| Written by Sam Schussler, MS, LAC
Anxiety is a feeling that happens to everyone. Whether it be pre-testing jitters, worries about an upcoming job interview, or a bit of nerves before a performance, mild anxiety can help us to prepare ourselves and pay attention. Anxiety disorders take these feelings a step further and involve excessive fear and anxiety. There are multiple types of anxiety disorders including separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, and generalized anxiety disorder.
Separation Anxiety Disorder
Separation anxiety disorder is categorized by developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached. This may including behaviors such as: recurrent distress when anticipating or experiencing separation; persistent worry about attachment figures being hurt, lost, or killed; refusal to go out due to fear of separation; fear of being alone or without attachment figures; repeated nightmares and sleep refusal; and even physical symptoms such as headaches and stomachaches. This fear and anxiety must be present for at least 4 weeks and cause significant distress or impairment in functioning. Children and adults can struggle with this disorder. Individuals with separation anxiety disorder may limit independent activities, avoid school or work, or fear traveling long distances without their attachment figures.
Selective Mutism
Selective mutism is defined as the consistent failure to speak in specific social situations where there is an expectation to speak, such as school or work. This failure to speak limits the person’s ability to engage with others and hinders their social, academic, and occupational development. These symptoms must occur for at least one month. Children tend to suffer more from selective mutism. Clinical studies suggest that many people may “outgrow” symptoms of selective mutism, though often symptoms of social anxiety disorder remain.
Specific Phobia
Specific phobia is a type of anxiety that centers around certain triggers such as an object or situation. Examples of specific phobia can include fear of flying, heights, animals, seeing blood, or getting injured. Individuals with specific phobia have intense fear or anxiety when exposed to their triggers, will actively avoid the triggers, will have significant distress when exposed to their triggers, and have impaired functioning. A well-known example of specific phobia is agoraphobia, which is categorized by marked fear or anxiety around at least two of the following situations: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd; and being outside of the home alone. Clients will typically have distressing thoughts about not being able to escape, not having access to help, or experiencing other incapacitating or embarrassing events. This anxiety is disproportionate to the actual danger posed by the situation.
Social Anxiety Disorder
Unlike agoraphobia, those with social anxiety disorder are more fearful of scrutiny of others and are more likely to be calm when left alone. Social anxiety disorder is defined by excessive fear or anxiety about social situations where the individual is being observed, engaging in social interactions, or performing in front of others. Social situations almost always provoke fear or anxiety and are either endured with intense distress or avoided entirely. This anxiety is out of proportion with the actual threat of the situation. Individuals with this condition have a significant deficit in functioning socially, academically, or occupationally. 75% of individuals begin experiencing symptoms of social anxiety disorder between 8 and 15 years old. Younger individuals tend to have higher levels of anxiety about specific situations whereas older individuals tend to have higher levels of anxiety about a wider range of situations.
Panic Disorder
Panic disorder is categorized by recurrent, unexpected panic attacks. Panic attacks are defined as an abrupt surge of intense fear or discomfort that reaches a peak within minutes. At least four of the following symptoms must occur: heart palpitations, accelerated heart rate, or pounding heart; sweating; shaking or trembling; shortness of breath or feelings of being smothered; feelings of choking; chest pain or discomfort; nausea; feeling dizzy or light-headed; chills or heat sensation; numbness or tingling sensations; feelings of detachment from oneself or from reality; fear of losing control or going crazy; or fear of dying. Another aspect of panic disorder is a persistent concern or worry that additional attacks will occur, or a significant, maladaptive change in behavior related to the attacks. Panic attacks may be contributed to other anxiety disorders or can be diagnosed on its own. Approximately 80% of individuals with panic disorder will have experienced a comorbid mental diagnosis at some point during their lifetime. Panic disorder occurs more commonly in women than their male counterparts in both adolescence and adulthood.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is defined as an excessive and persistent fear and worry that occurs more days than not for at least 6 months about a variety of events or activities. The anxiety and worry is associated with at least three of the following: feeling restless, keyed up, or on edge; being easily fatigued; difficulty concentrating or a blank mind; irritability; muscle tension; and sleep disturbance. Individuals with GAD find it difficult to control the worry and have significant distress or impairment in functioning. Many people with GAD report that they have felt anxious or nervous their whole life. Symptoms of GAD tend to be chronic and may wax and wane across the lifespan. Women are somewhat more frequently diagnosed with GAD and are more likely to have a comorbid anxiety or depressive disorder. Men are more likely to have a co-occurring substance use disorder.
Everyone experiences anxiety, though not everyone has an anxiety disorder. Terms like ‘anxiety’ and ‘panic attacks’ are often thrown around with limited understanding of their depth. Gaining a better grasp on the meaning of these words allows us to more effectively communicate how we are feeling and get the support that we need. If you are struggling with anxiety or another mental health concern, don’t hesitate to reach out for help. Engaging in therapy can lead to decreasing anxiety and improving your quality of life. A licensed mental health professional can assist you in overcoming these challenges.
Outside of the practice, Sam enjoys crocheting, painting, practicing yoga, and playing games.
My favorite quote is “I am the master of my fate, I am the captain of my soul” by William Ernest Henley. To me, this quote shows us that only we are the ones in charge of our lives and that we alone have the power to make positive and lasting change.
Check out Sam’s professional bio here.
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