Panic Attacks, Obsessive-Compulsive Disorder, and Social Anxiety
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a classification manual used by professionals in psychology. The profession requires knowledge of various branches of disorders to diagnose them and create a proper treatment plan. It can be achieved by analyzing three particular cases, examined according to DSM-5. Moreover, it is useful to analyze two recommended treatments for one of the clients, explaining why the information is vital for professionals in the field of psychology.
Panic attacks are classified as anxiety disorders characterized by recurrent intense panic sessions, not limited to a specific situation or circumstances. At present, the valid reasons for panic disorder development remain insufficiently recognized (American Psychiatric Association [APA], 2013). According to APA (2013), symptoms of a panic attack can appear against the background of a stressful milieu, with a genetic predisposition, in the presence of mental illness. Concerning the patient, Fred reveals that he does not have a hereditary mental illness background. According to APA (2013), possible alcoholic inheritance does not fit Fred’s case. The panic disorder trigger had become the moment when Fred was robbed at gunpoint at a subway station. However, the ground reasons are different; several risk factors can cause panic attack symptoms (APA, 2013). In Fred’s case, he experienced constant stress in the family associated with the rejection of his orientation’s close family members.
It is stated that Fred complains of daily anxiety, generally occurring when he is getting ready for work or at the end of the workday. According to the DSM-5 diagnostic guidelines (APA, 2013), attacks recur at least once a month. Another DSM-5 criterion is continuing concern about the possible emergent panic attacks (APA, 2013). The person is afraid that he or she will not be able to cope with anxiety or get help in time beforehand (APA, 2013). For this reason, many patients begin to avoid situations in which such attacks may occur, highlighted as “a significant maladaptive change in behavior related to the attacks” (APA, 2013, p. 208). Relevant to Fred, he decided to stop using the subway as it is considered dangerous. Instead, he prefers to make his way to work by bicycle, whereas the city infrastructure is not suitable. Thus, the patient can be diagnosed with panic attack disorder.
Obsessive-compulsive disorder (OCD) is an unstable condition characterized by anxious thoughts in a person. It is characterized by the appearance of continuously repeated specific ritual actions (APA, 2013). In Phil’s case, OCD symptoms appear in the form of compulsions. This disorder is marked by a pervasive concern about order, perfectionism, and control, lacking flexibility that ultimately decreases or interferes with the task (APA, 2013). At previous work, Phil was making sure displays were orderly and the clothes were correctly folded. Concerning DMV-5 criteria, OCD takes more than an hour per day or causes difficulties in society, work or study (APA, 2013). According to APA (2013), during performing compulsions, people may report “a distressing sense of “incompleteness” or uneasiness until things look, feel, or sound just right” (p. 239). For instance, Fred faced work problems since he could not stop arranging clothes by size when he had been appointed to the manager position. Consequently, it involved conflicts with Fhil’s boss and his termination.
As patients with obsessive-compulsive disorder require control, they tend to stay alone in their efforts, monitoring others’ actions. This is reflected in Phil’s inability to delegate tasks and entrust his wife to cook in the kitchen and do household chores. Compulsions have a medical significance when the patient feels overworked from performing them in response to obsessions (APA, 2013). In Phil’s case, he applied for medical help as he was stressed that he was not working; thus, the diagnosis is an obsessive-compulsive disorder.
Stacey exhibits characteristics of performance phobia and social anxiety; the latter’s features are the fear and anxiety of an individual. It is described as an “avoidant of social interactions and situations that involve the possibility of being scrutinized” (APA, 2013). Stacey’s ex-husband noted she did not perform any social interactions and interests. Anxiety becomes the cause of the nervous shock because of fear of public speaking (APA, 2013). There is a variation of constituents that can cause social anxiety. For instance, these are people’s mockery, criticism of their shortcomings, and condemnation of professional skills (APA, 2013). Relating to Stacey’s childhood, she experienced it being a target for other schoolmates to make fun of her.
A phobic disorder, especially social phobias, is the most severe in terms of its consequences on life quality. People with such phobias experience a threat and avoid social interactions, limiting their lifestyle choices and opportunities to develop and be successful (APA, 2013). One of the reasons for developing public speaking anxiety can also be justified by excessive shyness (APA, 2013). Stacey’s mother describes that Stacey was shy when she was little and tended to play alone with her dolls and stuffed animals. Nevertheless, such reasons as the emergence of neurotic diseases and strict parenting do not fit Stacey’s case. The psyche’s characteristics affect the degree of manifestation of phobia symptoms (Hooley et al., 2020). Stacey was afraid she would not perform public speaking, fearing that her classmates and teachers would make fun of her. She was paralyzed while delivering a speech; the patient’s diagnosis is a specific phobia, particularly public speaking anxiety.
Treatment for Fred
Cognitive therapy for panic disorder consists of identifying panic triggers, psychoeducation the patient, and explaining the ongoing processes from a scientific perspective. It is recommended to identify misconceptions about panic, refusal of protective behavior, and exposure. The latter displays frightening situations, which provides a person a new experience that a panic attack is manageable. Exposure reduces unfavorable outcomes as it is a crucial therapy element, allowing the patient to experience fear in a comfortable and safe environment (Hall & Lundh, 2019). It can be achieved through particular simulations and imagination. Exposure leads to a good results and recovery under the supervision of a specialist.
Psychotherapeutic sessions for treating panic attacks suggest several actions. The first is cognitive-behavioral therapy, which changes Fred’s perception of panic attacks and his behavior during them. Fear management courses are useful with a minimum of 8-10 sessions (Hall & Lundh, 2019). Besides, body-oriented psychotherapy is needed; this approach focuses on teaching relaxation and breathing control techniques to reduce anxiety during an attack (Hall & Lundh, 2019). It is required to investigate psychological trauma and suppressed emotions for an in-depth analysis of the causes and overcome increased stress (Hall & Lundh, 2019). Since panic attacks are caused by severe psycho-emotional stress in the relatives’ relationships, a counselor needs to consider conducting family sessions (Hall & Lundh, 2019). For instance, in the beginning, it should be Fred’s intimate partner. These therapy sessions can help with an attack and create a welcoming environment at home.
There is another solution for panic disorder treatment – medical therapy. Prescribing medications is advisable if the problem with attacks persists for a long time and the anxiety is intense, affecting the counseling (Guaiana et al., 2017). There are two types of drugs that can be prescribed; depending on the situation, specialists may consider benzodiazepines. These are quick-acting remedies for stopping anxiety symptoms compared to antidepressants (Guaiana et al., 2017). The disadvantage is the possibility of developing a benzodiazepine dependence (Guaiana et al., 2017). After analyzing Fred’s emotional state, in case of depression is detected, antidepressants for various groups can also be prescribed (Guaiana et al., 2017). The most in-demand are serotonin reuptake inhibitors, which significantly improve mood and suppress anxiety (Guaiana et al., 2017). Medical therapy is considered a complementary treatment for panic disorder.
Even though this approach does not solve the original problem that might return after drug withdrawal, it can bring amelioration of signs. The recommended duration of drug administration is 3 to 6 months after the therapeutic effect’s onset (Guaiana et al., 2017). When using psychotropic drugs, side effects are possible, such as drowsiness, lethargy, urinary retention, constipation or diarrhea, nausea, headaches, and dizziness (Guaiana et al., 2017). Simultaneously, adequate dosages and prescriptions of medicines strictly according to indications significantly reduce the risk of side effects.
The information from the articles can be used in maintaining the professional level of a specialist. The work requires numerous and multifaceted knowledge about a personality, suggesting different scientific explanations for the same psychological phenomena beyond the boundaries of general scientific logic. It is essential to stay current on new scientific research that may bring uncommon ways of treatment. However, it is also vital to investigate traditional approaches explored from different perspectives. Thus, specialists in psychology should have the appropriate competence and knowledge to implement their professional realization plans.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Web.
Guaiana, G., Barbui, C., Caldwell, D. M., Davies, S. J., Furukawa, T. A., Imai, H., Koesters, M., Tajika, A., Bighelli, I., Pompoli, A., & Cipriani, A. (2017). Antidepressants, benzodiazepines and azapirones for panic disorder in adults: A network meta‐analysis. The Cochrane Database of Systematic Reviews, 2017(7). Web.
Hall, C. B., & Lundh, L. G. (2019). Brief therapist-guided exposure treatment of panic attacks: A pilot study. Behavior Modification, 43(4), 564-586. Web.
Hooley, J. M., James Neal Butcher, J., N., Nock, M., & Mineka, S. (2020). Abnormal Psychology (18th ed.). Pearson.