Anxiety disorders cause people to feel excessively frightened, distressed, and uneasy during situations in which most others would not experience these symptoms. Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual’s quality of life. Anxiety disorders affect about 18% of the population above the age of 18 in any given year.

General Facts:

Panic Disorder: Is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. During these attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.

Obsessive Compulsive Disorder: persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.

Post Traumatic Stress Disorder: Usually develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers.

Phobias: Two major types of phobias are social phobia and specific phobia. People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of many potentially pleasurable and meaningful activities. People with specific phobia experience extreme, disabling and irrational fear of something that poses little or no actual danger (flying, water, elevators, etc.). The fear leads to avoidance of objects or situations and can cause people to limit their lives unnecessarily

Generalized Anxiety Disorders: Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea

Caregiver Tips: (ANXIETY)

• Primary role is to offer emotional support, understanding, patience, and encouragement.
• Prepare yourself to see an acute attack of anxiety by researching the above conditions.
• Offer positive reinforcement. Sensitivity is key since dismissive behavior often exacerbates the phobias and anxieties from which the person suffers.
• Get the patient out of the house! Encouraging normal social interaction to the greatest possible degree, given the circumstances, is a healthy step you can take to care for someone with an anxiety disorder.
• Plan ahead. Most people suffering from anxiety do not respond well to sudden changes or surprises. Observe and understand, to the greatest possible degree, the triggers of the person’s anxiety and avoid them at all costs.
• Maintain open communication with the sufferer’s treatment team.

Bipolar disorder, or manic depression, is a medical illness that causes one or more episodes of serious mania and depression. The illness causes a person’s mood to swing from excessively “high” and/or irritable to sad and hopeless, with periods of “normal” mood in between. These changes may be subtle or dramatic and typically vary greatly over the course of a person’s life as well as among individuals. Over 10 million people in America have bipolar disorder, and the illness affects men and women equally. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in childhood. Most people generally require some sort of lifelong treatment. While medication is one key element in the successful treatment of bipolar disorder, psychotherapy, support, and education about the illness are also essential components of the treatment process.

Symptoms:
Bipolar disorder is often difficult to recognize and diagnose. It causes a person to have a high level of energy, unrealistically expansive thoughts or ideas, and impulsive or reckless behavior. These symptoms may feel good to a person, which may lead to the denial that there is a problem. Another reason bipolar disorder is difficult to diagnose is that its symptoms may appear to be part of another illness or attributed to other problems such as substance abuse or trouble in the workplace.

Mania:

• Extreme high or euphoria
• Decreased energy
• Easily irritated or distracted
• Prolonged sadness
• Excessive energy/restlessness/racing thoughts/flight of ideas
• Decreased participation in activities normally enjoyed
• Increased talking/more rapid speech than normal
• Restlessness and irritability
• Ambitious/grandiose plans/unrealistic beliefs
• Increased anxiety
• Increased risk-taking behaviors

Depression:

• Feelings of guilt and hopelessness
• Impulsive behavior (spending, promiscuity, increased alcohol use)
• Decreased appetite
• Decreased sleep without fatigue
• Persistent physical symptoms that don’t respond to treatment
• Uncharacteristically poor judgment
• Thoughts of suicide/attempts

Caregiver Tips: (BIPOLAR)

• Watch for triggers and behaviors for clues of an upcoming change of mood or frame of mind. Inform doctors or therapists of changes in behavior.
• Never ignore comments about suicide, and report them to your friend’s or relative’s therapist or doctor.
• Provide a structured, supportive, tolerant, low stress, environment. Have a set routine in the environment.
• Become educated.
• Encourage medication to be taken as directed. Report any side effects to a medical professional before stopping the medication.

Signs & Symptoms

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed

Types of Depression:

Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy once pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person’s lifetime, but more often, it recurs throughout a person’s life.

Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

Postpartum depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

Seasonal affective disorder (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

Caregiver Tips: (DEPRESSION)

• Offer emotional support, understanding, patience, and encouragement.
• Engage your friend or relative in conversation, and listen carefully.
• Never disparage feelings your friend or relative expresses, but point out realities and offer hope.
• Never ignore comments about suicide, and report them to your friend’s or relative’s therapist or doctor.
• Invite your friend or relative out for walks, outings and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.
• Remind your friend or relative that with time and treatment, the depression will lift.

Schizophrenia is a chronic, severe, disabling brain disorder that affects the way a person acts, thinks, and sees the world. People with schizophrenia have an altered perception of reality. They may see or hear things that other people do not see or hear, speak in strange or confusing ways, or they may believe that others are reading their minds, controlling their thoughts, plotting to harm them, or feel like they’re being constantly watched. With such a blurred line between the real and the imaginary, schizophrenia makes it difficult to negotiate the activities of daily life. In response, people with schizophrenia may withdraw from the outside world or act out in confusion and fear.

Early Warning Signs:

• Hearing or seeing something that isn’t there
• Odd/Irrational statements
• Hostility/Fearful response to loved ones
• Inability to concentrate
• Paranoia/Feeling of being watched
• Extreme reaction to criticism
• Flat, expressionless gaze
• Strange use of words/way of speaking
• Inability to cry or express joy
• Social withdrawal
• Inappropriate laughter or crying
• Decline of personal hygiene
• Depression
• Extreme preoccupation with religion/occult
• Oversleeping or insomnia
• Inappropriate/bizarre behavior

Symptoms:
Positive Symptoms: disturbances that are “added” to a person’s personality.

• Delusions: A firmly held idea that a person has despite clear and obvious evidence that it is not true.

1. Delusions of persecution: belief that others are out to get them.
2. Delusions of reference: neutral environment event has special meaning: ex: tv is sending special messages to them.
3. Delusions of grandeur: Belief that one is a famous or important figure or has unusual powers.
4. Delusions of control: Belief that one’s thoughts or actions are being controlled by outside, alien forces.

• Hallucinations: hearing, seeing, feeling, tasting or smelling something that does not exist. The most common experience is hearing voices that give commands or comments to the individual.
• Disorganized Speech: Moving from one topic to another, in a nonsensical fashion. Individuals may make up their own words or sounds.

Negative Symptoms: Capabilities that are “lost” from the person’s personality.

• Social withdrawal
• Extreme apathy
• Lack of drive or initiative
• Emotional unresponsiveness

Caregiver Tips: (SCHIZOPHRENIA)

• A delusion will not go away by reasoning and therefore needs no discussion. Just sympathize saying it must be upsetting to feel like that.
• Provide solitude and structure. Communication should be brief, concise, clear, and ambiguous.
• Never ignore comments about suicide, and report them to your friend’s or relative’s therapist or doctor.
• Provide a structured, supportive, tolerant, low stress, environment. Have a set routine in the environment.
• Recognize changes in the person that signal they are ready for more independence, or need more help. Inform doctors and therapists of changes in behavior.

During a crisis, do not try to reason with acute psychosis. Remember the person may be terrified by his/her loss of control. Do not shout, use sarcasm, and avoid direct eye contact and touching. Decrease distractions and remain calm. Call someone for help as soon as possible.