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Anxiety E-mail

This page has been designed to give you some basic information on different types of anxiety and includes a basic list of symptoms to help the reader understand their experience from a mental health perspective. The information on this page has been reconstituted from several sources, including the National Institute of Mental Health (NIMH) website and the DSM-IV Diagnostic Manual.  See below for a link to the NIMH website if you would like to explore their website as well.  If you have any questions and wish to have a consultation, type into the box on the left-hand side of this page and ask me a question.  If I am unavailable or off-line, I will respond as soon as time permits.

Anxiety is a healthy response to the challenges we face in our day to day lives.  It can trigger heightened awareness to help us in stressful situations, such as a job interview, or making an important deadline for work.  It's believed that raised anxiety creates an opportunity in therapy for change and growth.  In this vein, all human developmental stages are accompanied with anxiety. When anxiety becomes overly pervasive, it interferes with day to day functioning and can be both emotionally and physically painful. 


According to the NIMH, there are five major types of anxiety disorders.  They are:

  • Generalized Anxiety Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Social Phobia (or Social Anxiety Disorder)

Generalized Anxiety Disorder

Generalized anxiety can be diagnosed when you have had persistent excessive worries for a period of 6 months or longer (DSM IV).  One of the sure signs that you have generalized anxiety disorder is when your anxiety is stronger than warranted for a given situation.  The challenge around how you do or how you don't develop the insight that your anxiety is more than what is considered healthy.  

Symptoms can include:

  • trouble falling or staying asleep
  • hair trigger startle response
  • chronic tension and muscle pain
  • fatigue
  • trouble swallowing
  • nausea
  • dizziness
  • shortness of breath
  • frequent urination

Obsessive-Compulsive Disorder

People with obsessive-compulsive disorder (OCD) have persistent, obsessive and often disturbing thoughts and use various rituals or compulsions to bind the ensuing anxiety. 

Rituals can include obsessively washing hands, counting, checking door locks, checking to make sure the stove burners are turned off, and many more behaviors.  Sometimes checking behavior involves very specific and elaborate sequencing, and must be performed over and over again, especially if the order of the sequence is broken.

While these rituals help to bind one's anxiety, they are often painful and deeply socially embarrassing.  While healthy people will do things like check the locks or the stove before leaving the house, people with OCD find  their repetitious rituals to be upsetting, but will compulsively continue to do them anyway. 

According to the National Institute of Mental Health, OCD affects around 2 million Americans, and it can often be accompanied by eating disorders, other anxiety disorders, or depression.

Panic Attacks

Panic attacks are sudden states of terror.  Symptoms generally include:

heart pounding
dizziness
nausea
sweatiness
feelings of terror
chills or flush
numbness or tingling in hands
chest pain
shortness of breathe
fear of death

Many people with panic attacks will end up in the emergency room, as they feel like they are dying from a heart attack.  Attacks can occur any time, and according to the NIMH, happen twice as much with women.  Part of the difficulty with panic disorder, is its unpredictable nature.  This causes many stricken with this problem to experience a constant sense of dread because the terror is so frightening that they worry constantly over when the next attack will come. 

While many people will have one or only several panic attacks, others can be totally disabled as they start to avoid all situations which are known potential triggers.   In extreme circumstances this can lead to agoraphobia (fear of open spaces).  It is believed that panic disorder is at least partly inherited.

Social Anxiety Disorder

Social anxiety disorder is when one becomes overly anxious in normal social situations.  It is accompanied by an intense fear of being watched and criticized by others.  Their fear of being embarrassed can be so intense that they will persistently dread upcoming social activities even weeks in advance.  This anxiety interferes with friendships, school and work. 

Social anxiety can co-exist with depression, substance abuse and other forms of anxiety.  Substance abuse is often used as a way to self-medicate.  Social anxiety disorder responds well to psychotherapy and psychotropic medications.


Post Traumatic Stress Disorder (PTSD)

Post traumatic stress disorder is the result of the experience of trauma.  Trauma can be anything from witnessing a frightening event, to actually having been directly  physically, sexually or emotionally abused.

While there are many possible reactions to trauma, people with PTSD can have a whole host of symptoms, including:

hair trigger startle response or hyper-vigilance
depression
dissociation (flat affect and emotionally disconnected)
emotional numbness
loss of motivation
irritability
aggressive behavior
violent behavior
flashbacks to the trauma
Loss of reality as the trauma is relived
avoidance of anything related to original trauma
substance abuse
other anxiety disorders

PTSD symptoms can lie dormant sometimes for many years after the initial experience of trauma.  Women are more likely than men to develop PTSD.  Psychotherapy and medication are often successful in the treatment of this disorder.
 
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2008 David Steinberg - PHD