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More prevalent in women (2:1)
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More prevalent in people under 45 y/o
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More prevalent in divorced/separated people
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More prevalent in people with lower socio-economic status
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Onset at ~late 20s
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Recurrent unexpected panic attacks
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Intense physical symptoms
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May last weeks, months or years
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Close morbidity rate to depression
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Women affected 3x more than men
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May be affiliated with stressors
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6 months of unrealistic worry and anxiety
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Affects 3% of population
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Associated with Major Depressive Disorder
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Psychodynamic Theory
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Inability of ego to intervene
id and superego produce anxiety unable to regulate anxiety and resorts to unconscious mechanisms ineffective use of defence mechanisms |
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Cognitive Theory
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Faulty thinking results in maladaptive behaviours and emotional disorders
Anxiety is maintained by dysfunctional assessment of environment |
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Biological Factors
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Genetics
Identical twins: 30% Close relative: 10-20% Cholecystokinin production: induce panic attacks Neuroanatomical Abnormal levels of blood-lactate Infusion of Sodium Lactate may precipitate panic attacks Neurochemical Norepinephrine: cause anxiety Serotonin and GABA decrease with panic/anxiety disorders |
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Normal
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Mild
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- Something is different
- Helps person focus attention to learn, solve problems, etc. - Perceptual field widens slightly - Alert, more perceptive - Able to recognize anxiety promote motivation and growth |
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Moderate
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- Disturbing feeling something is wrong
- nervous and aggitated - Difficulty concentrating - Perceptual field narrows a bit - Diminished cognitive skills |
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Severe
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- Perceptual field greatly reduced
- Does not notice external events attention focused on small part of specific area - Unaware of anxiety - Increase Vital Signs |
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Panic
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- Focused on defense
- Flight of ideas - Feels dread and terror |
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Signs and Symptoms
Anxiety response to object or situation Avoidance of object/situation Impairment of daily routine Acknowledge reaction is unreasonable |
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Anxiety may be triggered
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Women 2x as likely to be affected than men
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Recurrent distress over leaving home or attachment figure
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Excessive worry about the loss of figure
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Refusal to leave home
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Fear of being alone
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Refusal to sleep away from home or figure
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Nightmares with separation theme
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Physical symptoms
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Panic disorder signs and symptoms
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Fears being in places where escaping is difficult or embarrassing if panic does occur
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Planes, subways, buses, movie theatres, etc.
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May not meet daily commitments (ie. work, grocery shopping, appointments, etc)
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Knows behaviour is extreme
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More common in women than men
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Fear that person might do something embarrassing, or be evaluated negatively by others
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fear of public speaking, public eating, using public washrooms
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Self-medication with alcohol or street drugs to cope
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