Generalized Anxiety (GAD)
Generalized anxiety disorder (GAD), sometimes called "free floating anxiety," is a condition characterized by excessive, chronic anxiety that interferes with the ability to function in normal, daily activities. Generalized anxiety is distinguished from a phobia in that it is not necessarily triggered by any specific event. Excessive thinking and dwelling on "what ifs" characterize this disorder. Feelings of worry, dread, lack of energy, and loss of interest in life are common symptoms. The person gets caught in a vicious cycle of anxiety and worry and often becomes depressed about life and the state of anxiety he/she is experiencing. While the person may realize the thoughts are irrational, the fear is quite real. Physical manifestations include headaches, trembling, twitching, irritability, frustration and an inability to concentrate. Elements of social phobia and/or panic may also occur.
Exercise can help to relieve stress, tension, and anxiety.
GAD occurs in 3-4% percent of the population. Approximately 10% of people treated at anxiety clinics are diagnosed with GAD. More women than men suffer from GAD -- 60% are women; 40% are men. Many people who are diagnosed with GAD say they have been nervous all their lives. The risk factors for GAD include environmental stressors, genetics, and sleep deprivation. Stressors such as financial concerns, health, relationships, school or work problems can intensify the symptoms. A 20% greater risk for GAD exists among blood relatives of people with the disorder, and a 10% greater risk exists among people of relatives with depression. A correlation seems to exist among GAD and other disorders including depression, phobia disorder, and panic disorder. Anxiety is also a risk factor for sleeping disorders such as insomnia.
GAD is associated with irregular levels of neurotransmitters in the brain. Increasing levels of GABA (gamma-aminobutyric acid) and serotonin seem to reduce anxiety. Treatment for GAD is often a combination of medication and psychotherapy. Doctors may prescribe antidepressants, benzodiazepines, beta-blockers, or buspirone. The drug choice is influenced by the patients ability to tolerate the side effects and the drug’s effectiveness in reducing symptoms. Therapies for GAD include cognitive behavioral therapy, behavioral therapy, biofeedback, controlled exposure to anxiety-causing situations, meditation, and relaxation therapy. Research has shown that GAD is treatable and does respond to treatment in most cases. It is a good idea to locate a professional who specializes in anxiety disorders when seeking help for this condition.
Social Anxiety
Social anxiety disorder, also called social phobia, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety (intense nervousness) and self-consciousness arise from a fear of being closely watched, judged, and criticized by others.
A person with social anxiety disorder is afraid that he or she will make mistakes and be embarrassed or humiliated in front of others. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer "anticipatory" anxiety -- the fear of a situation before it even happens -- for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable yet is unable to overcome it.
Those who experience agoraphobia often believe that once they are stuck in this cycle, they are unable to care for themselves and are at the mercy of an unsafe location
People with social anxiety disorder suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. Without treatment, social anxiety disorder can negatively interfere with the person's normal daily routine, including school, work, social activities, and relationships.
People with social anxiety disorder may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Social anxiety disorder may be linked to other mental illnesses; such as, panic disorder, obsessive compulsive disorder, and depression. In fact, many people with social anxiety disorder initially see the doctor with complaints related to these disorders, not because of social anxiety symptoms.
The good news is that there are many forms of treatment that can help you cope with social anxiety, including medications that can strengthen weak signals by raising the levels of certain neurotransmitters in the brain or by improving the neurons’ ability to process signals. This ensures that the brain’s vital messages are delivered -- loud and clear.
Panic
Anxiety is a generalized mood condition that can occur without an identifiable triggering stimulus.
Panic disorder is different from "normal" fear and anxiety reactions to stressful events in our lives. It is a serious condition that strikes without reason or warning. Symptoms of panic disorder include, but are not limited to, sudden sensations of fear and nervousness, sweating, racing heart, dizziness, hot flashes, nausea, and sensitivity to light and sound. During a panic attack, the fear response is out of proportion for the situation which often is not threatening. Over time, a person with panic disorder develops a constant fear of having another panic attack; eventually, this can affect daily functioning and general quality of life.
Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. Fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where he/she believes an attack may occur.
Agoraphobia
Although the literal definition of agoraphobia is “fear of open spaces,” the reality of suffering with agoraphobia is somewhat different. In the majority of cases, people with agoraphobia have a fear of leaving what they feel is a “safe zone,” which for most sufferers is usually their home or any place where they feel safe.
For many people, agoraphobia develops when they begin to avoid a situation that makes them feel anxious. For example, if an anxious person felt very panicky while shopping, he or she may start to worry that panic will strike again on the next shopping excursion.
This worry is often enough to trigger another panic attack on the next outing. The person can soon begin to think the only way to control the terrifying symptoms is to avoid certain places. This becomes a vicious cycle leading one to become dependent on a "safe zone." As agoraphobia progresses, the person begins to avoid other places that may cause panic. Examples include standing in line at the supermarket, going to the hairdresser, sitting in a movie theatre, driving a vehicle, attending meetings, and enjoying social gatherings.
Specific phobia is marked by an exaggerated fear of animals or objects. A person with specific phobia might be horrified by a spider, a dog or a bird, or may be frightened by heights, water or the dark.
Unfortunately, avoidance behaviors complicate anxiety disorders and and can lead to agoraphobia. The more a feared situation is avoided, the harder it becomes to overcome the fear; therefore, the vicious cycle continues.
Only by facing the fear can a person learn to deal with that fear. Agoraphobia can be treated. Examples of treatment include cognitive behavioral therapy, drug therapy, or a combination of both.
PTSD
Post-traumatic stress disorder is a disorder that occurs following the experiencing or witnessing of a life-threatening event, such as military combat, natural disaster, serious accident, terrorist event, or a violent personal assault like rape. People who suffer from PTSD often relive the event through nightmares and flashbacks. They often have trouble sleeping and feel detached or estranged from life. These symptoms can be severe enough to interfere with daily activities and relationships. The disorder often impairs the person’s ability to function in society and family life, causing work problems, marital problems, or difficulty with parenting skills.
Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death.
A person suffering from PTSD may also suffer from related disorders such as depression, substance abuse, impairment of memory and cognition, as well as physical symptoms. Physical manifestations include headaches, gastrointestinal complaints, dizziness, chest pain and pain in other parts of the body. PTSD results in real biological and mental changes. People with PTSD tend to have higher levels of key hormones involved in the body’s reaction to stress. Thyroid function is often enhanced, while cortisol levels are lower than normal and epinephrine and nor epinephrine levels are higher than normal. Natural opiates continue to be produced and remain higher even after the trauma has passed. People with PTSD tend to have increased sensitivity to the startle reflex and suffer with sleep abnormalities.
The risk factors associated with developing PTSD after a traumatic event are associated with genetics and environment. The perception of a threat, danger, horror and/or fear is a factor. Those predisposed with feelings of responsibility, betrayal, or lack of control are more likely to develop this condition. People in an environment that promotes feelings of shame, guilt, or stigmatization are especially vulnerable. Lack of a social support system or concurrent events can make onset more likely. Women tend to suffer from PTSD twice as often as men. Events that can trigger PTSD are rape, childhood abuse, combat exposure, physical attack, and being threatened with a weapon. Approximately 30% of people who have been in a war zone experience PTSD.
PTSD is treated with a combination of medication and psychotherapy. Cognitive behavioral therapy, group therapy, and exposure therapy show promise in helping with the condition. The most widely used drugs to treat PTSD are SSRIs, such as Zoloft, Paxil, or Prozac. Medications can help ease the symptoms of depression and anxiety and help with sleep. Research is ongoing in the development of ways to treat this disorder.
OCD
Obsessive compulsive disorder, or OCD, is more than just repeated hand washing! OCD is an anxiety disorder defined by unwanted, anxiety-producing, intrusive thoughts (obsessions) and the actions the sufferer does to reduce the anxiety (compulsions).
Everybody has unwanted, intrusive thoughts, but people with OCD are unable to filter the thoughts and overreact to the fact that they had the thought. The thought is not the issue -- the reaction to the thought is what produces anxiety. OCDers utilize “safety behaviors,” called rituals or compulsions, to alleviate their anxiety symptoms although there may be no connection between the obsession and the compulsion.
Specific phobia is marked by an exaggerated fear of animals or objects. A person with specific phobia might be horrified by a spider, a dog or a bird, or may be frightened by heights, water or the dark.
Compulsions can be overt (counting, washing, cleaning, checking, tapping, etc.) or mental (praying, ruminating, worrying, etc.). Anything done to alleviate the anxiety is a compulsion.
Treatment for obsessive compulsive disorder is two-fold. Usually medications are indicated to help with the anxiety and the over concern with the thought. The most effective medications so far are the SSRI class of antidepressants. However, medications are not a cure-all. A 50% improvement of OCD symptoms with medication is thought to be a good result. The best treatment for OCD is cognitive behavioral therapy (CBT) and, specifically, a version of CBT called exposure-response prevention (ERP).
ERP asks the sufferer to face his or her fear. For example, the OCD patient is asked to touch something contaminated, think the “forbidden” thought, and/or perform the task that causes the anxiety. With a therapist present, the patient is exposed to his or her fear. The patient is then asked to resist performing the compulsion to alleviate the anxiety. Initially, the process is very difficult, but eventually, the person becomes used to or habituates to the anxiety and the triggering thought or action loses its power over the sufferer.
There is no cure for OCD; however, sufferers who practice CBT can potentially get off all medications and the intrusive thoughts become mere background noise instead of controlling their lives.