Anxiety – Psychological Disorders (PSY)

by Tarry Ahuja, MD

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    00:01 So, let’s start going through each now.

    00:03 Anxiety, so what is anxiety? So this is an emotional state, so it’s more emotionally driven of unpleasant physical and mental arousal.

    00:10 And so what happens with individuals with anxiety is that you have these intense, frequent, irrational and uncontrollable episodes, and so their thoughts and behaviors get a little bit out of control.

    00:22 And when you speak to individuals who have anxiety, they say, “My mind is racing a mile a minute and I really can’t control where I’m going,” and the thoughts don’t necessarily make sense, they become slightly irrational.

    00:35 So for example, somebody who is suffering from anxiety might say, “I have an appointment at 10 o’clock but it’s 9:10 right now and I haven’t put on my pants yet but my pants are still on the dryer, and that reminds me I need to get a new lint remover for the dryer and the stores are going to be closing in 20 minutes, and the car needs gas, and how am I going to make it to the store?” So you can see it’s snowballing out of control and their thoughts are going frantic.

    01:02 It’s not that they’re not connected, but it’s slightly irrational, as opposed to somebody who is maybe not suffering from anxiety might say, “I have an appointment in 20 minutes.

    01:10 I should probably get a move on and get in the car and get going,” end of story, full stop.

    01:16 So you can see how one is going quite frantic and one is a little bit more controlled, and that’s the biggest description that they say is I have a lack of control of my thoughts.

    01:28 Now, there are different types of anxiety disorders.

    01:30 So my kind of description was a blanket statement, but you can have things like panic disorders, where you have episodes of full-blown panic and at this point, you know, this is when they’re curled up on the floor, completely freaked out saying, “I can’t manage this situation.” And those are usually short-lived, but they can be quite cyclical, so they happen quite often and happen in a semi-regular pattern, or they can just be, you know, one-offs based on the situation in front of them.

    01:57 GAD is quite common and this is I think one of the reasons why it’s so common is because it’s the easiest, it’s an umbrella descriptor for all a bunch of anxiety disorder And so sometimes a lot of physicians, not that they don’t want to probe deeper, but because it’s just easier to say, “Well, it’s clearly anxiety so I’m going to classify that as generalized anxiety disorder.” And after further treatment or seeing a specialist and they start peeling the layers of that onion they realize actually, well, it’s not just GAD, it’s actually a specific type of phobia.

    02:31 And with specific phobias, there’s unreasonable fear of a certain object or situation.

    02:36 So again, there’s a huge exhaustive list of all these different types of phobias you can have and I’m sure in your everyday life you’ve heard of different phobias like I have a phobia for feet or I have a phobia for spiders and so on.

    02:50 You can have a list, an almost never ending list of certain things that will trigger some anxiety for you, for most individuals they would not.

    02:59 So I think we all don’t love spiders, but if there’s a spider in the room, I’m not going to have a complete panic attack or get really anxious.

    03:06 I’m just going to go get some toilet paper and maybe squish it and get rid of it, right? Flush it down the toilet, end of story.

    03:12 So, an example of a different phobia.

    03:15 Social phobias are this fear where you think people around you are watching you and judging you.

    03:20 And PTSD is one that we’ve discussed in other lectures and it will come up again and that’s post-traumatic stress disorder, and this is anxiety that is linked specifically to a traumatic event and it usually happens after the traumatic event.

    03:32 So examples would be a soldier coming home from a tour of duty in, say, Afghanistan.

    03:38 A pretty traumatic experience, you see a lot of crazy stuff, and then you come home being removed from that situation and you still have these episodes of anxiety, waking up in cold sweats, inability to, you know, properly reintegrate into society, another quite fairly common example of an anxiety disorder.

    03:58 Acute stress disorder is anxiety after trauma or a traumatic event, but this is in a shorter period.

    04:04 So the name, the descriptor “acute” refers to that is that shorter period.

    04:09 So this might be actually something that’s a little bit more tangible for the general population is you might get into, say, a car accident or you might see something fairly horrific and for the next little while you can stop thinking about it, it really affects you, and then slowly you kind of get over that, as opposed to PTSD, which is a little bit longer lasting.

    04:30 We have OCD, which is obsessive compulsive disorder, and this is when you have obsessions or compulsions, or both, about specific things.

    04:38 So, again, this is a term you may have heard before, OCD, and this is when you really hone in on a specific thing that if it’s not the way you like, it really, really bothers you to the point where you can no longer complete the task that you’re initially trying to do.

    04:54 So let me give you an example.

    04:56 Taking notes for the MCAT and you have a certain way of doing that.

    05:00 You know, a lot of us have our preference, yeah, I like to have a certain line, I like to have my favorite notepad and I do my thing.

    05:05 Now, if you don’t have one of those things, it kind of annoys you for a minute.

    05:09 You’re like, “Where’s my lucky pen? Oh, whatever.

    05:09 You’re like, “Where’s my lucky pen? Oh, whatever.

    05:11 I guess I’ll just use this one,” and you continue with your work.

    05:14 Now, somebody with OCD might say, “Has anybody seen my magic pen?” And, “I can’t do my work without my magic pen.” And it turns into an upheaval of the whole bedroom and destroying the desk and looking for this and they actually won’t be able to do their studying because they don’t have the pen.

    05:29 They’ve obsessed about that pen and without that they can’t complete it.

    05:33 It can be things like writing in the borders of the notepad or having the desk at the southward side of your house and your notepad needs to be exactly 45 degrees to the periphery of your desk.

    05:46 Like these are very specifics and that they sound like I’m making light of the situation, but this is exactly what individuals who have OCD do.

    05:53 They might not always vocalize it, but in their mind these are the things that they need to do and have in place, otherwise, they cannot complete the task.

    About the Lecture

    The lecture Anxiety – Psychological Disorders (PSY) by Tarry Ahuja, MD is from the course Individual Influences on Behavior.

    Included Quiz Questions

    1. Mary has been anxious and worried for the past year most of the day, every day.
    2. Jane hasn't been sleeping well and is having nightmares after being robbed in her house 2 days ago.
    3. Barry has been having flashbacks from his time in the military since he got back home 7 months ago.
    4. Drew has episodes of intense panic with sweating and difficulty breathing lasting for 10–15 minutes, which is triggered by specific situations.
    5. Mark has extreme anxiety when he needs to give a presentation.
    1. Drew has periods of irrational anxiety with sweating and difficulty breathing lasting for around 10 minutes when flying.
    2. Mark has been having flashbacks from his time as a policeman since he was discharged 5 months ago.
    3. Amy has social anxiety.
    4. Jane avoids all fish including trips to the zoo after having a severe allergic reaction from eating sushi.
    5. Diana goes and re-checks the locks on her doors 7 times before being sure she locked them.
    1. Obsessive compulsive disorder.
    2. Generalized anxiety disorder.
    3. Anxiety.
    4. Obsessive compulsive personality disorder.
    5. Agoraphobia.
    1. Social phobia.
    2. Specific phobia.
    3. Anxiety disorder.
    4. Introvert.
    5. Malingering.

    Author of lecture Anxiety – Psychological Disorders (PSY)

     Tarry Ahuja, MD

    Tarry Ahuja, MD

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