[MUSIC] Anxiety disorders are the most common of all the psychiatric disorders. And so it is imperative that we know what anxiety disorders are, how they might arise, and how we can treat them. My name is Vlasios Brakoulias, and I'm a psychiatrist that treats patients with anxiety, and obsessive-compulsive disorders. There's often a lot of misunderstanding surrounding anxiety disorders, and so providing education to my patients, and the general public can be very rewarding. Contrary to popular belief, anxiety disorders can be quickly and effectively treated, and so we're able to provide a lot of hope to our patients. The first point is that, anxiety disorders occur on a spectrum from normal to abnormal, or what we call pathological. This is the Yerkes-Dodson curve, that shows the distribution of levels of anxiety in our community, from very high levels to very low levels. Anxiety can even have positive effects, such as making as more prepared to face adverse event, being more cautious ,protective, being better workers, and being better achievers. We draw a line, where abnormal is based on a person's ability to work, and to live a happy life. The aim of treatment is to cross this arbitrary line, so that our patients live more normal lives, and use the positive effects of their anxiety to their benefit. [SOUND] For those of you that were frightened by this animal, you've just experienced the fight or flight response. We've all experienced the fight or flight response at some times in our lives. But for those with anxiety disorders, this faulty alarm signal goes off without any obvious threat. Consider this list of symptoms. These symptoms occur in the fight or flight response, and in states of anxiety. They are useful if we need to escape from a dangerous situation, but they are disabling if they occur for a prolonged duration at times when there is no real threat. So how common are anxiety disorders? This shows you that anxiety disorders are thought to occur in 10 to 20% of the population. It also shows you the prevalence of the different types of anxiety disorders. So what are the different types of anxiety disorders? A common, and relatively easily treated, anxiety disorder is panic disorder. Panic disorder occurs when anxiety symptoms arise quickly, and out of the blue. They always go away, but they are very frightening, and suffers feel that they will be last forever, or that they are going to have a stroke or a heart attack. Sometimes, people with panic disorder avoid crowded spaces, and areas such as shopping centers, and we call this avoidance, agoraphobia. Another very common anxiety disorder is generalized anxiety disorder. This is the worrying disorder, where people worry excessively about all sorts of normal everyday things. We can all worry about our husbands or wives coming home from work on time, or whether we will be able to pay a bill on time. But this worry is so excessive that it cannot be stopped, and it's associated with symptoms like tension, poor sleep, and poor concentration. Social phobia can be a devastating disorder, with dramatic implications on a person's ability to socialize from friendships in work. Social phobia occurs when someone is excessively focused on how they might be perceived by others in social situations, and it leads to avoidance of social situations. Or situations where they might be judged by others, for example, having to speak in front of class, or in front of a group of people. There are a whole range of specific phobias. People not only fear spiders, birds, snakes, blood, heights, needles, etc., but their fear is so excessive that they become overly distressed. And they avoid lots of different things, and they avoid to the extent that it becomes a real hassle for their lives, and that they can't function very well at work or in their households. And finally, obsessive compulsive disorder or OCD. OCD is a very disabling and distressing disorder, with a whole range of obsessions and compulsions. And these can include fears of contamination, and excessive hand washing, excessive doubts and checking, a need to have everything symmetrical or exact, and intrusive and distressing thoughts, or images that are unacceptable or disgusting. Although we don't know the exact cause for anxiety disorders, and we think that they are probably many different causes, we do have very effective treatments. There are many simple strategies for managing anxiety on your own. And these include relaxation techniques and exercise, with more information being available on the links, and in the course videos. The main treatment for anxiety disorders that is offered by health professionals is cognitive behavioral therapy, or CBT, and selective serotonin reuptake inhibitors, SSRIs, which is a specific type of antidepressant medication. These are both quite effective for anxiety disorders. So I'm here with Mani, who's a research psychologist who works with anxiety disorders, and who will tell us a little bit more about cognitive behavioral therapy, or CBT. So Mani, can you tell us, what is cognitive behavioral therapy? >> Cognitive behavioral therapy is a talking therapy, where we enable clients to understand their thoughts and behaviors. And then we teach them To handle these thoughts and behaviors that are causing anxiety, to bring them back to a healthier state of mind. >> So it's not the situation that leads to someone to be anxious. It's actually the way someone reacts to the situation, is that correct? >> That's correct. >> Yeah. >> Yes, yes. >> The other common problem with anxiety disorders is avoidance. Where people avoid things that they think will cause them to be anxious. How do you treat avoidance? >> Well yes, avoidance is a very common problem, and we treat avoidance in therapy by using exposure tasks. So we ask the client what they would like to do, and why they are afraid to do it. And then, we start with addressing their most least provoking thought. And then, slowly work up to the most provoking task that would cause some anxiety. For instance, if someone is afraid to speak in front of a group of people, how we address is that is, try and get the person to rehearse in front of a mirror, and then perhaps in front of a close friend, in front of their therapist. Maybe rehearse in front of two people before they actually get around to the addressing the anxiety with speaking in front of a group of people. >> So you're saying that they eventually build up confidence by practicing, and building up their courage. >> Their courage. Yes, you're right. >> So, when should we consider using medication for anxiety disorders? We should consider medication when psychological treatment has failed or is seen as too difficult. We might also consider medication when we don't have access to a psychologist, can't afford therapy, or when there are long waiting times. Sometimes, we just think that taking a pill would be easier and cheaper. But the trick is, that you have to take your medication regularly for it to be effective. Currently, the most widely used medication for anxiety disorders are selective serotonin reuptake inhibitors, or SSRIs, they are a type of antidepressant. When used over several weeks, most people begin to feel less anxious. They need to be taken every day, and are usually taken for about a year to ensure that the patient is fully recovered. There can be some side effects such as nausea and dizziness when these medications are started. And this can be quite anxiety provoking for people with anxiety disorders. But not everyone will experience these side effects, and they usually don't last longer than one week. For anxiety disorders, the quickest relief comes from medications called benzodiazepines. These are medications like diazepam, also called Valium, or alprazolam. These give quick relief, but are like painkillers in that, you have to keep taking them to stay well. And they're not usually recommended for long term use. You're bound to know someone with an anxiety disorder, so please let them know that their anxiety can be treated, and that help is available. People suffering from anxiety disorders can get help from their local doctor, or by contacting a specialized anxiety disorders clinic in their area. As you can see, anxiety disorders are common. There are some different types of anxiety disorders, and they can be effectively treated with both psychological treatments and medication. [MUSIC]
