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Anxiety disorders in adults – generalised
Anxiety is essentially a normal bodily response that enables us to deal with threats. An anxiety disorder occurs when anxiety becomes so intense and frequent that it interferes with everyday functioning. Effective treatments are available.
Generalised anxiety disorder (GAD) causes you to worry so much that it affects your everyday life. The worries are often vague and can be about many different things. Effective treatment is available.
Anxiety disorders is a collective term for mental disorders characterised 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 characterised by persistent worry, restlessness, unease and irritability (generalised anxiety). Anxiety can also occur as sudden attacks with intense physical reactions (panic disorder).
Different anxiety disorders
Different anxiety disorders have many features in common, but also some distinctive characteristics:
With 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 characterised 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.
Generalised anxiety disorder is characterised by being very anxious, constantly worrying about bad things that might happen, and feeling uneasy and restless.
Health anxiety or hypochondria is a persistent and debilitating fear of having, or developing, a serious illness.
Post-traumatic stress disorder occurs as a consequence 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 central 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 why anxiety persists, and is the greatest obstacle to the person’s everyday functioning.
Anxiety is characterised 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 harmless, but frightening.
Thought patterns: There is a connection between thoughts, physical arousal and feelings of anxiety. Thoughts can cause anxiety, make it worse and help maintain it. A stream of worry 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, for example, “I’m going to faint!” or “I’m making a fool of myself!”
Referral and assessment
To receive treatment from specialist health services, you need a referral. Your GP is usually the one who refers you for assessment and treatment, but other healthcare professionals can also refer you. Based on the referral and the priority-setting guide "Mental health care for adults", we will assess whether you are entitled to treatment from specialist health services
All referrals should include:
current medical history
relevant past and present illnesses
clinical findings
results of relevant supplementary examinations
up-to-date medication list
(When using the “good referral” template, which is integrated into most electronic patient record systems, the points above are covered.)
Specific to anxiety disorders in adults – generalised
description of the current medical history and course to date: onset, causes, symptoms, current treatment, course
impact on functioning, work situation, quality of life and relationships/family functioning, responsibility for 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 without the capacity to consent – contact details for their guardians
Early in the course of treatment, your clinician will focus on assessing how anxiety affects you and how it has developed over time. To gain insight into this, your clinician will want to find out:
How does anxiety affect your everyday functioning?
How long have you been troubled by anxiety?
Are there any specific events that triggered your anxiety?
Do you have any other mental health difficulties at the same time?
Is your anxiety limited to certain situations or objects?
How is the rest of your life situation?
Whether you know of other family members with the same type of problems.
During the assessment phase, it is important to conduct a thorough evaluation, so the assessment will include:
Your personal history.
Information about your medical history (anamnesis).
Relevant tests and interviews, known professionally as structured diagnostic interviews.
Relevant forms for you to complete yourself (self-report questionnaires).
Your clinician may decide that it would be appropriate to gather information from others who know you well and can describe things they may have noticed that you may not have been aware of yourself. This requires your consent to gather such information.
The assessment and diagnosis must be completed within 6 weeks of your first appointment. The first consultations will therefore be used for assessment. For more complex conditions, the assessment phase is extended to 12 weeks.
Treatment
Treatment for anxiety usually consists of a combination of different measures. An important principle in anxiety treatment is that you gradually learn to expose yourself to and cope with anxiety-provoking situations. 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 parts of the treatment if needed.
Shared decision-making
If you have an anxiety disorder, there are several possible treatments. 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 are given information about the advantages and disadvantages of the different options. You can then weigh these up with your healthcare professional, based on what matters to you.
Here are three questions you can ask your clinician:
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, medication and psychomotor physiotherapy are recommended approaches for generalized anxiety disorder (GAD). Different medications may be effective for generalized anxiety disorder. These are combined with psychotherapy.
After you have completed treatment with us in specialist healthcare services, you may benefit from follow-up with your GP and other healthcare professionals in primary care. A useful tool is a relapse prevention plan, with specific actions you can take based on your experience of what helps.
If necessary, your primary care clinician can seek professional advice from us. You can also discuss the possibility of a new referral if this becomes relevant.
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 rule, you should use public transport, and you must pay a co-payment. To get reimbursed for travel expenses you have paid, you must complete a travel expense claim form and send it toPatient travel.
You can reach our locations by public transport. Visit Agder public transport to find your route:akt.no
You may be entitled to reimbursement for necessary expenses when travelling to and from your place of treatment.
As a general rule, you should use public transport, and you must pay a co-payment. To get reimbursed for travel expenses you have paid, you must complete a travel expenses claim form and send it toPatient travel.
Practical information
Does the appointment not suit you? If you receive your appointment letter digitally on helsenorge.no, you can now send a direct message to the department you are visiting if you need a new appointment time. You must be a registered user on Helsenorge to access this service. You can also contact the department where you have an appointment or call the switchboard at:38 07 30 00
Visiting hours may vary between departments and locations. Please check with 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. Of course, you are welcome to do so, as long as you respect the privacy of other patients and staff.
Here are a few tips on using social media for patients and relatives:
Be considerate of others. You must have 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 can take photos of children or publish photos of their children online. Parents should act in the child’s best interests. When the child turns 12, their views must be given considerable weight. When the child turns 15, they decide for themselves whether they are comfortable being 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 others have posted photos of you online without your permission, you can ask them to delete them. If they do not comply, you can contact:www.slettmeg.no.
Audio recording It is not illegal to record conversations you take part in for private use. However, publishing and sharing recordings requires the consent of the person you are speaking with. Secretly recording conversations you do not take part in is illegal.
We encourage everyone to use their mobile phones considerately and be mindful of their fellow patients. It is important to set your phone to silent at night, and to 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 Sørlandet Hospital maintain a smoke-free environment.
If you need an interpreter, please inform the hospital well in advance of your appointment. The cost of the interpreter is covered by the health service.Helsenorge.no
