Anxiety Disorders

Most people experience a certain amount of worry, anxiety, and fear in their lifetimes. It is a normal part of living.

For an estimated 19 million Americans, however, worry, reliving past traumas as if they are present, anxiety, and fear are persistent and

overwhelming, and can interfere with daily life. These people suffer from anxiety disorders, a group of five psychiatric disorders that can be terrifying and crippling, but are treatable. Experts believe that anxiety disorders are caused by a combination of biological and environmental factors, much like physical disorders such as heart disease or diabetes. Anxiety disorders are real, serious, and treatable.

Fortunately, the vast majority of people with an anxiety disorder can be helped with the right professional care. Alone or in combination, psychotherapy, cognitive-behavioral therapy, and medication therapy are effective treatments. There are no guarantees, and success and treatment rates vary with the individual. Furthermore, people with an anxiety disorder sometimes suffer from clinical depression and substance abuse, further complicating proper diagnosis & prolonging treatment.

The five anxiety disorders are identified as: Obsessive-Compulsive Disorder, Phobias (including Social Phobia, also called Social Anxiety Disorder), Panic Disorder (and Panic Disorder with Agoraphobia), Post-Traumatic Stress Disorder, and Generalized Anxiety Disorder.

 Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder is characterized by uncontrollable obsessions and compulsions, which the sufferer usually recognizes as being excessive or unreasonable. Obsessions are recurring thoughts or impulses that are intrusive or inappropriate and cause the sufferer anxiety. Some common obsessions are:

• Thoughts about contamination, for example when an individual fears coming into contact with dirt, germs or "unclean" objects;
• Persistent doubts, for example whether or not one has turned off the iron or stove, locked the door or turned on the answering machine;
• Extreme need for orderliness;
• Aggressive impulses or thoughts, for example, being overcome with the urge to yell 'fire' in a crowded theater

 Specific (Simple) Phobia

Specific Phobia is characterized by the excessive fear of an object or a situation, exposure to which causes an anxious response, such as a Panic Attack. Adults with phobias recognize that their fear is excessive and unreasonable, but they are unable to control it. The feared object or situation is usually avoided or anticipated with dread.

Specific Phobia is diagnosed when an individual's fear interferes with their daily routine, employment (e.g., missing out on a promotion because of a fear of flying), social life (e.g., inability to go to crowded places), or if having the phobia is significantly distressful. The level of fear felt by the sufferer varies and can depend on the proximity of the feared object or chances of escape from the feared situation. If a fear is reasonable it cannot be classed as a phobia.

Specific Phobia may have its onset in childhood, and is often brought on by a traumatic event; being bitten by a dog, for example, may bring about a fear of dogs. Phobias that begin in childhood may disappear as the individual grows older. Fear of certain types of animals is the most common Specific Phobia. The disorder can occur alongside Panic Disorder and Agoraphobia.

 Social anxiety disorder or social phobia is the constant fear of being criticized or evaluated by other people. People with social phobia are nervous, anxious, and afraid about many social situations. Simply attending a business meeting or going to a company party can be highly nerve-wracking and intimidating. Although people with social anxiety want very much to be social and fit in with everyone else, their anxiety about not performing well in public is strong and tends to cripple their best efforts. They freeze up when they meet new people, especially those who are authority figures. They are particularly afraid that other people will notice that they are anxious -- and this fear permits the anxiety to grow and turn into a vicious cycle. People with social anxiety tend to avoid social situations as a result of the painfulness involved. Most socially-anxious people can remember being called "shy" as a child and can elicit experiences from their past that correlate with the social anxiety they now feel. Social anxiety tends to develop early and, without adequate treatment, is a chronic, unremitting, torturous condition. Today, however, the prognosis is good for overcoming social anxiety disorder altogether.

Panic Disorder

Unexpected panic attacks and the fear of having additional attacks characterize this problem. Many times the person does not know why they are having an attack. Sometimes, it seems to come from "out of the blue". A panic attack is usually accompanied by shortness of breath, dizziness or faintness, increased heart rate, trembling and shaking, hot or cold flashes, and a sense of detachment.  Other common symptoms include fear of dying or "going crazy", and the fear of losing control.

Agoraphobia is the fear of having panic attacks in public places (usually because they have happened there before) and then the avoidance of these places that are associated with panic attacks. Not knowing when the next panic attack could occur is anxiety provoking itself. As the panic attacks occur more frequently and in different locations, the person who is untreated begins to fear going anywhere "unsafe" or outside of their security zone, that is anywhere they might have a panic attack. Thus, it is common for the person with agoraphobia to avoid travel and stay close to home.        

 Posttraumatic Stress Disorder (PTSD)

 Someone who has been through a traumatic life experience may suffer future anxiety and panic over it, called Posttraumatic Stress Disorder. Severe wartime experiences, for example not only elicit anxiety and stress, they may induce flashbacks and panic attacks. Other post-traumatic conditions include rape or other sexual abuse, emotional abuse, and living through negative natural events, such as a devastating earthquake or hurricane.

Generalized Anxiety Disorder

Excessive worries about more than one circumstance characterize Generalized Anxiety Disorder (GAD). People with GAD are "bothered" or "worried" most of the time. Many times the worries are unrealistic, such as "What if my son goes to the baseball game today and gets in an accident?" or "What if I lose my job and I become homeless?"  All of us think about things like this, but people with GAD fixate on them and can’t get them out of their minds. Generalized anxiety has been termed free-floating because it can come and go at will, without apparent reason. Physical symptoms of GAD include (but are not limited to) bodily tenseness, lump in the throat, trouble falling asleep, dry throat, and difficulty in concentrating. It is very hard for the person with generalized anxiety to just be still and relax.

- Thomas A. Richards, Ph.D., Psychologist/anxietynetwork.com, www.adaa.org