Anxiety Disorders Explained
Anxiety Disorders are a group of mental disorders that are characterized by feelings of anxiety and fear.
- Anxiety is a worry about future events.
- Fear is a reaction to current events.
These feelings may cause physical symptoms, such as a fast heart rate and causing one to tremble. There are a number of anxiety disorders: including
There are a number of anxiety disorders: including:
- Generalized Anxiety Disorder
- Specific Phobias
- Panic Disorder
- Post-traumatic Stress Disorder
- Separation Anxiety Disorder
- Obsessive Compulsive Disorder
- Social Anxiety Disorder
- Agoraphobia, and
- Selective Mutism
It is believed that the cause of anxiety disorders is a combination of genetic and environmental factors.
Risk factors include a history of child abuse, family history of mental disorders, or poverty. Anxiety disorders often occur with other mental disorders, particularly
- Child abuse,
- A family history of mental disorders, or
Anxiety disorders often occur with other mental disorders, particularly: chronic depressive disorder
- Chronic Depressive Disorder
- Personality Disorder, or
- Substance Use Disorder
To be diagnosed, symptoms typically need to be present for at least six months, be more than would be expected for the situation, and decrease functioning. Other problems that may result in similar symptoms including hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use; and withdrawal from certain drugs, among others.
Without treatment, anxiety disorders tend to remain. Treatment may include lifestyle changes, counseling, and medications. Counseling is typical with behavioral therapy. Medications, such as an antidepressant or beta-blockers may improve symptoms.
- About 12% of people are affected by an anxiety disorder in a given year and between 5-30% are affected at some point in their life.
- Anxiety Disorders occur about twice as often in females as males, and
- Generally, begin before the age of 25.
- The most common are:
- specific phobia which affects nearly 12% and
- social anxiety disorder which affects 10% at some point in their life.
- Anxiety Disorders affect those between the ages of 15 and 35 and
- Become less common after the age of 55.
- Anxiety Disorders rates appear to be higher in the United States and Europe than any other region.
It is common that one may have fear or concern about certain situations, activities, places, organisms or a particular thing. One can go about naming hundreds of phobias that affect human beings, but in essence there are three main categories, according to the latest version of Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV-TR ) phobias explained are: Specific or Simple Phobias, Social Phobia ( aka social anxiety disorder ), and Agoraphobia ( fear of being alone in a public place ).
You may know someone that has felt anxious about heights when standing on the edge of a cliff or scaffolding or screamed out loud when startled by the presence of a spider or snake. Fear is an unpleasant emotion and rational response triggered by these potential or perceived threats of danger, pain, or harm.
However, some individuals can react to a certain situation, activity, place, organism or a particular thing ( the phobic stimulus ) by irrationally exaggerating or imagining the potential or perceived threat of danger, pain, or harm. These individuals feel panic, fear, or terror that is completely out of proportion to the actual threat.
In some cases, the mere thought or sight of the phobic stimulus by orientation, mention, seen in a book, or seen on TV is enough to trigger a heightened reaction. These heightened reactions may be indicative of one’s specific phobia.
Individuals with phobias are often well aware that their state of panic, fear, or terror are exaggerated or irrational; however, express that they have little or no control over his or her automatic anxious reaction. These anxious reactions to phobias are often associated with panic attacks, during which an individual may experience overwhelming physical sensations that may include, but not limited to, chest pain, pounding-heat, nausea, dizziness, hot or cold flushes, perspiration, or choking.
Categories Of Phobias
Phobias are generally classified into the following categories:
Specific or Simple Phobia
A ‘Specific Phobia’ is a lasting and unreasonable fear of a particular object or situation that evokes a specific reaction of intense anxiety in an individual or may cause an individual to avoid the object or situation. A Specific Phobia is caused by the presence or thought of a particular object or situation that usually poses little or no actual threat of danger, pain, or harm.
The distress that is associated with a specific phobia and/or his or her need to avoid the object or situation can significantly interfere with an individual’s ability to function ‘normally’.
Individuals with a Specific Phobia are often aware that their state of panic, fear, or terror are exaggerated or irrational; however, express that they are unable to control or overcome it.
There are five basic categories of specific phobia. There are five different types of specific phobias, based on the object or situation that is feared. These are:
- Animal or Insect: This is the most common category of specific phobias and can be, but not limited to, a fear of dogs, mice, snakes, or spiders
- Blood, Injection, or Injury: These involve a fear of seeing blood ( from a blood test injection ) or from physical trauma to the body ( invasive medical procedures or Injury from an accident ).
- Natural Environment: Examples include, but are not limited to, a fear of storms, heights, water, cooking oil, human or animal waste, or germs.
- Situational: These Specific phobias involve a fear of specific situations, such as flying, riding in a car, bus, or train, traveling over bridges or through tunnels, or being in a restricted space like a small room, cave, or elevator.
- Other: These include a fear of falling down, a fear of loud sounds, and a fear of costumed characters, such as clowns.
A ‘Social Phobia’ is a type of anxiety disorder that causes an individual to be anxious and lack self-conscience when thinking about or when engaged in certain social situations. An individual with a social phobia may have difficulty being in the presence of others, communicating or eating in front of others because of an overwhelming irrational fear of being judged, embarrassed, being singled out, scrutinized, or watched too closely. In extreme cases, a severe social phobia may cause an individual to avoid others in a reclusive manner, hiding away in his or her bedroom, home or apartment, or moving to a remote property for the purpose of seclusion.
According to the Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV-TR ), ‘Agoraphobia’ is said to be when an individual has an extreme or irrational fear of being alone in a public place, where the individual would perceive it to be difficult or embarrassing to flee an area if he or she felt panic due to stress, anxiety. An individual with Agoraphobia perceives the environment to be unsafe where every turn becomes a challenge to his or her exit and safety.
An individual with Agoraphobia would normally make an effort to avoid open spaces and crowded public places, such as busy airports, congested roadways, bridges or tunnels, sport-fan filled gymnasiums, packed clubs, bustling malls, crowded restaurants and cafes, prominent hectic tourist areas or places.
Those affected and infected with Agoraphobia will go to great lengths to avoid situations that make them venerable. In extreme cases, Agoraphobia may cause an individual to become reclusive, hiding away in his or her bedroom, home or apartment, or moving to a remote property for the purpose of seclusion.
A ‘Panic Disorder’ describes an individual who suffers long-term, recurring and disabling panic attacks that often strikes without reason or warning.
Distinguishing factors associated with a Panic Disorder can be:
- The presence of recurring and unexpected panic attacks.
- Constant worry, for at least a month after having a panic attack, that you will have a recurrence.
- Constant worry about the implications or consequences of a panic attack. This may include one’s thoughts and fears that the panic attack/s are a sign of an undiagnosed medical problem, causing the individual to seek repeated medical diagnosis and tests despite reassurances by professionals that one’s physical health is ok.
- Significant changes in behavior that relate to the Panic attacks.
During a panic attack, an individual can suddenly become overwhelmed by the physical sensations described above. These attacks reach a peak within about 10-minutes and usually last for up to half an hour, leaving the individual feeling exhausted.
Panic Disorder often occurs in conjunction with other serious illnesses or conditions, such as Depression, Post Traumatic Stress Disorder, or Substance Abuse.
Although the exact scientific cause/s of panic disorder are not fully understood, research and studies have shown that a combination of factors, including biological, physiological, and environmental, may be involved. These factors include, but are not limited to:
- Genetic. Mental illness is more common in individuals whose blood relatives also have a mental illness.
- Major Life-stress, either traumatic events and major life transitions, such as sexual, emotional or physical abuse, death of a loved one, separation from something of physical or emotional connection, divorce, a dysfunctional family, feelings of inadequacy, low self-esteem, loneliness, social or cultural expectations, a family member’s substance abuse, witnessing or being involved in an accident, or combat.
- Brain Abnormalities to include problems in regulating nerve and cell circuits or pathways that connect and control particular brain regions, such as the fight or flight response. Nerve cells within these nerve and cell circuits or pathways communicate through chemical reactions called neurotransmitters. The use of medications, micronutrients, psychotherapy or other medical or natural procedures can assist the brain circuits to function more efficiently. Also, defects in or injury to certain areas of the brain have also been linked to some mental health issues or conditions.
- Infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. One such case is known as Pediatric Autoimmune Neuropsychiatric Disorder ( PANDA ) associated with the Streptococcus Bacteria, linked to the development of Obsessive Compulsive Disorder ( OCD ) and other mental illness in children.
- Long-term Substance Abuse can contribute to anxiety ( panic disorder ), depression, and paranoia.
The symptoms of a panic attack may include:
- A fear that you are losing control or about to die
- Chills or hot flashes
- Difficulty breathing or shortness of breath
- Dizziness or feeling faint
- Intense feeling of dread
- Nausea or stomachache
- pounding heart or chest pain
- Sensation of choking or being smothered
- Tingling or numbness in the fingers and toes
- Trembling or shaking
It is important to re-emphasize that beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur. In worse cases, a person may feel they need to be reclusive.
Post-traumatic Stress Disorder or PTSD
Post-traumatic Stress Disorder or PTSD is a particular set of reactions that can develop in individuals who have been through a traumatic event which threatened their life, safety or that of others around them. This could be a car or other serious accident, physical or sexual assault, war or torture, or disasters such as bushfires or floods. As a result, the person experiences feelings of intense fear, helplessness or horror.
Symptoms of Post-traumatic Stress Disorder or PTSD
People with PTSD often experience feelings of panic or extreme fear, similar to the fear they felt during the traumatic event. A person with PTSD experiences four main types of difficulties.
- Reliving the traumatic event – The person relives the event through unwanted and recurring memories, often in the form of vivid images and nightmares. There may be intense emotional or physical reactions, such as sweating, heart palpitations or panic when reminded of the event.
- Being overly alert or wound up – The person experiences sleeping difficulties, irritability and lack of concentration, becoming easily startled and constantly on the lookout for signs of danger.
- Avoiding reminders of the event – The person deliberately avoids activities, places, people, thoughts or feelings associated with the event because they bring back painful memories.
- Feeling emotionally numb – The person loses interest in day-to-day activities, feels cut off and detached from friends and family, or feels emotionally flat and numb.
It’s not unusual for people with PTSD to experience other mental health problems at the same time. These may have developed directly in response to the traumatic event or have followed the PTSD. These additional problems, most commonly depression, anxiety, and alcohol or drug use, are more likely to occur if PTSD has persisted for a long time.
Have you experienced or seen something that involved death, injury, torture or abuse and felt very scared or helpless?
Have you then experienced any of the following:
- upsetting memories, flashbacks or dreams of the event?
- feeling physically and psychologically distressed when something reminds you of the event
If you answered yes to all of these questions, have you also experienced at least two of the following:
- had trouble remembering important parts of the event
- had very negative beliefs about yourself, others or the world
- persistently blamed yourself or others for what happened
- persistently felt negative, angry, guilty or ashamed
- felt less interested in doing things you used to enjoy
- feeling cut off from others
- had trouble feeling positive emotions (e.g. love or excitement)
And have you experienced at least two of the following:
- had difficulties sleeping (e.g. had bad dreams, or found it hard to fall or stay asleep)
- felt easily angered or irritated
- engaged in reckless or self-destructive behaviour
- had trouble concentrating
- felt on guard or vigilant
- been easily startled?
If all these things have been happening for a month or more, you may be experiencing Post-traumatic Stress Disorder.
How Common is Post-traumatic Stress Disorder or PTSD?
Anyone can develop PTSD following a traumatic event, but people are at greater risk if the event involved deliberate harm such as physical or sexual assault or they have had repeated traumatic experiences such as childhood sexual abuse or living in a war zone. Apart from the event itself, risk factors for developing PTSD include a past history of trauma or previous mental health problems, as well as ongoing stressful life events after the trauma and an absence of social supports.
Around 12 per cent of Australians will experience PTSD in their lifetime. Serious accidents are one of the leading causes of PTSD in Australia.
If you feel very distressed at any time after a traumatic event, talking to your doctor or other health professional is a good first step. If you experience symptoms of PTSD that persist beyond two weeks, a doctor or a mental health professional may recommend starting treatment for PTSD.
Treatments or Post-traumatic Stress Disorder or PTSD
Many people experience some of the symptoms of PTSD in the first couple of weeks after a traumatic event, but most recover on their own or with the help of family and friends. For this reason, treatment does not usually start until about two weeks after a traumatic experience. Even though formal treatment may not commence, it is important during those first few days and weeks to get whatever help is needed.
Support from family and friends is very important for most people. Trying, as far as possible, to minimize other stressful life experiences allows the person to focus more on his/her recovery. If a person feels very distressed at any time after a traumatic event, he/she should talk to a doctor or other health professional. If a person experiences symptoms of PTSD that persist beyond two weeks, a doctor or a mental health professional may recommend starting treatment for PTSD.
Effective treatments are available. Most involve psychological treatment (talking therapy), but medication and micronutrients can also be prescribed or utilized in some cases. Drug treatments are not recommended within four weeks of symptoms appearing unless the severity of the person’s distress cannot be managed by psychological means alone. Generally, it’s best to start with psychological treatment rather than use medication as the first and only solution to the problem.
Separation Anxiety Disorder or SEPAD
Separation Anxiety Disorder or SEPAD is usually considered something that was only considered in children; however, research now shows that people can experienceSeparation Anxiety Disorder or SEPAD over their lifespan, and it can even begin as an adult. Individuals who experience Separation Anxiety Disorder report intense and impairing anxiety about actual or imagined separations with their loved ones or home environment, leading to a need to maintain physical proximity. Separation Anxiety Disorder is thought to occur in about 23 to 40 percent of people with mental health problems.
Recent research indicates that adults experiencing Complicated Grief are also highly likely to have Separation Anxiety and worse depression symptoms, among other mental health challenges.
In a 2016 research study, Dr. Camilla Gesi and colleagues examined the relationship between complicated grief (CG) and Separation Anxiety Disorder or SEPAD. The study involved a sample of adults seeking help for Complicated Grief. The researchers wanted to understand how common Separation Anxiety Disorder is among people experiencing Complicated Grief, and if those with both Complicated Grief and Separation Anxiety Disorder were more likely to suffer from other mental health problems, too.
What is Complicated Grief?
Complicated Grief (CG), also known as traumatic grief or prolonged grief disorder, can occur after the death of a very close loved one. Research suggests that it affects between 10 to 20 percent of bereaved people, and it is associated with a negative impact on physical and mental health.
While everyone endures grief and emotional pain after the passing of a loved one, adults may be diagnosed with complicated grief if they also report persistent yearning, longing, and sorrow for at least 12-months (or six months for children). They must also report at least six of the following:
- significant difficulty accepting the death disbelief over the loss
- disbelief over the loss
- a difficulty with positive reminiscing about the deceased
- self-blame avoidance of reminders of the loss
- avoidance of reminders of the less social/identity disruption
- social/identity disruption
Obsessive Compulsive Disorder or OCD
Obsessive Compulsive Disorder or OCD, commonly called OCD, appears in different ways, and not every person has the same symptoms; many people have combinations of various OCD symptoms. In general, those who have OCD suffer from unwanted and intrusive thoughts that they can’t seem to get out of their heads (obsessions), often compelling them to repeatedly perform ritualistic behaviors and routines (compulsions) to try and ease their anxiety.
If you or a loved one suffers from Obsessive-compulsive Disorder, you’re not alone. Millions of people have it, and it doesn’t discriminate: This disorder affects men, women, teens, and children from every background, race, and ethnicity. But with the appropriate treatment, you are most likely to find relief.
Most adults who have Obsessive-compulsive Disorder are aware that their obsessions and compulsions are irrational, yet they feel powerless to stop them. They may spend several hours every day focusing on obsessive thoughts and performing seemingly senseless rituals involving hand-washing, counting, or checking to ward off persistent, unwelcome thoughts, feelings, or images. These can interfere with a person’s normal routine, schoolwork, job, family, or social activities. Trying to concentrate on daily activities may be difficult.
Untreated Obsessive-compulsive Disorder can be detrimental to all aspects of life, so getting proper treatment is essential to taking control over the illness and gaining relief. Learning about the disorder is critical to finding the right treatment and overcoming frequently incapacitating symptoms.
Unlike adults, children and teens with Obsessive-compulsive Disorder may not realize that their obsessions and compulsions are excessive or even view their symptoms as a disorder that can be treated.
Obsessive-compulsive disorder, or OCD, is a serious, yet treatable disorder that often occurs with depression and anxiety disorders. If not treated properly, it may become disabling.
Obsessive-compulsive Disorder has a neurobiological basis, although research has not identified any definitive causes. But researchers have been able to demonstrate that those certain areas of the brain function differently in people with OCD and that the symptoms may involve communication errors among different parts of the brain.
This disorder is most likely the result of a combination of neurobiological, genetic, behavioral, and cognitive factors that trigger the disorder in a specific person at a particular point in time.
Environmental factors may also contribute to the onset of Obsessive-compulsive Disorder, including traumatic brain injuries and a severe bacterial or viral infection such as strep throat or the flu. Studies suggest that infection doesn’t cause OCD, but it triggers symptoms in children who are genetically predisposed to it.
Most people who seek treatment experience significant improvement and enjoy an improved quality of life. It is important to work closely with a healthcare professional to determine the best option.
Getting Help for OCD
Therapy is usually a series of weekly one-hour office visits. You will be assigned exposure and response prevention (ERP) homework exercises specifically tailored to your symptoms. Complete your homework every week to make good progress and see the best results.
Medication may be prescribed when the anxiety associated with Obsessive-compulsive Disorder is severe, or if you have other conditions along with OCD. When a more intensive level of care is necessary, options include intensive outpatient, day program, partial hospital, and residential programs.
If you’re concerned about symptoms of Obsessive-compulsive Disorder, make an appointment with a therapist or your doctor. Your responses will help your therapist or doctor make a proper diagnosis and determine an effective treatment plan.
Be prepared to make the most of each office visit. Follow the tips below to make sure your concerns are addressed and your questions are answered.
- Write your questions ahead of time and bring them with you.
- Take notes during the appointment to make sure you understand what you are hearing.
- Ask for clarification whenever necessary.
- Ask questions and learn where you can find more information. You have a right to know.
- Be forthcoming and persistent about issues that concern you. Trust your instincts in your search to find a compatible doctor or therapist.
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