Anxiety Disorders

In the United States anxiety disorders are the most common type of psychiatric disorder (Hollander and Simeon, 2011). About 18 percent of the United States population experiences some type of anxiety disorder in any given year. Over a lifetime approximately 29 percent of the American population is faced with an anxiety disorder (Kessler, et al., 2012). 

Anxiety disorders recognized by the American Psychiatric Association (Diagnostic and Statistical Manual (2013) include:

•  Generalized Anxiety Disorder – Person experiences significant and uncontrollable anxiety and worry about a variety of matters for at least six months. Person may encounter sleep disturbance, poor concentration, edginess, fatigue, irritability or muscle tension.
•  Obsessive Compulsive Disorder (OCD) – Obsessions are intrusive and unwanted thoughts, urges or images causing marked anxiety and stress. Individuals typically attempt to ignore or suppress obsessions or control them with another thought or action (compulsive behavior). Compulsions involve repetitive and driven behavior or mental acts that a person engages in control his or her anxiety and obsessions. Obsessions and compulsions are often quite time consuming and cause distress and impairment.
•  Specific Phobia – Marked, persistent and disproportionate fear of an object or situation for at least six months. Exposure to the object or situation elicits immediate fear. Person may avoid feared situation or object. Significant distress or impairment is experienced.
•  Panic Disorder – Persistent and unexpected panic attacks. Panic attacks typically involved rapid heartbeat, sweating, trembling, shortness of breath, chest discomfort, nausea, dizziness, numbness, fear of losing control, fear of dying or feeling that things are not real.
•  Selective Mutism – For at least one month a person persistently does not speak in certain social situations (e.g. at school) despite speaking in other situations. This interferes with educational, social or occupational functioning. This problem is not due to a lack of understanding the spoken language or a communication disorder. Other problems should be ruled out, such as autism and psychosis.
•  Separation Anxiety Disorder – Developmentally inappropriate and excessive fear or anxiety in reaction to separation from those whom the individual is attached. This may involve anticipation or experiencing separation, persistent and excessive worry about losing major attachment figures, worry about experiencing separation, resistance to leave home due to fear of separation, fear of being alone, resistance to sleeping away from attachment figure, chronic nightmares about separation and physical complaints, such as headaches and stomachaches, when separated from attachment figures.
• Social Anxiety Disorder (Social Phobia) – Fear and anxiety about social situations where a person may be exposed to the scrutiny of others. Such individuals typically avoid these situations. Person fears being humiliated or embarrassed that leads to social rejection.
•  Other anxiety disorders include hoarding, hair pulling, agoraphobia, body dysmorphic disorder and skin picking.

People with anxiety disorders are often misunderstood and given advice that his not helpful. Others are more likely to act in an understanding and compassionate manner if they have had personal experience with anxiety disorders or if they have a friend or relative who has suffered from an anxiety disorder. Some religious groups appear more open and accepting of individuals experiencing mental illness than other groups (Adams, 1988).

Treatment for anxiety disorders varies, depending on the type of disorder. Psychotherapy for these disorders may include behavior therapy techniques, such as relaxation training, desensitization or exposure therapy. Cognitive psychotherapy helps people recognize and change thoughts about their circumstances and relationships that cause them to feel anxious. It is important that a treating psychotherapist have specific training in treating the type of anxiety disorder presented. Medication treatment for anxiety disorders can be complicated. Too often individuals are prescribed a class of medication called Benzodiazepines, such as Xanax or Valium. If not properly managed, these medications can become physically addicting. Benzodiazepines can offer immediate relief, but then the person does not learn to control his or her anxiety. A thorough psychological evaluation can offer recommendations about how treatment should proceed. 

A helpful website for additional information on anxiety disorders is www.adaa.org. The National Institute of Mental Health’s website is: www.numh.nih.gov.

References

Adams, S.B. (1988). Religious orientation and attitudes toward mental illness. Dissertation Abstracts International.

American Psychiatric Association (2013). Diagnostic and Statistical Manual (5th ed.). Washington D.C.: Author.

Comer, R. J. (2015). Abnormal psychology. New York: Worth Publishing.

Kessler, R.C., Petukhova, M., Sampson, N.A., Zaslavsky, A.M., & Wittchen, H. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods of Psychiatric Research, 21 (3).

Hollander E. & Simeon, D. (2011). Anxiety Disorders. In R.E. Hales, S.C. Yudofsky, & G.O. Gabbard (Eds.), Essentials of psychiatry (3rd ed., pp. 185-228). Arlington, VA: American Psychiatric Publishing.