Anxiety Disorders Panic Attack

Anxiety is a normal human response to stressful situations or events, such as speaking in public, new relationships or the first day on a new job. Anxiety disorders involve a person having extended periods of fears and uncertainties that last for at least six months. If not treated, anxiety disorders can get worse until they are debilitating. Of adults, it is said that about 40 million Americans are affected each year by some form of anxiety disorder.

One way of describing the symptoms is: irrational and excessive dread involving everyday situations. There is exaggerated worry and tension even when there is no real cause that would provoke the level of concern. There might be obsessive symptoms or phobias. Other symptoms include physical symptoms that mimic heart attacks, cause fainting, sweating and problems with breathing. In other disorders, the “fight or flight” process might be triggered, even though there is no real danger. There might be excessive worry and problems with social interaction.

The above symptoms are particular to specific types of anxiety disorder in some cases. Others are generalized, but the main aspect of the anxiety class of psychological disorder is in having excessive fear or worry when there is no real, current reason or cause. Sometimes anxiety disorders are in combination with other disorders.

There are four major groups or types of anxiety disorder: Generalized, Obsessive Compulsive, Panic, Post Traumatic Stress and Social Phobia.

In Generalized Anxiety Disorder (GAD), disaster is regularly perceived for six or more months as imminent or pending, when everyday situations are going on. There are ongoing, excessive worries and hyper states, racing and negative thoughts and other physiological problems, such as difficulty with sleeping. At one end of the spectrum, people with GAD are high functioning and able to get through work and life. At the other end, anxiety is severe enough to prevent doing required and normal activities.

With Obsessive-Compulsive Disorder (OCD), there are obsessions in the form of recurring, upsetting and unwanted thoughts and there are compulsions that are resolved by repetitive actions or “rituals”. Not completing the rituals in response to the thoughts adds to the anxiety. There might be obsessions with germ or diseases, safety and security, a sense of order, or a need to repeatedly check on things. There is a sense of senselessness to the activities in adults, while children may feel fine about the rituals. The rituals do not resolve the anxiety with pleasurable results and can range from odd, quirky habits to complete inability to carry on in life as a person cannot stop the rituals.

Panic Disorder causes episodes of abject terror or intense fear. These episodes are accompanied by symptoms which can include dizziness, sweating, breathing and heart rate problems. Feelings of imminent death from suffocation or heart attack are possible. There are no predictors or specific times of day, waking or sleeping, for the episodes and the episodes can last for 10 or more minutes. Some people have a single attack, then no more. Others have the attacks resolve when they get out of constantly stressful situations.  This disorder can become debilitating when avoidance of places or situations that trigger episodes or even becoming housebound are involved. Panic disorder is the most easily treatable of the anxiety disorders.

Post Traumatic Stress Disorder (PTSD) has been widely publicized in the milder and in the most more serious forms. This anxiety disorder is related to horrific or violent experiences where terror is at the maximum and great harm to the person or to others occurred or was threatened. Horrific auto accidents, combat experiences, natural disasters and man made disasters are well known examples of events which can lead to PTSD. Generally, the fear, whether the incident is real or in the form of a “flashback”, triggers a full blown “fight or flight” response, (hyperarousal) with accompanying major changes to the functions of the body and the mind. There may be episodes of anger, sleep problems, guilt, depression, excessive worries, memory issues of the triggering event, and other symptoms. Acute Stress Disorder (ACD) is a more temporary form of PTSD with serious symptoms that can resolve in a few weeks or develop into full PTSD. Conversely, PTSD sufferers may not show symptoms for a time after a triggering event.

NIMH, “Anxiety Disorders”

American Psychiatric Association, DSM-IV-TR, “Anxiety Disorders”