anxiety aNGˈzīədē A feeling of worry nervousness or unease typically about an imminent event or something with an uncertain outcome D esire to do something typically accompanied by unease ID: 1045487
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1. Anxiety Disorders
2. Anxiety or Anxiety Disorder?anx·i·e·ty /aNGˈzīədē/A feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.Desire to do something, typically accompanied by unease.anx·i·e·ty dis·or·der /aNGˈzīədē disˈôrdər/Excessive and persistent fear (an emotional response to real or perceived imminent threat)Excessive and persistent anxiety (anticipation of a future threat)-DSM-5
3. Activity - Which is it?Everyday Anxiety-or- Anxiety Disorder
4. Anxiety disorders are the most common type of psychiatric disorders affecting more than 25 million Americans.-American Psychiatric Association
5. Anxiety Disorders and ID/DAnxiety Disorders in people with ID are as common or more common than in the general population (DSM-5).Diagnostic criteria relies heavily on cognitive functioning and communication, which makes diagnosis complicated especially in those with more severe degrees of ID (DM-ID-2). Diagnosis for individuals with more severe degrees of ID may rely on behavioral observation.
6. Panic DisorderAn abrupt surge of intense fear or discomfort that reaches a peak within minutes with physiological symptoms (e.g. racing heart rate, sweating, trembling). These are commonly called panic attacks.Persistent worry about additional panic attacksChange in behavior to avoid situations associated with panic attacks.
7. Panic Disorder and IDDWhat signs might we observe? What symptoms might the person express?Grabbing chestBreathing rapidly/hardNauseaDizzinessPersistent expressed fear of having a ‘heart attack’ Avoidance of situations that bring on panic attacksAvoidance of exerciseHow would these signs differ for someone who does not use words to communicate? Uncontrollable screaming/cryingRefusal of activities
8. Social Anxiety DisorderMarked and persistent fear or anxiety about social situations that involve scrutiny by others. Examples include social interactions, being observed, and preforming in front of others. Fear of being humiliated, embarrassed, or rejected Social situations are avoided or endured with intense fear or anxiety.The fear or anxiety is out of proportion with the threat posed by the social situation.The fear and anxiety cause significant problems in areas of their life, such as social interactions, school, and work.
9. Social Anxiety Disorder and IDDWhat signs might we observe? What symptoms might the person express?Hides face during social interactionsRefusal to eat anywhere but at homeConstant need to cling to Designated Person in a social situationExpressed dislike for social activitiesEmotional dysregulation during social situations
10. Generalized Anxiety DisorderExcessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances.
11. Generalized Anxiety DisorderThe individual finds it difficult to control the worryThe fear and anxiety cause significant problems in areas of their life, such as social interactions, school, and work.Associated with three or more of these symptoms:Restlessness (feeling keyed up or on edge)Easily fatiguedDifficulty concentratingIrritabilityMuscle TensionSleep disturbance (difficulty falling asleep, staying asleep, or restlessness)
12. Generalized Anxiety Disorder and IDDWhat signs might we observe? What symptoms might the person express?Constant pacing (restlessness) or refusal to get out of bed (fatigue)Difficulties attending to a task, needs to switch tasks frequentlyEasily angered (quick fuse)Physical complaints (muscle soreness, headaches)Sleep issues (staying asleep/falling asleep)Expresses worry frequently (e.g. constantly worried about being late)
13. Diagnosis → TreatmentThe person I support has been diagnosed. They are taking medications, shouldn’t that fix all of the symptoms?
14. Treatment-National Institute of Mental Health
15. TreatmentIn the UK, clinical guidance identifies stepped interventions where non-pharmacological interventions are recommended first and medications are a last resort (Dagnan, Jackson, & Eastlake, 2018).One meta-analysis indicates the combination of psychotherapy and pharmacology may substantially improve quality of life (Bandelow, Michaelis, & Wedekind, 2017).
16. Not a therapist? You can still help!Proactive SupportsHelp the person you support to get active!Encourage non-caffeinated beverages (modeling is powerful!)Offer a healthy diet (modeling is powerful!) Encourage good sleep habitsMeditation
17. Not a therapist? You can still help!When the person you support is experiencing an anxiety response here are some helpful things you can do:Model deep breaths to help the person slow their breathingHelp the person feel safeDuring panic attacks remind the person it is temporary and will passHelp re-frame negative thoughts while honoring the person’s feelingsUse a distraction
18. Is the treatment working?Best practice is to utilize data-based decision making to determine if the treatment protocol is working not only for psychiatric medications (Mikkelsen, 2007) but also for behavioral interventions (Sailor, Dunlap, Sugai, & Horner, 2009).
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