Types Of Anxiety Disorders

By Dr. Stephen Antony, MD (Psychiatry)

It is normal to feel anxiety in reaction to stressful situations, we face stress from many sources, it could be financial, health related or from our relationships but over time it is essential that we use our anxiety to learn to master the situations and find solutions to our problems. In people with anxiety disorders the mechanism of worry and thought control is dysfunctional and they suffer from persistent anxiety on a daily basis with no obvious cause. Heir life may often be dominated by excessive irrational fear.

The dominant symptoms of anxiety include difficulty in sleeping and constant worry or fear that something bad may happen. The complete range of symptoms are listed below:

Anxiety disorders are a group of disorders and the following are the sub types of anxiety disorders:

• Anxiety due to a general medical condition
• Substance-induced anxiety disorder
• Generalized anxiety disorder
• Panic disorder
• Acute stress disorder
• Posttraumatic stress disorder (PTSD)
• Adjustment disorder with anxious features
• Obsessive-compulsive disorder (OCD)
• Social phobia, also referred to as social anxiety disorder
• Specific phobia, also referred to as simple phobia – Specific phobias have been further broken down to include fear of animals, such as fear of dogs (cynophobia), cats (ailurophobia), bees (apiphobia), spiders (arachnophobia), snakes (ophidiophobia); natural environment type, such as fear of heights (acrophobia), water (hydrophobia), or thunderstorms (astraphobia); blood injection/injury type, such as fear of pain (algophobia) or of being beaten (rhabdophobia); situational type, such as fear of flying (pteromerhanophobia), elevators, or enclosed spaces; and other type.

How the brain functions during anxiety disorders:

The brain has a tiny region known as the amygdala, its main function is to modulate fear and anxiety. Patients with anxiety disorders exhibit heightened amygdala response to anxiety cues.

The amygdala and other limbic system structures are connected to front part of the brain known as prefrontal cortex. The prefrontal cortex is responsible for logical thinking and making executive decisions, but it does not function properly in anxiety prone individuals.

The brain chemicals are also imbalanced in people with anxiety disorders, the chief neurochemicals responsible for healthy emotional and mental function are norepinephrine, serotonin, dopamine, and gamma-amino butyric acid (GABA), and these are found to be out of balance in people suffering from anxiety disorders.

Anti-depressant and anti-anxiety medications help in balancing out these neurochemicals and bring stability to the mind.

Features of different types of anxiety disorders:

Generalized Anxiety Disorder: It is characterized by a persistent and nagging feeling of intense fear or unease, usually accompanied by at least some of the physical symptoms mentioned earlier.

Panic Disorder: Panic disorder is a sudden bout of intense, irrational and overwhelming fear that reaches its peak at about 10 minutes and last anywhere from a few minutes to a few hours, it can present with strong heart palpitations, head pressure, shallow breathing hot/cold flashes and dizziness, it can be so scary that the person is convinced (s)he is dying or going crazy. The person with panic disorder always fears the next panic attack and tries to avoid situations that may cause such panic.

Agoraphobia: Agoraphobia is a fear of being in places or situations where it may be difficult or embarrassing to get out quickly or where you may have a panic attack and can’t get help. It is characterized by intense fear and physical symptoms of panic, it should not be confused with shyness or simple embarrassment.

Social Anxiety Disorder: People with social anxiety often display hypersensitivity to criticism, difficulty being assertive, low self-esteem, and inadequate social skills. They try to avoid public gatherings and speaking in front of groups, this fear is excessive and prevents them from performing well at work. Most patients with social phobia fear public speaking, while less than half fear meeting new people.

Obsessive-compulsive disorder: OCD manifests itself with disturbing repetitive, recurring thoughts and an obsessive need to carry out particular rituals or tasks. A person with OCD is aware that these thoughts and actions, fears and fixations are not realistic but is unable to control these thoughts. There may be persistent behaviors such as constant hand washing or hair combing.

Rituals like touching certain items or arranging them in order are uncontrollable. Symptoms of obsessive-compulsive disorder may often be seen co-existing with other anxiety symptoms such as eating disorders, depression or drug addiction.

OCD behaviors and rituals do not give pleasure to the patient, but the patient feels compelled to perform these acts as relief from anxiety itself.

Posttraumatic stress disorder: PTSD is caused after a person experiences or watches an event involving serious injury, death, or threat to the physical integrity of an individual, along with a response involving helplessness and/or intense fear or horror. The more severe the trauma and the more intense the acute stress symptoms, the higher the risk for PTSD. These individuals often have a physiologic vulnerability based on genetic (inherited) contributions and other personal characteristics.

Management:

Anxiety disorders can be treated through medications or psychotherapy. In psychotherapy, the therapist works with the patient and over a period of 10 to 12 weeks and help the patient deal with their fears, worries and problems, Most of the patients with anxiety problems like to have someone to take to a therapist who is compassionate and understands the patient and offers practical solutions to their fears and worries.

In some cases the situation may be more intense and the patient needs medication to break free from his/her anxiety disorder.

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