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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