According to the DSM-V, anxiety disorders include disorders that share features of excessive fear, anxiety, and related behavioral disturbances. Fear is an emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Although these two states overlap, there are differences: with fear more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behavior: and anxiety more often associated with muscle tension and vigilance in preparation for future danger, and cautious, or avoidant behaviors. Sometimes the level of fear or anxiety is reduced by pervasive avoidance behaviors. Panic attacks feature prominently within anxiety disorders as a particular type of fear response. Panic attacks are not limited to anxiety disorders but rather can be seen in other mental disorders as well. Anxiety disorders differ from one another in the types of objects or situations that induce fear, anxiety, or uphold this behavior, and the associated cognitive ideation. Thus, while anxiety disorders tend to be highly comorbid with each other, they can be differentiated by close examination of the types of situations that are feared or avoided in the content of the associated thoughts or beliefs.
Anxiety disorders differ from developmentally normative fear or anxiety by being excessive or persistent beyond their developmentally appropriate periods. They differ from persistent fear or anxiety, often stress dash induced, by persistent (e.g., typically lasting six months or more), although the criterion for duration is intended as a general guide with allowance for some degree of flexibility and is sometimes of shorter iteration in children have (in separation anxiety disorder and selective mutism). Since individuals with anxiety disorders typically overestimate the danger in situations they fear or avoid, the primary determination of whether their fear or anxiety is excessive or out of promotion is made by the clinician, taking cultural contextual factors into account. Many of the anxiety disorders develop in childhood and tend to persist if not treated. Most occur more frequently in females than in males (2:1 ratio). Each anxiety disorder is diagnosed only when the symptoms are not attributable to the physiological effects of a substance/medication or to another medical condition or are not better explained by another mental disorder.
Types of Anxiety Disorders and DSM and ICD Codes
309.21 (F93.0) Separation Anxiety Disorder
312.23 (F94.0) Selective Mutism
300.20 (__.__) Specific Phobia,
Specify if:
(F40.210) Animal
(F40.228) Natural environment
(___,__) Blood Injection-injury
(F40.230) Fear of blood
(F40.232) Fear of injections and transfusions
(F40.232) Fear of other medical care
(F40.233) Fear of injury
(F40.248) Situational
(F40.298) Other
300.23 (F40.10) Social Anxiety Disorder (social Phobia) (202)
Specify if: Performance only.
300.01 (F41.0) Panic Disorder (208)
__.__ (__.__) Panic Attack Specifier (214)
300.02 (F40.00) Generalized Anxiety Disorder (222)
__.__ (__.__) Substance/Medication Induced Anxiety Disorder (226)
293.84 (F06.4) Anxiety Disorder to Another Medical Condition (230)
300.09 (F41.8) Other Specified Anxiety Disorder (233)
300.00 (F41.9) Unspecified Anxiety Disorder (233)
Behavioral definition of Anxiety in Induvial psychotherapy
Excessive and/or unrealistic worry that is difficult to control occurring more days than not for at least six months about several events or activities. Motor tension (e.g., restlessness, tiredness, shakiness, muscle tension). Autonomic hyperactivity (e.g., palpitations, shortness of breath, dry mouth, trouble swallowing, nausea, diarrhea). Hypervigilance (e.g., feeling constantly on edge, experiencing concentration difficulties, having trouble falling or staying asleep, exhibiting a general state of irritability).
Long Term Goal in Individual psychotherapy.
Individual psychotherapy clients should see a reduction in overall frequency, intensity, and duration of the anxiety so that daily function is not impaired. Their anxiety levels should stabilize while increasing their ability to function daily. They should Resolve the core conflict that is their source of anxiety. They should enhance their ability to effectively cope with the full variety of life worries and anxieties and learn how to implement coping skills that result in a reduction of anxiety and worry while approving their daily functioning.
Behavioral Definitions of Anxiety in Family Psychotherapy.
Anxiety in the family setting is described as one or more family members experiencing excessive worry or a sense of impending doom that precludes their daily normal functioning in their roles and their family. One or more family members will experience jitteriness, restlessness, insomnia, high-level autonomic activity, palpitations, sweaty palms, or similar symptoms or anxiety. A family member’s symptoms of anxiety have caused undue distress within the family to the point that concessions are made to them. A family member may experience ruminations or controlling behaviors when their anxiety-ridden family member agitates other family members and alienates themselves from others. Anxiety symptoms within the parents or older family members may lead to a child's dysfunctional behavior. There may be one or more family members experiencing an inability to fly, travel by boat, or drive or the freeway due to irrational phobic fears.
Long term goals for treatment of anxiety in family psychotherapy.
Family members will learn how to utilize cognitive and behavioral techniques to reduce anxiety. They will be able to confront anxiety producing stimuli gradually to overcome debilitating fears. They should be able to resolve the underlying biochemical, interpersonal, or emotional issues that resulted in their symptoms of anxiety. Family members will learn about the symptoms, origins, and treatment of anxiety. Family members should be able to provide support to one another and learn how to reduce their anxieties. Family members should learn their appropriate roles in supporting their anxious family members and employing specific techniques to reduce anxiety levels and avoidance behavior.
Therapeutic Interventions to Consider Utilizing in Psychotherapy
These are some interventions individual dealing with anxiety can utilize or work with their therapist on –
Building trust, assessing nature of anxiety symptoms, completing client-report measures, a physical assessment regarding etiology, assessing level of insight, assessing for correlated disorder, assessing for culturally based confounding issues, assessing the severity of impairments, participation in a medication evaluation, monitoring medication compliance, discussing anxiety cycles, discussing the target of treatment, reading on anxiety, learning relaxation skills, completing relaxation homework’s, reading on relaxation and calming strategies, implementing worry time., learning techniques to postpone until worry time, discussing estimation errors, analyzing fears logically, developing insights into worry as avoidance, identifying distorted thoughts, completing exercises on self-talk, constructing anxiety stimuli hierarchies and selecting initial exposures, completing imagination exercises, completing homework on situational exposures, learning problem solving strategies, completing problem solving exercises, engaging in behavioral activation, developing interpersonal skills and relationships, completing homework on communication skills, differentiating between lapse and relapse, discussing management of lapse risk situations, encouraging routine use of strategies, developing a “coping card”, scheduling booster sessions, using acceptance and commitment therapy (AC), utilizing paradoxical interventions, completing cost benefit analysis, identifying unresolved conflicts, developing insight into past traumas, list life conflicts, reinforce responsibility acceptance and learning proper sleep hygiene.
If you or any of your loved ones are struggling with anxiety, feel free to schedule a free 15 minute consultation with Innovation Counseling Services.
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