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Mental disorders
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Help Lien : la phobie sociale Lien : Social Phobia(Social Anxiety Disorder) Lien : Spotlight on Social Anxiety Disorder
Lien: L'agoraphobie Lien: What is Agoraphobia?

Specific phobias are regarded as the forms of anxiety disorder that can be treated effectively with cognitive-behvaioural therapy (CBT). Significant improvements can be seen in the course of a single 2 to 3-hour session of CBT. In these sessions, the patient is exposed to the feared stimulus gradually, in a safe setting, until this stimulus no longer produces a fear reaction. CBT has even been found to be just as effective when administered by means of a “self-help” book.

In contrast, studies indicate that medications such as the antidepressants and anxiolytics that are effective for treating most other anxiety disorders have little effect on specific phobias.

Tool : Treating Anxiety Disorders

People who manage to avoid the things or situations that are the subject of their phobias can sometimes lead relatively normal lives. But people who have to take excessive steps to avoid these things or situations are regarded as functioning pathologically, and it is essential for them to seek help.


Unlike a panic attack, where the stimulus that causes the emotional reaction is diffuse or unconscious, a phobia is a fear that is irrational but that is consciously triggered by a specific stimulus or a particular situation.

When people are put in the presence of the thing or situation that triggers their phobia, they experience great anxiety and a pressing urge to be somewhere else. This leads them to adopt avoidance behaviours that can become serious handicaps in their social lives—for example, when someone has both social phobia and agoraphobia, the two phobias that most commonly arise from particular situations.

Social phobia is an excessive fear of being forced to play a role in society. People with social phobia are chronically afraid to speak in public, of course, but they may also experience great distress if they simply have to go to a party, or eat in a cafeteria, or write in the presence of other people, or hold a conversation, or meet someone new.

In fact, people with social phobia experience great fear at the mere thought of having to interact with other people. Social phobics are constantly afraid that they will do or say something stupid. They are unhealthily concerned about what other people may think of them. Their emotional, social, and professional lives are littered with lost opportunities, and they often end up leading solitary lives.

So we are not just talking here about simple shyness, or a slight uneasiness that someone may feel in the presence of others and that may actually help him or her mobilize the personal resources to adapt to the situation. To anxiety-provoking situations, people with social phobia actually cut themselves off from a whole range of activities, thus perpetuating the vicious cycle of their phobia.

Agoraphobia is, in some sense, even more disabling than social phobia, because with agoraphobia, the fear is triggered by the mere fact of being in public. Agoraphobics thus avoid going into stores, taking buses or subways, being in crowds, and so on.

What agoraphobics say they fear most is being stuck someplace where it would be hard to get away or to get help if they experienced a panic attack. Some people even develop their agoraphobia after experiencing an embarrassing panic attack in public.

Agoraphobia can even lead sufferers to close themselves up in the safety of their home, and some will completely refuse to come out of the house, sometimes for years on end.

There are various theories about the mechanisms that create the exaggerated fears characteristic of phobias. Many authors believe that these mechanisms may involve not only traumatic personal experiences, but also certain biological predispositions.


Lien : La panique

In treating panic disorders, as in treating most other forms of anxiety disorders, psychosocial therapies can complement medication very effectively. In these forms of therapy, patients are encouraged to understand their panic attacks and identify the things that trigger them. Relaxation therapies, for example, can provide patients with valuable tools to help them deal with the situations that make them anxious.

Tool : Treating Anxiety Disorders

Anxiety disorders arise when a person's internal alarm system starts working overtime and gets out of control. Because of the similarity of the physiological responses that accompany them, all of the anxiety disorders can be regarded as variations on the same theme—anxiety. There are some major similarities among all these disorders, but some major differences too.


Panic disorders resemble phobias and post-traumatic stress disorder in the intensely rising anxiety that they generate, but differ in that the source of this anxiety is more often internal rather than associated with any given external stimulus. Thus, whereas people with specific phobias can develop behaviours specifically designed to avoid the source of their anxiety, people with panic disorders find it much harder to do so. In fact, some patients with panic disorders develop behaviours to avoid such broad categories of locations that they are said to have panic disorder with agoraphobia.

  One common explanation of panic disorders is that they represent a form of conditioning between a particular physiological process (such as a rise in blood pressure) and a disagreeable situation (for example, being the target of verbal or physical aggression). Once this conditioning is established, whenever this physiological process (such as the rise in blood pressure) recurs, even if it is triggered by an entirely different situation (such as a discussion with one's supervisor, or in front of a large audience), it will, by association, cause the person to re-experience the disagreeable feelings that will trigger the panic attack.

The amygdala, a brain structure whose internal circuits are starting to be better understood, seems to be the part of the brain that is ideally suited to establishing this association between a physiological reaction and a threatening situation.


Lien : NATIONAL CENTER for PTSD Lien : Post-Traumatic Stress Disorder Lien : Survivors of Natural Disasters Lien : LE STRESS POST-TRAUMATIQUE (Quand le choc choque !)
Lien : L'état de stress post-traumatique Lien : "The Anatomy of Stress" Part 2 of 3" Lien : The Guide to PTSD and Drug Addiction Lien : PTSD and Nightmares

PTSD is often accompanied by depression and, in the most serious cases, a genuine risk of suicide. Like people with any other mental illness, people with PTSD will probably also tend to abuse alcohol or other drugs. Psychiatrists see this abuse as an attempt at self-medication that does not remedy anything in the long term.

Behavioural and cognitive therapies can alleviate the symptoms experienced by people who have PTSD. These forms of therapy often involve a process of desensitization, in which the patient is exposed to memories of the traumatic event in the secure setting of the psychotherapist's office. This process can help the patient to feel less afraid and eventually to manage his or her fears more effectively.

PTSD sometimes resolves itself over time, even without treatment. Thus, in a sense, the purpose of the psychotherapy is to accelerate this natural process of forgetting.

Tool : Treating Anxiety Disorders


People who experience events that involve loss of life or risk of death or serious physical injury may develop post-traumatic stress disorder (PTSD). The feelings of despair and horror associated with PTSD are manifested in the following three kinds of symptoms.

- Intrusion Symptoms

When PTSD sufferers manifest intrusion symptoms, they do not simply experience memories of the traumatic event—they cannot stop their memories from coming back to haunt them. Some of these people experience veritable flashbacks so invasive that it feels as if they are literally reliving the event. Nightmares are another form of intrusion symptoms.

- Avoidance Symptoms

When PTSD sufferers show avoidance symptoms, they try to avoid conditions and situations that might trigger memories of the traumatic event. They also tend to avoid talking about this event, so that they do not have to confront it directly. Another avoidance symptom is a dulling of the emotions, sometimes so extreme that these individuals become emotionally deadened. They lose interest in activities that they used to love, stay away from friends and family, and turn inwards on themselves.

- Overstimulation Symptoms

People with PTSD may experience many symptoms of hypervigilance that make it hard for them to concentrate and to finish the activities that they start. More specifically, these people may: experience insomnia and nervousness, tend to become frightened easily, have a constant sense of danger or imminent disaster, be highly irritable, and even engage in violent behaviour.

It was long thought that people could develop PTSD only if they were involved in disasters such as being in a plane crash, witnessing a homicide, or being trapped in a building that had collapsed in an earthquake or a bombing attack. War is in fact the main cause of PTSD, and in North America, the largest group of PTSD sufferers consists of Vietnam War veterans. Indeed, most of what we know about PTSD comes from studies of combat veterans.  

More recently, however, the list of events that may cause someone to develop PTSD has been expanded to include such experiences as being raped or being in an automobile accident.


Lien : Trouble obsessionnel-compulsif Lien : Précision des termes sur les T.O.C.

Over 90% of people with OCD have both obsessions and compulsions. Almost 50% also say they have multiple obsessions.

Cognitive-behavioural therapy
is the most effective treatment for most people with OCD. This therapy consists in exposing patients to situations that trigger their obsessions, then gradually giving them some ways of preventing the anxiety and the compulsive behaviours associated with them. For example, if someone is obsessed with cleanliness, the therapist might have him touch things that he perceives as “contaminated” until his anxiety disappears. The next step would be to have him not wash his hands after having handled a “contaminated” object.

Cognitive-behavioural therapy
for OCD typically involves 12 to 20 of these sessions, and 75% of the patients who complete the full course of treatment experience substantial, lasting relief from their obsessions and compulsions.

In the most severe cases of OCD, certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, can help prepare patients to benefit from cognitive-behavioural therapy.

Tool : Treating Anxiety Disorders Lien : Trouver de l'aide pour le TOC

People with obsessive-compulsive disorder (OCD) are the slaves of their repetitive thoughts and behaviours. These people recognize the absurdity and senselessness of these worries and rituals, but giving them up would take so much time and energy that it would seriously compromise their ability to function at work, at school, and at home.


Typically, a distinction is made between obsessions, which are intrusive, undesired thoughts, and compulsions, which are repetitive, often stereotyped actions. But obsessions and compulsions are closely related: the latter represent an attempt to calm the former.

Obsessions, then, are recurrent thoughts or mental images that impose themselves on an individual's consciousness. They resurface constantly and uncontrollably, so that the person's mind can never relax, and hence they constitute a major cause of distress.

Compulsions are repetitive behaviours in which people with OCD engage to try to drive away their obsessions and reduce the anxiety that they cause.

Compulsions tend to become stylized into sequences of elementary actions that the sufferer must perform at any cost in order to avoid anxiety and distress. Compulsions often resemble rituals in which the sequence and repetition of gestures is minutely codified and in extreme cases may even involve the patient's friends, family, and other people as well.


The following table lists the most common obsessive ideas and the corresponding compulsive behaviours.

Obsession   Compulsion
  • Fear of being contaminated by dirt, dust, germs, bacteria
  • Washing hands or entire body or cleaning objects excessively
  • Fear of losing control and hurting oneself or harming someone else
  • Engaging in slow, complex, time-consuming rituals revolving around organization and control
  • Feeling of having forgotten to do something important (turn off the faucet, lock the door, etc.)
  • Repeatedly checking whether you have done the thing in question (for instance, checking the door 100 times to see whether you have locked it)
  • Fear of having disgusting, violent, sexual, or sacrilegious thoughts
  • Reciting numbers, names, or phrases to drive away the undesired thoughts (for example, counting down from 10 then up to 10 a hundred times)
  • Need for symmetry, need to organize and save even the most useless objects
  • Tidying the house and arranging things in a certain order, saving things and being unable to throw any of them away

The factors that cause OCD are still poorly understood, but brain-imaging studies have shown abnormal activity in certain parts of the brains of OCD patients.


Lien : Generalized Anxiety Disorder Lien : L'anxiété généralisée (trouble de) (AG)

As with many other anxiety disorders, the treatments available to people who have generalized anxiety disorder (GAD) include various forms of psychotherapy, medications, or a combination of the two. It is up to each patient to talk with her doctor to see what form of treatment works best for her.

The medications prescribed for GAD include tranquilizers, such as the benzodiazepines, and antidepressants in the Prozac family.

One the most effective forms of psychotherapy used to treat GAD is cognitive re-evaluation, which helps patients to correct thinking patterns that cause them to worry. Other potentially beneficial therapeutic approaches include learning new ways to solve daily problems, confronting and gradually gaining control over one's worries, and various relaxation techniques.

In a recent Canadian study, 77% of GAD patients who had received short-term psychotherapy remained GAD-free one year after treatment.

Tool : Treating Anxiety Disorders

Generalized anxiety disorder (GAD) is manifested by worrying excessively over extended periods, about various things that are not necessarily interrelated. In other words, people with GAD worry about events that have a strong chance of never occurring.

Thus, if someone with GAD has a headache, consults the doctor about it, and is told that nothing is wrong, he or she may still worry that the cause was actually a brain tumour, and the doctor simply missed it.


In addition to illness, the most typical subjects of concern for people with GAD include being short of money, losing their jobs, and not being able to take proper care of their families, as well as more routine matters such as being late for an appointment.

But in this last case, a person with GAD might reason as follows: “If I'm late for this appointment, I might lose my job, and then I don't know how I'm going to make ends meet. I might be so broke that I'll have to sell my car.” Such trains of thought can lead to ruminations that last anywhere from a few minutes to several hours. By endlessly reviewing so many negative scenarios in this way, people with GAD become hypervigilant and highly vulnerable to environmental stressors. People with GAD are also far more susceptible to health problems involving weakening of the immune system.

Like many other anxiety disorders, generalized anxiety disorder probably has multiple causes.

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