Anxiety Disorders
There are several anxiety conditions identified in the DSM-5. They include Separation Anxiety, Selective Mutism, Specific Phobia, Social Anxiety Disorder, Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Substance Induced Anxiety Disorder, and Anxiety Disorder Due to Another Medical Condition.
It is important to make a distinction between fear/stress and anxiety. Fear and stress are the biological and emotional responses to a real life situation. Anxiety is the biological and emotional response to an anticipated situation.
Separation Anxiety
Separation anxiety can occur in children and adults. It is characterized by substantial anxiety related to the anticipation of being separated from an attachment figure. This can manifest in the following ways:
Selective Mutism
Selective Mutism is characterized by a consistent failure to speak in situations where speaking is expected even though the person is able to speak in most other situations.
Specific Phobia
Specific Phobia is characterized by severe and out of proportion anxiety about a specific object or situation that leads to avoidance of the object or situation.
Social Anxiety
Social Anxiety is characterized by severe anxiety about engagement in social situations in which the person may be scrutinized by others. The anxiety may lead to the person fearing negative evaluation or rejection, thus significant efforts are used to avoid such situations.
Panic Disorder
Panic Disorder is characterized by recurrent unexpected, onset of severe anxiety/discomfort that peaks within minutes where the person may experience the following:
It is important to note that a panic attack is unexpected. In other words, it comes out of nowhere and tends to resolve rather quickly. This helps distinguish it from phobia or other forms of anxiety. A panic attack is very much the same, but can occur in conjunction with many other anxiety, trauma, or depressive symptoms.
Agoraphobia
Agoraphobia is characterized by out of proportion fear of using public transportation, being in open/enclosed spaces, standing in line/in a crowd, and/or being outside of the home alone. These situations are avoided because escape may not be easy, or help is not readily available if panic symptoms emerge. As such, people avoid these situations.
Generalized Anxiety Disorder
Generalized Anxiety Disorder is characterized by excessive anxiety that occurs most days for at least six months. The person struggles to control the anxiety. The anxiety tends to manifest as:
Treatment Considerations
It is important to make a distinction between fear/stress and anxiety. Fear and stress are the biological and emotional responses to a real life situation. Anxiety is the biological and emotional response to an anticipated situation.
Separation Anxiety
Separation anxiety can occur in children and adults. It is characterized by substantial anxiety related to the anticipation of being separated from an attachment figure. This can manifest in the following ways:
- Excessive anxiety anticipating the separation from an attachment figure.
- Persistent and excessive anxiety about losing an attachment figure.
- Persistent and excessive anxiety about something bad happening that would lead to separation.
- Persistent reluctance to separate from attachment figure.
- Persistent and excessive anxiety about being alone/without attachment figure.
- Persistent reluctance to sleep away from attachment figure.
- Repeated nightmares about separation.
- Repeated complaints of physical problems when separation occurs.
Selective Mutism
Selective Mutism is characterized by a consistent failure to speak in situations where speaking is expected even though the person is able to speak in most other situations.
Specific Phobia
Specific Phobia is characterized by severe and out of proportion anxiety about a specific object or situation that leads to avoidance of the object or situation.
Social Anxiety
Social Anxiety is characterized by severe anxiety about engagement in social situations in which the person may be scrutinized by others. The anxiety may lead to the person fearing negative evaluation or rejection, thus significant efforts are used to avoid such situations.
Panic Disorder
Panic Disorder is characterized by recurrent unexpected, onset of severe anxiety/discomfort that peaks within minutes where the person may experience the following:
- Heart racing
- Sweating
- Shaking/trembling
- Shortness of breath
- Feelings of choking
- Chest pain
- Abdominal distress
- Feeling dizzy
- Chills or feeling hot.
It is important to note that a panic attack is unexpected. In other words, it comes out of nowhere and tends to resolve rather quickly. This helps distinguish it from phobia or other forms of anxiety. A panic attack is very much the same, but can occur in conjunction with many other anxiety, trauma, or depressive symptoms.
Agoraphobia
Agoraphobia is characterized by out of proportion fear of using public transportation, being in open/enclosed spaces, standing in line/in a crowd, and/or being outside of the home alone. These situations are avoided because escape may not be easy, or help is not readily available if panic symptoms emerge. As such, people avoid these situations.
Generalized Anxiety Disorder
Generalized Anxiety Disorder is characterized by excessive anxiety that occurs most days for at least six months. The person struggles to control the anxiety. The anxiety tends to manifest as:
- Feeling restless
- Being easily fatigued
- Problems with concentration or thinking
- Irritability
- Muscle tension
- Sleep disturbance.
Treatment Considerations
- Medication can be helpful but not often the first line of treatment.
- Psychological Treatments:
- Cognitive Behavior Therapy
- Different forms of exposure therapy
- Psychodynamic therapy
- Family therapy
- Stress Inoculation
- Stress/Anxiety reduction methods such as self-calming exercises.
- Hypnotherapy
- Addressing nutritional factors (e.g. excessive use of caffeine).