ANXIETY DISORDERS

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, a handbook for mental health professionals, describes a variety of anxiety disorders. These include generalized anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

A. Generalized Anxiety Disorder

People with generalized anxiety disorder feel anxious most of the time. They worry excessively about routine events or circumstances in their lives. Their worries often relate to finances, family, personal health, and relationships with others. Although they recognize their anxiety as irrational or out of proportion to actual events, they feel unable to control their worrying. For example, they may worry uncontrollably and intensely about money despite evidence that their financial situation is stable. Children with this disorder typically worry about their performance at school or about catastrophic events, such as tornadoes, earthquakes, and nuclear war.

People with generalized anxiety disorder often find that their worries interfere with their ability to function at work or concentrate on tasks. Physical symptoms, such as disturbed sleep, irritability, muscle aches, and tension, may accompany the anxiety. To receive a diagnosis of this disorder, individuals must have experienced its symptoms for at least six months.

Generalized anxiety disorder affects about 3 percent of people in the general population in any given year. From 55 to 66 percent of people with this disorder are female.

B. Phobias

A phobia is an excessive, enduring fear of clearly defined objects or situations that interferes with a person’s normal functioning. Although they know their fear is irrational, people with phobias always try to avoid the source of their fear. Common phobias include fear of heights (acrophobia), fear of enclosed places (claustrophobia), fear of insects, snakes, or other animals, and fear of air travel. Social phobias involve a fear of performing, of critical evaluation, or of being embarrassed in front of other people. See Phobia.

C. Panic Disorder

Panic is an intense, overpowering surge of fear. People with panic disorder experience panic attacks—periods of quickly escalating, intense fear and discomfort accompanied by such physical symptoms as rapid heartbeat, trembling, shortness of breath, dizziness, and nausea. Because people with this disorder cannot predict when these attacks will strike, they develop anxiety about having additional panic attacks and may limit their activities outside the home. See Panic Disorder.

D. Obsessive-Compulsive Disorder

In obsessive-compulsive disorder, people persistently experience certain intrusive thoughts or images (obsessions) or feel compelled to perform certain behaviors (compulsions). Obsessions may include unwanted thoughts about inadvertently poisoning others or injuring a pedestrian while driving. Common compulsions include repetitive hand washing or such mental acts as repeated counting. People with this disorder often perform compulsions to reduce the anxiety produced by their obsessions. The obsessions and compulsions significantly interfere with their ability to function and may consume a great deal of time. See Obsessive-Compulsive Disorder.

E. Post-Traumatic Stress Disorder

Post-traumatic stress disorder sometimes occurs after people experience traumatic or catastrophic events, such as physical or sexual assaults, natural disasters, accidents, and wars. People with this disorder relive the traumatic event through recurrent dreams or intrusive memories called flashbacks. They avoid things or places associated with the trauma and may feel emotionally detached or estranged from others. Other symptoms may include difficulty sleeping, irritability, and trouble concentrating. See Post-Traumatic Stress Disorder.


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