What is Anxiety?

How Therapy Works

Goals of Therapy:

• Symptom relief and functional improvement
• Building awareness and emotional regulation
• Preventing relapse and promoting independence
• Improving interpersonal and occupational functioning

Evidence-Based Therapies:

1. Cognitive Behavioral Therapy (CBT)

• Addresses irrational fears and avoidance
• Builds coping mechanisms and realistic thinking

2. Exposure and Response Prevention (ERP)

• Especially effective in OCD and phobias
• Gradual exposure to feared stimuli reduces anxiety response

3. Acceptance and Commitment Therapy (ACT)

• Helps individuals accept anxiety and commit to meaningful actions
• Encourages mindfulness and values-based living

4. Dialectical Behavior Therapy (DBT)

• Teaches emotion regulation and mindfulness
• Useful in cases with co-occurring emotional dysregulation

5. Mindfulness-Based Stress Reduction (MBSR)

• Reduces stress through meditation, breathing, and body awareness
• Improves present-moment focus and calmness

6. Psychoeducation

• Helps clients and families understand anxiety and treatment options
• Encourages consistent practice and lifestyle alignment

Assessment and Diagnosis

Clinical Interview and History Taking

• Evaluation of the frequency, intensity, and triggers of anxiety symptoms
• Personal and family psychiatric history is explored

Diagnostic Criteria (DSM-5-TR)

• Diagnosed based on specific symptom criteria defined by the DSM
• Must cause significant distress or impairment

Psychological Assessments and Tools

• Generalized Anxiety Disorder 7-item scale (GAD-7)
• Beck Anxiety Inventory (BAI)
• State-Trait Anxiety Inventory (STAI)
• Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), if OCD suspected

Medical Tests

• Rule out physical causes (e.g., hyperthyroidism, heart conditions)

Lab tests or imaging, if clinically indicated

Treatment for Anxiety

Anxiety Disorders are highly treatable with the right combination of interventions tailored to the individual’s needs.

1. Medication

Psychiatrists may prescribe medications to manage acute or chronic anxiety:

• SSRIs (e.g., Escitalopram, Sertraline)

• SNRIs (e.g., Venlafaxine, Duloxetine)

• Benzodiazepines (short-term use, e.g., Clonazepam, Alprazolam)

• Beta-blockers (e.g., Propranolol for physical symptoms)

• Buspirone (non-sedative anxiolytic)

2. Psychotherapy

Therapy focuses on identifying and challenging anxious thoughts, managing avoidance behaviors, and promoting healthier coping.

Signs and Symptoms

Symptoms of Anxiety Disorder can vary depending on the type but commonly include emotional, cognitive, physical, and behavioral components.

Physical Symptoms

• Muscle tension
• Headaches or fatigue
• Rapid heartbeat or chest tightness
• Sweating or trembling
• Gastrointestinal issues (e.g., nausea, IBS)

Behavioral Symptoms

• Avoidance of anxiety-provoking situations
• Compulsive behaviors (in some subtypes)
• Seeking excessive reassurance
  

Emotional Symptoms

• Persistent worry or fear
• Restlessness or feeling on edge
• Irritability

Cognitive Symptoms

• Difficulty concentrating
• Intrusive or racing thoughts
• Catastrophic thinking (“What if” scenarios)

Causes

Anxiety disorders arise from an interplay of genetic, biological, psychological, and environmental influences.

Biological Factors

• Imbalance in neurotransmitters like serotonin and GABA
• Overactivity in brain regions like the amygdala

Genetic Factors

• A familial background of anxiety or other mental health disorders.

Psychosocial and Environmental Factors

• Childhood adversity or trauma
• Ongoing stress (e.g., financial issues, work pressure)
• Negative thinking patterns or perfectionism
• Substance use or withdrawal

Types of Anxiety

 Anxiety manifests in various forms, each with specific features.

Generalized Anxiety Disorder (GAD)

• Excessive worry about everyday events or activities
• Challenging to manage, persisting for six months or longer.

Panic Disorder

• Sudden, intense panic attacks with physical symptoms
• Fear of future attacks or losing control

Social Anxiety Disorder (Social Phobia)

• Intense fear of social situations or scrutiny
• Avoidance of public speaking, meetings, or gatherings

Specific Phobias

• An unreasonable fear of particular objects or circumstances, such as heights or spiders.
• Leads to active avoidance and distress

Obsessive-Compulsive Disorder (OCD)

• Repetitive, intrusive thoughts (obsessions)
• Compulsive behaviors to relieve anxiety

Post-Traumatic Stress Disorder (PTSD)

• Anxiety following a traumatic event
• Flashbacks, nightmares, and hypervigilance

Separation Anxiety Disorder

• Excessive fear of being away from loved ones
• Common in children but can persist in adults

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