ANXIETY DISORDER

PROJECT REPORT
ANXIETY DISORDER

Supervisor Submitted by
Ms Girija Singh Himani Prajapati

M.G.D GIRLS’ SCHOOL, JAIPUR

SESSION 2023-24
 CERTIFICATE

This is to certify that the project report on ANXIETY

DISORDER was submitted by Himani Prajapati of class XII H
and has successfully completed under my guidance. To the best
of my knowledge, the information mentioned is true and reliable.

DATE SIGNATURE
 ACKNOWLEDEMENT

I avail this opportunity for expressing my deep gratitude to

our mentor, our psychology teacher Ms Girija Singh, for
her guidance and valuable suggestion during the
completion of this project. I have completed the project
successfully only because of her timely help, cooperation,
motivation and direction.

Himani Prajapati
XII H
 INDEX

S.NO TITLE
1. INTRODUCTION-
 What is anxiety disorder
 Early warning signs of anxiety disorder
 Types of anxiety disorder
 Who is affected
 How common is anxiety disorder in children
Is anxiety disorder hereditary
2. Signs and symptoms
3. What causes anxiety disorder
4. Risk factors
5. Diagnosing
6. Conditions that may look like anxiety disorder
7. Treatment
8. Self-Help, Coping, and Managing
9. Prognosis
10. Common misconception
11. CASE PROFILE-
patient’s history
history
signs and symptoms
past medical and psychiatric history
treatment
comclusion
12. Bibliography
 WHAT IS ANXIETY DISORDER

Anxiety is a normal reaction to stress. Mild levels of anxiety can be

beneficial in some situations. It can alert us to dangers and help us
prepare and pay attention. Anxiety disorders differ from normal feelings
of nervousness or anxiousness and involve excessive fear or anxiety.
Anxiety disorders are the most common of mental disorders. They affect
nearly 30% of adults at some point in their lives. Anxiety disorders can
cause people to try to avoid situations that trigger or worsen their
symptoms. Job performance, schoolwork and personal relationships can
be affected. In general, for a person to be diagnosed with an anxiety
disorder, the fear or anxiety must:
 Be out of proportion to the situation or be age inappropriate
 Hinder their ability to function normally
However, anxiety disorders are treatable with a number of
psychotherapeutic treatments. Treatment helps most people lead normal
productive lives.
 EARLY WARNING SIGNS OF ANXIETY DISORDER

Anxiety is a common mental health disorder today. Maybe you have

been experiencing symptoms of anxiety for years, or perhaps your
anxiety emerged as a result of a global pandemic, social divide, and
other environmental factors. Often our experience of anxiety is very
internally disruptive but invisible to others. We may hesitate to tell
others about what we are going through out of fear of being judged,
thoughts that we have failed in some way, or beliefs that if we ignore the
feelings of anxiety that it will just go away.
Common early warning signs of anxiety disorder include:
 Difficulty Sleeping
 Lack of Concentration
 Being Easily Irritated
 Feeling Tired
 Intense and Prolonged Worry
 Fast Heartbeat.
 Types of Anxiety Disorders

1. Generalized Anxiety Disorder

 Generalized anxiety disorder involves persistent and excessive
worry that interferes with daily activities. This ongoing worry
and tension may be accompanied by physical symptoms, such as
restlessness, feeling on edge or easily fatigued, difficulty
concentrating, muscle tension or problems sleeping. Often the
worries focus on everyday things such as job responsibilities,
family health or minor matters such as chores, car repairs, or
appointments.

2. Panic disorder
 The core symptom of panic disorder is recurrent panic attacks,
an overwhelming combination of physical and psychological
distress. During an attack, several of these symptoms occur in
combination:
 Palpitations, pounding heart or rapid heart rate
 Sweating
 Trembling or shaking
 Feeling of shortness of breath or smothering sensations
 Chest pain
 Feeling dizzy, light-headed or faint
 Feeling of choking
 Numbness or tingling
 Chills or hot flashes
 Nausea or abdominal pains
 Feeling detached
 Fear of losing control
 Fear of dying
  Because the symptoms can be quite severe, some people who
experience a panic attack may believe they are having a heart
attack or some other life-threatening illness. They may go to a
hospital emergency department. Panic attacks may be expected,
such as a response to a feared object, or unexpected, apparently
occurring for no reason. The mean age for onset of panic
disorder is 20-24. Panic attacks may occur with other mental
disorders such as depression or PTSD.

3. Phobias, Specific Phobia

 A specific phobia is excessive and persistent fear of a specific
object, situation or activity that is generally not harmful. Patients
know their fear is excessive, but they can't overcome it. These
fears cause such distress that some people go to extreme lengths
to avoid what they fear. Examples are public speaking, fear of
flying or fear of spiders.

4. Agoraphobia
 Agoraphobia is the fear of being in situations where escape may
be difficult or embarrassing, or help might not be available in the
event of panic symptoms. The fear is out of proportion to the
actual situation and lasts generally six months or more and
causes problems in functioning. A person with agoraphobia
experiences this fear in two or more of the following situations:
 Using public transportation
 Being in open spaces
 Being in enclosed places
 Standing in line or being in a crowd
 Being outside the home alone
 The individual actively avoids the situation, requires a
companion or endures with intense fear or anxiety. Untreated
 agoraphobia can become so serious that a person may be unable
to leave the house. A person can only be diagnosed with
agoraphobia if the fear is intensely upsetting, or if it significantly
interferes with normal daily activities.

5. Social Anxiety Disorder (previously called social phobia)

 A person with social anxiety disorder has significant anxiety and
discomfort about being embarrassed, humiliated, rejected or
looked down on in social interactions. People with this disorder
will try to avoid the situation or endure it with great anxiety.
Common examples are extreme fear of public speaking, meeting
new people or eating/drinking in public. The fear or anxiety
causes problems with daily functioning and lasts at least six
months.

6. Separation Anxiety Disorder

 A person with separation anxiety disorder is excessively fearful
or anxious about separation from those with whom he or she is
attached. The feeling is beyond what is appropriate for the
person's age, persists (at least four weeks in children and six
months in adults) and causes problems functioning. A person
with separation anxiety disorder may be persistently worried
about losing the person closest to him or her, may be reluctant or
refuse to go out or sleep away from home or without that person,
or may experience nightmares about separation. Physical
symptoms of distress often develop in childhood, but symptoms
can carry though adulthood.

7. Selective Mutism
 Children with selective mutism do not speak in some social
situations where they are expected to speak, such as school, even
 though they speak in other situations. They will speak in their
home around immediate family members, but often will not
speak even in front of others, such as close friends or
grandparents.

 The lack of speech may interfere with social communication,

although children with this disorder sometimes use non-spoken
or nonverbal means (e.g.,

 grunting, pointing, writing). The lack of speech can also have

significant consequences in school, leading to academic
problems and social isolation. Many children with selective
mutism also experience excessive shyness, fear of social
embarrassment and high social anxiety. However, they typically
have normal language skills.

 Selective mutism usually begins before age 5, but it may not be

formally identified until the child enters school. Many children
will outgrow selective mutism. For children who also have
social anxiety disorder, selective mutism may disappear, but
symptoms of social anxiety disorder may remain.
 WHO IS AFFECTED

 Anxiety disorders are the world’s most common mental disorders,

affecting 301 million people in 2019.
 More women are affected by anxiety disorders than men.
 Symptoms of anxiety often have onset during childhood or
adolescence.
 There are highly effective treatments for anxiety disorders.
 Approximately 1 in 4 people with anxiety disorders receive
treatment for this condition.

HOW COMMON IS ANXIETY DISORDER IN CHILDREN

Childhood anxiety disorders are very common, affecting one in eight
children. The National Institute of Mental Health estimates a prevalence
between the ages 13 and 18 years of 25.1 percent and a lifetime
prevalence of 5.9 percent for severe anxiety disorder. Anxiety disorders
in childhood generally follow an impairing course leading to additional
psychopathology and often interfere with social, emotional, and
academic development.

IS ANXIETY DISORDER HERIDITARY

Genetics may play a role in how likely you are to get anxiety. But
they’re not the whole story.
If someone in your family has these conditions, you’re more likely to, as
well. But it doesn’t mean you definitely will. And you can have anxiety
disorder even if no one else in your family does.
In most cases, the younger the person is when they get anxiety or
depression, the more likely it is to be hereditary.
Anxiety and depression can still be genetic if they show up in your older
family members. But often, new conditions in people that are over the
age of 20 are linked to painful or stressful life events.

SIGNS AND SYMPTOMS

Experiencing occasional anxiety is a normal part of life. However,

people with anxiety disorders frequently have intense, excessive and
persistent worry and fear about everyday situations. Often, anxiety
disorders involve repeated episodes of sudden feelings of intense
anxiety and fear or terror that reach a peak within minutes. These
feelings of anxiety and panic interfere with daily activities, are difficult
to control, are out of proportion to the actual danger and can last a long
time. You may avoid places or situations to prevent these feelings.
Symptoms may start during childhood or the teen years and continue
into adulthood.
Symptoms vary depending on the type of anxiety disorder you have.
General symptoms of an anxiety disorder include:
Physical symptoms:
 Cold or sweaty hands.
 Dry mouth.
 Heart palpitations.
 Nausea.
 Numbness or tingling in hands or feet.
  Muscle tension.
 Shortness of breath.
Mental symptoms:
 Feeling panic, fear and uneasiness.
 Nightmares.
 Repeated thoughts or flashbacks of traumatic experiences.
 Uncontrollable, obsessive thoughts.
Behavioral symptoms:
 Inability to be still and calm.
 Ritualistic behaviors, such as washing hands repeatedly.
 Trouble sleeping.

WHAT CAUSES ANXIETY DISORDER

Anxiety disorders are like other forms of mental illness. They don’t
come from personal weakness, character flaws or problems with
upbringing. But researchers don’t know exactly what causes anxiety
disorders. They suspect a combination of factors plays a role:
 1. Chemical imbalance: Severe or long-lasting stress can change the
chemical balance that controls your mood. Experiencing a lot of
stress over a long period can lead to an anxiety disorder.
2. Environmental factors: Experiencing a trauma might trigger an
anxiety disorder, especially in someone who has inherited a higher
risk to start.
3. Heredity: Anxiety disorders tend to run in families. You may
inherit them from one or both parents, like eye color.

RISK FACTORS
These factors may increase your risk of developing an anxiety disorder:
 Trauma. Children who endured abuse or trauma or witnessed
traumatic events are at higher risk of developing an anxiety
disorder at some point in life. Adults who experience a traumatic
event also can develop anxiety disorders.
 Stress due to an illness. Having a health condition or serious illness
can cause significant worry about issues such as your treatment and
your future.
 Stress buildup. A big event or a buildup of smaller stressful life
situations may trigger excessive anxiety — for example, a death in
the family, work stress or ongoing worry about finances.
 Personality- People with certain personality types are more prone
to anxiety disorders than others are.
 Other mental health disorders- People with other mental health
disorders, such as depression, often also have an anxiety disorder.
 Having blood relatives with an anxiety disorder- anxiety disorders
can run in families.
 Drugs or alcohol- Drug or alcohol use or misuse or withdrawal can
cause or worsen anxiety.
DIAGNOSING ANXIETY DISORDER
A psychologist and certain other mental health professionals can
diagnose anxiety and provide counseling (psychotherapy).
 Give you a psychological evaluation. This involves discussing your
thoughts, feelings and behavior to help pinpoint a diagnosis and
check for related complications. Anxiety disorders often occur
along with other mental health problems — such as depression or
substance misuse — which can make diagnosis more challenging.
 Compare your symptoms to the criteria in the DSM-5. Many
doctors use the criteria in the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5), published by the American Psychiatric
Association, to diagnose an anxiety disorder.

CONDITIONS THAT MAY LOOK LIKE ANXIETY

DISORDER
 Depression
 Diabetes
 Eating disorders
 Heart problems
 Panic disorder
 Post traumatic stress disorder
 Agoraphobia
 Asthma
 Endometriosis
 Social phobias
 TREATMENT

1. Mindfulness
When feeling anxious, a person can spend a significant amount of time
caught up in anxiety-provoking thoughts. Mindfulness guides us to
bring our attention back to the present moment and unhook from
thoughts that may be unhelpful.
Mindfulness is becoming more and more popular as people start to
realize how beneficial it is for a number of issues. There are many
resources available to support you to develop a mindfulness practice.

2. Relaxation techniques
A person who feels anxious most of the time has trouble relaxing, but
knowing how to release muscle tension can be a helpful strategy.
Relaxation techniques include:
 progressive muscle relaxation
 abdominal breathing
 isometric relaxation exercises.

3. Correct breathing techniques

 The physical symptoms of anxiety may be triggered by
hyperventilation, which raises oxygen levels and reduces the
amount of carbon dioxide in the blood. Carbon dioxide assists in
the regulation of the body’s reaction to anxiety and panic.
 It can be helpful for a person who suffers from anxiety to learn
how to breathe from their diaphragm, rather than their chest, to
safeguard against hyperventilation. The key is allowing your belly
to expand as you breathe in.
 You can make sure you are breathing correctly by placing one hand
on your lower abdomen and the other on your chest. Correct
 breathing means your abdomen moves, rather than your chest. It
also helps to slow your breathing while feeling anxious.
 Some people can find abdominal breathing challenging. There are
many other breathing techniques that you can try. You can also try
to hold your breath for a few seconds. This helps to boost carbon
dioxide levels in the blood.

4. Cognitive therapy
 Cognitive therapy focuses on changing patterns of thinking and
beliefs that are associated with, and trigger, anxiety. For example, a
person with a social phobia may make their anxiety worse by
negative thoughts such as, ‘Everyone thinks I’m boring’.
 The basis of cognitive therapy is that beliefs trigger thoughts,
which then trigger feelings and produce behaviors. For example,
let’s say you believe (perhaps unconsciously) that you must be
liked by everyone in order to feel worthwhile. If someone turns
away from you in mid-conversation, you may think, ‘This person
hates me’, which makes you feel anxious.
 Cognitive therapy strategies include rational ‘self-talk’, reality
testing, attention training, cognitive challenging and cognitive
restructuring. This includes monitoring your self-talk, challenging
unhelpful fears and beliefs, and testing out the reality of negative
thoughts.

5. Behavior therapy
A major component of behavior therapy is exposure. Exposure therapy
involves deliberately confronting your fears in order to desensitize
yourself. Exposure allows you to train yourself to redefine the danger or
fear aspect of the situation or trigger.
The steps of exposure therapy may include:
 Rank your fears in order, from most to least threatening.
 Choose to work first on one of your least threatening fears.
  Think about the feared situation. Imagine yourself experiencing the
situation. Analyse your fears -– what are you afraid of?
 Work out a plan that includes a number of small steps – for
example, gradually decrease the distance between yourself and the
feared situation or object, or gradually increase the amount of time
spent in the feared situation.
 Resist the urge to leave. Use relaxation, breathing techniques and
coping statements to help manage your anxiety.
 Afterwards, appreciate that nothing bad happened.
 Repeat the exposure as often as you can to build confidence that
you can cope.
 When you are ready, tackle another feared situation in the same
step-by-step manner.

6. Dietary adjustments
 The mineral magnesium helps muscle tissue to relax, and a
magnesium deficiency can contribute to anxiety, depression and
insomnia. Inadequate intake of vitamin B and calcium can also
exacerbate anxiety symptoms. Make sure your daily diet includes
foods such as wholegrain cereals, leafy green vegetables and low-
fat dairy products.
 Nicotine, caffeine and stimulant drugs (such as those that contain
caffeine) trigger your adrenal glands to release adrenaline, which is
one of the main stress chemicals. These are best avoided. Other
foods to avoid include salt and artificial additives, such as
preservatives. Choose fresh, unprocessed foods whenever possible.
7. Exercise
The physical symptoms of anxiety are caused by the ‘flight-or-fight’
response, which floods the body with adrenaline and other stress
chemicals. Exercise burns up stress chemicals and promotes relaxation.
Physical activity is another helpful way to manage anxiety. Aim to do
some physical activity at least three to four times every week, and vary
your activities to avoid boredom.

8. Learning to be assertive
Being assertive means communicating your needs, wants, feelings,
beliefs and opinions to others in a direct and honest manner without
intentionally hurting anyone’s feelings. A person with an anxiety
disorder may have trouble being assertive because they are afraid of
conflict or believe they have no right to speak up. However, relating
passively to others lowers self-confidence and reinforces anxiety.
Learning to behave assertively is central to developing a stronger self-
esteem.

9. Building self-esteem
People with anxiety disorder often have low self-esteem. Feeling
worthless can make the anxiety worse in many ways. It can trigger a
passive style of interacting with others and foster a fear of being judged
harshly. Low self-esteem may also be related to the impact of the
anxiety disorder on your life. These problems may include:
 isolation
 feelings of shame and guilt
 depressed mood
 difficulties in functioning at school, work or in social situations.
The good news is you can take steps to learn about and improve your
self-esteem. Community support organizations and counselling may
help you to cope with these problems.

10. Structured problem solving

Some people with anxiety disorders are ‘worriers’, who fret about a
problem rather than actively solve it. Learning how to break down a
problem into its various components – and then decide on a course of
action – is a valuable skill that can help manage generalized anxiety and
depression. This is known as structured problem solving.

11. Medication
It is important that medications are seen as a short-term measure, rather
than the solution to anxiety disorders.
Research studies have shown that psychological therapies, such as
cognitive behavior therapy, are much more effective than medications in
managing anxiety disorders in the long term. Your doctor may prescribe
a brief course of tranquillizers or antidepressants to help you deal with
your symptoms while other treatment options are given a chance to take
effect.

Self-Help, Coping, and Managing

1. Keep physically active.

 Develop a routine so that you're physically active most days of the
week. Exercise is a powerful stress reducer. It can improve your
mood and help you stay healthy. Start out slowly, and gradually
increase the amount and intensity of your activities.

2. Avoid alcohol and recreational drugs.

 These substances can cause or worsen anxiety. If you can't quit on
your own, see your health care provider or find a support group to
help you.
3. Quit smoking, and cut back or quit drinking caffeinated
beverages.
 Nicotine and caffeine can worsen anxiety.

4. Use stress management and relaxation techniques.

 Visualization techniques, meditation and yoga are examples of
relaxation techniques that can ease anxiety.

5. Make sleep a priority.

 Do what you can to make sure you're getting enough sleep to feel
rested. If you aren't sleeping well, talk with your health care
provider.

6. Eat healthy foods.

 A healthy diet that incorporates vegetables, fruits, whole grains and
fish may be linked to reduced anxiety, but more research is needed.

7. Learn about your disorder.

 Talk to your health care provider to find out what might be causing
your specific condition and what treatments might be best for you.
Involve your family and friends, and ask for their support.

8. Stick to your treatment plan.

 Take medications as directed. Keep therapy appointments and
complete any assignments your therapist gives. Consistency can
make a big difference, especially when it comes to taking your
medication.
9. Identify triggers.
 Learn what situations or actions cause you stress or increase your
anxiety. Practice the strategies you developed with your mental
health provider so you're ready to deal with anxious feelings in
these situations.

10. Keep a journal.

 Keeping track of your personal life can help you and your mental
health provider identify what’s causing you stress and what seems
to help you feel better.

11. Socialize
 Don’t let worries isolate you from loved ones or activities.
 PROGNOSIS

The evolution of anxiety disorders depends on many factors, although a

significant reduction in symptoms and discomfort is usually achieved.
In general, starting treatment when the disorder appears can help
prevent it from becoming chronic and from other anxiety disorders and
mental or physical disorders appearing. However, even in cases where
the person has suffered from an anxiety disorder for years, starting a
treatment can have significant benefits.
Many of these disorders begin in childhood and adolescence, so it is
especially important that children and young people access the
recommended treatments.
When an improvement in symptoms is achieved, professionals must
continue working with the person with the disorder to prevent their
relapse. This means that the final part of the treatment should focus on
identifying any difficulties or mild symptoms that may appear once the
treatment is finished, so that the person can face and overcome these
problems, therefore avoiding a recurrence of the disorder.
If the treatment received by the person suffering an anxiety disorder is
not adequate, their symptoms may not disappear, but with proper
treatment most people with anxiety disorders do improve.
 COMMON MISCONCEPTIONS
Myth: Anxiety is just worrying too much.
Fact: There is a difference between those feelings of nervousness in
certain situations and becoming so anxious that it interferes with your
life and turns into an intense feeling of fear.

Myth: Less stress will cure anxiety

Fact: Removing stress from your life (which is impossible) won’t
completely remove your anxiety. Finding ways to live a less stressful
lifestyle will help your symptoms, but it won’t completely cure how you
are feeling. Anxiety disorders aren’t caused by stress (although, it
doesn’t help), it’s a combination of three factors; genetic, environmental
and brain chemistry.

Myth: Anxiety only affects your mind

Fact: Anxiety can affect you both physically and mentally. Symptoms
of anxiety could include: an increased heartrate, rapid breathing or
difficulty breathing, muscle aches and tension, feeling sick, headaches

Myth: Exercise won’t help reduce anxiety

Fact: Studies show that although the effects of exercise may be
temporary, a brisk walk or other simple activity can deliver several
hours of relief, similar to taking an aspirin for a headache. Physical
activity can also increase self-confidence, help you relax and can even
improve your sleep, which in turn will reduce your feelings of anxiety.

Myth: Medication is the only treatment for anxiety

Fact: Being prescribed medication isn’t the only route to go down to
treat anxiety disorders. Psychological treatments such as cognitive
behavioral therapy (CBT) has been reported to help those with
generalized anxiety disorder; with the benefits lasting longer that those
of medication.
 BIBLIOGRAPHY
 https://www.mayoclinic.org/
 https://my.clevelandclinic.org/
 https://www.axahealth.co.uk/
 https://helpguide.org/
 https://www.psychiatry.org/
 https://www.nimh.nih.gov/
 https://en.wikipedia.org/
 https://www.nhs.uk/
 https://www.samhsa.gov/
 https://kidshealth.org/
 https://medlineplus.gov/
 https://www.mayoclinichealthsystem.org/
 NCERT Class 12 Psychology Text Book