Anxiety Disorders

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.