Anxiety

While anxiety disorders are differentiated according to the types of situations that are feared or avoided and the content of the associated thoughts or beliefs, anxiety disorders all include excessive fear and anxiety, as well as common avoidant behavioral patterns and physical symptoms (for example, feeling on edge, racing heart, wanting to isolate, etc).

Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Fear more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors. Panic attacks are an example of a of fear response that can be seen in multiple disorders. Anxiety more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors.

While many disorders have a biological cause or predisposition, many are also associated with a learned response based on a traumatic event. Our clients continually impress us by their ability to learn new healthy behavior patterns when we work partner together to treat the root cause of the distress.

Our team is ready to support clients in addressing the following:

Specific Phobia

Individuals with specific phobia are fearful or anxious about or avoidant of specific objects or situations. The fear, anxiety, or avoidance is almost always immediately induced by the phobic situation, to a degree that is persistent and out of proportion to the actual risk posed. Individuals with specific phobia typically experience an increase in physiological arousal in anticipation of or during exposure to a phobic object or situation(Craske et al. 2009). The individual tends to either actively avoid that which they fear, or endure it with intense fear or anxiety. The fear tends to impact their ability to relate to others, and/or may impact work performance.

Specific phobia sometimes develops following a traumatic event (e.g., being attacked by an animal or stuck in an elevator), observation of others going through a traumatic event (e.g., watching someone drown), an unexpected panic attack in the to be feared situation (e.g., an unexpected panic attack while on the subway), or informational transmission (e.g., extensive media coverage of a plane crash)(King et al. 1998). However, many individuals with specific phobia are unable to recall the specific reason for the onset of their phobias.

There are treatments for individuals who experience a Specific Phobia. If you suspect you may have a Specific Phobia, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Craske MG , Rauch SL , Ursano  R , et al: What is an anxiety disorder? Depress Anxiety 26(12):1066–1085, 2009

King NJ , Gullone E , Ollendic k TH : Etiology of childhood phobias: current status of Rachman’s three pathways theory. Behav Res Ther 36(3):2 97–309, 1998

Social Anxiety Disorder

In social anxiety disorder (social phobia), the individual is fearful or anxious about or avoidant of social interactions and situations that involve the possibility of being scrutinized. These include social interactions such as meeting unfamiliar people, situations in which the individual may be observed eating or drinking, and situations in which the individual performs in front of others. The cognitive ideation is of being negatively evaluated by others, by being embarrassed, humiliated, or rejected, or offending others.

Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict, trauma or abuse, may be associated with social anxiety disorder. Social anxiety disorder may be a learned behavior — some people may develop the condition after an unpleasant or embarrassing social situation. Also, there may be an association between social anxiety disorder and parents who either model anxious behavior in social situations or are more controlling or overprotective of their children.

Some of the symptoms of social anxiety disorder are:

  • Fear of situations in which you may be judged
  • Worrying about embarrassing or humiliating yourself
  • Intense fear of interacting or talking with strangers
  • Fear that others will notice that you look anxious
  • Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
  • Avoiding doing things or speaking to people out of fear of embarrassment
  • Avoiding situations where you might be the center of attention
  • Having anxiety in anticipation of a feared activity or event
  • Enduring a social situation with intense fear or anxiety
  • Spending time after a social situation analyzing your performance and identifying flaws in your interactions
  • Expecting the worst possible consequences from a negative experience during a social situation

There are treatments for social anxiety disorder. If you suspect you may have social anxiety disorder, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

References
American Psychiatric Association. (2013). Diagnostic and  statistical manual of mental disorders (5th ed.). Washington, DC:  Author. 

Panic Disorder

In panic disorder, the individual experiences recurrent unexpected panic attacks and is persistently concerned or worried about having more panic attacks or changes his or her behavior in maladaptive ways because of the panic attacks (e.g., avoidance of exercise or of unfamiliar locations). Panic attacks are abrupt surges of intense fear or intense discomfort that reach a peak within minutes, accompanied by physical and/or cognitive symptoms.

Panic attacks may be expected, such as in response to a typically feared object or situation, or unexpected, meaning that the panic attack occurs for no apparent reason. A panic attack may be a symptom of another anxiety disorder.

Some of the symptoms of panic disorder are:

  • Pounding or fast heartbeat.
  • Feeling weak, faint, or dizzy.
  • Tingling or numbness in the hands and fingers.
  • Sense of terror, or impending doom or death.
  • Feeling sweaty or having chills.
  • Chest pains.
  • Breathing difficulties or a choking feeling.
  • Feeling a loss of control.
  • Feeling unreal or detached.
  • Fear of going crazy or dying.

There are treatments for panic disorder. If you suspect you may have panic disorder, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

References
American Psychiatric Association. (2013). Diagnostic and  statistical manual of mental disorders (5th ed.). Washington, DC:  Author. 

Agoraphobia

Individuals with agoraphobia are fearful and anxious about two or more of the following situations: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd; or being outside of the home alone in other situations. The individual fears these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms. These situations almost always induce fear or anxiety and are often avoided or require the presence of a companion.

There are treatments for agoraphobia. If you suspect you may have agoraphobia, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

References
American Psychiatric Association. (2013). Diagnostic and  statistical manual of mental disorders (5th ed.). Washington, DC:  Author.

Anxiety Disorder

The key features of generalized anxiety disorder are persistent and excessive anxiety and worry about various domains, including work and school performance, that the individual finds difficult to control. In addition, the individual experiences physical symptoms, including restlessness or feeling keyed up or on edge; being easily fatigued; difficulty concentrating or mind going blank; irritability; muscle tension; and sleep disturbance.

Some of the symptoms of generalized anxiety disorder are:

  • 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 keyed up or on edge
  • Difficulty concentrating, or the feeling that your mind “goes blank”
  • Issues with confidence, self-esteem and perfectionism

There are treatments for anxiety disorder. If you suspect you may have anxiety disorder, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

References
American Psychiatric Association. (2013). Diagnostic and  statistical manual of mental disorders (5th ed.). Washington, DC:  Author.

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