What are anxiety disorders?

I am a member of several groups focusing on anxiety disorder and phobias. Recently I joined another group and was posting an introduction where I shared my history of dealing with agoraphobia. A member took the liberty to correct me by stating that:

...I believe agoraphobia is fear of big open places... usually means you don't want, or completely don't go outside. There are alot of terms, and many are related and share certain traits

I also had a therapist once (a therapist I was paying weekly mind you) tell me that I wasn't having nor had I ever had "panic attacks" but instead I was having "anxiety attacks." She reminded me that, "If I had a panic attack it would have sent me to the ER." Those of us with panic disorder or anyone who has ever had a panic attack knows this is not true, and also knows that once anyone has a panic attack they are CLEAR about it. Other words they know they didn't have an "anxiety attack" and they know the difference between panic and anxiety.

These comments got me thinking that maybe most people probably aren't familiar with the definitions and characteristics of agoraphobia and other anxiety disorders. The first person's definition is taken from the dictionary, is outdated and not one that professionals use to diagnose. I assume the therapist though her reducing my experience would bring me ease.

Since I have this space I will post information on the various anxiety disorders taken from the Anxiety Disorders Association of America's website in the hopes that it will educate those who may need more information.

GAD (Generalized Anxiety Disorder)
Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things. People with the disorder, which is also referred to as GAD, feel that worrying is beyond their control and they are powerless to stop it. They often expect the worst, even when there is no apparent reason for concern. This anxiety or worry occurs on more days than not for at least six months. Exaggerated and unrelenting worry often centers around issues of health, family, money, or work, and it can interfere with all aspects of a person's life.

Physical symptoms of generalized anxiety disorder include the following:

muscle tension
fatigue
restlessness
difficulty sleeping
irritability
edginess
gastrointestinal discomfort or diarrhea

OCD (Obsessive Compulsive Disorder)
People with obsessive-compulsive disorder (OCD) suffer from unwanted and intrusive thoughts that they can't seem to get out of their heads (obsessions), often compelling them to repeatedly perform ritualistic behaviors and routines (compulsions) to try and ease their anxiety. Most people who have OCD are aware that their obsessions and compulsions are irrational, yet they feel powerless to stop them. Some spend hours at a time performing complicated rituals involving hand-washing, counting, or checking to ward off persistent, unwelcome thoughts, feelings, or images.

Obsessions — unwanted intrusive thoughts

Constant, irrational worry about dirt, germs, or contamination.
Excessive concern with order, arrangement, or symmetry.
Fear that negative or aggressive thoughts or impulses will cause personal harm or harm to a loved one.
Preoccupation with losing or throwing away objects with little or no value.
Excessive concern about accidentally or purposefully injuring another person.
Feeling overly responsible for the safety of others.
Distasteful religious and sexual thoughts or images.
Doubting that is irrational or excessive.

Compulsions — ritualistic behaviors and routines to ease anxiety or distress
Cleaning — Repeatedly washing one’s hands, bathing, or cleaning household items, often for hours at a time.
Checking — Checking and re-checking several to hundreds of times a day that the doors are locked, the stove is turned off, the hairdryer is unplugged, etc.
Repeating — Inability to stop repeating a name, phrase, or simple activity (such as going through a doorway over and over).
Hoarding — Difficulty throwing away useless items such as old newspapers or magazines, bottle caps, or rubber bands.
Touching and arranging
Mental rituals — Endless reviewing of conversations, counting; repetitively calling up “good” thoughts to neutralize “bad” thoughts or obsessions; or excessive praying and using special words or phrases to neutralize obsessions.
Obsessions and rituals associated with obsessive-compulsive disorder can interfere with a person's normal routine, schoolwork, job, family, or social activities. Several hours every day may be spent focusing on obsessive thoughts and performing seemingly senseless rituals. Trying to concentrate on daily activities may be difficult. Left untreated, OCD can interfere with all aspects of life.


Children can suffer from OCD as well (see Helping a Child with OCD and Anxiety Disorders in Children and Teens). Unlike adults, however, children with OCD do not realize that their obsessions and compulsions are excessive.


Panic Disorder
Panic disorder is diagnosed in people who experience spontaneous, seemingly out-of-the-blue panic attacks and are preoccupied with the fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even during sleep.

A panic attack is defined as the abrupt onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms:


a feeling of imminent danger or doom
the need to escape
heart palpitations
sweating
trembling
shortness of breath or
a smothering feeling
a feeling of choking
chest pain or discomfort
nausea or abdominal discomfort
dizziness or lightheadedness
a sense of things being unreal, depersonalization
a fear of losing control or "going crazy"
a fear of dying
tingling sensation
chills or heat flush



Since many of the symptoms of panic disorder mimic those of illnesses such as heart disease, thyroid problems, and breathing disorders, people with panic disorder often make many visits to emergency rooms or doctors' offices, convinced they have a life-threatening illness. It often takes months or years and a great deal of frustration before receiving the correct diagnosis. Many people suffering from panic attacks don't know they have a real and treatable disorder.

Panic disorder typically develops in early adulthood. It is three times more common in women than in men. Many people don't know that their disorder is real and highly responsive to treatment. Some are afraid or embarrassed to tell anyone, including their doctors and loved ones, about what they experience for fear of being considered a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful or supportive.

The disorder often occurs with other mental and physical disorders, including other anxiety disorders, depression, irritable bowel syndrome, asthma, or substance abuse. This may complicate of getting a correct diagnosis.

Agoraphobia
Some people stop going into situations or places in which they've previously had a panic attack in anticipation of it happening again. These people have agoraphobia, and they typically avoid public places where they feel immediate escape might be difficult, such as shopping malls, public transportation, or large sports arenas. Their world may become smaller as they are constantly on guard, waiting for the next panic attack. Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety. About one in three people with panic disorder develops agoraphobia.

(from http://www.medicalnewstoday.com/articles/9672.php)

Agoraphobia is a Greek word that literally means "fear of the marketplace." This anxiety disorder involves the fear of experiencing a panic attack in a place or situation from which escape may be difficult or embarrassing.

The anxiety associated with agoraphobia is so severe that panic attacks are not unusual, and individuals with agoraphobia typically try to avoid the location or cause of their fear. Agoraphobia involves fear of situations such as:

-- being alone outside his/her home
-- being at home alone
-- being in a crowd
-- traveling in a vehicle
-- being in an elevator or on a bridge

People with agoraphobia typically avoid crowded places like streets, crowded stores, churches, and theaters.

What are the characteristics of agoraphobia?

Most people with agoraphobia develop the disorder after first suffering a series of one or more panic attacks. The attacks occur randomly and without warning, and make it impossible for a person to predict what situations will trigger the reaction. This unpredictability of the panic causes the person to anticipate future panic attacks and, eventually, fear any situation in which an attack may occur. As a result, they avoid going into any place or situation where previous panic attacks have occurred.

People with the disorder often become so disabled that they literally feel they cannot leave their homes. Others who have agoraphobia, do go into potentially "phobic" situations, but only with great distress, or when accompanied by a trusted friend or family member.

Persons with agoraphobia may also develop depression, fatigue, tension, alcohol or drug abuse problems, and obsessive disorders, making seeking treatment crucial.

Social Anxiety Disorder/Social Phobia

Social anxiety disorder can wreak havoc on the social and romantic lives of the 15 million American adults who suffer from the disorder, leaving them isolated, ashamed and in some cases, misdiagnosed, according to a new survey commissioned by the Anxiety Disorders Association of America (ADAA). One of the most troubling findings is that 36% of people with the disorder report experiencing symptoms for 10 or more years before seeking help.

“Social anxiety disorder can have a profound effect on social interactions that most people take for granted," says ADAA President & CEO Jerilyn Ross, MA, LICSW. "In extreme cases, the disorder can disrupt social lives to the point that people may have few or no relationships at all, making them feel powerless and alone."

Everyone can relate to feeling anxious before giving a presentation or asking someone out on a date. But those with social anxiety disorder experience an intense fear of being scrutinized and negatively evaluated by others in social or performance situations. Some people with the disorder, also called social phobia, literally feel sick from fear in seemingly nonthreatening situations.

The disorder is often selective. Some people may have an intense fear of talking to a salesperson or giving a speech, but they may be comfortable in other similar settings. Other people may become anxious during routine activities such as starting a conversation with a stranger or a person in authority, participating in meetings or classes, or dating and attending parties.

Although they recognize that the fear is excessive and unreasonable, people with social anxiety disorder feel powerless against their anxiety. They are terrified they will embarrass or humiliate themselves. The anxiety can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships.

Physical symptoms of social anxiety disorder may include blushing, profuse sweating, trembling, nausea, rapid heartbeat, shortness of breath, dizziness, and headaches.

Social anxiety disorder usually begins in childhood or adolescence, and children are prone to clinging behavior, tantrums, and even mutism.[they may mean autism]


Specific Phobias

New places, high bridges, old elevators may make all of us a bit uneasy or even frightened. We might try to avoid things that make us uncomfortable, but most people generally manage to control their fears and carry out daily activities without incident. But people with specific phobias, or strong irrational fear reactions, work hard to avoid common places, situations, or objects even though they know there's no threat or danger. The fear may not make any sense, but they feel powerless to stop it. People who experience these seemingly excessive and unreasonable fears in the presence of or in anticipation of a specific object, place, or situation have a specific phobia.

Having phobias can disrupt daily routines, limit work efficiency, reduce self-esteem, and place a strain on relationships because people will do whatever they can to avoid the uncomfortable and often-terrifying feelings of phobic anxiety. While some phobias develop in childhood, most seem to arise unexpectedly, usually during adolescence or early adulthood. Their onset is usually sudden, and they may occur in situations that previously did not cause any discomfort or anxiety. Specific phobias commonly focus on animals, insects, heights, thunder, driving, public transportation, flying, dental or medical procedures, and elevators. Although people with phobias realize that their fear is irrational, even thinking about it can often cause extreme anxiety.



Posttraumatic Stress Disorder (PTSD)

Posttraumatic stress disorder, or PTSD, is a serious potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events. Most people who experience such events recover from them, but people with PTSD continue to be severely depressed and anxious for months or even years following the event. They frequently relive the event through flashbacks and nightmares. Relaxing, concentrating, or sleeping may become difficult, and they often feel detached or estranged from others.

Posttraumatic stress disorder is characterized by three main types of symptoms:

Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.

Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.

Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.
PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However symptoms may not appear until several months or even years later.

Women are twice as likely to develop posttraumatic stress disorder as men, and children can also develop it. PTSD often occurs with depression, substance abuse, or other anxiety disorders.

Fast Facts About PTSD

7.7 million Americans age 18 and older have PTSD.

PTSD can develop after a traumatic event such as a sexual or physical assault, witnessing a death, the unexpected death of a loved one, natural disaster, or a terrorist attack.

Sixty-seven percent of people exposed to mass violence have been shown to develop PTSD, a higher rate than those exposed to natural disasters or other types of traumatic events.

People who have experienced previous traumatic events run a higher risk of developing PTSD.

Treatment of PTSD can include cognitive-behavioral therapy (CBT), group therapy, exposure therapy, and medication

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It is important that not only are we educated on our lives and what we are living with but that we educate others as well. It is important that we correct when we notice a mistake has been made or spoken. I know for me it is yet one more way that I strip away the unnecessary shame and empower myself.