
So if you have any health problems like any
of these conditions, talk to your doctor first and make sure it's okay to try out these exercises. Number two, if you're someone who has gone
through a traumatic event or traumatic events, you might want to skip ahead and master step
three and four first and then come back to exposure exercises. The reason for that step three and four are
going to help you to feel more in control of your emotions.
And if you're someone who's gone through a
traumatic event, just going through exposures without gaining that sense of control can
make the exposures really overwhelming and can make it harder to break apart those associations. Remember those fears we wrote down a moment
ago. What we're going to do now is try out a variety
of exposure exercises and see what gets us in closest contact with that fear.
These exposure exercises are designed to recreate
those sensations that you experience when you panic. So it might seem scary at first, what I want
you to remember is they're not painful. They're designed to get your body active in
the same way as when you have a panic attack. I want you after every exercise to rate them,
zero to 100% house Similar were the things you felt when you did this exercise to when
you experience a panic attack hyperventilate for one minute, hold your nose and breathe
through a straw for two minutes. Hold your breath for 30 seconds. Sit with your head covered by a heavy coat
or blanket for one minute.
Place a tongue depressor on the back of your
tongue Run quickly in place with high knees for two minutes. Step Up and down on the stair or a step stool
for two minutes. Hold up push up position for 60 seconds or
as long as possible. Sit in a hot stuffy room or sauna, a hot car
or a small room with a space heater. wear a tie turtleneck or scarf tightly around
your neck for two minutes. Drink a hot drink. Drink an espresso or coffee spin in an office
chair for one minute spin around while standing up for one minute.
Shake your head side to side for 30 seconds
while looking ahead. with your eyes open, put your head between
your legs and then sit up quickly. Lie down for one minute and then sit up quickly. Stare at yourself in a mirror for two minutes. Stare at a blank wall for two minutes. Stare at a small dot posted on the wall for
two minutes. Stare at an optical illusion for two minutes,
stare at a fluorescent light and then try to read something What got you closest in
touch with your fears? Usually 1-3 of these exercises should do it
now that you know how to recreate your fears. You have to start practicing these exposure
exercises. So I want you to take one week of your life. And each day that week. I want you to sit down and practice these
exposure exercises. Write down on a piece of paper what you're
afraid might happen when you do the exposure exercise. Then do the exposure completely fully be in
that present moment.
Be aware of what's happening in your mind
during the exposure, what's happening in your body. And then after the exposure on that same piece
of paper write down. Did your fear come true? Yes or no? How do you know if it came true or not? And what did you learn through this exposure,
then do it again, do it three times in a row. If you do this for one week in time, you should
start to break apart those associations that have been formed. Once you start to make progress with these
exposures, then you want to play with the details a little bit like maybe you do this
when you're home alone, or when you're outside in a crowded space or after drinking a lot
of caffeine. Check out this video right over here. It'll walk you through even more details.
To sum it all up. The goal is, I want to help you get comfortable
being uncomfortable. I want to help you to learn about what it's
like. experienced these difficult sensations and
then what actually happens to you when you go through them. So these associations are starting to break
apart. Now it's time to move to step three, which
is developing coping skills. But before I explain some of my favorite coping
skills, we have to talk about what a coping skill is and what a safety behavior is.
Safety behaviors give you some immediate relief,
but they keep you from getting in contact with the thing you fear. And when that happens when you're relying
on safety behaviors. These associations they don't break apart
because you're not learning any new information, completely avoiding a situation being on the
lookout for escapes, only being able to get through with a safe person. Those are some examples of things that can
be safety behaviors, coping skills, reduce your anxiety and help you to stay in contact
with the thing you fear So those associations do break apart. Because you are learning new information you
are getting in contact with a thing that is difficult for you safety behaviors reduce
learning, while coping skills enhance it. This can get really tricky because what's
a safety behavior for one person might be a coping skill for another. And what starts off as a coping skill might
eventually become a safety behavior. So it can get really confusing. All this stuff exists on a continuum from
highly safe behavior to highly coping behavior. To keep it really simple.
Ask yourself these two questions. Is this skill helping me to reach my goal
right now? is it helping me to be flexible in the situation I'm in? If the answers are, yes, that's probably a
good healthy coping skill. If the answer is no, then you might be dealing
with a safety behavior that you want to phase out over time. The first goal I want you to try is slow,
deep controlled breathing. This slows down your breathing, which triggers
your body's parasympathetic nervous system, the part of your body that calms you down. I got a whole video about this, so you can
check that out. But the quick version of it is, you want to
work your way up to breathing in for four seconds. Holding it and then out for four seconds,
so you can start by breathing in for two seconds, holding it out for two seconds, breathing
in for three seconds, holding it out for three seconds and then four.
And you can just keep doing that until you
feel like you're a little bit calmer and a little bit more present the dive reflex. This is a awesome skill that is universal
to all vertebrates on this planet. Basically you are fooling your body into thinking
you're diving into the water that also triggers your body's parasympathetic nervous system
that calms itself down. I've got a whole video on how to do that. So if you're interested in that skill, check
out that video. Get physically active, your body is fired
up.
So do something with that energized body. Go for run, go for a bike ride, do a ton of
jumping jacks do something that gives your body something to do think about The Doctor. One of my favorite episodes of Doctor Who
has The Doctor talking to a small child who's afraid of monsters under his bed. Now, there actually are monsters under his
bed spoilers for those of you haven't seen this episode, but it's you know, Doctor Who
that's going to happen.
But what's really amazing is what he tells
this child it's one of my favorite quotations about panic, and I'm going to read it to you
all here because I don't want this video taken down due to copyright violations filed from
the BBC. Let me tell you about scared. Your heart is beating so hard. I can feel it through your hands. There's so much blood and oxygen pumping through
your brain. It's like rocket fuel. Right now you can run faster and fight harder. You can jump higher than you've ever been
able to in your life. And you are so alert. It's like you can slow down time. What's wrong with scared? Scared is a superpower your superpower there
is danger in this room and guess what? It's you reach out to someone. Call text dm, connect with someone else. Ask them to send you support. Ask them to send you a funny meme to reassure
you or talk to them about something that's completely not related to panic. Connecting with someone else might help you
to get a little bit out of your head and help you to reach your Goal whatever it is in that
situation question for all the Psychees What is your favorite coping skill? Let's flood the comments section with a ton
of coping skills, so we can help whoever discovers this video in the future.
Step number four is to develop grounding skills. Some people who experienced panic also experienced
depersonalization or Derealization. This is where you are going through the motions
of your day. But you don't really feel that plugged in
to yourself to your body to your mind, you might feel like you're on autopilot. Or you might not feel like the things around
you are really happening.
One of my patients recently described it as
having this brain fog and it was really hard to just kind of navigate through daily events. So if this kind of stuff happens to you, we
need grounding skills that help you to feel plugged into your body plugged into your mind
plugged into the present. moment, or they ground you in an important
memory and important place or an important idea. Grounding skills can also be really helpful
if someone around you is having a panic attack and you want to help that person through this
difficult experience 54321 This is a skill that really engages all of your different
senses. It starts by looking at five different things
around you, then to touch four different things to listen to three different sounds, to pick
up on two different smells. And to notice one taste, it's usually whatever
taste is in your mouth. You really want to try to focus in on those
sensations and if there's one type of sensation that works a lot better for you.
It's okay just to stick to that one. Like if you really like the touching to touch
your hands or to touch your jeans or the material on your shirts. Stuff like that you can just focus on that
sensation that's totally fine. Make a list pick something that you know well,
and that you can't easily finish like your favorite movies or your favorite superheroes
or the places you like to go and your local community. I like to pick my favorite starships from
Star Trek and I just kind of cycle through those guys.
I'm a huge Trekkie. This is something that's going to ground you
in an idea, something that you care about, and it's going to make that feeling of depersonalization
Derealization, a little bit less scary, transport yourself to a place you know, well, this could
be your home, your school, your work, doesn't really matter where it is only what matters
is that you know a lot of details about it. Imagine walking through the front door of
this place entering it. What do you see next? what's around you keep thinking about all
the details as you navigate through the space.
This is going to ground you in a place that's
very familiar to you. And again, take you away from those some of
those feelings of depersonalization and derealization. Experience intense sensations. This includes listening to loud music or a
really funny video on YouTube, drinking a hot beverage, or sucking on a lemon or peppermint
candy. pinching the bridge of your nose, snapping
a rubber band against your arm, anything that's going to shock your nervous system and focus
your complete attention, get absorbed in an activity, do something that's going to completely
require all of your focus maybe something that you do well or you know how to do well
something that's really going to activate your mind and get your hands moving. Something like that would also get you out
of depersonalization derealization and make you feel a bit more present If you've tried
everything in this video and are still struggling there's two things I want you to consider.
The first is speaking with an anxiety expert,
a therapist who can guide you through this process in a much more detailed way than I
can in a short YouTube video. The other thing to consider is a consultation
with a psychiatrist, they might be able to prescribe medication that can bring down the
intensity of anxiety so that you can greater apply these things to your life.
If you want to learn more about anxiety check
out this playlist that has all my anxiety videos, you can learn a lot more about exposure
therapy and my own journey with anxiety or right over there. All right now it's time for the weekly Geck
Boo (GCBU) challenge. This is where I share how I'm working on getting
comfortable being comfortable this week. The big thing for me this week has been trying
to catch up on my inbox over the summer and fall I really let things get out of hand.
I had hundreds and hundreds of emails that
were that were needed a response. And I haven't responded to. So this week, the uncomfortable thing for
me is to go through it because it's very overwhelming to even open that inbox and to write uncomfortable
messages where I say, Hey, I'm sorry for this late response. I had a lot going on. And I'm now getting back to you like a year
after I promised. I'm so sorry. So that's, that's my weekly Geck Boo challenge.
What are you working on? Let me know in the comments below. Or if you want to join me this Friday, I'm
hosting my weekly office hours. This is a time where for one hour on Instagram,
I go live to hear about what you are working on out there in the Psychee community, and
how I can help and how we can help each other to reach our goals and to help each other
get comfortable being uncomfortable. So if you want to join me for my weekly live
office hours, come over to Instagram I'm @AliMattu and we'll talk about all this stuff and we'll
support each other. Share this video with someone who struggles
with panic in your life. And if you want more videos that celebrate
mental health, make psychology fun and easy to understand.
Be sure to subscribe to the psych show and
now my favorite comment of the week.
Tag: panic attack
Why Are You Anxious?
Many of us experienced symptoms of anxiety Whether it is from testing or applying for a new job But some people find it difficult to stop worrying Even in seemingly normal situations, this has a lasting effect on me Their quality of life, so what happens? And why do they get so anxious? Nearly seven million people Have general disorder which means That they are exposed to excessive anxiety most days, for a period of not less than six months This includes sleep disturbance, agitation and muscle strain Panic attacks may also occur, but their nature varies as they come In sudden and short periods of excessive fear that leads to Violent physical reaction such as tachycardia, shortness of breath and dizziness In fact, anyone can suffer from a panic attack, whether or not they have the disorder There may be no specific cause for this panic attack Although we do not fully understand it, anxiety is partly caused by the amygdala "glory" and the hypothalamus, which are responsible for circulating cortisol and adrenaline in the body. Genetically, 40 percent of people with general disorder have a relative with the same disease Which means I levels of these hormones you have linked to your genes The environment around you may be another factor Some diseases of the disorder are associated with traumatic experiences in childhood Levels of neutron transmitters such as GABA, serotonin, and dopamine may change Be another reason.
Serotonin hormone is responsible About the feeling of luxury and happiness It works by moving between Neuron and another in the brain via a difference called "synapses" Any unused Serotonin returns to the original neuron by a special carrier But those with certain anxiety disorders like OCD It has been suggested that a mutation in these vectors multiply the amount of Serotonin returned Before it gets to the receiving neuron This results in a decrease in the amount of the difference, "Synapse", leading to the effect of the feelings This was the reason for using drugs such as SSRIs In these anxiety states, Serotonin is prevented from returning to the original Neuron Also, many anxiety diseases show an excessive reaction in the amygdala and the gray area "periaqueductal gray area". This results in negative effects not only on the brain Even on our bodies.
In a study of nearly 300 people for a period of five years Those who had an amygdala tonsil with an overactive reaction showed higher rates of heart disease. Because the amygdala stimulates the production of white blood cells In the bone marrow leading Inflorescence affects Artery heart artery If you have a fear of a cause (phobia), this is one of the forms of anxiety diseases But since many fears help us to survive Like fear of spiders or heights, it has been suggested that These concerns may be stored in the DNA and inherited When mice are electrocuted after being exposed to a fruit smell They quickly learn to fear that smell But interestingly, the new generations of mice Also, you are afraid of these same fruit scents. Although generations of new mice did not experience electric shocks, it turned out to be Because of the strong reaction of the electrocution in the brain aromatherapy receptors Make new generations more sensitive to the same smells In such a way that the receivers are turned on for those odors These smells are associated with some cases of phobia.
For treatment, cognitive behavior therapy helps Get to know the thoughts that stimulate feelings Affecting behavior and aims to Change these thoughts to fight anxiety diseases On the other hand, medicines like SRIs and SNRIS It is used to prevent the absorption of serotonin or noreprivin But it may result in side effects and sometimes It negatively affects long use Benzodiazepines are also used to aid sleep Muscle relaxation, but it is also associated with dementia in older generations It is important to know that the basis of nervous and chemical anxiety is very complex And telling someone who is infected to calm down will not produce any result So we decided to make another video and show us what we're doing In order to overcome anxiety with some tips and tricks that We think it works. You can see it by clicking here. Subscribe for weekly science videos every Thursday .
Serotonin hormone is responsible About the feeling of luxury and happiness It works by moving between Neuron and another in the brain via a difference called "synapses" Any unused Serotonin returns to the original neuron by a special carrier But those with certain anxiety disorders like OCD It has been suggested that a mutation in these vectors multiply the amount of Serotonin returned Before it gets to the receiving neuron This results in a decrease in the amount of the difference, "Synapse", leading to the effect of the feelings This was the reason for using drugs such as SSRIs In these anxiety states, Serotonin is prevented from returning to the original Neuron Also, many anxiety diseases show an excessive reaction in the amygdala and the gray area "periaqueductal gray area". This results in negative effects not only on the brain Even on our bodies.
In a study of nearly 300 people for a period of five years Those who had an amygdala tonsil with an overactive reaction showed higher rates of heart disease. Because the amygdala stimulates the production of white blood cells In the bone marrow leading Inflorescence affects Artery heart artery If you have a fear of a cause (phobia), this is one of the forms of anxiety diseases But since many fears help us to survive Like fear of spiders or heights, it has been suggested that These concerns may be stored in the DNA and inherited When mice are electrocuted after being exposed to a fruit smell They quickly learn to fear that smell But interestingly, the new generations of mice Also, you are afraid of these same fruit scents. Although generations of new mice did not experience electric shocks, it turned out to be Because of the strong reaction of the electrocution in the brain aromatherapy receptors Make new generations more sensitive to the same smells In such a way that the receivers are turned on for those odors These smells are associated with some cases of phobia.
For treatment, cognitive behavior therapy helps Get to know the thoughts that stimulate feelings Affecting behavior and aims to Change these thoughts to fight anxiety diseases On the other hand, medicines like SRIs and SNRIS It is used to prevent the absorption of serotonin or noreprivin But it may result in side effects and sometimes It negatively affects long use Benzodiazepines are also used to aid sleep Muscle relaxation, but it is also associated with dementia in older generations It is important to know that the basis of nervous and chemical anxiety is very complex And telling someone who is infected to calm down will not produce any result So we decided to make another video and show us what we're doing In order to overcome anxiety with some tips and tricks that We think it works. You can see it by clicking here. Subscribe for weekly science videos every Thursday .
How to cope with anxiety | Olivia Remes | TEDxUHasselt
Anxiety is one of most prevalent mental health disorders, with 1 out of 14 people around the world being likely affected. Leading up to conditions such as depression, increased risk for suicide, disability and requirement of high health services, very few people who often need treatment actually receive it. In her talk “How to cope with anxiety”, Olivia Remes of the University of Cambridge will share her vision on anxiety and will unravel ways to treat and manage this health disorder. Arguing that treatments such as psychotherapy and medication exist and often result in poor outcome and high rates of relapses, she will emphasise the importance of harnessing strength in ourselves as we modify our problem-coping mechanisms. Olivia will stress that by allowing ourselves to believe that what happens in life is comprehensive, meaningful, and manageable, one can significantly improve their risk of developing anxiety disorders.
Anxiety is one of most prevalent mental health disorders, with 1 out of 14 people around the world being likely affected. Leading up to conditions such as depression, increased risk for suicide, disability and requirement of high health services, very few people who often need treatment actually receive it. In her talk “How to cope with anxiety”, Olivia Remes of the University of Cambridge will share her vision on anxiety and will unravel ways to treat and manage this health disorder. Arguing that treatments such as psychotherapy and medication exist and often result in poor outcome and high rates of relapses, she will emphasise the importance of harnessing strength in ourselves as we modify our problem-coping mechanisms. At TEDxUHasselt 2017, Olivia will stress that by allowing ourselves to believe that what happens in life is comprehensive, meaningful, and manageable, one can significantly improve their risk of developing anxiety disorders.
This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx
Generalized anxiety disorder (GAD) – causes, symptoms & treatment
What is generalized anxiety disorder? Generalized anxiety disorder—sometimes shortened to GAD—is a condition characterized by excessive, persistent and unreasonable amounts of anxiety and worry regarding everyday things. Find more videos at http://osms.it/more.
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Panic Attack and Anxiety Attack Caught on Camera! Panic Disorder
Panic Attack and Anxiety Attack Caught on Camera! Its Okay NOT To Be Okay!
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5 Differences Between Generalized Anxiety Disorder and Anxiety
Differentiating between normal anxiety and generalized anxiety disorder (GAD) can be tricky. How do you know, especially if you are a little more anxious than others, whether or not your anxiety is significant enough to qualify as a disorder?
#anxiety #generalizedanxietydisorder #gad
Disclaimer: This video is not meant to be a diagnostic tool. If you notice you have symptoms of anxiety, it’s best to contact a professional.
Related Videos:
6 Signs You May Have Anxiety and Not Even Know It
A Declassified Guide to Anxiety
Anxiety: 11 Things We Want You To Understand
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https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
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Have anxiety symptoms? Please refer to a professional!
45 SCARY but VERY COMMON ANXIETY SYMPTOMS / panic attack / disorders
I have created this very extensive list for you guys. I hope this will ease your mind 🙂
Anxiety and panic attacks can cause all kinds of mental and physical symptoms. So this video is a summary of all kinds of symptoms have lived trough myself or know others have experienced. In case i have missed one please let me know in the comments so i can create a complete list of anxiety symptoms.
Here the list:
1. Ringing in the ears
2. Impaired hearing
3. blurry vision
4. insomnia
5. dry mouth
6. Jaw pain
7. Feeling of floating
8. Ear pressure
9. Dizziness
10. Headaches
11. Hypochondria
12. Need for control
13. concentration problems
14. constant body checking
15. Afraid of being alone
16. Extremely health coscious
17. New phobias
18. fear of making a fool of yourself
19. waiting for impending doom
20. avoid public spaces
21. constant fear of death
22. feeling of being confined
23. very self- aware
24. helpless
25. depression
26. frequent crying
27. mood swings
28. Heart sensations
29. shortness of breath
30. burning sensations
31. chronic fatigue
32. electric shock feelings
33. restless leg syndrome
34. decreased or increased energy
35. muscle twitching
36. muscle tension
37. Numbness
38. decreased sex drive
39. Easily starled
40. Excessive sweating
41. off balance feeling
42. frequent urination
43. weak limbs
44. Drug and alcohol abuse
Extended list of symptoms i got from the comment section:
45. weight loss
46. pharmacophobia (fear of taking medication)
47. depersonalization / derealization
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How to Survive Anxiety & Panic Attacks | Black Friday
Weird tips and “brain hacks” I’ve found useful that I wanted to share for those of us, blessed as we are, with panic or anxiety disorders. Particularly needed at this weird and sucky time!
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The Anxiety Life Changer: How to Improve Your Resilience
Anxiety is debilitating. So this groundbreaking therapy is a life changer. It will make you more psychologically resilient & change your life.
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ABOUT THE SERIES:
Acceptance and Commitment Therapy is the science-backed way to break you free from your thoughts, help you reach your goals, & change your life. In this groundbreaking series, Triple Board Certified psychologist and ACT expert Dr. Judy Ho walks you through everything you need to know about acceptance and commitment therapy. In doing so, she teaches you how to revolutionize your self-identity and truly understand what it means to be happy.
Dr. Ho first explains where acceptance and commitment therapy came from, how it puts you in a position to successfully reach your goals, and why we don’t reach our goals in the first place.
She then walks through the six core processes that are at the foundation of acceptance and commitment therapy: acceptance, cognitive defusion, being present, self as context, values, and committed action.
‘Acceptance’ sounds simple, but applying this concept can be difficult. However, Dr. Ho gives you the expertise that will make it easier to practice this part of acceptance and commitment therapy. According to Dr. Ho, the thing that often stands in the way of our doing something meaningful is fear. However, ACT gives you the tools to that will motivate you to both understand and successfully tolerate that fear. In doing so, you’re in a better position to reach your goals.
The next process of ACT is ‘Cognitive Defusion.’ According to Dr. Ho, this process will change your relationship with your thoughts. The way to do this will surprise you; it requires looking past the constraints of language and understanding your thoughts in a whole new light.
You’ve probably heard of the next concept – ‘Being Present’ – but acceptance and commitment therapy takes this concept a step further. ACT uses evidence-based techniques that give you the power to non-judgmentally experience the world around you. Dr. Ho shows you how in this series.
Having a healthy sense of self is the key to self-discovery and finding your purpose. But what actually defines a healthy sense of self is different than you’d expect. Dr. Ho explains those differences in the session focused on the 4th module, ‘Self as Context.’ She shares how this process will strengthen your own self-identity.
Processes 5 and 6 are intertwined – ‘Values’ and ‘Committed Action.’ Values define our belief systems and exist to give our lives purpose. So how can you ensure that your goals are rooted in your values and bring meaning to your life? And how can you use ‘Committed Actions’ to link your values to your behavior? Dr. Ho tells you how in our final session.
After finishing this series, you will understand how to (and be motivated to) traverse the research-backed road to self-discovery that acceptance and commitment therapy provides.
Anxiety Disorders: OCD, PTSD, Panic Attack, Agoraphobia, Phobias, GAD Generalized
http://www.stomponstep1.com/anxiety-disorders-ocd-ptsd-panic-attack-agoraphobia-phobias-gad-generalized/
SKIP AHEAD:
0:25 – Anxiety Definition & Symptoms
1:13 – Anxiety Differential Diagnosis
2:12 – Generalized Anxiety (GAD)
3:05 – Panic Attacks, Panic Disorder & Agoraphobia
5:01 – Specific Phobia & Social Anxiety Disorder (Social Phobia)
7:55 – Obsessive-Compulsive Disorder (OCD)
9:29 – Posttraumatic Stress Disorder (PTSD)
Anxiety is uncontrolled fear, nervousness and/or worry about trivial or non-existent things. It is an unpleasant fear of future events that are unlikely to occur. Some patients have insight and realize that their uneasiness is illogical, but that does not alleviate symptoms. A certain level of anxiety is considered normal in many situations, but frequent anxiety or anxiety that inhibits function is pathologic.
During anxiety sympathetic nervous system activation can result in physical symptoms such as Palpitations, Tachycardia, Shortness of breath, Muscle tension, Restlessness, Lack of focus, Sweating or chills and Changes in sleeping pattern.
In order to make a diagnosis of anxiety, one must rule out other potential causes of these symptoms. The differential diagnosis for anxiety includes other psychiatric disorders, cardiac abnormalities (such as myocardial infarction or valvular disease), endocrine disorders (like hyperthyroidism) and respiratory disease (such as asthma or Pulmonary Embolism). Substances such as street drugs and prescribed medications must also be ruled out as a potential cause of the symptoms.
We are going to hold off on discussing most of the different treatment options for anxiety until a later video that will cover all of pharmacology for the psychiatry section. That video will cover things like SSRIs, anxiolytics and cognitive behavioral therapy which can be used to treat anxiety disorders. However, during this video I will mention a couple treatment options that are used for specific anxiety disorders.
We will start our discussion with Generalized Anxiety Disorder or GAD. You can see here in the top right corner I give GAD a high yield rating of 2. For those of you who aren’t familiar with the High Yield Rating it is a scale from 0 to 10 that gives you an estimate for how important each topic is for the USMLE Step 1 Medical Board Exam. GAD is a prolonged period of near constant anxiety. Their anxiety is not linked to a specific item, person, or situation (AKA it isn’t a phobia).
They usually worry about a wide variety of things including school/work performance, finances, health, friends and/or family members. Their anxiety is “generalized” across many situations. Their anxiety frequently presents with “physical” symptoms and may be severe enough to impair function.
A Panic Attack is sudden onset period of extremely intense anxiety accompanied by numerous signs and symptoms of anxiety. The attack is often associated with a sense of impending doom. These “episodes” usually last 10 to 30 minutes and are disabling. The patient returns to their normal level of function soon after the panic attack. They may be brought on by an inciting event or be completely unprovoked.
I’d like to stop here for a moment to clarify the difference between generalized anxiety disorder and a panic attack. GAD can be thought of as a constant moderate level of anxiety while panic attacks are short periods of severe anxiety.
Panic Disorder is recurrent panic attacks that are unprovoked and have no identifiable trigger. The onset of these anxiety episodes is unpredictable. Patients may be relatively asymptomatic between attacks, but often have anxiety about having more attacks. Their fear is related to the panic attacks themselves rather than a particular external stimuli. This differentiates Panic Disorder from Panic Attacks that are caused by things like phobias.
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