Anxiety disorders: An information guide - CAMH

1 AnxietydisordersAninformationguideAnx ie tydisorde rsAnin fo rmat io ngui deA Pan Americ an Hea lth Organizatio n /Wor ld Health Or gan iz ati on Col labo rati ng Cen tr e3973b/02-2011/P041everyonefeelsanxiety, ,suchaspanicdisorder,specificphobias, ,PhDDanielleBourdeau,MDKateKitchen,MSWL indaJoseph-Massiah,RN,PhDFo r mor e infor mat ion on addic tio n and me nt al healt his sue s, or to downloa d a copy of this br oc hure , pl eas evis it ou r website s publ ic at io n maybe ava il ablein othe r fo rma ts . Forin forma ti on abo ut al te rnate fo rma ts , to or de r mul tip leco pi es of this bro ch ur e, or to orde r other CA MHpu bli ca ti on s, pl ea se cont ac t Sal es and Di st ri buti on:To ll-f ree : 1 80 0 661-11 11To ro nto : 41 6 595-6 059E-mail : publi cat ion s@c amh.

2 NetOn li ne stor e: ht tp :/ /stor e. ca mh. netTo mak e a do nat io n, pl ease cont ac t the CA MH Founda ti on:Te l.: 416 979 -6 909E-mail : fou ndat ion@c amh .ne tIf you have que stions,con ce rn s or com plim ents about servicesat CAMH, pl easecon tact th e Cl ient Rel ations Service:Te l.: 416 53 5-8 50 1 ext. 202 8 or 2078 Dis pon ible en fran ais .Anx ie tydiso rde rsAninfor ma tio ngui deNeil r, PhDDaniel leBourdeau,MDKate Kitchen,MSWLi ndaJoseph-Massiah,RN, 3/1/11 12:31 PM Page iLibraryandArchivesCanadaCataloguingin PublicationAnxietydisorders:an informationguide: a guide for peoplewith anxietyand their families/ Neil A. [et al.].1. Anxiety Anxiety Patients Rector,Neil A. II. Centrefor Addictionand 22C2004-907081-9isbn:978-1-77052-428-6(p rint)isbn:978-1-77052-429-3(pdf)isbn:978 -1-77052-430-9(html)isbn:978-1-77052-431 -6(epub)pm041 Printedin CanadaCopyright 2005,2008 Centrefor Addictionand MentalHealthNo part of this work may be reproducedor transmittedin any form orby any meanselectronicor mechanical,includingphotocopyingand recording,or by any informationstorageand retrievalsystemwithoutwrittenpermissionf rom the publisher exceptfor a brief quotation(not to exceed200 words)ina reviewor publicationmay be availablein other informationabout alternateformatsor othercamhpublications,or to place an order, please contactSales and fran aissous le titre :Les troublesanxieux.

3 Guided'InformationThis guide was producedby the following:Development:MichelleMaynes,cam hEditorial:Diana Ballon,Kelly Coleman,Nick Gamble,camhGraphicdesign:Nancy Leung,Eva Katz,camhPrint production:ChristineHarris,camh3973/02-2 011 3/1/11 12:31 PM Page iiCON TEN TSv ACKNOWLEDGMENTSvi INTRODUCTION1 Anxietyandanxietydis or ders1Wh at is nor ma l anxi et y?How do es anxie ty affect us?Wh en is anxi et y a pro ble m?Wh at ar e the anxie ty dis ord ers?2 Whatca usesanxie ty di sorders?14Ps ych ol ogi cal fac to rsBi ol og ic al fac to rsOt he r fact or s3 Treat mentsforanxiety di sord er s21 Cog niti ve -beh av ioural therapyMedi cat io n opt io ns4 Recovery andre lapse pr ev ention33Pr eve nt ing re lapse and pro mot ing wellnessRe lati onsh ip wi th a part ner5 Helpforpartners andfamili es37Wh at hap pe ns wh en someo ne you lo ve has an Anxiety disorder?

4 Wh en your relat ive is first diagnosedHow to re late to your fami ly memberPart ners and famili es need to take care of themselvesEx pla inin g anxi ety di so rders to child 3/1/11 12:31 PM Page iiiREFERENCES45 SUGGESTEDREADINGS46 INTERNETRESOURCES49 Anxietydis orders: 3/1/11 12:31 PM Page ivvACK NOW LE DGMENTSWe would like to th an k the peo ple wh o sharedth eir pe rs onalex pe rie nce s with anxie ty wi th us, and th e pe op le with anxietydi sord er s, fa mi ly mem ber s and men tal he alth profe ss ion als whore vi ew ed ea rlier dr af ts. Re vi ewe rs includedSh eila Gamblenan dVer on ic a King; profe ssi on al rev ie wer s we re SandieLeith,msw,rsw, Ma ry Lalo nd e,ot,and Do nn a Weick,msw, would also like to thank past au th ors of othe r guidesin thisse rie s who se wor k prov id ed a fo un dation for the inf orm ationpre se nt ed here.

5 In parti cular, we wou ld like to thank ChristinaBar th a, Ca rol Pa rker an d Cath y Th om 3/1/11 12:31 PM Page vviINTRODUCTIONTh is gu id e is fo r pe op le wi th anxi ety disorders , the ir fam ilies ,par tn er s, fri ends an d any on e els e wh o might be in te re e many as pect s of an xi ety disor der s discus sed in this bookwill an sw er some co mm on que stio ns , an d he lp re ade rs discussan xie ty dis orders wi th tre atm en t pro viders . 3/1/11 12:31 PM Page vi11. An xi ety an danx ie ty dis ordersEv eryo ne feels anx ie ty fr om ti me to ti me . Few people ge t througha wee k without some an xio us ten sio n or a fe eling th at som ethin gis not goi ng to go we ll. We may fee l an xie ty when we re facin g anim port an t event , su ch as an exam or job inte rview, or when weper ce iv e some threat or dange r, such as wak in g to strange soun dsin th e nigh t.

6 Howev er, su ch every day an xiety is gene rally occa -si on al, mild and bri ef, whi le the anxi ety fe lt by the person wit h anan xie ty dis order oc cur s fr eq uen tly , is more inte nse , and lastslon ger up to hou rs, or even days .Un fo rtu nat ely, anxi ety disor der s ar e comm on. Res earc h sh owsth at up to one in fou r adu lts has an an xie ty di sorder som etime inth ei r lif e, and that on e pe rson in 10 is likely to have had an an xi -et y di sor der in the past ye ar . Anxie ty disorders are the most com -mon ment al healt h pro blem in wom en , an d are se cond on ly tosu bst an ce use dis ord er s in me n. Anxi ety dis orde rs can make itha rd for peopleto wo rk or study , to managedaily tas ks an d tore lat e well with oth er s, an d often re sult in financialstrain andprof oun d pers onal suf fer in ople oft en live with an xi ety disor ders for years be fore th ey aredi agn os ed and trea ted.

7 If yo u susp ect that you have an Anxiety dis -ord er, it is impo rtan t to see k pr ofess ional treatment as soon asposs ible . Anxi et y di so rd ers are tr eatable,and early treatment canhe lp to ens ure tr eatm ent succes 3/1/11 12:31 PM Page 1 Anxietydis orders: AninformationguideTh e si x main ca te gor ie s of an xi ety disor de rs areph obias,panic dis -ord er(wi th or wit ho ut ago rap ho bi a),generalizedanxietydisorder,obs es siv e- compulsiv e disor der,acute str ess disorderandposttraumaticst res s di sorder(Ame rican Psych iatri c Associ ati on [apa], 20 00).Ea ch of th ese anxi ety dis or de rs is distinct in some ways, bu t theyall sh are the same hallm ark feature s: irr at ion al and ex cessi ve fear appr eh ens ive and ten se fe eli ngs dif fic ult y ma nagi ng dai ly tasks and /or distre ss relatedto th es e tas ks.

8 In th e followingex amp les, Susan, Joh n and Lin da* sh ow the secom mon feat ures, altho ugh the precis e natu re of the ir fe ars diffe sa n has ha d rec ur re nt and unexp ected panic attacksfor the pastfiv e yea rs:It st art ed on a ni ght when I was drivingho me in the rain. Ibegan to feel shaky and dizz y, and had tro uble fo cus ing. Atfirs t, I tho ug ht it was so methingthat I had eaten earlier,butthen my mind st ar ted to drift, and I tho ught, Whatif I pas sout? and W hat if I m dying? I star ted to shake all over,an d it was as if my entire body was wi red . I quicklypulledthecar over and call ed my daughterto com e and get me. Sinc ethen, I ve had do zens and do zens of thes e attacks.

9 At first, theat tac ks occurredjus t when I was dr iving, but now I experiencethem in shop pi ng mal ls , standingin line-upsand even onthe bu s. It seems as if I spend most of my day worryingandwai ti ng for the next hn de sc ribes a li fe lon g patter n of being exce ss ively shy and fear -in g emba rra ssmen t in so cial si tuati ons:For as long as I can rem em ber , and as far back as when I was2*A ll nam es and ide nt ifyingdet ails have bee n 3/1/11 12:31 PM Page 2 Anxietyand anx ietydisordersseven years old , I hated being the centre of class ,I tri ed to remai n as invis ib le as po ss ible, prayingthat theteac her wou ld no t cal l upo n me to ans wer a my turn to make pr esentations, I wou ld n t sleep for aweek , wo rry ing that I wo ul d for get what I was supposedto say ,stu mble over my wor ds, and loo k completely stupid.

10 It s as ifno thi ng s chang ed: no w at wor k I dr ead havingto att endmee ti ngs , meet wit h the boss, have lun ch with colleagues,andthe worst , give mo nthl y repo rts to the team . I m pretty su reever yo ne kno ws how unco mf ortab le I am , and they all proba -bly thi nk I look weir d and so und stu pid .Lin da , a 34 -yea r-old marr ie d wom an , has stru ggled with doubtingobs es sio ns and check in g co mp ulsi on s since she was 15. Sh ede sc rib es her cur ren t pro ble ms:I am wo rried that unl ess I take every pr ecau tio n necess ary topreven t harm,I am go ing to be resp ons ible fo r som ethin g terri -ble hap have to chec k, rec heck, check again,retu rn tochec k, cont inu e checking thekitchensto ve, the lights , theiron, my cu rli ng iro n, theTVcab le to ensur e that I don tcau se a fire.