[MUSIC] Anxiety disorders are the most common

of all the psychiatric disorders. And so it is imperative that we

know what anxiety disorders are, how they might arise, and
how we can treat them. My name is Vlasios Brakoulias, and I'm
a psychiatrist that treats patients with anxiety, and
obsessive-compulsive disorders. There's often a lot of misunderstanding
surrounding anxiety disorders, and so providing education to my patients, and
the general public can be very rewarding. Contrary to popular belief,
anxiety disorders can be quickly and effectively treated, and so we're able to
provide a lot of hope to our patients. The first point is that, anxiety
disorders occur on a spectrum from normal to abnormal, or what we call
pathological. This is the Yerkes-Dodson curve,
that shows the distribution of levels of anxiety in our community,
from very high levels to very low levels. Anxiety can even have positive effects,
such as making as more prepared to face adverse event,
being more cautious ,protective, being better workers, and
being better achievers. We draw a line, where abnormal is
based on a person's ability to work, and to live a happy life. The aim of treatment
is to cross this
arbitrary line, so that our patients live more normal lives, and use the positive
effects of their anxiety to their benefit. [SOUND] For those of you that
were frightened by this animal, you've just experienced the fight or
flight response. We've all experienced the fight or flight
response at some times in our lives. But for those with anxiety disorders, this
faulty alarm signal goes
off without any obvious threat. Consider this list of symptoms. These symptoms
occur in the fight or
flight response, and in states of anxiety. They are useful if we need to escape
from a dangerous situation, but they are disabling if they occur for a prolonged
duration at times
when there is no real threat. So how common are anxiety disorders? This shows you
that anxiety
disorders are thought to occur in 10 to 20% of the population. It also shows you
the prevalence of
the different types of anxiety disorders. So what are the different
types of anxiety disorders? A common, and relatively easily treated,
anxiety disorder is panic disorder. Panic disorder occurs when anxiety
symptoms arise quickly, and out of the blue. They always go away, but they are very
frightening, and suffers feel that they will be last forever, or that they are
going to have a stroke or a heart attack. Sometimes, people with panic
disorder avoid crowded spaces, and areas such as shopping centers, and
we call this avoidance, agoraphobia. Another very common anxiety disorder
is generalized anxiety disorder. This is the worrying disorder, where people worry
excessively about
all sorts of normal everyday things. We can all worry about our husbands or
wives coming home from work on time, or whether we will be able
to pay a bill on time. But this worry is so excessive that it
cannot be stopped, and it's associated with symptoms like tension,
poor sleep, and poor concentration. Social phobia can be a devastating
disorder, with dramatic implications on a person's ability to socialize
from friendships in work. Social phobia occurs when someone
is excessively focused on how they might be perceived by
others in social situations, and it leads to avoidance
of social situations. Or situations where they might be
judged by others, for example, having to speak in front of class,
or in front of a group of people. There are a whole range
of specific phobias. People not only fear spiders, birds,
snakes, blood, heights, needles, etc., but their fear is so excessive
that they become overly distressed. And they avoid lots of different things,
and they avoid to the extent that it becomes
a real hassle for their lives, and that they can't function very well
at work or in their households. And finally,
obsessive compulsive disorder or OCD. OCD is a very disabling and distressing
disorder, with a whole
range of obsessions and compulsions. And these can include fears of
contamination, and excessive hand washing, excessive doubts and checking, a need to
have everything symmetrical or exact, and intrusive and distressing thoughts,
or images that are unacceptable or disgusting. Although we don't know the exact
cause for
anxiety disorders, and we think that they are probably many different causes,
we do have very effective treatments. There are many simple strategies for
managing anxiety on your own. And these include relaxation
techniques and exercise, with more information being available
on the links, and in the course videos. The main treatment for anxiety disorders
that is offered by health professionals is cognitive behavioral therapy, or CBT,
and
selective serotonin reuptake inhibitors, SSRIs, which is a specific type
of antidepressant medication. These are both quite effective for
anxiety disorders. So I'm here with Mani, who's a research psychologist who
works with anxiety disorders, and who will tell us a little bit more about
cognitive behavioral therapy, or CBT. So Mani, can you tell us,
what is cognitive behavioral therapy? >> Cognitive behavioral
therapy is a talking therapy, where we enable clients to understand
their thoughts and behaviors. And then we teach them To handle these thoughts and
behaviors that are causing anxiety, to bring them back to
a healthier state of mind. >> So it's not the situation that
leads to someone to be anxious. It's actually the way someone reacts
to the situation, is that correct? >> That's correct.
>> Yeah. >> Yes, yes. >> The other common problem with
anxiety disorders is avoidance. Where people avoid things that they
think will cause them to be anxious. How do you treat avoidance? >> Well yes,
avoidance is a very common problem, and we treat avoidance in therapy
by using exposure tasks. So we ask the client what
they would like to do, and why they are afraid to do it. And then, we start with
addressing
their most least provoking thought. And then, slowly work up to the most provoking
task that would cause some anxiety. For instance, if someone is afraid to
speak in front of a group of people, how we address is that is, try and get the
person to rehearse in front of a mirror, and then perhaps in front of a close
friend, in front of their therapist. Maybe rehearse in front of two
people before they actually get around to the addressing the anxiety with
speaking in front of a group of people. >> So you're saying that they eventually
build up confidence by practicing, and building up their courage. >> Their courage.
Yes, you're right. >> So, when should we consider using
medication for anxiety disorders? We should consider medication when
psychological treatment has failed or is seen as too difficult. We might also
consider medication when
we don't have access to a psychologist, can't afford therapy, or
when there are long waiting times. Sometimes, we just think that taking
a pill would be easier and cheaper. But the trick is, that you have to
take your medication regularly for it to be effective. Currently, the most widely
used medication
for anxiety disorders are selective serotonin reuptake inhibitors, or SSRIs,
they are a type of antidepressant. When used over several weeks,
most people begin to feel less anxious. They need to be taken every day,
and are usually taken for about a year to ensure that
the patient is fully recovered. There can be some side
effects such as nausea and dizziness when these
medications are started. And this can be quite anxiety provoking
for people with anxiety disorders. But not everyone will experience
these side effects, and they usually don't last
longer than one week. For anxiety disorders, the quickest relief comes from
medications called benzodiazepines. These are medications like diazepam,
also called Valium, or alprazolam. These give quick relief, but
are like painkillers in that, you have to keep taking them to stay well. And
they're not usually recommended for
long term use. You're bound to know someone with
an anxiety disorder, so please let them know that their anxiety can be
treated, and that help is available. People suffering from anxiety disorders
can get help from their local doctor, or by contacting a specialized anxiety
disorders clinic in their area. As you can see,
anxiety disorders are common. There are some different types
of anxiety disorders, and they can be effectively treated with both
psychological treatments and medication. [MUSIC]