ANXIETY DISORDERS

Charles E. Martin, Ph.D.

Note:  This information is provided for informational purposes only.  It is not intended as treatment advice or to replace personal psychological care or medical attention if needed.  There is no substitute for the experience and judgment that a professional can provide to evaluate and treat any psychological,  emotional, mood, or mental problem face to face.  Many medical conditions have symptoms that are similar to psychological disorders and it is always good judgment to have a medical checkup as a first step.   If you are, or have been, in professional counseling or treatment and any information given in this site is contrary to advice you have received, you should consult your therapist or doctor.

Everyone feels some degree of anxiety or nervousness from time to time.  Some of the best examples are public speaking or interviewing for a new job.  However, if the anxiety you experience is not temporary, and especially if it begins to interfere with your functioning in life, you may be experiencing an anxiety disorder.

Having an Anxiety Disorder doesn't mean you are crazy.  It simply means you are experiencing higher than levels of fear or apprehension that usually can be treated.

The Kinds of Anxiety Disorders

Generalized Anxiety Disorder - is where there is almost constant worry and fretting over things in life, usually without good reason.  The worry seems endless and the worst is usually expected to happen.  The worry may interfere with sleep or concentration.

        Symptoms of Generalized Anxiety Disorder:

                    (1)   little or no control over the tendencies to worry excessively

                    (2)  feeling restless or "on edge"

                    (3)  sleep disturbance

                    (4)  irritability and tenseness

                    (5)  difficulties with concentration

                    (6)  feelings of fatigue

Panic Disorder - is having periods of sudden extreme fear where the person feels he or she is dying, going crazy, or having a heart attack.  There are intense physical symptoms like shortness of breath, choking, trembling, and a racing heart.  Almost always a secondary fear will become a focus - that of having another panic attack.  Often the apprehension and dread of having another panic attack leads to the person avoiding places where they experienced any anxiety, sometimes to the point of rarely leaving the safety of home.

        Symptoms of Panic disorder:

                    (1)  fear of dying, losing control, or going crazy

                    (2)  dizziness or feeling faint

                    (3)  racing or pounding heart

                    (4)  intense apprehension and dread

                    (5)  choking sensations

                    (6)  shortness of breath or feelings of smothering

                    (7)  trembling, shaking, or agitation

                    (8)  nausea

                    (9)  chest pain or discomfort

                  (10)  sweating

Agoraphobia - is a type of anxiety in which the person fears being caught without an easy means of escape, such as in buildings, driving on the Interstate, crossing bridges, or in elevators.  Often this form of fear disorder seriously restricts how far from home a person can travel or where they can go.  Often associated with panic disorder, this form of anxiety can significantly restrict a person's lifestyle or movements away from home.

        Symptoms of Agoraphobia:

                    (1)  much anxiety about being in situations or places where escape might be impeded or difficult.  When in church or theaters, seating is usually near an exit.

                    (2)  excessive worry about being embarrassed by having an anxiety or panic attack

                    (3)  travel is restricted or avoided.

                    (4)  usually a secondary "fear of the fear" so that anything that increases the possibility of panic is avoided.

                    (5) there is often a "safe" distance that can be traveled away from home.  This may be quite restricted.

                    (6)  often there is fear of any situation where the person feels he has no control or easy means of escape, such as riding public transportation or traveling on interstate highways.

Obsessive-Compulsive Disorder - is a type of anxiety characterized by repetitive thoughts or impulses (the obsessions) and repetitive actions or rituals (the compulsions)  that a person feels no control over.  Common obsessions are of being contaminated by germs, of repeated doubts and worries (such as excessively checking doors to see if they are locked), or of rigid rules for how things must be arranged.  Some common compulsions are excessive washing of the hands, repeatedly checking doors or lights, or precisely arranging things in a particular order.  The compulsive behavior serves to reduce the internal anxiety felt by the obsessional thoughts, but usually lasts only temporarily.

        Symptoms of Obsessive-Compulsive Disorder (OCD):

                    (1)  persistent and recurring thoughts or images in the mind that the person feels little control over.

                    (2)  the thoughts or images cause marked  distress and anxiety.

                    (3)  the person attempts to neutralize or reduce the anxiety by other thoughts or some form of action.

                    (4)  undertaking repetitive behaviors or rituals that serve to reduce the anxiety present, such as excessive checking, excessive cleaning, or counting.

                    (5)  often having rigid rules or procedures that must be performed in a precise way to "undo" the anxiety or obsessive thoughts.

                    (6)  the person often knows that the obsessive thoughts or compulsive behaviors are unrealistic, but feels helpless to stop them.

Post Traumatic Stress Disorder (PTSD) - is a form of anxiety where there is a reliving of some very traumatic event that has happened in life.  The events might be an accident or injury, some natural disaster such as flood, or a personal tragedy such as rape.  Often the person has recurring dreams, flashbacks, or reliving of the traumatic event, and these moments cause much distress.

        Symptoms of PTSD:

                    (1)  the person was exposed or experienced some event which caused actual or possible injury, and the reaction to this event was horror, fear, or helplessness.

                    (2)  there are usually nightmares, flashbacks, and continued reliving of the event.

                    (3)  there is usually avoidance of anything connected to the traumatic event, such as conversation or related objects.

                    (4)  feelings and emotions become dulled.

                    (5)  often there is an inability to recall some important aspect of the traumatic event.

                    (6)  depression

Specific Phobias - are an excessive fear of some object of situation, such as a fear of dogs, a fear of heights, or a fear of flying or public speaking.  Phobic individuals avoid the feared object or situation and rarely allow their fears to become very intense through this avoidance.  An example would be to never ride an elevator.

        Symptoms of Specific Phobias:

                    (1)  irrational or excessive fears of an object or situation, such as fear of heights or sight of blood.

                    (2)  the fears tend to be persistent

                    (3)  behavior is changed, sometimes to the extreme,  to avoid the feared object of situation.

                    (4)  the closer a person comes to the object or situation, the more marked the anxiety reaction.

Social Phobias - are excessive fears about being judged or evaluated in public or of exposure to unfamiliar people.  Often social phobias can prevent a person from going to normal and usual places such as restaurants or stores.

        Symptoms of Social Phobia:

                    (1)  an avoidance to situations, especially in public, where there are unfamiliar people or there is some potential of being evaluated or scrutinized by others.

                    (2)  an unrealistic fear of being embarrassed.

                    (3)  the avoidance interferes with a person's normal routine, activities, or relationships.

                    (4)  the fears are unrealistic, unreasonable, or excessive.

Acute Stress Disorder - a reaction to a situation where the person experienced or observed a traumatic event that involved actual or possible injury or death.

        Symptoms of Acute Stress Disorder:

                    (1)  the traumatic situation caused a reaction of intense fear, horror, or helplessness. 

                    (2)  there are dissociative reactions, such as feelings of detachment or being emotionally "numb"

                    (3)  there may be amnesia or feelings of being in a daze.

                    (4)  the traumatic event is relived by nightmares, flashbacks, or of recurring thoughts.

                    (5)  the reaction causes some impairment in social, job, or other functioning.

                    (6)  difficulties in sleeping, increased startle reaction, poor concentration, irritability, and restlessness.

Note:  In many of the anxiety disorders, there may be associated depression, low self-esteem, and reduced self-confidence as a result of the fears present.  Often anxiety disorders also lead to abuse of alcohol or drugs as "self medication."

Treatment of Anxiety Disorders

There are three methods of treating anxiety disorders - 

                    1.  Counseling alone (also called psychotherapy)

                    2.  Medication alone

                    3.  Some combination of both counseling and medication

Not all anxiety disorders require medication.  Many can best be treated with counseling alone.  Counseling involves talking with a mental health professional, such as a Clinical Psychologist or a Master's level therapist.  Clinical Psychologists have a doctorate degree (Ph.D. or Psy.D.) and specialize in the treatment of stress, emotional, anxiety, and mental disorders.  Master's level therapists are generally Licensed Clinical Social Workers (L.C.S.W.).  Occasionally psychiatrists (MD degree) do counseling, but generally they specialize in the evaluation and administration of medication for mental health problems.

Counseling involves talking about problems and developing coping skills and solutions to the problem.  If medication seems needed, counselors work with family doctors and psychiatrists who will evaluate and prescribe the appropriate medications.

Several of the anxiety disorders are usually treated with a combination of counseling and medication.  The best way to find the most appropriate treatment is to meet with a mental health professional and have the problem evaluated.

Dr, Martin treats anxiety disorders and would be pleased to have you call for an appointment (690-9998).