Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.
There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, and various phobia-related disorders. Please see my advice on panic and anxiety during the COVID-19 crisis as quoted in LIVING WITH PANIC AND ANXIETY ATTACKS DURING THE CORONAVIRUS CRISIS .
Signs and Symptoms
Generalized Anxiety Disorder
People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.
Generalized anxiety disorder symptoms include:
- Feeling restless, wound-up, or on-edge
- Being easily fatigued
- Having difficulty concentrating; mind going blank
- Being irritable
- Having muscle tension
- Difficulty controlling feelings of worry
- Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep
People with panic disorder have recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that come on quickly and reach their peak within minutes. Attacks can occur unexpectedly or can be brought on by a trigger, such as a feared object or situation.
During a panic attack, people may experience:
- Heart palpitations, a pounding heartbeat, or an accelerated heartrate
- Trembling or shaking
- Sensations of shortness of breath, smothering, or choking
- Feelings of impending doom
- Feelings of being out of control
People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks.
A phobia is an intense fear of—or aversion to—specific objects or situations. Although it can be realistic to be anxious in some circumstances, the fear people with phobias feel is out of proportion to the actual danger caused by the situation or object.
People with a phobia:
- May have an irrational or excessive worry about encountering the feared object or situation
- Take active steps to avoid the feared object or situation
- Experience immediate intense anxiety upon encountering the feared object or situation
- Endure unavoidable objects and situations with intense anxiety
There are several types of phobias and phobia-related disorders:
Specific Phobias (sometimes called simple phobias) : As the name suggests, people who have a specific phobia have an intense fear of, or feel intense anxiety about, specific types of objects or situations. Some examples of specific phobias include the fear of:
- Specific animals, such as spiders, dogs, or snakes
- Receiving injections
Social anxiety disorder (previously called social phobia) : People with social anxiety disorder have a general intense fear of, or anxiety toward, social or performance situations. They worry that actions or behaviors associated with their anxiety will be negatively evaluated by others, leading them to feel embarrassed. This worry often causes people with social anxiety to avoid social situations. Social anxiety disorder can manifest in a range of situations, such as within the workplace or the school environment.
Agoraphobia: People with agoraphobia have an intense fear of two or more of the following situations:
- Using public transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line or being in a crowd
- Being outside of the home alone
People with agoraphobia often avoid these situations, in part, because they think being able to leave might be difficult or impossible in the event they have panic-like reactions or other embarrassing symptoms. In the most severe form of agoraphobia, an individual can become housebound.
Separation anxiety disorder: Separation anxiety is often thought of as something that only children deal with; however, adults can also be diagnosed with separation anxiety disorder. People who have separation anxiety disorder have fears about being parted from people to whom they are attached. They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated. This fear leads them to avoid being separated from their attachment figures and to avoid being alone. People with separation anxiety may have nightmares about being separated from attachment figures or experience physical symptoms when separation occurs or is anticipated.
Treatment for Anxiety Disorders
Anxiety disorders are generally treated with talk psychotherapy to include cognitive behavioral therapy(CBT), medication, or both. There are many ways to treat anxiety and people should work with their therapist and doctor to choose the treatment that is best for them. To be assessed for an anxiety disorder, contact Donna Schwartz, LICSW at 202-728-9550 or [email protected]