Anxiety disorders Agoraphobia: fear of open spaces, public places,

crowded places, and any other place from where there is

Anxiety is the commonest psychiatric no easy escape to a safe place.
symptom in clinical practice, anxiety disorders
are one of the commonest psychiatric disorders A full-blown panic attack may occur (agoraphobia with
in general population panic disorder) or only a few symptoms (such as
dizziness or tachycardia) may occur (agoraphobia without
panic disorder).
Anxiety is a ‘normal’ phenomenon, characterised
by state of apprehension or unease arising out
of anticipation of danger.
Social anxiety: irrational fear of activities or social
interaction, by fear of performing activities in the presence
Feature Panic Disorder Generalised Anxiety Disorder .of other people
The patient is afraid of being viewed by others critically, or
Main Recurrent, unexpected panic Persistent, excessive worry about .embarrassment/ humiliation
Symptom attacks. various events. marked distress and disturbance in routine daily
functioning. examples : fear of blushing (erythrophobia),
Onset Sudden, peaks within minutes. Gradual, chronic. public speaking, participating in groups, speaking to
Episodic (attacks last minutes to Persistent (worry lasts for .strangers, urinating in a public lavatory (shy bladder)
Duration
hours). months/years). •Phobia, Definition: intense, irrational, and persistent fear of
a specific object, situation, or activity, is disproportionate to
Fear of losing control, dying, or General worry (health, finances, actual danger posed. leads to avoidance behavior Treatment of Anxiety Disorders
Focus
"going crazy." work, etc.). •types :1. Agoraphobia, 2. Social phobia, 3. Specific phobia.
Physical Palpitations, chest pain, dizziness, 1. Psychotherapy
Muscle tension, restlessness, fatigue.
Symptoms sweating. CBT: Restructuring negative thoughts,
exposure therapy. Supportive
May occur spontaneously (no •Clinical Features, 1.Presence of the fear of an object,
Trigger
specific trigger).
Associated with ongoing stressors. situation or activity. 2. fear is out of proportion to the Therapy: Coping mechanisms,
danger, 3. fear-irrational and unjustified ,4. unable to Mindfulness: Stress reduction
Common Etiology of Anxiety Disorders control, 5. persistent avoidance
2. Pharmacotherapy
1. Biological Factors: First-Line: SSRIs (e.g., Escitalopram), SNRIs
Genetics: heritability ~30-40%,Neurochemical Imbalance: Dysregulation of serotonin, (e.g., Venlafaxine),
GABA,norepinephrine,Brain Circuitry: Hyperactive amygdala, reduced prefrontal •Presentation of Phobia: Patients may describe panic-like Second-Line: Benzodiazepines (short-term),
regulation symptoms when encountering the feared stimulus. Eg;
acrophobia (fear of high places), zoophobia (fear of animals) Buspirone, Beta-blockers (for performance
Autonomic Dysregulation: Heightened sympathetic activity
and claustrophobia (fear of closed places). anxiety). Others: Pregabalin, TCAs.
2. Psychological Factors:
Cognitive Biases: Catastrophic thinking, negative interpretation of events. 3. Lifestyle Modifications
Behavioral Factors: Avoidance reinforces anxiety, Personality: Neuroticism, Exercise, sleep hygiene, balanced diet,
perfectionism, Early Life Experiences •MSE for Phobia: Appearance & Behavior: May appear avoiding stimulants.
tense or avoidant when discussing the feared stimulus, Mood:
3. Environmental Factors: Anxious, Thought Content: Preoccupation with specific fears 4. Other Interventions
Stressful Events: Trauma, chronic stress, financial or relationship issues. Relaxation techniques, biofeedback, support
Parental Influence: Overprotectiveness, Substance Use: Caffeine, nicotine, or medical groups
conditions like thyroid dysfunction.