Psychology

Anxiety and Depression Most people feel anxious or depressed at times. Losing a loved one, getting fired from a job, going through a divorce, and other difficult situations can lead a person to feel sad, lonely, scared, nervous, or anxious. These feelings are normal reactions to life's stressors. But some people experience these feelings daily or nearly daily for no apparent reason, making it difficult to carry on with normal, everyday functioning. These people may have an anxiety disorder, depression, or both. It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. The good news is that these disorders are both treatable, separately and together. Depression and anxiety disorders are different, but people with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms. Many people who develop depression have a history of an anxiety disorder earlier in life. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.
Anxiety
Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, somatic complaints and rumination. It is the subjectively unpleasant feelings of dread over something unlikely to happen, such as the feeling of imminent death. Anxiety is not the same as fear, which is felt about something realistically intimidating or dangerous and is an appropriate response to a perceived threat; anxiety is a feeling of fear, worry, and uneasiness, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing. It is often accompanied by restlessness, fatigue, problems in concentration, and muscular tension. Anxiety is not considered to be a normal reaction to a perceived stressor although many feel it occasionally.
Types of Anxiety:
Existential anxiety The state in which a being is aware of its possible nonbeing and this are the three categories for the nonbeing and resulting anxiety: ontic (fate and death), moral (guilt and condemnation), and spiritual (emptiness and meaninglessness).
Test and performance anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam.
Stranger and social anxiety Humans generally require social acceptance and thus sometimes dread the disapproval of others. Apprehension of being judged by others may cause anxiety in social environments. Anxiety during social interactions, particularly between strangers, is common among young people.
Generalized anxiety Overwhelming anxiety, if not treated early, can become a generalized anxiety disorder (GAD), identified by symptoms of exaggerated and excessive worry, chronic anxiety and constant, irrational thoughts.
Trait anxiety reflects a stable tendency to respond with state anxiety in the anticipation of threatening situations.
Choice or decision anxiety Anxiety induced by the need to choose between similar options is increasingly being recognized as a problem for individuals and for organizations.
Positive psychology In positive psychology, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.
Anxiety Disorders Anxiety disorders are a group of mental disorders characterized excessive feelings of anxiety and fear, where anxiety is worry about future events and fear is a reaction to current events. These feeling may cause physical symptoms such as a racing heart and shakiness. There are various forms of anxiety disorders, including generalized anxiety disorder, phobic disorder, and panic disorder. While each has its own characteristics and symptoms, they all include symptoms of anxiety. Anxiety disorders are partly genetic but may also be due to drug use including alcohol and caffeine. They often occur with other mental disorders, particularly major depressive disorder, bipolar disorder, certain personality disorders, and eating disorders. The term anxiety covers four aspects of experiences that an individual may have: mental apprehension, physical tension, physical symptoms and dissociative anxiety. The emotions present in anxiety disorders range from simple nervousness to bouts of terror. There are other psychiatric and medical problems that may mimic the symptoms of an anxiety disorder, such as hyperthyroidism. Common treatment options include lifestyle changes, therapy, and medications. Medications are typically recommended only if other measures are not effective. Anxiety disorders occur about twice as often in females as males, and generally begin during childhood.
Classification:
Generalized anxiety disorder (GAD) is a common, chronic disorder characterized by long-lasting anxiety that is not focused on any one object or situation. According to Schacter, Gilbert, and Wegner's book Psychology: Second Edition, generalized anxiety disorder is "characterized by chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance".
Phobias-The single largest category of anxiety disorders is that of phobic disorders, which includes all cases in which fear and anxiety is triggered by a specific stimulus or situation.
With panic disorder, a person suffers from brief attacks of intense terror and apprehension, often marked by trembling, shaking, confusion, dizziness, nausea, and/or difficulty breathing.
Agoraphobia is the specific anxiety about being in a place or situation where escape is difficult or embarrassing or where help may be unavailable.
Social anxiety disorder (SAD; also known as social phobia) describes an intense fear and avoidance of negative public scrutiny, public embarrassment, humiliation, or social interaction.
Obsessive–compulsive disorder (OCD) is a type of anxiety disorder primarily characterized by repetitive obsessions (distressing, persistent, and intrusive thoughts or images) and compulsions (urges to perform specific acts or rituals).
Post-traumatic stress disorder (PTSD) is an anxiety disorder that results from a traumatic experience. Post-traumatic stress can result from an extreme situation, such as combat, natural disaster, rape, hostage situations, child abuse, bullying, or even a serious accident.
Separation anxiety disorder (SepAD) is the feeling of excessive and inappropriate levels of anxiety over being separated from a person or place.
Situational anxiety is caused by new situations or changing events.
A common anxiety disorder in children is school phobia, which in some cases can be a type of separation anxiety. Sometimes the anxiety has no obvious cause. In other instances, the child may experience bullying from classmates, or even a teacher. They could also be stressed from the workload they are given.
Causes:
Drugs
Stress
Genetics
Persistence of anxiety
Evolutionary
Signs and Symptoms:
Feelings of panic, fear, and uneasiness
Uncontrollable, obsessive thoughts
Repeated thoughts or flashbacks of traumatic experiences
Nightmares
Ritualistic behaviors, such as repeated hand washing
Problems sleeping
Cold or sweaty hands and/or feet
Shortness of breath
Palpitations
An inability to be still and calm
Dry mouth
Numbness or tingling in the hands or feet
Nausea
Muscle tension
Dizziness

Depression Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being. Depressed people feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate, attempt, or commit suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains, or digestive problems may also be present. Depressed mood is not always a psychiatric disorder. It may also be a normal reaction to certain life events, a symptom of some medical conditions, or a side effect of some drugs or medical treatments.
Kinds of Depression:
Major depressive disorder/ Clinical Depression is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities.
Chronic depression, or dysthymia, is characterized by a long-term (two years or more) depressed mood.
Atypical depression
The key symptoms of atypical depression include:
Overeating
Oversleeping
Fatigue
Extreme sensitivity to rejection
Moods that worsen or improve in direct response to events
Bipolar disorder -- sometimes referred to as manic depression -- is a complex mood disorder that alternates between periods of clinical depression and times of extreme elation or mania. There are two subtypes of bipolar disorder: bipolar I and bipolar II.
With bipolar I disorder, patients have a history of at least one manic episode with or without major depressive episodes.
With bipolar II disorder, patients have a history of at least one episode of major depression and at least one hypomanic (mildly elated) episode
Seasonal Affective Disorder is much more common the further from the equator you go, where the end of summer means the beginning of less sunlight and more dark hours. A person who develops a depressive illness during the winter months might have SAD.
Postpartum depression (postnatal depression) If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed postpartum depression.
Psychotic Depression When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression.
Causes:
Lifestyle factor
Discrimination
Life events
Non psychiatric illnesses
Psychiatric syndromes
What are the signs and symptoms of depression?
Depression is not uniform. Signs and symptoms may be experienced by some sufferers and not by others. How severe the symptoms are, and how long they last depends on the individual person and his illness. Below is a list of the most common symptoms:
A constant feeling of sadness, anxiety, and emptiness
A general feeling of pessimism sets in (the glass is always half empty)
The person feels hopeless
Individuals can feel restless
The sufferer may experience irritability
Patients may lose interest in activities or hobbies they once enjoyed
He/she may lose interest in sex
Levels of energy feel lower, fatigue sets in
Many people with a depressive illness find it hard to concentrate, remember details, and make decisions
Sleep patterns are disturbed - the person may sleep too little or too much
Eating habits may change - he/she may either eat too much or have no appetite
Suicidal thoughts may occur - some may act on those thoughts
The sufferer may complain more of aches and pains, headaches, cramps, or digestive problems. These problems do not get better with treatment.
Treatment for Anxiety and Depression:
Psychotherapy
Cognitive-behavioral therapy (CBT) is effective for anxiety disorders. CBT, as its name suggests, has two main components: cognitive and behavioral. In cases of social anxiety, the cognitive component can help the person question how they can be so sure that others are continually watching and harshly judging him or her. The behavioral component seeks to change people's reactions to anxiety-provoking situations. Interpersonal therapy (IPT) - helps the patient through uneasy personal relationships
Electroconvulsive therapy (ECT)- a term which replaced 'shock therapy' is sometimes useful for treatment-resistant depression.
Counseling
Medications
Reduce consumption of caffeine
Regular exercise
Eating a healthy diet
Meditation
Sleep
Social Support
Stress Reduction
Smoking cessation
Mixed Anxiety-Depressive Disorder
Mixed anxiety-depressive disorder is a diagnostic category defining patients who suffer from both anxiety and depressive symptoms of limited and equal intensity accompanied by at least some autonomic features. This disorder is caused by a combination of biological, psychological, and environmental factors.
Risk Factors:
History of mental health disorders in the family, including substance addictions
Living in poverty
Lack of social or familial support
Having a serious or chronic illness
Certain types of personalities such as dependent, pessimistic, avoidant
Low self-esteem
Childhood trauma
Stress
Treatment: Treating mixed anxiety-depressive disorder can be difficult for physicians because some treatments are more effective for depressive symptoms where others are more effective for anxiety symptoms. The current treatment that has been most effective is Cognitive Behavioral Therapy.
Resources:
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