People who 1. worry excessively, 2. know they are worrying excessively, but 3. still can't stop worrying may have Generalized Anxiety Disorder. It is a genetic condition that often starts in teenage or young adult years, but can begin at any time in life. Both medications and Cognitive Behavioral Therapy are useful in treating the condition.
Social Phobia is another likely genetic condition in which one experiences extreme fear of bring judged in a social situation outside of family or close friends. Social Phobia can be very debilitating.
"School Phobia" (school avoidance due to severe anxiety) can occur in children who may develop Social Phobia as adults.
In the newest edition of DSM, OCD has been moved to a separate category. But since it involves a strong reaction to stress and has historically been call an anxiety disorder, I will include it here.
OCD requires either an Obsession or a Compulsion.
An Obsession is an intrusive, disturbing thought that one tries to suppress, but cannot.
A Compulsion is behavior to minimize the Obsession.
Panic Disorder is a sudden onset of extreme anxiety that accompanies physical symptoms that are often mistaken for a heart attack or "fear of going crazy". Luckily, Panic Attacks are usually short lived, lasting 5-20 minutes. But they can be extremely disabling. After one has experienced several panic attacks, the fear of another can cause "anticipatory dread" which is a more constant feeling of anxiety. It is a genetic condition that responds well to medication (both symptom treatment and prevention) and Cognitive Behavior Therapy.
Post-traumatic Stress Disorder is a response to life threatening events. They can be caused by war, assault, motor vehicle accidents or even witnessing extremely stressful events. Symptoms include:
1. Intrusive Symptoms: Nightmares, Flashbacks or "marked physiological distress" when remembering symbols of the traumatic event.
2. Avoidance Behaviors: tendancy to avoid anything that reminds the victim of the traumatic event. Avoidance of places, conversations, thoughts, or anything that reminds them of the trauma.
3. Negative Mood and Thoughts: Negative emotion, bad thoughts about oneself, feelings of detachment, unable to see the positives in oneself, others or the world.
4. Physiological Hyperactivity: Irritable, anger outbursts, difficulty sleeping or making decisions, reckless behavior, and exaggerated startle.
Medications can be helpful for minimizing anxiety, mood, sleep and nightmares, but, in my opinion, psychotherapy is key to successful treatment.
I am often asked "what is anxiety?" Some level of physiological reaction to stress or fear is normal. An Anxiety Disorder is where that reaction becomes severe enough or prolonged enough to interfere with normal functioning at work or school, your family life or your social life. There are several types of Anxiety Disorders.
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Larry O. Sanders, MD. PC