Anxiety Disorders

Characteristic Symptoms

Anxiety is a normal cognitive and physiological response designed to call our attention to the seriousness of an event or situation, and motivate us to action. Anxiety disorders are not mild and brief, but severe and chronic. Panic attacks, a consuming wave of fear and dread, are a common characteristic of the anxiety disorders.

A panic attack is a sudden surge of overwhelming fear and anxiety that reaches a peak within minutes. The DSM-5 lists 13 potential symptoms of a panic attack:

Four or more of these symptoms must be present for the episode to be considered a panic attack. A panic attack may be a one-time occurrence in an individual’s life, but many people experience multiple episodes.

Types of Anxiety Disorders

SEPARATION ANXIETY DISORDER

Separation Anxiety Disorder is an inappropriate and excessive fear or anxiety concerning separation from home or those to whom the individual is attached. The fear or anxiety is persistent, lasting at least four weeks in children and adolescents, and six months or more in adults.

SELECTIVE MUTISM

Selective Mutism is a failure to speak in some social settings and to some people for at least one month. A child with selective mutism may talk normally at home, or when alone with their parents, but cannot speak at all, or speak above a whisper, in other social settings.

AGORAPHOBIA

Agoraphobia is characterized by the avoidance of situations or places in which it is thought that escape might be difficult, or help unavailable in the event of a panic attack or other incapacitating or embarrassing symptoms.

GENERALIZED ANXIETY DISORDER (GAD)

Generalized Anxiety Disorder (GAD) is excessive anxiety and worry, even though there is little or nothing to provoke it. The anxiety is severe enough to affect the individual’s ability to function in their daily lives. The person will often recognize that their anxiety is more intense than the situation warrants, however, they may have difficulty in controlling these thoughts and feelings. With GAD, the anxiety is usually accompanied by physical symptoms such as fatigue, sleeplessness, headache, muscle tension, sweating, shortness of breath, irritability, and hot flashes.

Treatment & Support

ANXIOLYTICS

Anxiolytic (anxiety-relieving) drugs are available for health professionals to prescribe. The most common side effect of these drugs is daytime drowsiness, or what some have described as a “hung-over feeling.” Benzodiazepines lower anxiety by increasing the activity of the neurotransmitter GABA. Due to risk of dependency, individuals with substance-abuse problems are not good candidates for treatment with benzodiazepines.

Buspirone (BuSpar) is a unique anxiolytic agent found to be effective in treating generalized anxiety disorder. While the exact mechanism of action for Buspirone is unknown, its anti-anxiety effects are the result of changes produced in the serotonin neurotransmitter system. Common side effects include dizziness, drowsiness, and nausea. Unlike the benzodiazepines, Buspirone is not addictive and must be taken for at least two weeks to counteract the symptoms of anxiety.

PSYCHOTHERAPY

The psychotherapeutic approach shown to be most effective in treating anxiety disorders is cognitive-behavioral therapy (CBT). CBT reduces anxiety by eliminating beliefs and behaviors that maintain the disorder. To be effective, the therapy must be specific to the individual’s anxieties. For example, an individual with a specific phobia who is fearful of dirt and germs may be encouraged to actually get his or her hands dirty during a session. As anxiety builds because of the “contamination,” the therapist works with the patient to develop skills for managing the physical sensations and negative thoughts. Over a number of sessions, the therapist might encourage the person to wait for increasingly longer periods of time before washing. Treatment usually lasts from twelve to twenty weeks.