Anxiety Disorders
DEFINITION
What are Anxiety Disorders?
“If you are depressed you are living in the past.
If you are anxious you are living in the future.
If you are at peace you are living in the present.”
― Lao Tzu
A person living with anxiety worries about future events that may not necessarily happen. In other words, an anxious person generates “what-if” and the worst-case scenarios that may or may not happen in the future.
Worrying about the ‘what ifs’ can consume your mind, attention and focus and eventually consume your life. “I called my parents’ house twice and nobody answered. What if something happened to them?”, “What if I get struck by a lightning when I go for a walk in the rain?”, “What if I have a panic attack when I take the subway?” The more you generate what if scenarios, you will be more you will train your brain to focus on bad things. The key is to rewire your brain to stop worrying about things you can’t control.
We have no power over changing the past and we have no control over the future. We also cannot control other people’s behaviors. Like Jack Canfield said: “You only have control over three things in your life: the thoughts you think, the images you visualize and the actions you take.”
Worrying a lot may give you the illusion that you have control over negative events that may happen in the future. However, over time, constant worrying about the things that have not happened yet will lead you feel that you have no control over your life.
It’s time for you to live in the present moment. Let me help you to rewire your brain so that your mind starts focusing on the present time, starts seeing positive patterns and generating positive thoughts.
TYPES OF ANXIETY DISORDERS
Panic Disorder
Panic attacks symptoms include:
- Shortness of breath or hyperventilation
- Heart palpitations or racing heart
- Chest pain or discomfort
- Choking feeling
- Trembling or shaking
- Feeling dizzy, light-headed, or faint
- Numbness or tingling sensations
- Sweating
- Nausea or upset stomach
- Fear of dying, losing control, or going crazy
- Feeling unreal or detached from your surroundings
Panic attacks produce intense fear that begins suddenly, often with no warning. An attack typically lasts for 10 to 20 minutes, but in extreme cases, symptoms may last for more than an hour. The experience is different for everyone, and symptoms often vary.
Panic Disorder is characterized by one experiencing recurrent, unexpected panic attacks and developing persistent fear or worry about additional panic attacks (or their consequences) recurring. A person who is suffering from a Panic Disorder lives in fear of having another unexpected panic attack.
Agoraphobia
Agoraphobia is characterized by the excessive fear of situations where escape could be difficult, or in which help would not be available if something bad were to happen. Agoraphobia often develops after having one or more panic attacks.
A person with agoraphobia will go to great lengths to avoid one or more of the following situations:
- Using public transportation (cars, buses, trains, ships, airplanes)
- Being in open spaces (parking lot, marketplaces, bridges)
- Being in enclosed places (movie theatre, shops)
- Standing in line or being in a crowd
- Being outside of the home alone
Specific Phobia
Specific Phobia is characterized by the excessive fear of an object or a situation, exposure to which causes an anxious response, such as a panic attack. Individuals with phobias recognize that their fear is excessive and unreasonable, but they are unable to control it. The feared object or situation is usually avoided or anticipated with dread.
There are five different types of Specific Phobia:
- Animal Type (e.g. dogs, snakes, or spiders)
- Natural Environment Type (e.g., heights, storms, water)
- Blood-Injection-Injury Type (e.g. fear of seeing blood, receiving a blood test or shot, watching television shows that display medical procedures)
- Situational Type (e.g., airplanes, elevators, driving, enclosed places)
- Other Types (e.g., phobic avoidance of situations that may lead to choking, vomiting, or contracting an illness; in children, avoidance of loud sounds like balloons popping or costumed characters like clowns)
Social Anxiety Disorder (Social Phobia)
Social Anxiety Disorder (formerly called Social Phobia) is characterized by intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with Social Anxiety Disorder may worry about acting or appearing visibly anxious (e.g. blushing, stumbling over words), or being viewed as stupid, awkward, or boring. As a result, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress.
Many people with Social Anxiety disorder also experience strong physical symptoms, such as a rapid heart rate, nausea, and sweating, and may experience panic attacks when confronting a feared situation. Although they recognize that their fear is excessive and unreasonable, people with Social Anxiety Disorder often feel powerless against their anxiety.
Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder is characterized by recurrent, uncontrollable and unwanted thoughts (obsessions) and ritualized, repetitive behaviors (compulsions) one feels compelled to perform.
Obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety.
Obsessions often have themes to them, such as:
- Fear of contamination or dirt
- Doubting and having difficulty tolerating uncertainty
- Needing things orderly and symmetrical
- Aggressive or horrific thoughts about losing control and harming yourself or others
- Unwanted thoughts, including aggression, or sexual or religious subjects
Compulsions are repetitive behaviors that one feels driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to one’s obsessions or prevent something bad from happening.
Compulsions typically have themes, such as:
- Washing and cleaning
- Checking
- Counting
- Orderliness
- Following a strict routine
- Demanding reassurance
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder is characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.
Symptoms include:
- Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
- Overthinking plans and solutions to all possible worst-case outcomes
- Perceiving situations and events as threatening, even when they aren’t
- Difficulty handling uncertainty
- Indecisiveness and fear of making the wrong decision
- Inability to set aside or let go of a worry
- Inability to relax, feeling restless, and feeling on edge
TREATMENT MODEL
How to treat Anxiety Disorders?
Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are the most effective treatments for anxiety disorders. CBT and DBT are both empirically supported treatments and they both aim to teach effective coping skills to deal with anxiety symptoms.
My Treatment Goals while utilizing both CBT and DBT Techniques
- Promote self-awareness by teaching the patient identify negative, irrational and maladaptive thoughts, feelings and beliefs (cognitive distortions) and learn their impact in the development of maladaptive behaviors
- Utilize cognitive restructuring techniques to help patient challenge and replace their negative or distorted thinking and with more realistic and positive thoughts
- Teach mindfulness skills to be more present in the here-and-now rather than worrying about the future
- Teach effective coping skills to tolerate and manage anxiety symptoms
- Teach relaxation skills (e.g. diaphragmatic breathing, progressive muscle relaxation) and teach the patient how to apply these skills to their daily life
- Teach the patient identify, challenge, and replace biased, fearful and negative self-talk with positive, realistic, and empowering self-talk
- Teach effective strategies for establishing healthy boundaries with others