Anxiety Disorders ANXIETY QUIZ

Transcription

1 ANXIETY QUIZ

2 Quick Vocab: Fear- Autonomic Nervous System, is a response to a stimulus (FIGHT OR FLIGHT) Anxiety- Anticipation, muscle tension, vigilance Trait Anxiety- someone s average range of anxiety (stable over time) State Anxiety- someone s level of anxiety at any given state Chronic Anxiety- A significant level of anxiety that persists over time. Anxiety Disorders Treatable More Predominant in Women (2:1 ratio, generally) A great deal of Clinical Judgement involved (descriptive words like: excessive, inappropriate, etc.) Cultural Considerations Taijin Kyofusho (Japan/Korea; page 205)- Characterized by social-evaluative concerns that would seem like social anxiety disorder, body dysmorphic disorder, or delusional disorder. Clients feel that their traits make others uncomfortable (gaze). Trung gio (Vietnamese, page 211)- hit by the wind may result in reporting symptoms that are similar to panic attacks Ataque de nervios (Latin American, page 211)- Attack of nerves associated with panic disorders. Can involve trembling, screaming, suicidal behavior, derealization, Khyal attacks (Cambodia, page 211)- Soul loss associated with panic disorders

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4 Case Study A (Panic & Agoraphobia) Mandy is an 18 year old, heterosexual, Caucasian female. She is presenting for counseling in a nervous, apprehensive, state. She reports several past instances where she has freaked out, experiencing difficulty breathing, trembling, feeling nauseous and dizzy. She continues to explain that some instances are worse than others, but multiple times she thought I was going to die. Reportedly, this first occurred a little over a year ago when a stray dog chased her through her yard. She reports that she was able to make it inside of her home before the dog caught up with her. Since then, she has experienced these symptoms before attempting outside activities. Often she isn t able to stay outside long, and when she can, it s extremely uncomfortable and she cannot calm down until she returns to the safety of her home. Mandy explains that more times than not she experiences her symptoms in anticipation to, or during these outdoor activities; however, several of her worst experiences did not seem to be attached to any certain situation. She has even had an intense episode during the night, while she was sleeping. This has caused her to start fearing other activities. She reports that she is afraid of leaving the home because she may experience symptoms and doesn t know what she would do. This has caused her to avoid many every day activities, especially new situations. This includes skipping school, missing extra-curricular activities, hanging out with her friends etc. She appears to counseling in a desperate state. She is scared to attend school, and even when she does she cannot focus. She is now on the verge of not graduating/failing. She reports that she can t enjoy times with her friends and her social relationships are beginning to fail as well. She has seen multiple doctors and they haven t found a medical cause for her symptoms. They have referred her to you for mental health counseling.

5 Case Study B (Persistent Depressive Disorder, W/ Episodes w/out current) Robert is a 20 year old African American heterosexual male. He is currently a junior in college, and was referred to counseling by his parents. Reluctantly, he reports to you that there have been times where he wasn t able to report to school because of poor sleep (couldn t fall asleep at night, leading him to oversleep in the morning). He continues reporting that during these periods he feels lethargic, doesn t want to do anything (even activities he would normally enjoy), and he cannot eat. Even when he does make it to school, he doesn t speak with friends and cannot focus on material. He said that these periods typically only last a couple weeks, but it has happened multiple times in the past. Robert s parents confirm his report of these especially bad times. They report Robert was a happy and energetic kid, but about two years ago (around age 18) he seemed to change. His parents continue reporting that, in addition to what Robert has mentioned, he started becoming irritable, indecisive, and his self-esteem plummeted on a consistent basis. His parents tell you that occasionally he would have good days where he seems like his old self, but those periods never seem to last more than a week or so. A majority of the time he just seems off, and a few bad days (in Robert s words) were more like months without any breaks. When interviewed, Robert explains that this is just normal, every-day life. He knows that sometimes he has especially bad days, but he doesn t see any significance to what his parents report. In his words he just has some good days, some bad days, like everyone else. He reports that he s not currently experiencing intense symptoms. His last episode seemed to be about three weeks ago. His parents report that he hasn t seemed like his old self in quite a while. While home for break, they decided it was a good time to get their son some help.

6 Case Study #C Social Phobia (similar to Agoraphobia) Phil is a 14 year old Caucasian male in the 10 th grade, seeing you because my parents are making me. His parents present to the first session with Phil to help give you some background information. When asked what made them try counseling they tell you: Phil, after being classified as a gifted student through junior high started showing reluctance to attend school around the end of 8 th grade. His parents reported it as a phase. He spent the summer at home, not spending time with his friends (something he used to really enjoy). Once high school started, he showed persistent fear of going to school and his grades began to suffer. During his sophomore year, Phil was caught drinking in the bathroom at school and suspended for a couple days. His parents, having had enough are bringing him to you for help. Upon interviewing Phil, he explains that towards the end of 8 th grade he was in the talent show. During his performance he tripped and fell. The crowd started laughing and Phil was soo mortified he was unable to finish his skit. That s why I never want to go back, no matter what I do, they ll make fun of me! This reportedly started a cycle where the more nervous/anxious Phil became, the more he worried he was going to act stupid and be made fun of. He tells you stories about trying to fit in. In an attempt to please certain groups, he would try to laugh along at others jokes even though he knew deep down the jokes were about him. At night he would tell his parents that he can t do anything without others laughing or making fun of him. His parents report having similar issues in their childhoods, but they were able to grow out of it. They feel as though Phil would do the same. During this time Phil s grades have hit an all-time low. He is unable to focus in class because he is worried about what his classmates are saying about him. He has a hard time leaving the house, even to visit friends. Not only does school cause anxiety for Phil, but his fear has spread to almost all social situations. It seems as though he cannot leave the home without feeling intense feelings of anxiety or worry. One day at school, things were soo bad, Phil hid in the bathroom where he found other classmates drinking. They offered him a drink and he couldn t say no. He found that after a couple drinks he wouldn t worry soo much so he continued to meet these guys in the bathroom during school. Eventually he was caught, suspended, and now he sits before you today.

7 FEEDBACK FORM What, would you say, was the muddiest point, or questions that you still? What was one aspect of the lecture that you found particularly interesting?