Types of Anxiety: Just the Facts

The umbrella term "anxiety" can refer to a group of disorders. Anxiety itself may be the primary complaint or it may arise after confronting the main focus of the disorder, such as a person only feeling anxious after encountering a snake, for which they have a phobia. There are also varying levels of anxiety. It is not abnormal to feel anxious when facing a stressful situation. But if that stress continues for days or weeks, then a disorder might be in play. If that anxiety peaks resulting in extreme distress or abnormal behaviors, then there may be a disorder.

Main Categories of Anxiety Disorders

  • Generalized anxiety disorder (GAD) is simple anxiety taken to an extreme. Some symptoms are shakiness, sweating, heart pounding, and overwhelming, if unfocused fear.
  • Panic disorder manifests in “attacks” that are debilitating. The attacks may be predictable based on an event, but can also be unpredictable. There is intense apprehension accompanied with uncomfortable physical symptoms, some of which are interpreted by the victim as a heart attack or near death.
  • Phobia, also called “specific phobia,” is characterized by an irrational fear that is focused on a thing or a situation. For instance, we all feel a twinge when looking off the top of a tall building, but if someone is immobilized, shaking, sweating, etc., he may have acrophobia, a fear of heights. These phobias might be focused on things we all react to, such as giving a public speech, or they may be bizarre, such as a fear of beards.
  • Social anxiety disorder is the fear of interacting with other people and can be a crippling disorder because it can interfere with work and creating relationships. With a compelling desire to avoid all social situations, victims often have trouble leaving their houses.
  • Obsessive-compulsive disorder (OCD) is characterized by invasive thoughts and nearly automatic behaviors that are repetitive and disruptive in nature. One common obsession is with germs; germophobes are likely to wash their hands over and over until they are raw and might be unable to touch any surfaces outside their home.
  • Post-traumatic stress disorder (PTSD) comes on after a very dramatic event or a series of events. The events producing PTSD are epic, such as a war or a natural disaster, or severe abuse by a parent. The victim of this disorder may have hyper-alertness, nightmares, and recurrent thoughts. They also suffer from depression and anxiety.

Similarities Between the Disorders

All these disorders share the basic quality of having anxiety. Anxiety is based on fear and causes the sympathetic nervous system to be activated. As such, they share many physiological symptoms such as increased breath and heart rate. Treatment is similar for many of these disorders, as the biological problem may be a reduced amount of serotonin available in the brain. Susceptibility is the same. If someone in the family has any of these disorders, statistically it is more likely another family member will suffer from one of these disorders.

Differences Between the Disorders

Each disorder has its own unique characteristics that differ so much it may be hard to see them as belonging to the same family of disorders. Someone with panic disorder or phobia may seem completely calm and normal until something triggers them to their activated state. The obsessive-compulsive type might continuously reveal themselves in subtle ways. They almost never have a “break down” like one would see with panic or phobia. Social disorder is obvious to anyone who approaches the victim. The treatments can be similar, but there are key differences in the goals and approaches by the psychotherapists.

Treatments

Treatment plans for each of these disorders starts with exercise, good sleep, and a balanced diet. Beyond that, the treatments of some are the same and some are very significantly different.

  • Generalized anxiety disorder – antidepressants, benzodiazepines and another type of drug called busipirone are the medical interventions for this disorder. Cognitive behavioral therapy is used, or specific anxiety management therapy focused on educating the person and relaxation. Cognitive restructuring is not appropriate.
  • Panic disorder- SSRI (selective serotonin reuptake inhibitor) antidepressants are the favored medication. Barbiturates may be prescribed for as-needed use. Cognitive behavioral therapy is recommended, with the goal of recreating the fear and creating a new way to deal with it.
  • Phobia- victims may be given a barbiturate to deal with the situation on an as-needed basis, but it’s less likely they will be given a regime of drugs. With exposure therapy, they are introduced to the fear producing stimulus in a slow and safe way.
  • Social anxiety disorder- This may require antidepressants, or mild tranquilers, but the emphasis is on psychotherapy. Symptoms might also include stammering and nausea. Cognitive behavioral therapy attempts to address “core” beliefs, such as “I am unworthy.”
  • Obsessive-compulsive disorder – SSRIs are tried first, with tricyclics as the second medical line of defense. Cognitive Behavioral Therapy is used, with a focus on ERP (exposure and response prevention).
  • Post-traumatic stress disorder - This can be treated with antidepressants, especially SSRIs. If patients do not respond and their symptoms are severe, they might be given specific antipsychotic drugs. Exposure therapy and EMDR are the therapies of choice for PTSD.

Hope exists for each of these conditions. With the right treatment, symptoms can be dramatically reduced. While there will likely always be some low level of anxiety, functionality can be restored with the proper medication and psychotherapy.

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