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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, it has often been overshadowed by schizophrenia, depression, and bipolar disorders. However, anxiety is said to be present in approximately 13% of individuals in the United States. 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 given as much for 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 each disorder.
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 criteria is that it is impacting your daily life in an unmanagable way. In addition to this, specific criteria must also be met.
Phobias
Phobias are intense fears about specific things such as animals, objects, or situations. An example of this could be related to a fear of spiders (arachnophobia), blood, cats or other animals, etc. 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 something you are afraid of.
Treatment
- Talk Therapy
- Systematic Desensitization
- Eye Movement Desensitization Reprocessing (EMDR) Therapy.
Generalized Anxiety
Generalized anxiety is when someone is worried about multiple items in their life such as relationships, natural disasters, school or work performance, etc. In general, these worries are hard to control and often pop back up which makes it increasingly more difficult to live 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
- Encompass exploring life core conflicts that continue the anxiety
- Mindfulness based strategies to help reduce symptomology of anxiety such as body sensations
- Strategies to manage overwhelming rumination and negative self-talk.
- Eye Movement Desensitization Reprocessing Therapy (EMDR)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- 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 heartbeat
- Rapid breathing
- Chest pain
- Dizziness
- Abdominal pain.
- Additionally, the psychological symptoms can come in the form of panic about the panic attack, 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, Benzodiazepines, and Anti-Histamines (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 form of intense worry related to interacting with others. Someone may be afraid of saying the wrong thing, feeling embarrassed, and overthinking things that they may have said (Choc, 2019). This anxiety can be present in one situation or many aspects in life. This type of anxiety can keep someone from interacting in social settings they know or even trying new things. 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
- Trembling
(National Institute of Mental Health, 2021).
Treatment
Social anxiety can run in the family or be associated with something more environmental.
Talk therapy and medication together is considered the most effective treatment. Types of talk therapy that work well are cognitive behavior therapy (CBT) and humanistic based therapies. Both work to challenge an individuals thinking and behavior to decrease distress during actual exposure based events. Additionally, support groups with other individuals experiencing social anxiety can increase 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, beta-blockers, and antihistamine (Non OTC) (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 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). Cognitive Behavior Therapy (CBT) is considered the gold standard when treating OCD. Within the CBT modality, the therapy of choice for treatment of OCD is Exposure Response Prevention (ERP). Within this therapy, you and your therapist will talk about and create a list of your obsessions and compulsions ordering them from least distressing to worst. Once this list is created, your therapist will create and design a set of tasks for you to overcome the obsessions and fears through something called exposure therapy. The reason this is effective is 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 worry 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 (dependent on age) (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 circumstance 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 decrease symptoms. If you or someone you know is 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
