By: Dr. John D. Moore
If you are looking for information on anxiety disorders, you have come to the right place. At its core, anxiety is nothing more than a mental and physiological response to stress. The emotion itself can manifest in the form of fear, nervousness, worry or panic. It’s something we a lot with our clients in Chicago seeking anxiety relief.
For some people, anxiety can become excessive, which has the capacity to interfere with normal “life” activities. Examples include your ability to concentrate at work or spend time in a meaningful way with friends or loves ones.
When symptoms become excessive, anxiety is considered to be problematic or as the Diagnostic and Statistical Manual of Mental Disorders (DSM) refers to it – an “anxiety disorder”.
Speaking of anxiety disorders …
Anxiety disorders are one of the most common mental health conditions in the United States. We don’t have exact numbers but the current research suggests somewhere around 40 million people live with some form of anxiety, according to the National Institute of Mental Health.
Can you get rid of anxiety?
You may have heard from well-intentioned people that you can somehow “get rid” of anxiety by putting worrisome thoughts out of your mind. If only this approach were true. The reality is that anxiety doesn’t work that way. All of us are wired to experience some form of anxiety. It is part of our human condition.
Trying to “get rid” of anxiety is like trying to eliminate hydrogen from water (H2O). Without the hydrogen, you can’t have water. The same concept is true for human beings. Without anxiety, you wouldn’t have much of a person.
It might be better to think of anxiety as something that can be reduced or managed as opposed to eliminating. Here, I am talking about learning how we think about anxiety through the lens of acceptance, which paradoxically reduces its impact on the psyche over the course of time.
What are the anxiety disorders?
There are six main anxiety disorders, according to the DSM. All of them contain the essential ingredient of fear, which manifests itself in different forms. In fact that is what binds all of the anxiety disorders together – fear.
What follows is a brief walkthrough of each anxiety disorder with accompanying symptoms. I’m going to give you a basic overview and try to avoid getting into the clinical jargon as much as possible.
Bear in mind that some of these symptoms can be caused by certain drugs (legal or illegal) and/or a medical problem. This is why it is critical that you visit your doctor and report changes in mood.
OK – let’s check out the six primary anxiety disorders.
Six Anxiety Disorders
1. Post Traumatic Stress Disorder (PTSD)
PTSD can happen when a person experiences or witnesses a life threating situation or in any way perceives personal danger to themselves or a loved on.
Examples include being in a car accident or watching a shooting. It can also involve being physically abused (or watching someone you care about being abused).
If you served or serve in the U.S. Military and are exposed to combat situations, you are at a higher risk for potential PTSD than those not in hazardous zones.
Symptoms of PTSD typically include:
- Reliving the traumatic event as if it is happening right now.
- Recurring, unwanted and intrusive thoughts about the experience.
- Dreams about the traumatic event that reoccur in the same or different form. (Read this post on dream meaning)
- Excessive emotional and/or physical response to something that triggers the memory.
- Avoidant behaviors, such as not wanting to go near a place that involved the traumatic event or reminds you of the event.
Real Life Example:
I have a client we’ll call Nick. He worked at a popular retail outlet as a floor clerk. One evening while helping customers, someone came into the store with a gun and started shooting people. Nick quickly dropped to the floor and crawled behind a counter. While he was hiding, he hit a panic button to signal the police.
He shared with me that he remained hidden until first responders arrived and told him he could get up. Once this happened, he was able to see that the shooter had killed 2 people and seriously injured 2 more.
Days after the incident at the store, Nick started to experience problems sleeping. He had nightmares about the shooting and started to panic big time whenever he thought of returning to the store. The first time he tried to go back to work, he became overwhelmed with fear. The fear was so intense that it prohibited him from walking through the door.
Each time I walked into the store, I felt like I went back in time to the day of the shooting.
Generalized Anxiety Disorder
2. Generalized Anxiety Disorder (GAD)
GAD is the manifestation of anxiety in the form of excessive worry. A person who lives with GAD will commonly be so consumed with worry that they fear it will cause them psychological harm (a nervous breakdown) or maybe even kill them. The focus of worries can be thematic, meaning they tend to cycle through different topics over the course of time.
Examples of GAD include excessively worrying about the safety of a loved one or having enough resources for retirement. The keyword again is excessive. Here, we are talking about anxious thoughts that interfere with activities of daily living. These worries act as a barrier to concentration and/or focus.
Symptoms of GAD typically include:
- Difficulty sleeping
- Shortness of breath
- Muscle tension
Real Life Example:
“Janet” was a student of mine who had a severe form of GAD. Throughout the day, she regularly worried about her son’s safety as a postal delivery person. Her main fear was centered on him getting into a car accident.
She would repeatedly call her son throughout the day, inventing reasons to make contact. Many of the “check calls” were designed to verify he was safe and able to answer the phone.
At night, her mind would fill with thoughts of her son getting into an accident. Sometimes, Janet would switch her focus of worry and be consumed with her son’s ability to retire.
When the theme of worry focused on her son’s finances, Janet would make inquiry about how much money he had in his 401K plan or how much liquid cash he had in the bank.
As time went on, her son became more and more distant from her because excessive worrying.
“I couldn’t stop thinking about my son’s personal finances. Would he have enough money to retire?”
Obsessive Compulsive Disorder
3. Obsessive Compulsive Disorder (OCD)
OCD is a form of anxiety whereby a person experiences recurrent, obsessive thoughts that are intrusive in nature. These thoughts are unwelcome, persistent and almost always fear-based.
To stop these obsessive thoughts, a person with OCD with engage in a variety of ritualistic behaviors to compensate. These behaviors are known as compulsions. OCD related compulsions can become so intense that they interfere with activities of daily living.
Examples of OCD compulsions include the constant need to make sure a door is locked or tapping a metal spoon to your bicuspids five times before getting dressed.
Notice there is a ritualistic element involved. Verbal annunciations can also be part of the ritualistic dynamic. Examples might be need to say: Blue Monkey ten times before leaving the house for the day. Another example might be whistling from low to high seven times before getting into the shower. Here is a true story of OCD that I experienced with someone while flying.
OCD related thoughts can also be focused on fears of illness or sickness. Some people refer to this as “germaphobia”. Excessive, ritualistic handwashing is an example of someone with this form of OCD. More than a few celebrities live with OCD, which you can learn about here.
Real Life Example:
Dale is a buddy of mine. I noticed early on in our friendship that he regularly tapped his foot on a doorway rug twelve times before leaving his home. When I asked him why he did this, he shared that he had been doing this ever since he could remember.
One day I asked Dale if he could try to leave his home without tapping the rug. He shared with me that he made it about 30 feet outside of his house before he ran back inside to tap the rug. The urge to tap was so overwhelming that unless he engaged in this ritualistic behavior, he couldn’t leave his home.
Dale said that whenever he tried to break free from the tapping in the past, he would experience intrusive thoughts involving terrible, horrible things.
“I couldn’t leave the house unless I tapped that rug 12 times. I felt like something bad would happen if I didn’t do it!”
Social Anxiety Disorder
4. Social Phobia (Social Anxiety Disorder)
A person who has social anxiety disorder/social phobia holds strong, irrational fears social or performance situations where embarrassment may occur. An example might be public speaking. Some with social anxiety disorder also hold fears of being scrutinized or humiliated in front of others – particularly in unfamiliar places.
If you have social anxiety, the core fear is judgement by others with an inability to escape or get away. In most all cases, social anxiety is hallmarked by persistent feelings of being judged.
Common manifestations of social anxiety include:
- Fearful of eating in public
- Using a public restroom
- Talking in front of others
- Writing in front of others
- Accidentally urinating on yourself
- Stage fright and/or public speaking
- Avoidant of social situations
Real Life Example:
A former client of mine named Eric came to me for counseling around some family issues. During the course of our work together, he shared that he was completely terrified eating in front of others because his hands would shake and tremble. As a result of this fear, he avoided restaurants, family meals around the holidays and even fast food places.
The problem for Eric was that he was recently promoted at his job and required on occasion to dine with others. He had successfully been able to dodge eating with others until the promotion but now he would have to deal with it.
“I can’t eat at a table with other people because my hands shake. It embarrasses me big time.”
5. Panic Disorder with Agoraphobia
Panic disorders are paradoxical in nature because the experience involves heavy doses of fearing fear itself. People who have experienced a panic attack often believe something bad will happen, such as passing out. Some even think they will “go crazy”. The fear of another attack can cause the person to engage in avoidant behaviors that they believe act as a trigger.
When things get really bad with panic disorders, the individual may start to isolate themselves. This is called agoraphobia (Greek for “Fear of Marketplace”). In severe cases, the individual may not leave their home or travel to public places. The end result can mean that a person can become a prisoner in their own home.
Common features of a panic attack:
- Fast heart palpitations (tachycardia)
- Choking feeling
- Chest discomfort or pain
- Nausea and some abdominal distress
- Depersonalization (feeling separated from self)
- Fear of losing control/going “crazy”.
- Fear of dying
- Hot flashes/chills
- Numbness and/or tingling sensations
A therapist I am aware of (we’ll call her Trisha) experienced a panic attack while shopping at the mall one day. It hit her from out of the blue and for no apparent reason.
The attack was so intense that she thought she was going to lose control of her mind. At one point, she shared with me that she felt like she was watching a movie when the attack happened.
Her fears of experiencing another panic attack intensified over the course of time. She started to avoid going to the mall. In time, she stopped going to the supermarket, fearing that too would cause another attack like the one that happened at the mall.
“It got so bad that I avoided going shopping at the mall or grocery store. I would lock myself inside for days because I feared another panic attack.
6. Specific Phobias
If you have a phobia, you hold an intense fear of an object, activity or situation. An example might be a strong fear of snakes or being super afraid of spiders. As with many of the six anxiety disorders, there is a recognition on the part of the individual that the fears are excessive and irrational.
There are more phobias of different things, places or situations that can be listed in this one page.
Here are some common, specific phobia characteristics:
- Major fear and reaction to a phobic causing “thing”.
- Extreme anxiety when exposed to the object.
- Avoidant behaviors of feared situation.
- Can cause significant distress or impairment
Real Life Example:
My cousin Maggie is terrified of horses. Whenever she sees one on television or in movies, she looks the other way. Whenever she has the occasion to pass by a horse, she immediately starts to “freak out”. Clinically, she can be classified as having hippophobia.
“I would start to get super scared anytime I saw a horse. I felt helpless because I knew that horse wouldn’t harm me. Still, it freaks me out whenever I see one.”
Anxiety Disorders Final Thoughts
Hopefully, the material you have read on this page helped you to better understand the six anxiety disorders. Bear in mind that only a licensed mental health professional can diagnose you. It is possible for you to have characteristic of an anxiety disorder but not have a full on condition as outlined by the DSM.
Regardless of what type of anxiety you may be living with, there is good news. Anxiety can be reduced with many effective forms of treatment, including one of 9 different types of cognitive behavioral therapies (CBT).
The more you learn about anxiety and how it presents itself in your life, the more empowered you will be to create positive change. If you are looking for practical resources to help you better manage your anxiety, consider picking up a copy of The Anxiety and Phobia Workbook by Dr. Edmund Bourne.