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Anxiety
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Physicians Guide to the Management of Huntington's Disease
Anxiety

Patients with HD are vulnerable to anxiety because of life circumstances, but also because of physical changes in the brain. Patients may develop a social phobia related to embarrassment about visible symptoms.

As thought processes become less flexible, patients may be made anxious by trivial departures from the usual routine. Patients may worry for days in advance about what to wear when going to the hairdresser or whether to attend a family function.

In addressing anxiety, attempts should be made to decrease the complexity of the patient's environment. Stopping a job that has become too difficult may result in a remarkable decline in symptoms.

Assisting the caregiver in establishing a predictable routine for the patient is helpful. Some caregivers find it useful to refrain from- discussing any special events .

Some patients will not improve with counseling and environmental interventions and will require pharmacotherapy.

The clinician should first assess whether the anxiety is a symptom of some other psychiatric condition, such as a major depression.

Patients with obsessive-compulsive disorder may be made anxious by obsessions about danger or "germs," or if their rituals are interrupted.

Anxiety disorder  The National Alliance for the Mentally Ill (NAMI) is a nonprofit, grassroots, self-help, support and advocacy organization of consumers, families, and friends of people with severe mental illnesses, such  as schizophrenia, major depression, bipolar disorder, obsessive-compulsive disorder, and anxiety disorders.