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Extended_defintion_KL_Adrianne_2018.pdf

Extended Definition To: Mr. David M. Merchant, Intern Coordinator From: Adrianne Avenicci, college intern Subject: Extended Definition of Anxiety and the Types of Disorders Date: January 22, 2018 The purpose of this memo is to give an extended definition of anxiety disorders to determine the most effective treatment. Introduction Anxiety is a general term that is used to describe a common feeling of fear or worry that is triggered by anticipation or ruminations. Feeling anxious about an upcoming event or worrying about a future career path is common and nothing to worry about. This is known as common anxiety. However, when the symptoms become extreme so that the fear and worry take over every aspect of life, a disorder has developed that can be disabling. It is important to be aware of the difference between anxiety and anxiety disorders because a disorder requires medical attention. Anxiety Disorders: An Overview of Current Knowledge According to anxietycentre.com, “anxiety has become the number one mental health issue in North America” (“Current Anxiety Disorder Statistics”). It currently affects around a third of the adult population. However, as figure 1 shows below, only a third of them receive treatment with only 10 percent receiving proper treatment. This, alone, is reason enough to take the time to research and better understand anxiety disorders.

Memo to Dr. David M. Merchant, Intern Coordinator January 22, 2018 Page 2

Figure 1. Percentage of the Population Affected vs. Percentage Effectively Treated Source: Folk, Jim. “Anxiety Disorder General Statistics.” Anxietycentre.com, 25 Apr. 2017,

www.anxietycentre.com/anxiety-statistics-information.shtml. Types and Symptoms There are different types of anxiety disorders with the most common being generalized anxiety, social anxiety, and panic disorder. Generalized anxiety disorder is associated with excessive anxiety and worry for an extended period. Physiological symptoms of generalized anxiety include restlessness, irritability, blank- mindedness, fatigue, and feeling out of control. Physical symptoms include muscle tension, pacing, and exhaustion. Social anxiety disorder is having anxiety in social or performance environments. Anxiety in those with this type of disorder stems from fear of embarrassment, rejection, or humiliation. These individuals feel severely anxious communicating with other people, are highly self- conscious, and worry for days or weeks before a social event. Other symptoms of this disorder include isolation, lack of friends, and feeling sick when around others. Individuals with panic disorder experience reoccurring, unexpected panic attacks. Panic attacks are defined as a sudden, intense fear associated with heart palpitations, accelerated heart rate, shaking, shortness of breath, and an overwhelming gloomy feeling. Other symptoms include: feeling out of control and avoiding places that have or could trigger a panic attack.

Memo to Dr. David M. Merchant, Intern Coordinator January 22, 2018 Page 3 Causes Anxiety has been shown to have many causes that are directly linked to internal and external forces, including medical conditions, daily life stressors, and genetics. Medical conditions including heart disease and thyroid problems can result in anxiety, and certain medications like steroids and anti-depressants can as well. Use of drugs like cocaine, amphetamine, and marijuana has also been shown to induce anxiety. These factors are all considered chemical triggers of anxiety. Anxiety is also often caused by daily stressors in life, traumatic experiences, or developmental factors from childhood. College exams, marriage, and losing a job are common examples of daily stressors that cause generalized anxiety. Being in a car wreck or being a victim of rape are traumatic experiences that are often linked to more serious anxiety disorders, such disorder. Adults tend to develop anxiety disorders that stem from their upbringing, specifically the way their parents influenced them as children. Anxiety most often presents itself in adults due to genetics. According to psychologist Amy Przeworski, Ph.D., “Individuals inherit a predisposition to being an anxious person, [and] about 30 to 40 percent of variability is related to genetic factors” (Vann). However, treatments to alleviate, and eventually control, anxiety has evolved significantly in recent years. Demographics According to the National Institute of Mental Health, “anxiety disorders affect 18.1 percent of adults in the United States [which accounts for] approximately 40 million adults between the ages of 18 and 54” (“Current Anxiety Disorder Statistics”). This statistic only accounts for the people who have sought out help. As mentioned earlier, approximately 30 percent of the adult population is affected by anxiety. Figures 2 and 3 show the lifetime prevalence of anxiety disorders in adults and adolescents, respectively.

Figure 2. Past Year Prevalence of Any Anxiety Disorder Among U.S. Adults (2001-2003) Source: “Any Anxiety Disorder.” National Institute of Mental Health, U.S. Department of Health and Human

Services, Nov. 2017, www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml.

Memo to Dr. David M. Merchant, Intern Coordinator January 22, 2018 Page 4

Figure 3. Lifetime Prevalence of Any Anxiety Disorder Among Adolescents (2001-2004) Source: “Any Anxiety Disorder.” National Institute of Mental Health, U.S. Department of Health and Human

Services, Nov. 2017, www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml.

Current Treatment Options Anxiety can be treated with psychotherapy or medications, or a combination of both. Cognitive behavioral therapy is a common psychotherapy that instructs the individual to think, behave, and react differently to anxiety-causing situations. Cognitive therapy and exposure therapy are two methods that are used in cognitive behavioral therapy. Cognitive therapy concentrates on diverting the harmful thoughts that are associated with the anxiety disorder, while exposure therapy focuses on challenging the fears associated with the anxiety disorder. These therapy sessions can be conducted individually or in a group setting. Group therapy, however, has been shown to be more effective for social anxiety disorders, as it helps expose the individual to more people that undergo the same sufferings. Unlike psychotherapy, medications prescribed for anxiety disorders do not cure anxiety but relieve anxiety symptoms. Antidepressants, beta-blockers, and anti-anxiety medications like benzodiazepines are the commonly prescribed medications. Each medication is prescribed for certain symptoms and most have lasting side effects. The dose and treatment plan chosen depends on the individual, and trial and error are often used until the right one is found. Since medication only relieves symptoms, the combination of both medication and psychotherapy is often the most effective treatment. Anxiety has developed into the most common mental illness in North America. Anxiety disorders are very complex and need extensive time and research to fully diagnose and treat individuals with these disorders. With effective treatment averaging only 10 percent of the population diagnosed, better treatment plans need to be implemented.

Memo to Dr. David M. Merchant, Intern Coordinator January 22, 2018 Page 5 Closing I look forward to expanding my research and reporting back to you with the best treatment option. If you have any questions, please contact me either by email at [email protected] or by cell-phone at 555-1234. References “Anxiety Disorders.” National Institute of Mental Health, U.S. Department of Health and Human

Services, Mar. 2016, www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.

“Anxiety.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Aug. 2017, www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961.

“Any Anxiety Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, Nov. 2017, www.nimh.nih.gov/health/statistics/any-anxiety- disorder.shtml.

“Current Anxiety Disorder Statistics.” Current Anxiety Disorder Statistics, www.calmclinic.com/anxiety/anxiety-disorder-statistics.

Folk, Jim. “Anxiety Disorder General Statistics.” Anxietycentre.com, 25 Apr. 2017, www.anxietycentre.com/anxiety-statistics-information.shtml.

Vann, Madeline R. “Is Anxiety Hereditary?” EverydayHealth.com, Everyday Health, 24 Aug. 2015, www.everydayhealth.com/news/is-anxiety-hereditary/.

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