Anxiety or fear-related disorders

An anxiety disorder may make people feel anxious most of the time or for brief intense episodes, which may happen for no obvious reason. People with anxiety disorders may have anxious feelings that are so uncomfortable that they avoid certain activities that could cause these feelings. 

Some people have occasional anxiety attacks so intense that they are terrified or immobilized. People with anxiety disorders are usually aware of the unreasonable and excessive nature of their fears. 

When they come for treatment, they may say, “I know my fears are ridiculous, but I just can’t seem to stop them.” 

When the cognitive, physical, and behavioral symptoms of anxiety are persistent and severe, and anxiety causes extreme distress in a person’s life to the extent that it negatively affects their  ability to manage day-to-day tasks, it may be beyond normal range. 

The following examples of anxiety symptoms may indicate an anxiety disorder: 

1. Cognitive: anxious thoughts such as “I’m losing control”; anxious predictions such as “I’m going to fall flat on my face and make a fool out of myself”; and anxious beliefs such as “only weak people get anxiety”.

2. Physical: excessive physical reactions relative to the situation (i.e., heart palpitations and shortness of breath in response to being in Home Depot. The physical symptoms of anxiety may be mistaken for symptoms of a physical illness, such as a heart attack. 

3. Behavioral: avoidance of feared situations such as driving, avoidance of activities that elicit sensations similar to those experienced when anxious, subtle avoidances (behaviors that aim to distract the person, e.g., excessive talking during periods of anxiety) and safety behaviors (habits to reduce anxiety and feel “safer,” e.g., always having a cell phone available in case you need to call for help).

The major categories of anxiety disorders are classified according to the focus of the anxiety.

A brief description of each is given below, based on the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear.

Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

This disorder is characterized by panic attacks and sudden feelings of terror sometimes occurring repeatedly and without warning. A panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.

Many people will go to desperate measures to avoid an attack, including social isolation.

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

GAD impacts nearly 7 million U.S. adults, yet less than half receive treatment. Women are twice as likely to be affected as men, and GAD tends to co-occurs with symptoms of depression.

Obsessive-compulsive disorder (OCD) affects around 1–3% of the population and is characterised by unwanted, intrusive, persistent or repetitive thoughts, feelings, ideas, sensations (obsessions), or behaviours that makes the sufferer feel driven to do something (compulsions) to get rid of the obsessive thoughts.

This only provides temporary relief and not performing the obsessive rituals can cause great anxiety.

A person’s level of OCD can be anywhere from mild to severe, but if severe and left untreated, it can destroy a person’s capacity to function at work, at school or even to lead a comfortable existence in the home.

More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g., saying something stupid or not knowing what to say).

Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Approximately 7% of U.S. adults are impacted by social anxiety in a given year.

Post-traumatic stress disorder (PTSD) is a psychological reaction to an extremely stressful event outside the range of everyday experience, such as fighting in a war, physical violence, or a natural disaster.

The symptoms may include depression, anxiety, flashbacks, recurrent nightmares, and avoidance of situations that might trigger memories of the event. 

Other anxiety disorders include:

• Agoraphobia

• Separation anxiety disorder