For PSP

What is Anxiety?

Anxiety is a normal human emotion and refers to distress, fear, worry, or panic about a future negative outcome, such as a danger or threat. Anxiety symptoms can include feelings of uneasiness, distress, apprehension or dread. Sometimes we experience physical symptoms of anxiety, such as headaches, stomach upset, tight muscles, or sweating.

A low to moderate degree of anxiety can improve our performance in certain situations. For example, when we realize we need to study for an upcoming test, or when we need to ensure our survival, like when we sense an approaching car as we are about to cross the road.

Anxiety Disorders are typically diagnosed when anxiety is experienced over a long period of time and when symptoms of anxiety interfere with a person’s ability to live a fulfilling life.

What is depression and what are the symptoms?

Depression is more than having the blues for a little while. The Canadian Mental Health Association describes this condition as “grappling with feelings of severe despair over an extended period of time.” The symptoms of depression include feelings of hopelessness, worthlessness, restlessness, and excessive irritability. People with depression also experience disruptions like insomnia, oversleeping, slowed thinking and moving, over- or under-eating, loss of pleasure or interest in activities, recurring thoughts of death or suicide, and sometimes unexplained physical problems, as described by the Mayo Clinic.

Depressive Disorders are typically diagnosed when symptoms of depression cause significant distress or interfere with a person’s ability to live their life in a fulfilling way. Depression is an umbrella term used to cover the spectrum of depressive disorders, including:

Seasonal Affective Disorder (SAD): This type of depression often occurs in the fall or winter months. However, SAD may occur in the summer months. The symptoms are the same as other depressive episodes, but they often occur at the same time each year.

Persistent Depressive Disorder (previously known as Dysthymia): This is a form of depression that includes the same symptoms as a major depressive episode. A person can be diagnosed with Persistent Depressive Disorder when their symptoms are present for 2 years or longer, even if that person does not experience enough depressive symptoms to meet diagnostic criteria for a major depressive episode.

Major Depressive Disorder: This is a common mood disorder that is more serious than occasional feelings of sadness. A person with Major Depressive Disorder will experience 5 or more symptoms associated with depression and these last for a 2-week period or longer. Some of the signs or symptoms associated with Major Depressive Disorder include:

• Depressed mood
  • Loss of interest or pleasure in activities you
  • once enjoyed
  • Fluctuation in appetite
  • Sleep dysregulation
  • Slowed thinking
  • Low energy
  • Fatigue
  • Irritability
  • Feelings of guilt or worthlessness
  • Difficulty concentrating
  • Suicidal thoughts or behaviours

Who gets Depression?

• Depression can develop in anyone from across the lifespan. Depression is one of the most common mental health disorders in the general public.
• Risk factors for depression can include hereditary factors, biological factors, the environment, high levels of stress, or physical illness.

What is GAD?

Generalized Anxiety Disorder (GAD) involves excessive, uncontrollable, worrying and feeling anxious or tense about several events and activities (e.g., work, finances, relationships, health). The difficulties with anxiety must last for at least 6 months.

GAD vs. normal worry

GAD is more than worry. Most people worry about things from time to time. People with GAD find that their worrying significantly affects their everyday lives. They may try to control their worry by doing things like visiting doctors frequently, asking others for reassurance, over-preparing for potential challenges, reminding others continuously about things, avoiding doing new things, or taking on new challenges or opportunities to avoid worrying about something else.

What are the symptoms of GAD?

• A person with GAD persistently finds it difficult to relax and control their worry about several different events. The difficulties occur on most days and last for many months. The symptoms experienced may include fatigue, difficulty sleeping, restlessness, difficulty concentrating, muscle tension, and irritability.
• A person with GAD may not always recognize that their worries or tension levels are excessive or that their level of anxiety is disproportionate to the actual likelihood of the worrisome/feared event occurring. For example, a person with GAD may worry each day that their car will break down, despite the fact that their car is well maintained and has not broken down in the past.
• For a person with GAD, worries are typically related to various fears and concerns about what might happen in the future. For example, a person with GAD may worry about their ability to cope with a future illness or their fear of performing in front of colleagues at an upcoming meeting. Their worries are not confined to a specific situation (e.g., social settings), are not about the anticipation of a panic attack, and are not obsessions (e.g., intrusive thoughts, images, or impulses).
• The worry and/or physical symptoms experienced by a person with GAD cause significant distress or impairment in ability to function in social, occupational, or other important areas.
• A person with GAD commonly experiences symptoms of other anxiety disorders, depression, or alcohol/substance abuse.

Who gets GAD?

• GAD typically develops in childhood or adolescence but can also begin in adulthood.
• GAD often develops following a stressful life event, but not everyone who experiences stressful events will develop GAD. Many people who are eventually diagnosed with GAD report a history of being described as ‘worriers’ who were overly concerned about how things would turn out and how they would cope.
• In addition to personality factors and stress, biological (e.g., genes) and environmental (e.g., parenting style) factors can also contribute to the development of GAD.

What is PD?

Panic Disorder (PD) involves the experience of fearing recurrent and unexpected panic attacks in situations that are of little danger. During a panic attack, people experience sudden and strong physical symptoms including a racing heart, hyperventilation, shaking, and upset stomach, as well as thoughts of losing control, going crazy, having a heart attack, or dying.

What is panic?

• Severe panic sensations can happen to anyone.
• In general, anxiety tends to involve worrying about future events, whereas panic tends to focus more on the present. Panic also involves feeling a sense of approaching danger, a fear of losing control, and the perception of helplessness.
• Panic attacks can be terrifying experiences. Often, people who have panic attacks will start to avoid places where they might have a panic attack and where they might also have difficulty getting help. The condition is called “Agoraphobia.”

Who gets PD?

• PD usually has a sudden onset when people are in their mid-to-late twenties; however, children can also develop PD and PD can emerge later in adulthood.
• Stressful life events are common at the time when PD first develops.

What is SAD?

Individuals with Social Anxiety Disorder (SAD; previously called Social Phobia) experience considerable anxiety and fear when in social or performance situations. Their extreme anxiety often arises with exposure to unfamiliar people or situations and results in fears of being scrutinized and judged by others. Individuals with SAD commonly avoid social interactions.

Social Anxiety is more than shyness.

Most people experience some degree of shyness from time to time. But, people with SAD find that it significantly affects their everyday lives. People with SAD often avoid doing things, meeting people, or taking on new challenges or opportunities because of their fear.

What are the symptoms of SAD?

• People with SAD usually fear acting in a way they believe will be embarrassing or humiliating. In addition, people with SAD are often afraid that others will notice their physical symptoms of anxiety (e.g., sweating, blushing).
• When people with SAD face feared social situations, their physical symptoms may take the form of a panic attack (i.e., a discrete period of intense and sudden fear, apprehension or terror, with physical symptoms such as heart palpitations, blushing, trembling, sweating and faintness).
• People may fear specific aspects of social situations, such as writing or eating in public, using public toilets, or being observed by others at work.
• People with SAD usually recognize that their fear is unreasonable or excessive.
• Many people show signs of shyness and inhibition in social situations, but people with SAD can experience considerable disruption to their daily lives, reducing their quality of life overall. Some individuals with SAD are unable to be out in public and experience significant distress when they enter social situations.
• People with SAD can experience intense distress as a result of their symptoms and may have difficulties maintaining their normal routine. People with SAD may also experience disruptions in their occupational, academic, and/or social functioning.

Who gets SAD?

• SAD typically develops in adolescence. SAD can develop after the age of 25, but such circumstances are uncommon.

What is Specific Phobia?

A person with a specific phobia (SP) experiences intense anxiety when they are exposed to a particular feared situation or object, which either leads them to avoid the situation/object or faced with intense distress.

What are the symptoms of Specific Phobia?

• The experience of intense fear that arises when one anticipates or is exposed to a specific object or situation.
• The distress experienced when exposed to the feared situation/object may take the form of a panic attack (i.e., a discrete period of intense and sudden fear, apprehension or terror, with physical symptoms such as heart palpitations, blushing, trembling, sweating, and faintness).
• People with SP usually recognize that their fear is unreasonable or excessive.
• People with SP either experience considerable distress about having the phobia and/or they avoid the feared object/situation. If the feared object/situation cannot be avoided, their normal routine will be significantly disrupted (including work, academic study, relationships, and/or social activities).
• There are 5 major SP category types, including: Animal (e.g., spiders, snakes), Natural environment (e.g., heights, storms), Blood-injection-injury (e.g., receiving an injection), Situation (e.g., elevators, enclosed spaces, flying), and Other (e.g., fear of vomiting, fear of illness).

Who gets a Specific Phobia?

• Different types of phobias tend to emerge at different life stages. For example, a fear of animals, blood, and water tends to develop in early childhood, whereas a fear of heights tends to develop in adolescence.
• Factors contributing to the development of a specific phobia may include childhood fears that are not resolved, parental modeling, or exposure to a stressful or traumatic situation, such as a natural disaster or being bitten by an animal.

In the context of mental health discussions, traumatic stress often refers to the experiences when a person is exposed to a Psychologically Traumatic Stressor. A psychologically traumatic stressor is a stressor that may cause psychological trauma, which is why such stressors are often referred to as Potentially Psychologically Traumatic. A potentially psychologically traumatic event involves a person experiencing, or believing they are about to experience, one or more potentially psychologically traumatic stressors including, but not limited to, physical or sexual assault, being in a car accident, or sudden death of a loved one.

What is a Posttraumatic Stress Injury (PTSI)?

The phrase Operational Stress Injury (OSI) was developed to decrease the stigma that can be associated with other language (e.g., mental disorder; diagnosis). OSI categorizes mental health problems that result from exposures to potentially psychologically traumatic events as “injuries”. The hope was to help make psychological injuries sustained during operational duties as legitimate as physical injuries. The phrase OSI is often used to reduce stigma and to acknowledge that while Posttraumatic Stress Disorder (PTSD) may occur from exposure to one or more potentially psychologically traumatic events, there are many other disorders that can also occur (e.g., Major Depressive Disorder and Panic Disorder). There were concerns raised that “operational” limited such injuries to symptoms following exposures that occur during active operational duty; as such, the phrase posttraumatic stress injury (PTSI) is now used as an umbrella term that includes OSIs, but PTSI includes exposures across different contexts.

Symptoms of a posttraumatic stress injury (PTSI) may occur immediately after exposure to a potentially psychologically traumatic event, but may also not occur until weeks or even months after the exposure. If symptoms occur following exposure to a potentially psychologically traumatic event, and the symptoms do not improve within a month, we recommended that you seek support.

What is Posttraumatic Stress Disorder (PTSD)?

Posttraumatic Stress Disorder (PTSD) is a mental health problem wherein a person experiences problematic symptoms after being exposed, directly or indirectly, to an actual or perceived threat against themselves or someone else. Chronic exposure to potentially psychologically traumatic events can have an effect similar to exposure to a potentially psychologically traumatic event. If symptoms occur following exposure to a potentially traumatic event and the symptoms do not improve within a month, persist, increase, or prevent a person from participating in different areas of their life, a diagnosis of PTSD may be appropriate; however, some symptoms that follow exposure to a potentially traumatic event may not indicate PTSD. If you have concerns regarding your mental health, we recommend that you speak with a medical professional, psychologist, or other mental health professional.

What are the symptoms of Posttraumatic Stress?

According the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5), the symptoms of PTSD include the following:

• Feeling like you re-experience the incident repeatedly
• Nightmares
• Impulsive behaviour
• Low mood
• Increased vigilance
• Negative beliefs or views about the world
• Feelings of anxiousness or restlessness
• Feeling on edge or that the incident could happen again
• Becoming upset when reminded of the incident
• Avoiding anything that reminds you of the event
• Withdrawing from friends and family
• Losing interest in activities that used to be enjoyable
• Being unable to feel pleasure
• Constantly worrying
• Trouble concentrating
• Irritability
• Sleep Dysregulation (e.g. difficulty falling asleep or staying asleep)
• Worrying about others trying to hurt you
• Panic symptoms (e.g., shortness of breath, increased heartrate, dizzy)
• Having fears of dying.

Who gets PTSD?

• Any person who is exposed to 1 or more potentially psychologically traumatic events is technically at risk of developing PTSD, but exposure alone is not enough to develop PTSD.
• Other factors that may play a role in developing PTSD include the number of potentially psychologically traumatic event exposures, proximity or closeness to the event(s), the length of exposure(s), and level of resources the individual has or has access to following the exposure(s).
• Certain occupations, such as those performed by Public Safety Personnel (PSP), can place these individuals at a higher risk because they can be exposed to potentially psychologically traumatic events or other elevated risk factors more frequently.