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Someone who suffers from Obsessive-Compulsive Disorder suffers from recurring irrational, intrusive thoughts which they are unable to dispel with logical thinking or simple reason. These thoughts, or obsessions, can occur incredibly frequently and can cause great anxiety and unhappiness. Often a patient will not be able to get the thought "out of his/her head". To deal with these invasive thoughts, patients may engage in repetitive rituals, or compulsions, to reduce the anxiety they are feeling. Some common rituals include hand washing, counting, and checking but compulsive rituals can take many shapes and forms. They can also be highly debilitating, and patients suffering from OCD may spend many hours every day performing these rituals in an attempt to keep their anxiety in check. Not all sufferers engage in rituals - in some cases the condition consists only of intrusive, worrying rumination about one or two particular concerns. Worry, a feature of many anxiety disorders, is very common in OCD.
Professor Menzies has a particular interest in child, adolescent and adult OCD having led research trials of new CBT treatment procedures for these conditions at the University of Sydney over the last decade. He is one of only two Australian members of the international Obsessive-Compulsive Cognitions Working Group. He is the founder of the recently formed Australian and New Zealand OCD Research Alliance. He is the Clinical Patron of the Tasmanian Support Network for Child and Adolescent OCD. He is the co-editor of the 2003 international handbook on OCD for the prestigious Wiley Series in Clinical Psychology.
Though all of us have occasional anxious moments, people who suffer from Generalised Anxiety Disorder (GAD) experience excessive levels of anxiety, distress and tension which interferes with their capacity to live normal, happy lives. This anxiety can be continuous, and may be without apparent reason. It may include concern over events or issues unlikely to occur, and typically includes worries about everyday aspects of living like health, money, housing, children and the like. Physically, people suffering from this condition may experience interrupted sleep, muscle tension, rapid heart rate, headaches, fatigue and concentration problems, as well as an increased risk of other problems, such as depression, substance abuse or another anxiety related disorder. In general, people with GAD can be described as 'worriers'.
A phobia is an extreme and persistent fear of a specific object, situation or activity. Phobias are characterised by the enormous level of fear involved - someone who is afraid of spiders might still be able to walk through a garden, whereas someone with a phobia of spiders might find such a task terrifying and impossible. This fear cannot be rationalised or contained by the phobic, and often limits his or her capacity to function on a day to day basis. Phobias can be divided into three categories :
- Specific phobia is an extreme fear of a particular object or situation. Someone who suffers from a specific phobia might, for example, be terrified of flying, or of water, or of a particular animal or insect.
- Social phobia (also known as Social Anxiety Disorder) is fear, anxiety and tension related to the possibility, either real or perceived, of embarrassment or humiliation occurring during social interactions or public situations. Such situations might include public speaking, professional meetings, social gatherings or dating.
- Agoraphobia is an overwhelming fear of having a panic attack or losing control in some way in a difficult or potentially embarrassing situation. In particular, the individual with Agoraphobia fears being unable to escape or get help in 'unsafe' or unfamiliar settings away from the home. Severe agoraphobia can be highly debilitating, and often results in patients being housebound and unable to carry out even the most simple of tasks such as walking to the mailbox, or shopping for groceries.
Post-traumatic stress can occur in people who have experienced, witnessed or been told about a severe physical or emotional trauma or crisis. Patients who suffer from this condition find it very difficult to put the traumatic event behind them, and often experience recurring nightmares, flashbacks and hysteria or severe distress when exposed to reminders of their trauma. They may also experience difficulty sleeping, depression and emotional detachment.
Patients with Performance Anxiety suffer extreme tension and apprehension in and about situations in which they are required to perform a given task. These situations might be very public, like performing a musical recital at a concert hall, or they may be small social gatherings where the patient is required to perform a task in front of friends, peers or partners. It is not uncommon for people who are highly skilled in a particular area to suffer Performance Anxiety, and to feel that they cannot meet up to the expectations of their given audience or themselves.
Panic Disorder involves discrete, sudden and unexpected bursts of anxiety known as panic attacks. These may involve rapid heart rate, tightness in the chest, feelings of restricted airflow or suffocation, racing thoughts, sweating, nausea, and the belief that one is losing control, will collapse or go mad. Panic Attacks may be daily and may come to be associated with particular places (bus stops, trains, shopping centres, cinemas). Often Panic Disorder precedes the development of Agoraphobia as the sufferer begins to restrict their movements in order to 'stay safe'.
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