Generalized Anxiety Disorder (GAD):
Individuals with GAD experience excessive worrying about multiple different things, more days than not, to the point that it may interfere with their physical and mental health. The chronic worry creates significant anxiety and physiological sensations (e.g., stomach distress, muscle tension, fatigue, heart palpitations, irritability, etc.). Individuals with GAD typically worry about topics that are concerns shared by most people but have difficulty turning off a worry and often spiral to imagining the worst-case scenario. Individuals with GAD often experience sleep difficulties (falling asleep, waking up frequently) secondary to the physical sensations brought on by worry. Individuals with GAD may have trouble trying new experiences (travel; recreational/social activities) as they have difficulty tolerating the uncertainty of not knowing exactly what to expect and/or how to “control” the situation.
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Social Anxiety (or Social Phobia):
Individuals with social phobia are excessively concerned with the negative judgment of others. While they remain interested in social connections, they tend to avoid social interactions to reduce their distress and discomfort. The vast majority of adults with social phobia report having experienced this worry for as long as they could remember, and typically describe having been shy and quiet during their school years. Physical sensations accompanying anxiety (such as stomach upset, difficulty concentrating, shaking, voice trembling, and blushing) can increase fear and embarrassment in social situations. Most adults and children with social anxiety find it difficult to initiate conversations, express opinions/be assertive, speak in groups, make eye contact, tell jokes, and take risks, particularly in dating situations. In the worst cases, people with social anxiety become very isolated and depressed. In some cases, individuals with social anxiety will overextend themselves socially in order to please everyone. These people appear socially comfortable and connected, but express very little social enjoyment due to their constant need for approval by others.
Panic Attacks and Panic Disorder with Agoraphobia:
Panic attacks are common in all anxiety disorders and in the general public (approximately one-third of the population has had a panic attack in the past year). However, those who suffer from panic disorder have persistent fear of having a panic attack in a situation in which they cannot escape or get help. A panic attack is defined as the emergence of four or more physiological sensations (e.g., heart race, dizziness, light-headedness, stomach distress, trembling, feelings of derealization) peaking in intensity within 10 minutes. Those with panic disorder typically fear a catastrophic outcome from panic attacks; for example, I am going to lose control of myself, I am going to die, I am going to go crazy, and/or I am going to embarrass myself. Often, people with Panic Disorder tend to avoid situations that might elicit a panic attack (called Agoraphobia). Examples of avoided situations: locations (airplanes, traffic, large open spaces); foods (caffeine, sugar, alcohol); emotions (excitement, anger, anxiety); and activities (exercise, sex).
Individuals with health anxiety have an excessive fear of illness and/or death. Frequently, these individuals engage in excessive health safety behaviors such as scanning their body for symptoms or seeking excessive reassurance from loved ones and health professionals regarding their health status. Despite these efforts, they rarely find relief. While some individuals with health anxiety may constantly research their perceived symptoms and/or illnesses (online searches, frequent doctor’s visits), others may excessively avoid health information and health professionals to magically prevent illness. Individuals with health anxiety feel more vulnerable to disease, and, as a result, are intolerant of uncertainty regarding diseases and illness.
A specific phobia refers to the excessive and persistent fear of specific objects or situations that is understood as out of proportion to any actual danger. The fear causes life-interfering distress and/or impairment. Common types include:
- Animals (e.g., dogs, cats, spiders, insects, rats, birds, and snakes)
- Natural Environment and Weather (e.g., heights, storms, natural disasters, and water)
- Blood-Injection-Injury Type (e.g., seeing blood, receiving a blood test or injection, watching medical procedures)
- Situational Type (e.g., driving, flying, elevators, and enclosed places)
- Other Type (e.g., choking or vomiting, loud noises, or fears of costumed characters)
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Post-traumatic Stress Disorder (PTSD):
PTSD is an anxiety disorder that can develop following a traumatic event (i.e., exposure to a threat to the physical safety of self or others–either experiencing the threat directly or witnessing the threat to another). The traumatic event is experienced with a sense of intense fear, horror, or helplessness. In children, the reaction involves disorganized or agitated behavior. Symptoms of PTSD include:
- re-experiencing the trauma (i.e., flashbacks, nightmares, recurrent intrusive thoughts)
- hyperarousal (i.e., feeling jumpy or easily startled, difficulty sleeping and restlessness, irritability, difficulty concentrating, and hypervigilance or feeling on guard all the time)
- avoidance (i.e., avoiding places, people, events, or objects that remind a person of his or her trauma, emotional numbness, loss of interest in previously-enjoyed activities, difficulty remembering important aspects of the trauma, feeling cut-off from people)
Many individuals experience a few of the symptoms described above following a trauma. However, a person develops PTSD when these symptoms last more than one month and become life-interfering. In some cases, it can be months or years following a trauma before symptoms emerge.
PTSD symptoms can arise in people of all ages who have experienced a traumatic event; however, symptoms may appear differently in children compared to adults. Younger children may develop the following symptoms: repetitively acting out the event during play, separation anxiety, decrease in speech, bedwetting, and/or stomachaches and headaches. Symptoms in teenagers are more likely to resemble those of adults but may also include disruptive and destructive behaviors. In addition to the symptoms described above, those with PTSD often have emotional reactions such as anger, guilt and shame as well as disruption in sleep, diet, and exercise habits.
Separation Anxiety Disorder:
Children, teens, and adults with separation anxiety typically fear being away from loved ones and/or home. Common worries of separation include harm to themselves or loved ones as well as fears of having uncomfortable sensations associated with anxiety (e.g., stomach distress) or illness while away. While the worry of separating can occur during daytime activities, anxiety tends to escalate around nighttime and during extended trips. Some children will exhibit oppositional behaviors (e.g., meltdown, tantrums, aggression) in an effort to avoid leaving parents/home. Separation anxiety can interfere with social relationships given reluctance to enter new social situations that require temporary separation from loved ones.