Posts from 2017-09

Anxiety Disorders

 

Definition

 

While we all experience temporary anxiety at some time or another, the anxiety disorders are long-term states of anxiety triggered by various causes. The American Psychological Association describes anxiety and anxiety disorders as, “...an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry.” In anxiety disorders, the anxieties do not gradually decline or go away over time. In fact, they may increase in occurrence or intensity over time. They often interfere with interpersonal relationships, school, or job performance. Anxiety disorders may take several different forms: generalized anxiety, panic attacks, or differing forms of social anxiety disorders:

 

Signs and Symptoms

 

Generalized Anxiety Disorder

 

Generalized anxiety disorder takes the form of excessive anxieties or worry for long periods of time. Typical symptoms of generalized anxiety disorder are:

 

  • General feelings of restlessness

  • Feeling “on edge”

  • Getting tired easily

  • problem in concentrating

  • Occasionally having the mind “go blank”

  • Being irritable

  • Feelings of tension in the muscles

  • Obsessive worrying

  • Problems in sleeping, such as difficulty in falling asleep, inability to remain asleep, or feelings of dissatisfaction with the quality of sleep.

 

Panic Disorder

 

This disorder is characterized by recurring panic attacks. A panic attack is feelings of sudden fear without clear or distinctive causation accompanied by palpitation or pounding of the heart, rapid heart rate, shaking or trembling, sweating, shortness of breath, feeling of smothering, and feelings of impending disaster or doom.

 

Most common symptoms of panic disorder are:

 

  • Sudden attacks of intense, unreasoning fear

  • Repeated attacks of sudden intense, unreasoning fear

  • The feeling of loss of control or being out of control

  • Constant worry about when the next attack will occur

  • Fear of certain situations which appear to have triggered panic attacks in the past

  • Avoidance of situations or places which appear to have triggered panic attacks in the past

 

 

Social Anxiety Disorder

 

Social anxiety disorder, which is also called “social phobia,” is characterized by intense worries about and fears social situations. Fears may focus on embarrassment, negative judgments of other people, fears of possible rejection, and fears of inappropriate behaviors.

 

Other symptoms of social anxiety disorder are:

 

  • Anxiety about being in situations with other people

  • Anxiety about the ability to talk to other people, to carry on a natural conversation

  • Extreme self-consciousness in situations in front of other people/

  • Anxiety about being humiliated in front of other people

  • Anxiety about being rejected by other people

  • Anxieties about offending other people.

  • Fears of being judged adversely by other people

  • Excessive worry about future social situations

  • Avoiding social situations

  • Difficulties in making and keeping friends

  • Anxious reactions, such as sweating, trembling, or blushing when around other people

  • feelings of nauseousness or being sick to the stomach when with other people or in social situations.

 

 

A psychologist should asses the presence of social anxiety disorder as there are certain health conditions which may cause behaviors similar to social anxiety disorder. Some medications, also, might cause similar reactions and behaviors. The psychological assessment will consider the person as a whole in regard to symptoms and behaviors rather than disproportionately focusing on specific behaviors. Thus, the assessment may discover associated conditions, such as obsessive-compulsive disorder or depression.

 

Risk Factors

 

There are a number of risk factors to the incidence of anxiety disorders, among which are::

 

  • Having been a shy child

  • Females are more likely to develop anxieties disorders than males

  • Poverty or few economic resources

  • The status of being divorced or widowed

  • Having been exposed to stressful life experiences in childhood or later

  • Genetic predispositions, anxiety disorders sometimes follow family lines

  • Parent having suffered from mental disorders

 

Treatments and Therapies

 

The treatments for anxiety disorders involve psychotherapy and may also include medications.

 

Psychotherapy

 

Psychotherapy, or “Talk therapy,” focuses on the personal background of the patient, the identification of circumstantial and situational causative factors for anxiwety, therapeutic approaches to defusing causative circumstances and situations, and the development of coping mechanisms. A part of psychotherapy would be some temporary discomfort in thinking about the causation and reactions to particular feared situations in learning to get past them

 

Cognitive Behavioral Therapy (CBT)

 

Cognitive Behavioral Therapy provides another approach in psychotherapy in dealing with anxiety disorders. The focus of this therapy is on learning new ways of thinking about and reacting to anxiety-producing situations. CBT can assist in the learning of new social skills and in the development of coping mechanisms to anxiety-producing situations. The intent of cognitive therapy is on the identification, challenging, and then the neutralization of thoughts related to anxiety-inducing circumstances.

 

Exposure therapy is another approach which gives the patient the opportunity to confront fears for the purpose of conditioning their responses from negative to positive. This is effective in aiding people who fear particular situations or circumstances to be more comfortable and functional in them.

 

Thus, there are a variety of approaches to leaning to deal with anxiety disorders through psychotherapy. The objective of psychotherapy is the create within the client the ability for normal, anxiety-free functioning in otherwise fearful situations and circumstances.

 

 

Attention Deficit Hyperactivity Disorder (ADHD)

 

 

Definition:  Attention-deficit/hyperactivity disorder (ADHD) is defined as “a brain disorder characterized by an continuing pattern of inability to focus attention often accompanied by hyperactivity/impulsivity which interferes or disturbs functioning.”

 

 

 

  • Inattention or lack of ability to focus attention makes it difficult to focus on a task for a period of time. Focus wanders resulting in disorganization and lack of progress and accomplishment. Defiance and/or lack of comprehension is not a factor in this form of inattention.

  • Hyperactivity is a condition in which one is constantly in motion inappropriate to the time and place, fidgeting, regular hand or leg motion, and/or excessive talking, and general restlessness.

  • Impulsiveness means taking actions with incomplete forethought or preparations. Unexpectedly doing things “on the spur of the moment.” Further, this often occurs without regard to potential danger or harm. It is a desire for instant gratification and a need for immediate rewards. Interrupting the conversations of other people often occurs. Decisions are often made without the consideration of long-term consequences.

 

 

 

Signs and Symptoms

 

 

It is the three characteristic behaviors, Inattention, hyperactivity, and impulsivity, which are the most identifiable elements in ADHD. Some people may demonstrate only one of these behaviors, but other people may demonstrate all three. It is typical of children to demonstrate all three behaviors.

 

While some inattention is normal, when it becomes noticeable and effects the individual's interpersonal, social, or job activities, it becomes a negative ADHD factor.

 

In people representing ADHD symptoms, the behaviors of inattention, hyperactivity, and impulsiveness are presented as more severe than non-ADHD people. These symptoms occur more regularly. What is also important is the fact that these behaviors have the result of reducing or interfering with the ability of the ADHD individual to function normally in social situations, at work, or in school

 

Inattention

 

Typical and common behaviors for people demonstrating inattention often:

 

  • Make careless mistakes and/or overlook details at school or at work

  • Experience difficulty in maintaining their attention while playing, at school, at work, and in conversations. They have problems in reading anything of any significant length.

  • They don't seem to listen or hear when they are being spoken to. They can't carry on a focused conversation on a single topic for any length of time.

  • Do not listen to or carefully follow instructions.

  • Have difficulty in completing tasks at school, on the job, or in social situations.

  • Start work on tasks, but soon lose their focus. They get easily sidetracked.

  • Do not seem to be able to get organized or stay organized. They don't do things in the normal or expected sequence. Their belongings and work spaces are not organized. They are not good in time management. Thus, they often fail to meet expected deadlines.

  • Do not like tasks that involve focused mental effort and attention. They are not good in working on long-term projects as they cannot stay focused on them to completion.

  • May regularly lose things that are necessary to pursue tasks or in daily life.

  • Are easily distracted and often experience thoughts that change their focus.

  • Are over-reactive to external stimuli

  • Forget things and do not do ordinary things expected, like returning phone calls or messages, doing errands or chores, and keeping appointments

 

Hyperactivity-Impulsivity

 

For people demonstrating hyperactivity and impulsiveness, theyoften:

 

  • Squirm and fidget. They have trouble sitting quietly.

  • Can't remain seated for typically expected periods of time, such as during a class or in a meeting.

  • Demonstrate physical restlessness, hand actions, foot actions, looking around.

  • Can't focus on a particular activity for very long.

  • Want to talk constantly.

  • Don't give someone they are talking to the chance to complete their thoughts. Finish their sentences for them. They don't wait their turn to talk, but blurt out and talk out of turn.

  • Intrude unexpectedly into conversations, games, or other activities.

 

 

Diagnosis:

 

 

The ADHD diagnosis requires an array of diagnostic approaches by a licensed psychologist. Critical elements of the diagnosis require the symptoms of hyperactivity, impulsiveness, and inattention, and these symptoms must be chronic not just short-term or temporary. Further, their effect must be the impairment of the functioning of the individual. The symptoms cannot be due to medical or psychiatric conditions or medications.

 

 

 

The symptoms of ADHD can occur as early as ages 3 to 5 and can persist into adulthood. In children and adolescents in school or home, the condition may be the source of disciplinary problems. The behaviors of impulsivity, restlessness, and inattention persist into adulthood. Adults with ADHD often are characterized by poor performance in academic situations, problems in the work environment, and conflicted or problematical interpersonal relationships.

 

 

Risk Factors for ADHD:

 

 

While it is not certain what causes ADHD, there are certain factors which can contribute to it:

 

 

  • Genes: often ADHA behavior is found in family lines

  • The use of alcohol, smoking, and drug use in pregnancy

  • Prenatal environmental toxins, such as lead, exposure

  • Low weight at birth

  • Certain injuries to the brain.

 

 

The incidence of ADHD is more common in males than in females, but females with ADHD tend to focus in the area of inattention. There are further conditions which may accompany ADHD, such as anxiety disorders, learning disabilities, drug abuse, and conduct disorders.

 

Treatment Therapies:

 

There is not “cure,” as such, for ADHD. However, a number of treatment therapies can contribute to behavioral changes. Typical treatments are psychotherapy, education/training, medication, and some combination of these treatments.

 

 

Psychotherapy:

 

Psychotherapy for ADHD patients contributes to insights about behavior and associated coping mechanisms.

 

Behavioral therapy:

 

Behavioral therapy has as its objective to assist the patient in recognizing ADHD behavior and determining approaches to changing it. This could involve varying kinds of practical assistance, such as in focusing on the completion of projects and tasks and/or approaching and coping with emotionally-charged circumstances. Critical elements of behavioral therapy focus on self-monitoring of behavior and the development of a system of praise and rewards for correct behavior in, for example, the controlling of anger and thinking things out before acting.

 

Family members can learn forms of positive and negative feedback to assist the ADHD patient in self-monitoring. Such assistance can involve the creation of rules, lists of required activities which must be completed, various structured routines around activities in daily life.

 

One approach in psychotherapy is cognitive behavioral therapy which teaches the patient personal mindfulness. Meditation can also be useful. It is necessary for the patient to learn to be aware of their emotional states, what generates, stimulates, and motivates them, and how they can be encountered and appropriate responses. It can include training in learning to think before acting and learning to recognize and avoid unnecessary risks.

 

Additionally, family and marital therapy can aid the patient and immediate family on encountering, reacting to, and amending disruptive behaviors.

 

Thus, ADHD represents a psychological problem which can be the source of a number of personal, academic, and career problems, but there are a number of therapies which can be effective in alleviating many of these problems and to aid the patient in developing positive coping mechanisms.

 

 
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