Anxiety disorders: an information guide PDF
Preview Anxiety disorders: an information guide
2993-MHB-AnxietyCOVER:2993-MHB-AnxietyCOVER 10/14/09 12:40 PM Page 1 Anxiety everyonefeelsanxiety,butonlysomepeopleexperi- A n enceanxietydisorders.Thisguideexploresthedifference x i e betweennormalanxietyandanxietydisorders,suchas t y panicdisorder,specificphobias,obsessive-compulsive d is disorders disorderandpost-traumaticstressdisorder.Itlooksatthe o r d reasonswhysomepeopledevelopanxietydisordersand e r presentsanoverviewofpsychologicalandmedication s treatments.Theguidealsolooksatlong-termstrategiesto helppeoplewithanxietydisordersmanagetheiranxiety A An n andsuggestswaysthatfamilymemberscanhelp. i n f o r m a information t i o n g u i d e guide Thispublicationmaybeavailableinotherformats. ForinformationaboutalternateformatsorotherCAMH publications,ortoplaceanorder,pleasecontactSales andDistribution: Toll-free:1800661-1111 Toronto:416595-6059 E-mail:[email protected] Onlinestore:http://store.camh.net Tomakeadonation,pleasecontact theCAMHFoundation: NeilA.Rector,PhD Tel.:416979-6909 DanielleBourdeau,MD E-mail:[email protected] KateKitchen,MSW Website:www.camh.net LindaJoseph-Massiah,RN,PhD Disponibleenfrançais. ISBN 978-0-88868-481-3 41 0 P 9 0 0 0-2 APanAmericanHealthOrganization/ 93/1 WorldHealthOrganizationCollaboratingCentre 29 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page i Anxiety disorders An information guide Neil A. Rector, PhD Danielle Bourdeau, MD Kate Kitchen, MSW Linda Joseph-Massiah, RN, PhD 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page ii LibraryandArchivesCanadaCataloguinginPublication Anxietydisorders:aninformationguide:aguideforpeoplewithanxiety andtheirfamilies/NeilA.Rector...[etal.]. 1.Anxiety—Popularworks. 2.Anxiety—Patients—Familyrelationships. I.Rector,NeilA. II.CentreforAddictionandMentalHealth. RC531.A6342005 616.85’22 C2004-907081-9 isbn:978-0-88868-481-3(print) isbn:978-0-88868-795-1(pdf) isbn:978-0-88868-796-8(html) isbn:978-1-77052-249-7(epub) pm041 PrintedinCanada Copyright©2005,2008CentreforAddictionandMentalHealth Nopartofthisworkmaybereproducedortransmittedinanyformor byanymeanselectronicormechanical,includingphotocopyingandrecording, orbyanyinformationstorageandretrievalsystemwithoutwrittenpermission fromthepublisher—exceptforabriefquotation(nottoexceed200words)in arevieworprofessionalwork. Thispublicationmaybeavailableinotherformats. Forinformationaboutalternateformatsorother camhpublications,ortoplaceanorder,pleasecontact SalesandDistribution: Toll-free:1800661-1111 Toronto:416595-6059 E-mail:[email protected] Onlinestore:http://store.camh.net Website:www.camh.net Disponibleenfrançaissousletitre: Lestroublesanxieux:Guided'Information Thisguidewasproducedbythefollowing: Development:MichelleMaynes,camh Editorial:DianaBallon,KellyColeman,NickGamble,camh Graphicdesign:NancyLeung,EvaKatz,camh Printproduction:ChristineHarris,camh 2993/10-2009/pm041 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page iii CONTENTS v ACKNOWLEDGMENTS vi INTRODUCTION Anxiety and anxiety disorders 1 1 Whatisnormalanxiety? Howdoesanxietyaffectus? Whenisanxietyaproblem? Whataretheanxietydisorders? What causes anxiety disorders? 2 14 Psychologicalfactors Biologicalfactors Otherfactors Treatments for anxiety disorders 3 21 Cognitive-behaviouraltherapy Medicationoptions Recovery and relapse prevention 4 33 Preventingrelapseandpromotingwellness Relationshipwithapartner Help for partners and families 5 37 Whathappenswhensomeoneyoulovehasananxietydisorder? Whenyourrelativeisfirstdiagnosed Howtorelatetoyourfamilymember Partnersandfamiliesneedtotakecareofthemselves Explaininganxietydisorderstochildren 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page iv iv Anxietydisorders:Aninformationguide REFERENCES 45 SUGGESTEDREADINGS 46 INTERNETRESOURCES 49 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page v v ACKNOWLEDGMENTS Wewouldliketothankthepeoplewhosharedtheirpersonal experienceswithanxietywithus,andthepeoplewithanxiety disorders,familymembersandmentalhealthprofessionalswho reviewedearlierdrafts.ReviewersincludedSheilaGamblenand VeronicaKing;professionalreviewerswereSandieLeith,msw, rsw,MaryLalonde,ot,andDonnaWeick,msw,rsw. Wewouldalsoliketothankpastauthorsofotherguidesinthis serieswhoseworkprovidedafoundationfortheinformation presentedhere.Inparticular,wewouldliketothankChristina Bartha,CarolParkerandCathyThomson. 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page vi vi vi INTRODUCTION Thisguideisforpeoplewithanxietydisorders,theirfamilies, partners,friendsandanyoneelsewhomightbeinterested. Themanyaspectsofanxietydisordersdiscussedinthisbook willanswersomecommonquestions,andhelpreadersdiscuss anxietydisorderswithtreatmentproviders. 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page 1 1 1. Anxiety and anxiety disorders Everyonefeelsanxietyfromtimetotime.Fewpeoplegetthrough aweekwithoutsomeanxioustensionorafeelingthatsomething isnotgoingtogowell.Wemayfeelanxietywhenwe’refacingan importantevent,suchasanexamorjobinterview,orwhenwe perceivesomethreatordanger,suchaswakingtostrangesounds inthenight.However,sucheverydayanxietyisgenerallyocca- sional,mildandbrief,whiletheanxietyfeltbythepersonwithan anxietydisorderoccursfrequently,ismoreintense,andlasts longer—uptohours,orevendays. Unfortunately,anxietydisordersarecommon.Researchshows thatuptooneinfouradultshasananxietydisordersometimein theirlife,andthatonepersonin10islikelytohavehadananxi- etydisorderinthepastyear.Anxietydisordersarethemostcom- monmentalhealthprobleminwomen,andaresecondonlyto substanceusedisordersinmen.Anxietydisorderscanmakeit hardforpeopletoworkorstudy,tomanagedailytasksandto relatewellwithothers,andoftenresultinfinancialstrainand profoundpersonalsuffering. Peopleoftenlivewithanxietydisordersforyearsbeforetheyare diagnosedandtreated.Ifyoususpectthatyouhaveananxietydis- order,itisimportanttoseekprofessionaltreatmentassoonas possible.Anxietydisordersaretreatable,andearlytreatmentcan helptoensuretreatmentsuccess. 2993-MHB-AnxietyINSPG:2993-MHB-Anxiety 10/14/09 12:44 PM Page 2 2 Anxietydisorders:Aninformationguide Thesixmaincategoriesofanxietydisordersarephobias,panicdis- order(withorwithoutagoraphobia),generalizedanxietydisorder, obsessive-compulsivedisorder,acutestressdisorderandposttraumatic stressdisorder(AmericanPsychiatricAssociation[apa],2000). Eachoftheseanxietydisordersisdistinctinsomeways,butthey allsharethesamehallmarkfeatures: •irrationalandexcessivefear •apprehensiveandtensefeelings •difficultymanagingdailytasksand/ordistressrelated tothesetasks. Inthefollowingexamples,Susan,JohnandLinda*showthese commonfeatures,althoughtheprecisenatureoftheirfearsdiffer. Susanhashadrecurrentandunexpectedpanicattacksforthepast fiveyears: ItstartedonanightwhenIwasdrivinghomeintherain.I begantofeelshakyanddizzy,andhadtroublefocusing.At first,IthoughtitwassomethingthatIhadeatenearlier,but thenmymindstartedtodrift,andIthought,“WhatifIpass out?”and“WhatifI’mdying?”Istartedtoshakeallover, anditwasasifmyentirebodywaswired.Iquicklypulledthe caroverandcalledmydaughtertocomeandgetme.Since then,I’vehaddozensanddozensoftheseattacks.Atfirst,the attacksoccurredjustwhenIwasdriving,butnowIexperience theminshoppingmalls,standinginline-upsandevenon thebus.ItseemsasifIspendmostofmydayworryingand waitingforthenextattack. Johndescribesalifelongpatternofbeingexcessivelyshyandfear- ingembarrassmentinsocialsituations: ForaslongasIcanremember,andasfarbackaswhenIwas *Allnamesandidentifyingdetailshavebeenchanged.
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