Anxiety Disorders

The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ; published by the American Psychiatric Association) lists the criteria for several Anxiety Disorders, including:

Panic Disorder Without Agoraphobia
Panic Disorder With Agoraphobia
Agoraphobia Without History of Panic Disorder
Specific Phobia
Social Phobia
Obsessive-Compulsive Disorder (OCD)
Posttraumatic Stress Disorder
Acute Stress Disorder
Generalized Anxiety Disorder
Anxiety Disorder Due To (a general medical condition)
Substance-Induced Anxiety Disorder
Anxiety Disorder, Not Otherwise Specified (NOS)

A "Panic Attack," which, in and of itself, does not have a diagnostic code and is not diagnosed as a separate anxiety disorder, occurs in several of the Anxiety Disorders. A panic attack consists of a period of intense physical and psychological distress or fear and can manifest in several of the following symptoms:
Heart palpatations or feeling like the heart is pounding, sweating, trembling, shortness of breath, chest pain, nausea, lightheadedness, feeling detached from oneself, fear of losing control, fear of dying, numbness, and chills or hot flashes. The physiological symptoms of a panic attack closely resemble the physiological symptoms one might experience at a time of intense fear, hence it is widely accepted that panic attacks are in some way a fear reaction to something imagined or real.

Similarly, Agoraphobia is not a separate anxiety disorder, but rather a symptom of some other anxiety disorders. Simply put, agoraphobia is anxiety related to fear of not being able to escape from a difficult or embarrassing situation, such as being on a bridge, traveling in a vehicle, or simply being outside the home, which is what the etiology of the word itself means: Fear of the Marketplace.

In this article we will focus on the more common anxiety disorders that are seen in clinical practice:

Specific Phobia-- A specific phobia is the intense and unreasonable fear of an object or situation, such as the fear of snakes, heights, flying, seeing blood, etc. Sometimes even the mere thought of the feared object or situation can cause symptoms of anxiety or a panic attack.

Obsessive-Compulsive Disorder-- This can be either obsession or compulsions or both. Obsessions are recurrent, intrusive thoughts or impulses that cause intense anxiety that the sufferer tries to control, realizing that these thoughts are not based in reality, but in his or her own mind. Compulsions are repetitive behaviors (such as counting, hand-washing, checking and re-checking something, etc.) that the person feels compelled to perform. Typically, the sufferer recognizes that that the obsessions or compulsions are unrealistic, but is unable to control the behavior. The obsessions or compulsions can cause the sufferer intense anxiety, consume a lot of their time, and greatly interfere with their personal, occupational, or social activities.

Posttraumatic Stress Disorder-- A lot has been said over recent years concerning PTSD in relation to individuals who experienced 9-11 or served in wars. However, this disorder is also seen in individuals who have been exposed to any traumatic event that threatened life or serious injury, whether it was personally experienced or witnessed. Typically, a sufferer experienced recurrent and intrusive memories and images of the traumatic event, as well as recurrent nightmares of the event. Sometimes the sufferers cannot remember the trauma and they often try to avoid anything that reminds them of the trauma. There are often other symptoms present, such as sleep problems, anger issues, and/or hypervigilence.

Generalized Anxiety Disorder-- Individuals with GAD often experience frequent, excessive worry and anxiety about numerous things. People who worry a great deal, even about "little things" are evaluated for possible GAD. Other symptoms can include irritability, being "on edge," and sleep problems. This worry and anxiety causes significant interference with work, social, or other areas of life.

Fortunately, the Anxiety Disorders can be effectively treated. Stress Management Counseling Center utilizes both Cognitive Behavioral Therapy and Mindfulness-Based Stress Reduction to treat anxiety disorders. Both of these modalities are evidence-based practices that have been shown to be highly effective in treating anxiety disorders.

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