 |
Anxiety Disorders |
All of us, at
one time or another, experienced anxiety, a feeling of apprehension or tension,
in reaction to stressful situations. There is nothing “wrong” with such
anxiety. It is a normal reaction of stress that often helps, rather than
hinders, our daily functioning. Without some anxiety, for instance, most of us
probably would not have much motivation to study hard, undergo physical exams,
or spend long hours at our jobs. But some people experience anxiety in situations in
which there is no external reason or cause for such distress. When anxiety
occurs without external justification and begins to affect people daily
functioning, mental health professionals consider it a psychological problem
known as anxiety disorder. Four major type of anxiety disorder are phobic
disorder, panic disorder, generalized anxiety disorder, and
obsessive-compulsive disorder.
PHOBIC
DISORDER
Phobic
Disorder is an intense, irrational fear of a specific object or situation. For
example, claustrophobia is a fear of enclosed places, acrophobia is a fear of
high places, xenophobia is a fear of strangers, social phobia is the fear of
being judged or embarrassed by others, and electrophobia is a fear of electricity.
The
objective danger posed by an anxiety-producing stimulus is typically
small or nonexistent. However someone suffering from the phobia, the danger is great
and a full-blown panic attack may follow exposure to the stimulus. Phobic
disorders differ from generalized anxiety disorders and panic disorders in that
there is a specific, identifiable stimulus that sets off the anxiety reaction.
Phobias
may have only a minor impact on people's lives if those who suffer from them
can avoid the stimuli that trigger fear. Unless they are firefighters or window
washers, for example, a fear of heights may have little impact on people's
everyday lives (although it may prevent them from living in a high floor in an
apartment). On the other hand, a social phobia, or a fear of strangers,
presents a more serious problem. In one extreme case, a Washington woman left
her home just three times in 30 years – once to visit her family, once for a
medical operation, and once to purchase ice cream for a dying companion.
PANIC DISORDER
In another type
of anxiety disorder, panic disorder, panic attacks occur that last from
a few seconds to several hours. Unlike phobias, which are stimulated by
specific objects or situations, panic disorders do not have any identifiable
stimuli. Instead, during an attack, anxiety suddenly - and often without
warning—rises to a peak, and an individual feels a sense of impending,
unavoidable doom. Although the physical symptoms differ from person to person, they
may include heart palpitations, shortness of breath, unusual amounts of
sweating, faintness and dizziness, gastric sensations, and sometimes a sense of
imminent death. After such an attack, it is no wonder that people tend to feel exhausted.
Panic
attacks seemingly come out of nowhere and are unconnected to any specific
stimulus. Because they don't know what triggers their feelings of panic,
victims of panic attacks may become fearful of going places. In fact, some
people with panic disorder develop a complication called agoraphobia, the fear
of being in a situation in which escape is difficult and in which help for a
possible panic attack would not be available. In extreme cases, people with agoraphobia
never leave their homes.
In
addition to the physical symptoms, panic disorder affects how information is processed
in the brain. For instance, people with panic disorder have reduced reactions
in the anterior cingulate cortex to stimuli (such as viewing a fearful face)
that normally produce a strong reaction in those without the disorder. It may
be that recurring high levels of emotional arousal experienced by patients with
panic disorder desensitizes them to emotional stimuli.
GENERALIZED
ANXIETY DISORDER
People
with generalized anxiety disorder experience long-term, persistent anxiety and
uncontrollable worry. Sometimes their concerns are about identifiable issues involving
family, money, work, or health. In other cases, though, people with the
disorder feel that something dreadful is about to happen but can't identify the
reason, experiencing "free-floating" anxiety.
Because
of persistent anxiety, people with generalized anxiety disorder cannot concentrate
or set their worry and fears aside; their lives become centered on their worry.
Furthermore, their anxiety is often accompanied by physiological symptoms such
as muscle tension, headaches, dizziness, heart palpitations, or insomnia.
OBSESSIVE-COMPULSIVE
DISORDER
In
obsessive-compulsive disorder, people are plagued by unwanted thoughts, called
obsessions, or feel that they must carry out actions, termed compulsions,
against their will. An obsession is a persistent, unwanted thought or idea that
keeps recurring. For example, a student may be unable to stop thinking that she
has neglected to put her name on a test and may think about it constantly for
the two weeks it takes to get the paper back. A man may go on vacation and
wonder the whole time whether he locked his house. A woman may hear the same
tune running through her head over and over. In each case, the thought or idea
is unwanted and difficult to put out of mind. Of course, many people suffer
from mild obsessions from time to time, but usually such thoughts persist only
for a short period. For people with serious obsessions, however, the thoughts
persist for days or months and may consist of bizarre, troubling images
As part of
an obsessive-compulsive disorder, people may also experience compulsions,
irresistible urges to repeatedly carry out some act that seems strange and
unreasonable, even to them. Whatever the compulsive behavior is, people
experience extreme anxiety if they cannot carry it out, and even if it is
something they want to stop. The acts may be relatively trivial, such as
repeatedly checking the stove to make sure all the burners are turned off, or
more unusual, such as continuously washing oneself.
