Anxiety Disorders

What Is An Anxiety Disorder?

Everyone experiences anxiety from time to time, but it is often not severe enough to warrant a diagnosis by a professional. Some level of anxiety is a necessary survival mechanism to make a body react to danger and fear harm. When we face enough danger to possibly cause us physical harm or even death, we respond psychologically and physically using anxiety. This response is known as "fight or flight" because it activates us to either defend ourselves, or to run away and escape injury. In a life threatening situation, this fight or flight response can save our lives.

In our civilized world, however, we don't typically encounter threats to our physical being on a day-to-day basis. Some physical danger still exists in a possible traffic or other accident, but generally we don't encounter the dangers of our prehistoric ancestors. Instead, we are faced with problems and stress that complicate our lives. Today's problems pose a different kind of threat, such as losing a job, having our marriage break-up, or maybe having our children fail in school. These may be threats to our well-being, but have more of a psychological than a physical impact. These psychological threats can trigger a mild version of the fight or flight response, that we call anxiety. In a mild version of anxiety, this can help us by alerting us to a problem, and motivating us to try to resolve the problem. If we never felt anxious about anything, we would have little motivation to respond to problems, until we were faced with a genuine crisis. Normal anxiety is not a sign of a psychological disturbance, because we all experience it, and it helps us manage out lives by alerting us to problems requiring a response. Anxiety disorders develop when the level of anxiety becomes severe, even in response to minor or common problems, or when the anxiety never goes away, and actually interferes with our problem solving.  A panic disorder is an example where the anxiety we experience is very immediate and severe.

Anxiety problems are very common. In the United States, more people are likely to experience anxiety related problems than coughs and colds. Depending on the type of anxiety disorder, they can exist as commonly as in 1% of the population for some disorders, to as high as 58% of combat veterans experiencing post traumatic stress to some degree. Medications for anxiety management is very common and can be very effective, but not without psychotherapy. Many anti-anxiety medications produce dependency, and the withdrawal symptoms are often similar to anxiety symptoms. These medications control the symptoms but cannot identify and eliminate the root causes. Psychological treatment helps the person identify the root cause and focus on reducing the inappropriate anxiety response, so medication is no longer necessary, and will help deal with any dependency side effects.

Types of anxiety disorders include:

Panic Disorder
Panic disorder is an anxiety disorder in which unexpected panic attacks occur repeatedly, and not due to a substance or another psychological disorder or phobia. Panic disorder can occur with or without agoraphobia being present.

A panic attack consists of extreme anxiety including specific patterns of symptoms associated with extreme physiological arousal. There may be physical symptoms too, such as heart palpitations, trembling or shaking, dizziness, sweating, hot flashes, or numbness in the extremities. Often, there are chest pains which cause the person to believe he/she is experiencing a heart attack. The person may also experience shortness of breath. Nausea is often present, and sometimes the person has difficulty swallowing or feels like he/she is choking. There may be a feeling of unreality, or being detached from oneself. A panic attack often results in a fear of dying, losing control or going crazy. The attack occurs suddenly, and often without a trigger.

Social Anxiety
Social anxiety or social phobia, is a persistent fear of social situations and embarrassment (such as giving a speech or interacting with strangers at a party). Some social situations provoke more anxiety than others. In extreme cases, social anxiety may sometimes develop into a panic attack. People with social anxiety cannot control their fears even though they realize that they are exaggerated or even unwarranted. They begin to avoid social situations in which they need to interact or perform in front of people, and this tends to interfere with their normal life. Social anxiety tends to develop during a person's teen years, but can also develop in excessively shy children.

Many people may experience social anxiety to some degree, but manage to avoid those social situations that make them feel uncomfortable. They may not feel that their life style is too limited, and may not feel that their anxiety is severe enough to seek treatment. However, when social anxiety becomes more severe and interferes with a person's normal activities (such as in their work place), by being fearful of meeting and talking to strangers in any capacity, then treatment becomes necessary.

Generalized Anxiety Disorder
General Anxiety disorder (GAD) occurs when a person has chronic anxiety, including excessive worrying about a lot of different life events over a period of at least six months. The person may feel a sense of restlessness, tension and tiredness, with difficulty sleeping. He or she may also find it hard to concentrate and be more irritable than usual. People with generalized anxiety disorder describe themselves as excessive worriers, who often become more upset by problems than the average person. 

Many persons with generalized anxiety may experience panic attacks in response to more severe stress. Eventually, they might begin to worry about worrying since they see themselves as anxious persons who can't handle stress very well. They further develop additional anticipatory anxiety when they are about to face a stressful situation, such as starting a new job.

Agoraphobia
Agoraphobia is the feeling of intense anxiety when a person feels he or she is in a place where they cannot escape easily. Persons who have had panic attacks in the past often worry about having another attach in a public place where they cannot seek refuge easily and get help. This fear causes them to confine themselves to what they consider safe or familiar surroundings, and will only venture out to a few secure locations, such as their home, work, and the homes of close friends or relatives. They typically avoid bridges, tunnels, elevators, highways without shoulders, limited access roads with infrequent exits, or being in crowded places. In extreme cases, they will not leave their home.

Agoraphobia almost always occurs with panic disorder, but can also occur on its own. Sometimes when a person is suspected of having multiple phobias, agoraphobia is the best explanation for a problem, especially when the theme common to all of the fears is a difficult escape. Persons in psychotherapy for agoraphobia will also have the difficult challenge of keeping and attending their regular appointments with their psychologist. They will often fear leaving their homes to come to the office and will frequently cancel appointments. This problem is therefore addressed as part of treatment.

Specific Phobias (such as fear of flying, fear of rats, etc.)
A specific phobias is the disorder in which a person has an anxiety response when exposed to a specific event or object, such as fear of snakes, or fear of flying. Phobias are divided into four types: animal type (fear of animals or insects), natural environment type (storms, heights, etc), blood-injection-injury type (seeing blood, getting a shot, etc.), and situational type (flying, tunnels, bridges, etc.). A specific phobia usually develops during childhood or in the mid-20s. Although phobias are relatively common in the general population, they are rarely diagnosed because people tend to manage their lives around the phobia, rather than seeking treatment.

Sometimes a specific phobia develops as following a trauma. For example, a person may experience a severe car accident, and becomes fearful of driving, or a person is attacked by a dog, and becomes fearful of animals. These phobias, however, are categorized as Post Traumatic Stress Disorder, which as different from a specific phobia that is formed without a history of trauma.

Obsessive Compulsive Disorder.
Obsessive compulsive disorder (OCD) is an anxiety disorder in which the person experiences either obsessions or compulsions that interfere with his/her normal life. Obsessions are defined as persistent ideas, thoughts, or impulses that intrude on a person's thoughts, and cause significant distress in his/her life. Compulsions are repetitive behaviors that are performed in an effort to reduce anxiety. (Typically the anxiety is caused by obsessions). Approximately 2 percent of the general population will develop an obsessive compulsive disorder during their lifetime. OCD can develop in childhood, but most often it develops in adolescence or young adults.

Obsessions are not just excessive worrying about real problems, such as those found in a generalized anxiety disorder. A person with an obsessive compulsive disorder will typically try to ignore these thoughts and ideas, while a person with a psychotic disorder may ruminate on a single idea, and would not try to avoid thinking about it. Obsessive ideas do not generate the same kind of personal distress as those in an anxiety disorder.

Most people with OCD spend a lot of time during the day dealing with either obsessions, compulsions, or both. These obsessions and compulsions significantly interfere with their normal life functioning, which is the main reason why persons will seek treatment.

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