Anxiety, Help!

Anxiety can come in many forms and is considered the most prevalent mental health disorder (Bystritsky et al., 2013). Although anxiety is the most prevalent mental health condition, it has often been overshadowed by schizophrenia, depression, and bipolar disorders which are just as debilitating as anxiety-based disorders. However, anxiety is said to be present in approximately 13% of individuals in the United States. 13%! That is extremely high, considering schizophrenia, depression, and bipolar I and II together only make up half of the individuals that suffer from anxiety-based disorders. So why is the attention not also on individuals facing anxiety? My belief is that there is more funding and awareness around these other disorders and due to this anxiety has received less of a spotlight. Currently, the research indicates that anxiety is responsible for decreased work productivity, increased mortality rates, and increased alcohol and substance use (Bystritsky et al., 2013). 

To bring more awareness to this topic, I will break down the types of anxiety that can be experienced, how to manage anxiety-based symptoms, and the best treatments available for anxiety.

Six Types of Anxiety

According to Choc (2019) there are six major types of anxiety. These types are Phobia’s, Generalized Anxiety, Panic Disorders, Social Anxiety, Obsessive Compulsive Disorder (OCD), and Separation Anxiety.

What determines when these become disorders? Well one crucial thing is that it is impacting your daily life. The others are that the criterion for each disorder is met.

Phobias

Phobias are intense fears about specific things such as animals, objects, or situations. An example of this could be related to fear of spiders (arachnophobia), fear of blood, fear of cats or other animals, fears of anything else. Phobias are primarily related to fear, but the differentiating factor is that these fears are out of proportion to what you should experience when you see and something you are afraid of.

Treatment

Systematic Desensitization and/or Eye Movement Desensitization Reprocessing (EMDR) Therapy.

Generalized Anxiety

Generalized anxiety is when someone is worried about multiple items such as relationship,  natural disasters, school or work performance or other items in their life. In general, these worries are hard to control and often pop back up which makes it increasingly more difficult to  live your life the way you want. Symptoms may also come in the form of body sensations such as neck pain, headaches, and/or back pain.

Treatment

Talk Therapy which encompass exploring life core conflicts that continue the anxiety as well as mindfulness based strategies to help reduce symptomology of anxiety such as body sensations, and overwhelming rumination of worrying thoughts and negative self-talk. Additionally, EMDR therapy has shown to be effective in the treatment of anxiety. Lastly, Selective Serotonin Reuptake Inhibitors (SSRIs) have shown to be effective in parallel with talk therapy to be the most effective treatment for generalized anxiety.

Panic Disorder

Panic attacks are characterized by the following physical symptoms, racing hear, rapids breathing, chest pain, dizziness, and/or abdominal pain. Additionally, the psychological symptoms can come in the form of panic about the panic attach, feelings of doom, derealization (world is not real) or depersonalization (experiencing something outside of yourself). This can be brought on by either identifiable things or by something unidentifiable.  Regardless of what may trigger it, it can cause feelings of fear related to the panic itself happening again. Then the issue becomes about losing control and panicking instead of the original reason for the panic attack. Additionally, panic attacks and agoraphobia can occur together if the panic disorder worsens (Ham et al., 2005).

Treatment

There are many treatments for panic disorders including talk-therapy (specifically CBT) and medications. Medications warranted for panic disorders are SSRIs and Benzodiazepines (Ham et al., 2005). For additional medication information please speak with a psychiatrist about a medication management plan.

Social Anxiety

Social anxiety disorder is also known as social phobia. This is the most common of the anxiety Disorders. This disorder is characterized by a persistent fear of being judged by others. The Symptoms can come in the for of intense worry of interacting with other people. Someone may be afraid of saying the wrong thing, feeling embarrassed and overthinking things that they may have said (Choc, 2019). This anxiety can range by being present in one situation or many aspects in life. This type of anxiety can keep someone from interacting in social settings that are unknown to them or trying new things that involve others. Although this anxiety may keep someone from interacting in social situations, someone with this disorder may still feel comfortable interacting with family or close friends. Other somatic symptoms include nausea, rigid body posture, blushing, sweating, and trembling (National Institute of Mental Health, 2021).

Treatment

Social anxiety can run in the family or be associated with something more environmental.  No one knows why some families have it more than others. As for how this is treated, talk therapy and medication together is the most effective treatment. Types of talk therapy that work well are cognitive behavior therapy (CBT) and humanistic based therapies. Both work to challenge and individuals thinking, and behavior to decrease distress during actual exposure based events. Additionally, support groups with other individuals experiencing social anxiety can hold corrective experiences. As for medications, there are many medications that help assist in the reduction of social anxiety symptoms. These medications include anti-anxiolytics, anti-depressants, and beta-blockers (National Institute of Mental Health, 2021).  For medication management, please speak with a psychiatrist to find the right medication for you.

Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder. However, in recent years. OCD has been reclassified into its own category (Choc, 2019). OCD is comprised of two distinct characteristics. The first is associated with recurring unwanted thoughts, ideas, sensations which are also known as obsessions. The second is associated with feeling driven to do something in a repetitive way also known as compulsions. The repetitive behaviors can come in the form of hand washing, checking things, cleaning, and rituals. Many individuals who experience OCD have distressing thoughts that are not impacting their daily lives and have found ways to manage their symptoms (American Psychiatric Association, 2021). For those who have not yet found a way to manage these symptoms, OCD can feel painful and overwhelming.  OCD is a biologically based disorder meaning that it is inheritable and therefore, the treatment of OCD is lifelong and treated best from a management style perspective.

Treatment

OCD is treated best using two methods, therapy, and medication. For OCD, there are specific therapies and medications. Therapies used to treat OCD are evidence-based treatments (EBT).  A combination of Cognitive Behavior Therapy (CBT) is considered the gold standard when treating OCD. Within CBT the therapy of choice for treatment of OCD is and Exposure Response Prevention (ERP). Within this therapy, you and your therapy will talk about and created a list of  all your obsessions and compulsions ordering them from least distressing to worst. Once this list is created, your therapist will create and design a task for you to overcome the obsessions and fears through something called exposure therapy. The reason this is effectiveis that it confronts the fears directly that someone with OCD may be struggling with. Other types of interventions in ERP are Imaginal exposure, habit reversal training and cognitive therapy which all seek to challenge fears, assumptions, and negative thoughts that continue OCD symptoms.

Separation Anxiety

Separation anxiety is characterized by someone experiencing persistent and excessive worried related to being separated from an attachment figure. Separation anxiety is considered a normal part of the development of a child. However, where separation anxiety becomes burdensome is when this anxiety impairs development (Choc, 2019). Separation anxiety is something that can happen at all stages of life and is related to the separation of one person from a primary attachment figure (partner, parent, sibling). Individuals who experience this type of anxiety can be said to be “overbearing” or “possessive” towards their attachment figure. This type of anxiety can usually develop from major stressors involving early caregivers such as loss or abandonment.

Treatment

Separation anxiety is common and treatable through talk-based therapies. The best separation anxiety therapy is attachment based or relational therapy. Medication in conjunction with therapy has shown the greatest outcomes. Medications include anti-anxiolytics and anti-depressants (Mayo Clinic, 2021). For medication management, please speak with a psychiatrist to find the right medication for you.

Speak up!

As with any anxiety-based circumstances that you are dealing with, the best thing you can do is not to isolate yourself. Therapy and a building a social network of individuals that can understand what you are dealing with can help to decrease symptoms. If you are or know someone dealing with any of these symptoms, direct them to a therapist or give them InProcess Counseling’s information to get started on a path to living a life not chosen by anxiety.

References

American Psychiatric Association. (2021). What is obsessive-compulsive disorder? Home │ psychiatry.org. https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder

Anxiety & Depression Association of America. (2021). Treatments for OCD. https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/treatments-for-ocd. https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/treatments-for-ocd

Bystritsky, A., Khalsa, S., Cameron, M., & Schiffman, J. (2013). Current diagnosis and treatment of anxiety disorders. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628173/

Choc. (2019, August 9). 6 major types of anxiety disorders. CHOC Children’s Health. https://health.choc.org/6-major-types-of-anxiety-disorders/

Ham, P., Waters, D., & Oliver, N. (2005, February 15). Treatment of panic disorder. AAFP American Academy of Family Physicians. https://www.aafp.org/afp/2005/0215/p733.html

Mayo Clinic. (2021, April 5). Separation anxiety disorder – Diagnosis and treatment – Mayo Clinic. Mayo Clinic – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/separation-anxiety-disorder/diagnosis-treatment/drc-20377457

National Institute of Mental Health. (2021). Social anxiety disorder more than just shyness. https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness. https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness