Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC

Executive Director, AllCEUs

Objectives

~ Explore common causes for anxiety symptoms

~ Identify common triggers for anxiety

~ Identify current best practices for anxiety management including

~ Counseling Interventions

~ Medications

~ Physical Interventions

~ Supportive Treatments

~ Anxiety can be debilitating

~ Low-grade chronic stress/anxiety erodes energy and ability to concentrate

~ Anxiety is a major trigger for:

~ Addiction relapse

~ Increased physical pain

~ Sleep problems

Triggers for Anxiety

~ Abandonment & Rejection

~ Low self-esteem

~ Irrational thoughts and cognitive distortions

~ Unhealthy social supports/relationships

~ Ineffective interpersonal skills  relationship turmoil and/or social anxiety

~ The unknown & Loss of control

~ Negative self talk and cognitive distortions

~ Negative others

~ Physical complaints

~ Sense of powerlessness

~ Death & Loss

~ People and pets

~ Jobs and promotions

~ Safety and security

~ Dreams and hopes

~ Sickness, spiders and other phobias

~ Failure

~ Perfectionism

~ Negative self-talk

~ Anxiety, depression and substance disorders as well as a range of physical disorders are often comorbid. This provides researchers key opportunities to explore pathways to mental disorders and provides clinicians key opportunities to intervene accordingly.

~ Anxiety disorders should be treated with psychological therapy, pharmacotherapy, or a combination of both.

~ Cognitive behavioral therapy can be regarded as the psychotherapy with the highest level of evidence.

~ Current conceptualization of the etiology of anxiety disorders includes an interaction of psychosocial factors such as childhood adversity or stressful events, and a genetic vulnerability.

General Treatment Recommendations

~ Current conceptualization of the etiology of anxiety disorders indicates clinicians need to explore the interaction of:

~ Psychosocial factors such as:

~ Childhood adversity or stressful events

~ Trauma related brain changes

~ Coping skills (learned or not learned)

~ Trauma issues still needing to be dealt with (domestic violence, parental absence, bullying…)

~ Current stressors

~ Current availability of social support

General Treatment Recommendations

~ Current conceptualization of the etiology of anxiety disorders includes an interaction of:

~ Genetic vulnerability

~ Medications

~ Susceptibility to effects and development of dependence

~ Which medications will be effective

~ Vulnerabilities – Which conditions are more challenging for each person

Medications

~ First-line drugs are the SSRIs and SNRIs

~ Effexor was effective according to the Hamilton Rating Scale for Anxiety

~ Zoloft, Paxil, Luvox, Lexapro, Celexa have all been found effective.

~ At least 4 different genetic variations can be correlated with development of generalized anxiety disorder. Different medications are more or less effective depending upon the genetic makeup of the person.

~ There is a higher mortality rate among benzodiazepines users compared with nonusers.

~ There is an increased risk for dependence with use for more than 6 months.

~ An increased risk of dementia was also identified in long-term (>6 months) benzodiazepine users.

~ Benzodiazepines do not treat depression, and may be associated with a higher suicide risk in comorbid anxiety and depressive disorders.

~ Other treatment options include tricyclic antidepressants, seroq