We're here again! It's time for Part Two of "The Anxiety and Panic Series." This week, we're breaking down all of the major types of anxiety. Please feel free to read about each type, or skip around to the sections most relevant to you. I want you to browse the topics at your leisure, but I discourage use of the information in this article to make your own diagnosis (of yourself or others). As always, nothing in this article constitutes a medical evaluation or should take the place of a consultation with a mental health professional. Ok? Ok, let's get started!
Diagnostic Basics
Today's article will highlight the major criteria mental health providers use to diagnose different types of anxiety. And as we discussed in the last article, these criteria come from our diagnostic manual, nicknamed "the DSM five" (DSM-V). The criteria in this guide were created after experts in the field discussed and agreed on phenomenology.
Most disorders listed in the DSM-V mandate that the condition has lasted for a minimum period of time, has caused some level of distress or dysfunction (usually in work, school, or relationships), and cannot be the direct result of use of a substance or another medical or psychiatric condition. Today we have one exception - anxiety that is induced by use of substances or a medical problem. More on that later!
For the purposes of this blog post, we'll discuss the following types of anxiety:
Selective Mutism
Generalized Anxiety Disorder
Separation Anxiety
Social Anxiety Disorder
Panic Attacks
Panic Disorder
Specific Phobia
Agoraphobia
Anxiety from drugs, medicine or medical conditions
Selective Mutism
*This section discusses sexual trauma. Please skip if this will be upsetting to you.*
Maya Angelou, born Marguerite Johnson, is undoubtedly one of the greatest literary and humanitarian voices of modern American history. But did you know that for a large portion of her childhood, she was mute? If you're familiar with her story, you may know that she experienced selective mutism after being raped. Like others with this condition, Angelou had a chronic and persistent failure to speak (some speak only in selected situations, to certain people, or will whisper). Dr. Angelou has said she was thought to be an "idiot" by many. Selective Mutism can cause impaired academic, occupational and of course social functioning. Interestingly, it has nothing to do with a communication disorder, and also is not due to autism or psychotic disorders like schizophrenia. Please hear Maya Angelou's story here:
*Video courtesy of Bart Georgi Chashymie YouTube Channel
Generalized Anxiety Disorder
We often think of the "worry wart" as someone who can always find something that concerns them. It may be about family, work, or even what they'll eat for dinner. But more than being a comical sitcom stereotype, those impacted by excessive worry can suffer a great deal. Generalized Anxiety Disorder impacts nearly 7 million adults in this country, with women being impacted twice as often as men. Typically, they experience fatigue, restlessness, poor concentration, muscle tension, inability to sleep and irritability - all associated with apprehension about how things are going to play out in their work or family lives, with their health, the condition of the world and everything in between. This type of anxiety can last for a very long time - and to be diagnosed, one would have to experience it most days over a 6-month period.
Separation Anxiety
Did you know both adults and children can suffer from extreme fear and intense anxiety when being separated from those to whom they feel attached? Another potentially chronic issue, lasting 6 months or more, Separation Anxiety is characterized by excessive distress and worry when the idea of separation from loved ones is presented. People impacted may avoid leaving their home, spending the night away from their loved ones, and frequently fear loss of those close to them. They become preoccupied with fears of disaster, death, kidnapping, accidents, or getting sick - if that means they'll be separated from family. Sometimes, they feel afraid to be alone in their home, or even feel physically ill with the thought of separation.
Social Anxiety Disorder
Do you know anyone who fears social situations, afraid of what others may think of them? They may be suffering from Social Anxiety Disorder, the most common type of anxiety in America. For 6 months or more, people with Social Anxiety Disorder become very fearful or anxious in public settings, worried they'll do something embarrassing. Typically, it takes a great deal of effort and brings on a ton of fear for these people to socialize, which causes problems not only at school or parties, but also at work, or job interviews. Below, this video explains what it feels like to live with Social Anxiety Disorder:
*Video courtesy of As/Is YouTube Channel
Panic Attacks
Panic attacks themselves are not considered mental disorders. They can occur as part of any anxiety disorder, or other condition, and are characterized by a sudden surge of intense fear or discomfort. After a few minutes, the fear will peak and can be made up of 4 or more of the following symptoms:
Palpitations
Tremor
Sweating
Shortness of breath
Feelings of choking
Chest pain
Nausea
Dizziness
Hot flushes or chills
Tingling or numbness
Feeling like life isn't real
Fear of "going crazy"
Fear of dying
Panic Disorder
In Panic Disorder, the above symptoms occur. What sets panic disorder apart from just the phenomenon of panic attacks, though, is an ongoing worry after the attack that another one will happen. Then, people sometimes develop behaviors and habits to avoid further panic attacks, like trying not to exercise, get overheated, or go to new places. Panic Disorder is not due to the use of a substance, or another medical condition.
Specific Phobia
Are you afraid of spiders, heights, snakes or bridges? Many people are! But if your fear of some specific object or situation is always immediate, intense, unbearable, and way out of proportion to the actual threat posed, you may have a phobia. It is estimated that over 19 million adults in America live with phobias! Phobic objects can range from airplanes to costumed characters to situations that might cause vomiting. In the Animal Planet video clip below, a man named Marvin faces his fear. Notice, he doesn't look like someone who would be afraid of anything. Phobias have nothing to do with bravery. Watch below:
Agoraphobia
"The fear of open squares or open places" was first described in an 1873 article from the Journal of Mental Science. Today, the idea of agoraphobia has been expanded to mean being afraid of not only open spaces, but being anywhere in public where it may not be possible to leave, or to get help if panic or another embarrassing or incapacitating situation happened. Sufferers may have a fear of public transportation, parking lots, or large marketplaces. They may fear being in enclosed spaces like a movie theater or shop. People may also fear standing in line, being in a crowd, or being outside of their home alone at all. The fear of leaving home is extreme, lasts for 6 months or more, and negatively impacts social and professional life.
Anxiety from drugs, medicine or medical conditions
Substance- or Medication-induced Anxiety, and Anxiety Due to Another Medical Condition, are both characterized by predominant anxiety or panic attacks. When these symptoms are produced as a direct result of a substance that has the ability to produce anxiety symptoms, we attribute the anxiety to the substance. In general, this causes impairment in functioning like all other anxiety disorders but is caused by ingestion of things like caffeine, alcohol, marijuana, amphetamines, cocaine, pain medications, etc. Sometimes the panic starts once the substance has been ingested and caused intoxication, other times it starts once the drug begins to wear off. When medical conditions are thought to be the culprit of anxiety or panic attacks, they are thought to be the direct cause of such symptoms. It's not the same thing as a person having cancer and becoming anxious about their prognosis. Instead, Anxiety Due to Another Medical Condition is when a disease process in the body actually causes anxiety symptoms, like perhaps in certain thyroid disease states.
Now that we've identified all the major types of anxiety, we can start to explore the "whys" behind these disorders. In Part Three, we will discuss some of the psychological and neurological theories we have about why our bodies produce or release the anxiety symptoms we've discussed today. Please feel free to share this article, comment below or contact us at www.hopegrove.us/contact to have your anxiety questions answered by Dr. Thomas. We'll see you next week!