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Anxiety disorders – phobic and panic anxiety
Anxiety is basically a normal bodily response that enables us to face threats. An anxiety disorder is when anxiety becomes so intense and frequent that it interferes with everyday functioning. Treatments with good results are available.
Symptoms
Anxiety disorders is a collective term for mental disorders characterized by anxiety or fear. Some anxiety disorders are associated with specific objects or situations (phobic anxiety), being critically judged by others (social anxiety), or becoming ill (health anxiety). Anxiety disorders may be characterized by persistent worries, restlessness, agitation, and irritability (generalized anxiety). Anxiety may also occur as sudden attacks with intense physical reactions (panic anxiety).
Different anxiety disorders
Different anxiety disorders have many features in common, but also some distinctive characteristics:
In social anxiety disorder, people fear situations in which they risk being subjected to other people’s critical gaze and being judged as nervous, weak, or stupid.
Panic disorder is characterized by sudden attacks of intense fear that something terrible will happen, accompanied by severe physical discomfort and persistent fear of further attacks.
Some people also develop agoraphobia, with an intense fear of leaving home and being in public places, such as cinemas, shopping centres, buses, and trains, where it is difficult to get away quickly.
Generalized anxiety disorder is characterized by feeling anxious much of the time, constantly worrying about bad things that might happen, and feeling restless and agitated.
Health anxiety, or hypochondria, is a persistent and disabling fear of having or developing a serious illness.
Post-traumatic stress disorder occurs as an aftereffect of extremely frightening events, such as disasters, serious accidents, abuse, and rape. The threat is relived as intrusive and distressing memories and intense physical arousal.
A key feature of anxiety disorders is the development of avoidance behaviour, in which people avoid places or situations they believe will trigger their anxiety. Avoidance is one reason the anxiety persists and is the biggest problem for the person’s daily functioning.
Anxiety is characterized by specific bodily reactions and thought patterns.
Bodily reactions: Increased heart rate, palpitations, tension, trembling, sweating, and rapid breathing. An anxiety attack may be accompanied by dizziness, seeing spots, nausea, a sense of unreality, numbness, and chest pain. These reactions are all harmless, but frightening.
Thought patterns: There is a connection between thoughts, physical arousal, and feelings of anxiety. Thoughts can create anxiety, cause it to intensify, and help maintain it. A stream of worried thoughts can sustain stress in the body and a sense of danger and lack of control. Catastrophic thoughts are frightening thoughts about being unable to cope with a situation or something being seriously wrong with the body, such as “I’m going to faint!” or “I’m making a fool of myself!”
Referral and assessment
To receive treatment in specialist healthcare services, you need a referral. Your GP is usually the person who refers you for assessment and treatment, but other healthcare professionals can also refer you. Based on the prioritisation guide, we willMental healthcare for adultsdetermine whether you are entitled to treatment in specialist healthcare services.
All referrals should include:
Current medical history
Relevant past and current illnesses
Clinical findings
Results of relevant additional examinations
Updated medication list
(When using the “good referral” template integrated into most electronic patient record systems, the points above are covered)
Description of the current medical history and progress to date: onset, causes, symptoms, current treatment, progress
Description of functioning, work situation, quality of life, relationship/family functioning, and care of children
Substance use problems?
Suicidality?
Results of any tests (BAI/BDI, MADRS)
Assessment:
Provisional diagnosis, suicide risk, understanding of the problem, prognosis.
Remember
When referring children or patients who lack the capacity to consent, include contact information for their guardians
Early in the course of treatment, the hospital clinician will focus on assessing how anxiety affects you and how it has developed over time. To gain insight into this, the clinician will want to find out:
How does anxiety affect your everyday functioning?
How long have you been troubled by anxiety?
Are there specific events that triggered your anxiety?
Whether you also have other concurrent mental health problems
Is your anxiety limited to certain situations or things?
What is your situation in life otherwise?
Whether you know of others in your family who have the same type of problems
The assessment often includes:
Your personal history
Medical history (anamnesis)
Structured clinical interview
An assessment and diagnosis must be completed within 6 weeks of your first appointment. The first consultations will therefore focus on assessment. For more complex conditions, the assessment period is extended to 12 weeks.
Treatment
Treatment for anxiety usually consists of a combination of different measures. An important principle of anxiety treatment is that you gradually learn to expose yourself to and manage situations that trigger anxiety. This means that you take an active part in planning and carrying out your own treatment.
Treatment is provided individually, in a group, or online. Relatives may take part in some sessions if needed.
Shared decision-making
You and your healthcare professional can decide together what is best for you. This is called shared decision-making. Taking part in decisions is your right.
Shared decision-making means that you receive information about the advantages and disadvantages of the different options. You can then weigh them up with your healthcare professional based on what matters to you.
Here are three questions you can ask your healthcare professional:
What options do I have?
What are the possible advantages and disadvantages of these options?
How likely is it that these advantages and disadvantages will apply to me?
Cognitive therapy and medication are the main treatments for phobic anxiety and panic disorder. Psychoeducation and exposure therapy may be part of cognitive therapy.
Treatment can be provided individually or in a group.
After completing treatment with us in specialist healthcare services, you may benefit from follow-up care from your GP and other healthcare professionals in primary healthcare services. A useful tool is a relapse prevention plan, with practical steps you can take based on your experience of what helps.
If needed, your primary healthcare provider can consult us for professional advice. You can also discuss the possibility of a new referral if appropriate.
You can reach our locations by public transport. Visit Agder public transport to find your route:akt.no
You may be entitled to reimbursement of necessary expenses when travelling to and from your treatment location.
As a general rule, you should use public transport, and you will have to pay a deductible. To claim reimbursement for travel expenses you have paid, you must complete a travel expense form and send it toPatient travel.
Practical information
Is your appointment inconvenient? If you receive your appointment letter digitally at helsenorge.no, you can now send a message directly to the department you are due to visit if you need to reschedule your appointment. You must be a registered user of helsenorge to access the service. You can also contact the department where you have an appointment or call the switchboard on:38 07 30 00
Visiting hours may vary between departments and locations. Please contact the department where you have an appointment for more information.
Kristiansand: 17:00–19:00 on weekdays 14:00–16:00 and 18:00–19:00 on weekends and public holidays
Postnatal ward: 16:00–18:00 every day for the newborn’s healthy siblings.
Many patients and relatives want to take photos/videos or blog about their time in hospital. This is of course permitted, provided you respect the privacy of other patients and staff.
Here are a couple of helpful tips on using social media for patients and relatives:
Be considerate of others. You must obtain consent if you want to take photos or videos of patients or staff. All patients are entitled to privacy while in hospital.
Parents/guardians decide whether you may take photos of children or publish photos of their children online. Parents should consider what is in the child’s best interests. Once a child has turned 12, their views must be given significant weight. Once a child has turned 15, they decide for themselves whether they are happy to be photographed and whether the photos may be published.
Remember that staff must also give their permission if you want to publish photos you have taken of them.
You should remove content you have published if the person concerned asks you to. If someone has posted photos of you online without permission, you can ask them to delete them. If they do not comply, you can contact:www.slettmeg.no.
Audio recordings It is not illegal to record conversations in which you participate for private use. However, publishing and sharing recordings requires the consent of the person you are speaking with. Secretly recording conversations in which you do not participate is illegal.
We encourage everyone to use their mobile phones considerately and to be mindful of fellow patients. It is important to put your phone on silent at night and on silent or vibrate during the day. To avoid disturbing other patients, it is a good idea to leave the room if you need to have a long conversation.
Smoking can cause discomfort to others. Thank you for being considerate and helping to ensure that Sørlandet Hospital is a smoke-free environment.
If you need an interpreter, please inform the hospital well in advance of your appointment. Interpreter costs are covered by the health service.Helsenorge.no