lOMoARcPSD|1709022
lOMoARcPSD|1709022
1. Define treatment refractory anxiety.
The basic definition of treatment-refractory anxiety requires that
standard anxiety disorder treatments have been successfully
delivered and found to be either totally ineffective (no response)
or only modestly effective ( response but no remission) ( Roy-
Byrn, 2015). Ineffective treatment includes,
• failing at least one first line treatment (SSRI/SNRI)
• failing psychotherapeutic treatment like CBT which is
said to be psychotherapy with the highest level of
evidence.
• Current symptoms are in the moderate range with
impairment.
2. Describe two common comorbidities of treatment
refractory anxiety.
1) Unrecognized substance uses: Cannabis, identified as the
most widely used illicit drug, has been reported to have
both anxiogenic and anxiolytic effects. Habitual cannabis
use has been associated with anxiety disorders, it can
cause or worsen anxiety for some people. Those with
anxiety may not realize that their substance use
contributes to or worsens their symptoms. Alcohol is
another substance that may cause rebound anxiety after
drinking. Even caffeine, not typically viewed as a “drug,”
can worsen anxiety and prevent someone from feeling
better (Neuroscience Education Institute, n.d).
2) Co-occurring mental health disorders: It’s common for
people to deal with more than one mental health struggle
at a time. For example, someone with treatment-
refractory anxiety may also be suffering from personality
disorder, ADHD, trauma, abuse or posttraumatic stress
symptoms disorder. Managing multiple conditions
simultaneously can be a bit more complex, making it
more challenging to reach total symptom relief
(Neuroscience Education Institute, n.d; Bandelow, 2017).
These circumstances highlight the importance of
gathering a robust mental history prior to establishing a
treatment plan.
3. Discuss two possible approaches to treatment for
treatment refractory anxiety.
To treat refractory anxiety a clinician must fi rst re-evaluates the
client to determine if it is a case of “pseudo-resistance” or true
, lOMoARcPSD|1709022
treatment resistance anxiety. Pseudo refractory-anxiety may be
the result of insu 昀케 cient treatment, inadequate delivery of
treatment or
lOMoARcPSD|1709022
1. Define treatment refractory anxiety.
The basic definition of treatment-refractory anxiety requires that
standard anxiety disorder treatments have been successfully
delivered and found to be either totally ineffective (no response)
or only modestly effective ( response but no remission) ( Roy-
Byrn, 2015). Ineffective treatment includes,
• failing at least one first line treatment (SSRI/SNRI)
• failing psychotherapeutic treatment like CBT which is
said to be psychotherapy with the highest level of
evidence.
• Current symptoms are in the moderate range with
impairment.
2. Describe two common comorbidities of treatment
refractory anxiety.
1) Unrecognized substance uses: Cannabis, identified as the
most widely used illicit drug, has been reported to have
both anxiogenic and anxiolytic effects. Habitual cannabis
use has been associated with anxiety disorders, it can
cause or worsen anxiety for some people. Those with
anxiety may not realize that their substance use
contributes to or worsens their symptoms. Alcohol is
another substance that may cause rebound anxiety after
drinking. Even caffeine, not typically viewed as a “drug,”
can worsen anxiety and prevent someone from feeling
better (Neuroscience Education Institute, n.d).
2) Co-occurring mental health disorders: It’s common for
people to deal with more than one mental health struggle
at a time. For example, someone with treatment-
refractory anxiety may also be suffering from personality
disorder, ADHD, trauma, abuse or posttraumatic stress
symptoms disorder. Managing multiple conditions
simultaneously can be a bit more complex, making it
more challenging to reach total symptom relief
(Neuroscience Education Institute, n.d; Bandelow, 2017).
These circumstances highlight the importance of
gathering a robust mental history prior to establishing a
treatment plan.
3. Discuss two possible approaches to treatment for
treatment refractory anxiety.
To treat refractory anxiety a clinician must fi rst re-evaluates the
client to determine if it is a case of “pseudo-resistance” or true
, lOMoARcPSD|1709022
treatment resistance anxiety. Pseudo refractory-anxiety may be
the result of insu 昀케 cient treatment, inadequate delivery of
treatment or
