Anxiety disorders

Start with general open questions
I understand you have had problems with anxiety
Can you tell me what you mean by that?
Do you feel tense, on edge, keyed up?
Do you have difficulty relaxing?
Do you feel worried or nervous?

Then home in on specific symptoms
Can I suggest some of the things you may be feeling or experiencing?

Anxiety Symptoms - 3 main groups
1. Physical
2. Thoughts /psychological
3. Behaviour

Physical -tiredness, insomnia, headache, dizziness, blurred vision, ringing in the ears, tightness in the throat, dry mouth, feeling of choking, tense and stiff shoulder, racing heart, unable to catch breath, tight chest, fast and shallow breathing, churning stomach, feeling sick, tense muscles, sore joints, sweating, needing the toilet, loss of libido, pins and needles, weekeness in legs, legs like jelly..

Thoughts - restlessness, irritability, poor concentration, fear of death, heart attack or nervous breakdown

Behaviour - avoidance, running away from an anxiety provoking situation, these behaviours are maintaining factors

Circumstances of these symptoms
How long?
How often?
Where?
When - tirggers VS out of the blue
Discrete episodes of panic VS generalised anxiety
Avoidance
Anticipatory anxiety


PANIC ATTACKS vs GENERALISED ANXIETY DISORDER
Do you have this feeling all the time?
Do you ever have panic attacks?
when your anxiety is overwhelming?
when you feel you're going to die?
what do you do when this happens? (run home?)

Panic attacks
Recurrent attacks of severe anxiety
Attacks last for minutes only
Not restricted to any particular situation
Symptoms - palpitations/choking/dizzy
Secondary fear of dying/losing control/going mad
Several severe attacks of autonomic anxiety have occurred within a period of 1 month
- in circumstances with no objective danger
-no predictable situation
-comparative freedom between attacks

Generalised anxiety disorder
Anxiety which is generalised and persistent
Free-floating - not predominant in any environment
Continuous feeling of nervous/trembling/muscle tension/sweats/dizzy/palpitations
Must suffer primary symptoms of anxiety most days for at least several weeks at a time (apprehension/motor tension/autonomic overactivity)