Overview of Anxiety Disorders

Anxiety disorders are quite common and it is estimated that as many as one person in four will have an anxiety problem at some point in their life. Anxiety disorders are treatable with psychotherapy and with medication. Cognitive-behavioral therapy, in particular, has long been demonstrated to be an effective treatment for anxiety problems. This treatment usually involves learning techniques to reduce the intensity of anxiety, better manage stress, and challenge the avoidance behaviors that maintain the anxiety. There are a number of anxiety disorders: phobias, panic disorder, agoraphobia, social phobia, generalized anxiety, obsessive-compulsive disorder, and posttraumatic stress disorder.

Phobias

Phobias are related to anxiety that occurs in specific situations, such as fear of heights, dogs, enclosed spaces, dentists, bridges, flying, or receiving injections. While most people would experience some fear or anxiety in many of those situations, a phobia occurs when the anxiety is excessive and unreasonable. Phobias are severe to the point that the anxiety interferes with the person’s normal routines or functioning. There is a tendency to avoid the situations causing the phobic distress and often the avoidance can interfere with the person’s life.

Panic Disorder

Panic episodes (panic attacks) are like short but very intense blasts of anxiety that seem to come out of the blue. They often only last a few minutes but leave the person exhausted from the intensity of the anxiety. Panic episodes include strongly felt and distressing physical symptoms such as heart racing, sweating, trembling, shortness of breath, nausea, flushing, or dizziness. Sometimes they are accompanied by perceptual changes such as tunnel vision, feeling unreal, or feeling detached from oneself. Individuals with panic disorder may believe that they are having a heart attack or losing their mind and sometimes go to a medical emergency department because of the panic feelings. Very often, once one has had a number of panic episodes, the person develops a fear or preoccupation that they will have another. They can develop a style of scanning for any physical sensations that might suggest a panic is about to occur. It is also not unusual for the panic sufferer to go on to become increasingly avoidant of situations where they have experienced panic attacks. For example, if one has a panic episode on a bus or car, the person may then reduce or even stop taking buses or driving in a car. It is possible that the panic difficulty then becomes associated with agoraphobia.

Agoraphobia

Agoraphobia occurs when the person has excessive fear and anxiety related to situations where escaping or leaving may be difficult. Agoraphobia is associated with a fear of going out of one’s home, being caught in traffic, standing in line or being in a crowded environment. The avoidance can become very pervasive and problematic, and in some cases the person is unable to leave their home due to the anxiety. When agoraphobia is associated with panic attacks, the avoidance is about trying to avoid situations where one might have a panic episode.

Social Phobia

Social phobia manifests in a fear and anxiety about other people. Specifically, social phobia is about the fear of negative evaluation by others. Those with social phobia worry about being judged or embarrassed in social situations. They therefore tend to avoid interactions with others and especially interactions where they may have to perform or be the center of attention. The anxiety and distress associated with social phobia is severe enough to interfere with the person’s life. For example the person may avoid social gatherings, dating, attending classes, or applying for particular jobs because of the anxiety.

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder manifests in a generalized tendency to worry about many things. Unlike other anxiety problems, the worrying is not limited to specific situations, people, or physical sensations. Rather, there is a worried style of thinking that tends to be long lasting and be applied to most situations. Accompanying the worrying thinking style is a constant state of muscle tension so that the person usually feels “on edge”.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder has two primary symptoms: obsessions which are cognitions such as thoughts or images, and compulsions, which are behaviors or actions. Obsessions are intrusive thoughts that are typically the worst thing one can imagine. The person struggles with trying not to have the thought as the accompanying anxiety is so distressing. Compulsions are ritualized or superstitious behaviors such as counting, washing in a ritualized way, or excessive checking of locks or appliances. Not doing the behavior is associated with an increase in anxiety while doing the behavior serves to contain or lower the anxiety, at least in the short run. In the long run, though, the person’s anxiety is maintained by the repetition of the compulsive behavior.

Related Sites:

Anxiety Disorders Association of America
www.adaa.org

The Obsessive-Compulsive Foundation
www.ocfoundation.org