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| Division of Occupational Therapy - OT Connect Anxiety Disorders
Anxiety disorders are the most common mental illness in the United States. When suffering from an anxiety disorder, a person will experience unpleasant emotional, cognitive, behavioral, or physical experiences of stress (Cara & MacRae, 1998). Anxiety disorders are also characterized by a diffuse, unpleasant, vague sense of apprehension that result in a severe dysfunction in a person's daily activity (Rogers, 2003). Anxiety disorders are distinguished from normal anxiety when they persistently interfere with daily functioning (self-care, social life, parenting, personal relationships, and leisure activities). Many people believe that anxiety resembles fear; however, fear is an alerting signal based on a known cause, and anxiety is an unknown response (Rogers, 2003). It is important to remember that a medical condition may be involved with anxiety such as Multiple Sclerosis, Lupus, Rheumatoid Arthritis, caffeine usage, nicotine usage, hypoglycemia, PMS, and hypoxia, just to name a few. Also, if the person experiencing anxiety is using prescription drugs or illegal drugs (steroids, aspirin, cocaine, and hallucinogens), the drugs may be the cause of the anxiety (Rogers, 2003). What are common symptoms of anxiety disorders?
Age of Onset: The onset of anxiety disorders is not limited to any age group. It can be diagnosed in children and adults. Bias: Women are diagnosed with anxiety disorders twice as often as men, except with Obsessive - Compulsive Disorder, which is equal between men and women. There is not a specific cause, but anxiety disorders appear to be impacted by the social/physical environment, personality traits, or genetics. Cross - cultural research suggests that anxiety disorders exist in all human societies, but there are differences in prevalence and in the form or expression (Carson, et al, 1998). Current Medical Treatment: Medications addressing the physiological component of anxiety are prescribed in conjunction with other types of therapy. Anti-anxiety drugs and antidepressant medications are commonly prescribed. Antipsychotic drugs may also be utilized in treatment and have been proven successful (Cara & MacRae, 1998).
Occupational Therapy Involvement Education is the most important occupational therapy involvement. Occupational therapists teach the individual how to manage anxiety in order to continue functioning and to face, rather than avoid, situations that irrationally generate fear (Cara & MacRae, 1998). Occupational therapy assessments are used to find out to what extent the individual’s daily life activities are affected by the disorder. Interviews, observations, role and interest checklists, comprehensive occupational therapy assessments, and functional assessments are used frequently. Some common occupational therapy treatment interventions are assertiveness and general social skills training, community mobility/re-entry, expressive activities, functional behavior training, lifestyle alterations, cognitive approaches, and time management (Cara & MacRae, 1998). Relaxation training is a simple but effective method used to decrease anxiety. Deep breathing exercises are key to relaxing. It is important to breathe slow, inhaling through the nose, and exhaling through the mouth. Muscle relaxation allows the individual to slowly release their muscles until they reach a state of deep relaxation. Visualizing pleasant objects, scenes, memories, or mental pictures can also help the individual to relax. Treatment may occur at home if the person is homebound secondary to agoraphobia. References:
How OT Makes a Difference: Evidence-Based Practice Ginsburg, G (1998). Social anxiety in children with anxiety disorders: relation with social and emotional functioning. Journal of Abnormal Child Psychology 3:26. The aim of the study, Social anxiety in children with anxiety disorders: relation with social and emotional functioning, was to evaluate the link between social anxiety and social/emotional functioning in a clinic sample of children with anxiety disorders. More specifically, linkages between social anxiety and (a) self-perceptions of social acceptance and global self-worth, (b) positive and negative peer interactions, and (c) social skills. One hundred and fifty four children with diagnoses like social phobias, generalized anxiety disorder, agoraphobia, panic disorder, and post-traumatic stress disorder, were evaluated at a child anxiety disorder clinic. The children were administered the Social Anxiety Scale for Children – Revised (SASC-R). The results of the study were consistent with previous studies. Children who reported high levels of social anxiety perceived their social acceptance and global self-worth to be low. They also reported that the sample population demonstrated more negative interactions with peers, and were viewed as having less assertive and less responsible social skills than were children with low levels of social anxiety. The findings of this study suggested that interventions designed to alleviate children’s social anxiety should aim to reduce their socially avoidant behavior and increase their level of social skills. Occupational therapy can play a large role when dealing with children that have an anxiety disorder. An occupational therapist can work with children on social skills training, assertiveness training, and skills when interacting in a group setting. Working with children in a group can be a beneficial therapeutic treatment technique. Occupational therapy enhances social skills by increasing self-confidence through expressive activities, such as journal writing, collages, and artistic activities, to name a few. Allowing children to participate in activities they are skilled at is another technique that occupational therapists can bring into the child's life. (Anecdotal Interview of Anxiety Disorders obtained through www.adaa.org) Marc* is an individual that has had a diagnosis of Generalized Anxiety Disorder. It was this diagnosis that led him to a mental health hospital where he received Occupational Therapy (OT) during his three-week stay. Marc was treated by a Certified Occupational Therapy Assistant (COTA) six days a week and for three days a week, he was seen by an Occupational Therapist (OTR). Marc felt that his stay was worthwhile, and that the OTR and COTA were very helpful. He said that he was able to choose some of the activities that around which treatment revolved. He said, “When they gave me the choice of which activity I would rather do, I would always choose the easiest, so they started giving me two hard activities to choose from.” He stated that he was bored with one or two treatments, but that the rest of the sessions were 'pretty fun'. Marc said that the treatments usually dealt with activities that helped him make it through the day. Some examples he gave were managing his money, relieving his stress, relaxing himself, ways to cope, and things that he did to pass the time so that he wouldn’t worry so much. Marc mentioned that all of his treatment in the hospital became more challenging as his three weeks went on. He also stated that, “OT was great because I still use a few of the techniques that my therapists showed me to get through my long days.” He went on to say, “When my day takes a turn for the worse, I use several methods of relaxing that they showed me.” Marc said that since his stay at the hospital, he feels like he can cope better than he could before his stay. Marc left our interview by stating, “I was bad for a while, and even though my days seem to last long, I can deal with them easier. I can’t say that OT was the major cause of this, but they sure helped me out. I can say that I would recommend OT to everyone on the [adaa.org] message board.” *Name has been changed for interviewee protection.
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