Anxiety Disorders:  An  Overview

Social Anxiety Disorder

 “In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick in my stomach-it almost felt like I had the flu. My heart would pound, my palms would get sweaty, I would get this feeling of being removed from myself and from everybody else.”

“When I would walk into a room full of people, I’d turn red and it would feel like everybody’s eyes were on me. I was embarrassed to stand off in a corner by myself, but I couldn’t think of anything to say to anybody. It was humiliating. I felt so clumsy, I couldn’t wait to get out.” (www.nimh.nih.gov, 2011)

People with social anxiety disorder experience intense feelings of anxiety in social or performance situations. For some people, the fear and anxiety may be limited to one particular situation (e.g., public speaking), while others may experience anxiety in a variety of social situations (e.g., conversations with unfamiliar people, dating, being assertive, talking with supervisors or authority figures, being the center of attention). People with social anxiety are usually afraid that they will behave in a way or show visible signs of anxiety (e.g., blushing, sweating) that will be embarrassing or humiliating. As a result, most people with social anxiety will either avoid social situations all together or endure them with great distress.

Examples of common anxiety provoking social situations: public speaking, conversation with unfamiliar people, dating, being assertive, talking with supervisors or authority figures, being the center of attention, eating or drinking in public, participating in meetings, or attending parties.

Physical symptoms that may accompany social anxiety: blushing, sweating, trembling, nausea, dizziness, or difficulty speaking.

  1. Do you often feel nervous, self-conscious, or uncomfortable interacting with other people? Do these feelings prevent you from doing things you want to do?
  2. Do you feel like your social anxiety has held you back or prevented you from pursuing academic or career opportunities that require interacting with unfamiliar people?
  3. Do you have trouble stating your opinion or asking for something that you deserve because you worry about what others will think of you?
  4. Do you limit how involved you become with people because you are afraid of letting them get to know you? Do you worry that if people really knew you, they wouldn’t like you?
  5. Do you like other people and daydream about a better social life but doubt your ability to achieve your dream because you are too shy to really get to know people?

If yes, you may be suffering from social anxiety disorder.

Panic Disorder

“For me, a panic attack is almost a violent experience. I feel disconnected from reality. I feel like I’m losing control in a very extreme way. My heart pounds really hard, I feel like I can’t get my breath, and there’s an overwhelming feeling that things are crashing in on me.”

“It started 10 years ago, when I had just graduated from college and started a new job. I was sitting in a business seminar in a hotel and this thing came out of the blue. I felt like I was dying.”

“In between attacks there is this dread and anxiety that it’s going to happen again. I’m afraid to go back to places where I’ve had an attack. Unless I get help, there soon won’t be any place where I can go and feel safe from panic.” (www.nimh.nih.gov, 2011)

When someone experiences a panic attack, s/he feels an unexpected or sudden rush of intense fear or discomfort. The sudden rush of fear is usually accompanied with any combination of the following physical symptoms: sensation of shortness of breath or smothering, chest pains or discomfort, dizziness or faintness, fear of dying, fear of losing control or impending doom, feeling of choking, feelings of detachment, feelings of unreality, nausea or upset stomach, numbness or tingling in the hands, feet, or face, palpitations, fast heart rate, or pounding heart, sweating, chills, or hot flashes, trembling or shaking.

Panic attacks can be experienced by individuals without anxiety disorders or as a part of different anxiety disorders. However, in panic disorder, the panic attacks are unexpected and individuals experience persistent worries about having an attack or its consequences. Individuals may avoid situations where the panic attacks could occur or where there would be no easy escape.

Sometimes people with panic disorder avoid certain daily activities (such as going to the grocery store, traveling by car or bus, waiting in lines etc.), or refuse to go to places without a trusted other person. Individuals who avoid situations where escape might be difficult or, if a panic attack were to occur, help might be unavailable, are said to have agoraphobia. People can have panic disorder and agoraphobia, and in some cases, agoraphobia on its own.

  1. Do you have rushes of fear that make you think you are sick, dying, or losing your mind? When these panic-related thoughts happen, does it feel as if your heart is going to burst out of your chest or as if you cannot get enough air?
  2. Do you feel dizzy, faint, trembly, sweaty, short of breath or just scared to death?
  3. Do these feelings sometimes come from out of the blue, when you least expect them?
  4. Are you worried about when these feelings will happen again?
  5. Do these feelings interfere with your normal daily routine or prevent you from doing things that you would normally do?

If yes, you may be suffering from panic disorder.

Generalized Anxiety Disorder

“I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”

When my problems were at their worst, I’d miss work and feel just terrible about it. Then I worried that I’d lose my job. My life was miserable until I got treatment.

“I’d have terrible sleeping problems. There were times I’d wake up wired in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I’d feel a little lightheaded. My heart would race or pound. And that would make me worry more. I was always imagining things were worse than they really were. When I got a stomachache, I’d think it was an ulcer.” (www.nimh.nih.gov, 2011)

People with GAD have constant, excessive and uncontrollable anxiety and worry about a number of events or activities in their lives. They often anticipate the worst to occur and cannot stop themselves from frequently worrying about it. When worried, they often experience physical symptoms such as: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or their mind going blank, irritability, muscle tension, or difficulties falling asleep, staying asleep or experiencing restless sleep.

  1. Are you a worrier?
  2. Do you have anxiety and worry about a number of areas of your life that you find difficult to control?
  3. Do you often worry about future events and expect things to go badly?
  4. Do you experience restlessness, muscle tension, difficulties sleeping, fatigue, irritability or other physical symptoms when you worry?

If yes, you may be suffering from general anxiety disorder.

Obsessive-compulsive Disorder

“I knew it didn’t make sense — the rituals I was doing weren’t really going to prevent bad things from happening, but I couldn’t stop myself.  If I wasn’t careful enough, if I wasn’t really sure, then I felt like disaster was right around the corner.  At the beginning it was almost manageable, but the thoughts and rituals just kept growing.  I started avoiding a lot of things just so I wouldn’t have to get into that cycle of thoughts and compulsions.” (www.nimh.nih.gov, 2011)

People with OCD have unwanted thoughts or images (obsessions) that come into their mind and cause them extreme discomfort or anxiety. Often times individuals with this disorder develop rituals (actions or special thoughts) called compulsions that they use to counteract the obsessions that come into their mind and reduce the anxiety that they feel. The actions or rituals may temporarily reduce the anxiety, but this relief does not last for long. Individuals feel that they cannot stop themselves from engaging in the rituals even though the rituals may interfere with daily functioning and/or create a lot of distress for them.

Examples of obsessions: concern about dirt, germs, or other contaminates; fearful thoughts about the safety of self or others; excessive moral or religious concerns; upsetting mental images.

Examples of compulsions:  repetitive behaviors such as hand washing, ordering and checking; mental acts such as praying, counting, repeating words or phrases.

  1. Do you have upsetting thoughts or images that enter your mind repeatedly?
  2. Do you feel as if you can’t stop these thoughts or images, even though you would like to?
  3. Do you have difficulty stopping yourself from doing things again and again, such as counting, checking on things, washing your hands, doing things until they seem perfect or collecting objects?
  4. Do you worry a lot about upsetting things that could happen to you or your loved ones?

If yes, you may be suffering from obsessive-compulsive disorder.