Anxiety is the body and mind’s natural reaction to threat or danger. In certain cases, high levels of anxiety are considered normal and helpful if they prompt an escape from danger. In situations such as interviews and exams, anxiety can enhance performance.
When anxiety becomes excessive or debilitating, however, it is then considered an Anxiety Disorder. In recent decades, there has been a dramatic improvement in our understanding of anxiety and how it can be treated.
In primary Anxiety Disorders, the symptoms tend to have followed a set pattern over several months or years. The symptoms occur independently of other mental health problems.
Subtypes of Anxiety Disorder
There are six recognised groups of anxiety disorders:
Panic Disorder is sudden episodes of acute severe anxiety/panic associated with a fear of death or collapse. The key feature of the disorder is the sudden onset, occurring “out of the blue”, with no identifiable trigger. It can be accompanied with a persistent concern about future attacks and consequences of the attack.
A fear of being away from a place of safety, often associated with panic. Sufferers can become house-bound or confined to small “safe” areas.
Excessive anxiety and self-consciousness in social situations with a central fear of being judged negatively harshly or appearing foolish. It leads to avoidance of performance situations as well as hiding away in social gatherings.
Generalised Anxiety Disorder (GAD)
A disorder of uncontrolled worrying, spread across numerous everyday themes. Sufferers constantly agonise over what they anticipate might go wrong in the future, causing distress, sleep disturbance and exhaustion.
Post-Traumatic Stress Disorder (PTSD)
A carefully defined disorder resulting from a trauma such as a road traffic accident or an assault. Sufferers are troubled with intrusive memories or flash-backs of the incident and they are on a state of high alert.
Obsessive Compulsive Disorder (OCD)
A complex and disruptive disorder in which sufferers feel compelled to ward off contamination, disaster or other negative events by carrying out time consuming rituals such as washing, checking or ruminating.
Common obsessions include:
- Fears of getting a disease, e.g. cancer, AIDS
- Fears about dirt, germs and contamination
- Fears of harming others, especially a loved one
- Inordinate concern with order, arrangement or symmetry
- Fears that things are not safe, especially household appliances
The Anxiety Disorders Service is a comprehensive, multi-disciplinary, assessment, treatment and aftercare service for sufferers from primary Anxiety Disorders. It aims to deliver the best available treatments for anxiety in an accessible and flexible way as well as providing follow up care and support for those that need it.
Anxiety Disorders Programme
The Anxiety Disorders Programme was established by St Patrick’s Mental Health Services in April 2005 and caters for a wide range of anxiety disorders. It is delivered by a multidisciplinary team catering for adult anxiety sufferers, offering service users a combination of cognitive behavioural therapy (CBT), psychiatry, and occupational therapy to assist them to manage the disorder.
The aims of the programme include increasing knowledge and understanding through psycho-education and group psychotherapy. Additionally, it provides anxiety sufferers with the opportunity to learn skills and strategies to help overcome their difficulties.
It focuses on addressing the physical, psychological and behavioural aspects of the anxiety disorder using group psychotherapy. The therapeutic framework of the programme is based on cognitive behavioural therapy models and mindfulness and self-compassion approaches.
The groups are run over three days allowing for goal work and continued therapy to take place outside of the active group setting. This is an important component of the programme which links in with the service user’s weekly goals set in group psychotherapy.
Group work focuses on the cognitive behavioural models for anxiety and working through the thoughts and behaviours that maintain the anxiety and distress. Goal planning, setting and review are a key feature of group work. Other groups include behavioual workshops, compassionate mindfulness practice, stress vulnerability, relapse prevention and medical theoretical input.
Mindfulness and self-compassion practice is an established component in the programme and has been integrated into the various cognitive models over the past ten years. This is predominantly a meditative experiential practice group however other aims include teaching service users to take care of themselves so they are able to live fuller and healthier lives. The practice facilitates changes in the service user’s perception of the source and nature of their difficulties, and their responses to them. Additionally, it promotes a way of being that helps service users manage and ‘be with' difficult sensations, emotions and cognitions.
Level 1 is accessed following assessment with the Clinical Nurse Specialist. This is an open five week programme, three days attendance weekly where the psychotherapy groups are facilitated on Monday, Tuesday & Wednesday. Level 1 comprises of two streams
- OCD Group
- GASPP Group (panic, social anxiety, GAD, phobias)
Level 2 is a closed eight week psychotherapy programme that focuses on the deeper formulation and experiential process. The commitment is one day attendance weekly.
Level 3 is the afterare/follow up group that runs monthly. This commitment is for a half day attendance monthly.
All levels of the programme are open to both inpatient and day patients.
Anxiety Disorders Programme
The Programme is facilitated in the Thomson Centre, St Patrick’s University Hospital.
In addition, specialised anxiety disorder assessments and individual cognitive behavioural psychotherapy is provided at Dean St Patrick’s Clinic.
There is a very good atmosphere at St Patrick's. Communication is very good between patients and staff and should be maintained on an informal basis. The food is very good and is a great morale booster for everyone.
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