Course Lesson Lesson Title Author Development Date

Number State

Psychology 53 Anxiety Ilanna S. October 19,

Disorders Mandel 2008
IIC-2.3 Describe the
a. Explaining why one person would be curious and another
situational cues and individual
anxious in the same situation
characteristics giving rise to
b. Discussing why one person responds to stereotyping without
curiosity and anxiety.
anxiety and another person responds with anxiety
VA-1.1 Distinguish the
a. Listing criteria that distinguish normal from disordered
common characteristics of
behavior
abnormal behavior.

VA-1.2 Cite examples of

a. Describing observable symptoms of abnormal behavior
abnormal behavior.

VA-1.3 Relate judgments of

c. Describing some abnormal behaviors specific to particular
abnormality to contexts in
contexts or circumstances
which those judgments occur.

1. Prepare Phase

OPENING REMARKS:
Do you know anyone who is constantly plagued by worries and even suffers from panic
attacks? Or, have you known someone who obsessively does things like washing their
hands twenty or thirty times a day? Have you ever met someone who has to stop what
they’re doing because they think they’re having a heart attack but it’s really a panic
attack? These are all forms of anxiety disorders. While anxiety is a common fact of
every day life for millions of people for logical reasons such as financial problems, an
impending divorce, an upcoming final exam or other practical problems, some people
live in a constant state of anxiety and can’t seem to get out of it. Today we’re going to
explore anxiety disorders and learn why some people fall into panic or anxiety while
others stay calm and patient. In the meantime: do you know anyone who suffers regularly
from any of these 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

Do any of the reactions in the photograph below resonate with you?

Do you ever feel like pushing this button?

Do you sometimes walk around feeling like this?

Anxiety disorders affect millions of people and these disorders can make life extremely
unpleasant and even cause people to fall into depression.

Lesson Expectations

Explain why one person would be curious and another anxious in the same situation
Discuss why one person responds to stereotyping without anxiety and another person
responds with anxiety

List criteria that distinguish normal from disordered behavior

Describe observable symptoms of abnormal behavior

Describe some abnormal behaviors specific to particular contexts or circumstances

Key Terms

Anxiety is a physiological and psychological state characterized by cognitive, somatic,

emotional, and behavioral components. These components combine to create the painful
feelings that are typically recognized as uneasiness, apprehension, or worry. Anxiety is a
normal reaction to stress. It may help a person to deal with a difficult situation, for
example at work or at school, by prompting one to cope with it. When anxiety becomes
excessive, it may fall under the classification of an anxiety disorder.

Anxiety disorders are the most common psychiatric illnesses affecting children and
adults. Anxiety disorders may develop from a complex set of risk factors, including
genetics, brain chemistry, personality, and life events. An estimated 40 million adult
Americans suffer from anxiety disorders. Anxiety disorders are highly treatable, yet only
about one-third of those suffering from an anxiety disorder receive treatment.

Generalized Anxiety Disorder (GAD). Generalized anxiety disorder is characterized

by excessive, unrealistic worry that lasts six months or more; in adults, the anxiety
may focus on issues such as health, money, or career. In addition to chronic worry,
GAD symptoms include trembling, muscular aches, insomnia, abdominal upsets,
dizziness, and irritability.

Obsessive-Compulsive Disorder (OCD). People suffering from OCD are plagued by

persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears;
typical obsessions include worry about being contaminated or fears of behaving
improperly or acting violently. The obsessions may lead to performing a ritual or
routine (compulsions), such as washing hands, repeating phrases, or hoarding, to
relieve the anxiety caused by the obsession.

Panic Disorder. People with panic disorder suffer severe attacks of panic, which may
make them feel as if they are having a heart attack or can't breathe, for no apparent
reason. Symptoms include heart palpitations, chest pain or discomfort, sweating,
trembling, tingling sensations, feeling of choking, fear of dying, fear of losing
control, and feelings of unreality. Panic disorder often occurs with agoraphobia, in
which people are afraid of having a panic attack in a place from which escape would
be difficult, so they avoid these places.
 Posttraumatic Stress Disorder (PTSD). Posttraumatic stress disorder can follow an
exposure to a traumatic event such as a sexual or physical assault, witnessing a death,
the unexpected death of a loved one, or natural disaster. Three main symptoms are
associated with PTSD: "reliving" of the traumatic event through flashbacks or
nightmares; avoidance behaviors (avoiding places related to the trauma) and
emotional numbing (detachment from others); and physiological arousal such
difficulty sleeping, irritability, or poor concentration.

Social Anxiety Disorder (Social Phobia). Social anxiety disorder is also called social
phobia. It is characterized by extreme anxiety about being judged by others or
behaving in a way that might cause embarrassment or ridicule. This intense anxiety
may lead to avoidance behavior. Physical symptoms associated with this disorder
include heart palpitations, faintness, blushing, and profuse sweating.

Specific Phobias. People with specific phobias suffer from an intense fear reaction to
a specific object or situation (examples: spiders, dogs, heights). The level of fear is
usually inappropriate to the situation and it is recognized by the sufferer as being
irrational. This inordinate fear can lead to the avoidance of common, everyday
situations.

Agoraphobia - is an anxiety disorder, often precipitated by the fear of having a panic

attack in a setting from which there is no easy means of escape. As a result, sufferers
of agoraphobia may avoid public and/or unfamiliar places. In severe cases, the
sufferer may become confined to his or her home, experiencing difficulty traveling
from this "safe place."

2. Deliv er & Pr actice P hase

Let’s work with three of the most common of anxiety disorders:

PANIC ATTACKS

They’re real and they can debilitate peoples’ lives.

What happened to Kerry that caused her to start having panic attacks? What wax the
context in which her attacks existed?

What did she experience as a result? What were her symptoms?

What happened to Kerry’s life?

What did Kerry do to start to recover?

Watch: Panic Attacks

http://gtm-media.discoveryeducation.com/videos/39988/chp943123_256k.asf
POST-TRAUMATIC STRESS DISORDER

What was the context for PTSD developing in Jenny?

What was the behavior that caused Jenny to develop PTSD?

How did Jenny react? What were her behaviors as a result?

What were her symptoms?

Why did Jenny come to believe she was ‘mad’?

What helped Jenny to start her recovery?

Watch: PTSD

http://gtm-media.discoveryeducation.com/videos/39988/chp943122_256k.asf

OBSESSIVE-COMPULSIVE DISORDER

What are some of the symptoms of OCD?

What are some of the things that people do when they have OCD?

What distinguishes Craig’s behavior from ‘normal’ behavior?

What was he doing that distinguished his abnormal behavior?

How does OCD manifest itself with Sherry?

What does Sherry think about disease in general?

What does it say about Sherry that she knows this is not ‘logical’?

Watch Obsessive-Compulsive Disorder:

http://gtm-media.discoveryeducation.com/videos/39988/chp943112_256k.asf

Now, let’s see what you’ve learned:

www.raptivity.com – Standard Pack 2 Quadrant Practice

The Four Quadrants are as follows:

Panic Disorder
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
Post-Traumatic Stress Disorder

The RIGHT HAND SIDE CHOICES with their answers are:

Follows a traumatic event or assault (PTSD)

Avoidance behaviors (PTSD)
Characterized by excessive unrealistic worry (GAD)
Often accompanied by muscles aches, pains and insomnia (GAD)
People with this suffer with consistent, recurring thoughts (OCD)
People with this often perform repetitive ritualistic behavior (OCD)
People with this often fear they’re choking or dying from a heart attack (Panic Disorder)
People with this also suffer what is known as agoraphobia (Panic Disorder)

NORMAL VERSUS ABNORMAL BEHAVIOR

Over the centuries the notions of ‘normal’ and ‘abnormal’ have radically changed. For
example, people with epilepsy were once considered ‘mad’ because it was a greatly
misunderstood condition. We now know that epilepsy is a neurological condition that can
be treated with medication. As we discussed in our lesson on “Stress and Health”,
everyone experiences stress and by the same reasoning, everyone feels anxious at some
points in time. Often this is SITUATIONAL ANXIETY. That is, the response is short-
term and will be alleviated when the situation changes.

CHRONIC ANXIETY is different. Here is a very good brief list to look at which
describes the behaviors that differentiate the ‘normal’ versus ‘abnormal’ blues:

http://cas.umkc.edu/casww/normvsab.htm

Anxiety becomes ‘abnormal’ when it begins to interfere with our daily lives.

Here’s a thoughtful 3-minute musical interpretation of anxiety disorders:

http://www.youtube.com/watch?v=lKYDcAsahXY

What kinds of fears do people with anxiety disorders experience?

What happens to them as a result – what do they feel – how do their fears manifest in
their lives?

3. S ummariz e Phase
Explain why one person would be curious and another anxious in the same situation

Discuss why one person responds to stereotyping without anxiety and another person
responds with anxiety
List criteria that distinguish normal from disordered behavior

Describe observable symptoms of abnormal behavior

Describe some abnormal behaviors specific to particular contexts or circumstances

4. As sessmen t Phase

Assignment – True and False

1. Post-traumatic stress disorder always follows a traumatic or stressful event that the
person cannot seem to recover from.
a. True
b. False

2. Anxiety disorders are considered stressful but not abnormal

a.True
b. False
No, anxiety disorders are classified as abnormal behavior

3. Some of the observable symptoms of panic attacks are the feeling of a heart attack,
feeling like one is going to faint and/or feeling that the room is closing in on them.
a. True
b. False

4. Generalized anxiety disorder is characterized by anxiety that lasts more than three
months.
a. True
b. False
GAD is characterized by anxiety that lasts more than six months.

5. Difficulty sleeping, irritability, or poor concentration are all symptoms of generalized

anxiety disorder.
a. True
b. False
No, these are symptoms of Post-Traumatic Stress Disorder.

6. The reason why some people respond calmly and others respond with anxiety has as
much to do with situations and events as it does our environment.
a. True
b. False
Yes, for example panic attacks are brought on by an event or situation, just as
general anxiety can be. The sources of other phobias are not as well known but our
social environment can certainly affect our responses to events.
7. Sufferers of agoraphobia may avoid public and/or unfamiliar places but only for a
short time until they become comfortable with them.
a. True
b. False
No, these feelings can last for many years unless the person seeks treatment.

8. When anxiety becomes excessive, it may fall under the classification of an anxiety
disorder.
a. True
b. False

9. Ritualistic behaviors such as repetitive hand washing are symptoms of social phobias
just as much as they are symptomatic of obsessive-compulsive disorder (OCD).
a. True
b. False
No, these are only symptomatic of OCD and have nothing to do with social phobias.

10. People can suffer from short-term or situational anxiety and recover quickly without
treatment or therapy.
a. True
b. False
Yes, for example, the loss of a friend or family member can cause short-term
situational anxiety and/or depression which people recover from once they’ve
adjusted to the loss in their life.

11. Generalized anxiety disorder has nothing to do with stress.

a. True
b. False
No, this is not true. Extreme stress can actually be the precursor to the onset of
GAD.

12. In the video on Kerry and panic attacks, the young girl named Kerry began to suffer
from panic attacks as a result of bullying.
a. True
b. False
Yes, this was the traumatic event that caused Kerry to first suffer from panic attacks
and eventually change schools.

13. Normal versus abnormal behavior is not only distinguished by what we do but also
how often we do it.
a. True
b. False
Yes, the constant repetition of certain behaviors (like hand washing) to the point of
being excessive becomes abnormal behavior.

14. People with OCD can develop an unreasonable fear that they will contaminate others.
a. True
b. False
No, it’s the other way around. They’re fearful that others will contaminate them and
so they engage in constant washing rituals to the point that it interferes with heir
daily lives.

15. Of all the anxiety disorders, only OCD truly prevents people from living a ‘normal,
healthy’ daily routine.
a. True
b. False
No, this isn’t true. Any of these anxiety disorders can and do interfere with peoples’
daily lives to the point that they often cease to function in a healthy way.

Extra Assignment

A friend of yours has been suffering with a lot of anxiety lately. You’ve noticed that
they’re often extremely worried and they’ve had what you would describe as panic
attacks? But, are they? Here’s the assignment:

1. Describe your friend’s situation – what are they going through and why
2. What are your friend’s symptoms and how long have they been going on?
3. What do you think your friend is suffering from and why? (Give it a name and
explain your choice)

This can be written in the form of an essay using quotations 9APA STYLE), or a short
story, or a conversation between two people.

5. Additional Resources

http://www.nlm.nih.gov/medlineplus/anxiety.html - Excellent website

http://www.youtube.com/watch?v=ki5mZ9dKqdk&feature=related – A wonderful hour

long video on anxiety disorders