Mental Disorders

'Just because I can't explain the feelings causing my anxiety, doesn't make them less valid'
-Lauren Elizabeth, social media personality

Introduction

Anxiety is a common, familiar emotion that human beings experience in  everyday life. When put under stress or in a fear-inducing circumstance, such as  attempting a difficult exam or giving a speech in front of a large audience, one often feels those jitters. However, on various occasions in our life, these jitters can also act as a motivating factor to help maintain focus, perform well and do our best. Not only is anxiety present under stressful circumstances, it also is an essential ingredient for survival. When crossing a busy road, something keeps us from not making hasty decisions and that something is 'anxiety'. However, it is when that anxiety becomes frequent and intense, interfering with our daily life functioning that it switches from being healthy to harmful. It is at this point in time when one should seek professional help. [1]  

According to the American Psychological Association, Anxiety is “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure”. [2] Anxiety Disorders are characterized by excessive fear, anxiety, and related behavioral disturbances. [3] This section elaborates the signs and symptoms for anxiety. 

Signs and Symptoms:

All anxiety disorders share some similar signs and symptoms, however, the different sub-types include disorder specific signs and symptoms. General signs and symptoms of anxiety disorders include:

  • Panic attacks
  • Excessive fear
  • Avoidance behaviors
  • Over-estimation of threat/danger
  • Under-estimation of one’s ability to deal with threat
  • Feeling wired and uneasy
  • Anticipatory fear and mind racing/over thinking
  • Sleep disturbances (either in falling or maintaining sleep)
  • Inability to calm down or relax
  • Excessive stress
  • Increased heart rate with cold, and sweaty hands and feet
  • Pain in chest or neck and shortness of breath
  • Increased muscle tension or tightness
  • Feeling nauseated, dizzy or weak
  • Irritability
  • Poor concentration

Though, there may be different reasons for the occurrence of such symptoms, such as changes in brain activity or distinct environmental factors, they all are features of anxiety.

Types of Anxiety Disorders

Although the sub-types of anxiety disorder share similar characteristics, certain differentiating factors can help make the diagnosis efficient. Listed are the different types of anxiety disorders followed by brief explanations:

1) Separation Anxiety Disorder

Separation anxiety disorder refers to  persistent excessive fear or anxiety of separation from home or, a place or person you are extremely attached to. Previously, separation anxiety was applied to individuals under 18. However, the latest version of the DSM categorizes it as an anxiety disorder that can occur at all ages.

Despite the fact that a considerable amount of separation anxiety for children is considered a part of an infant’s healthy development, it usually ends by the age of 2. This is  when children grasp the idea of parents not being in sight at all times.

However, when the level of anxiety is excessive at a certain developmental phase, it is then considered to be a separation anxiety disorder. As such, symptoms must be present for at least four weeks in children and adolescents and six months or more in adults, and must cause some sort of impairment in school, social, occupational or personal functioning as a result of the anxiety.

2) Selective Mutism

Selective Mutism refers to a severe anxiety disorder where a person is physically unable to speak in certain social circumstances or to certain individuals, e.g. to classmates at school or to relatives you don't see very often. The disorder usually begins during childhood and, if left untreated, could continue into adulthood.

However, it is important to note that an individual with selective mutism, child or adult, doesn’t refuse or choose not to speak, they are quite literally/ physically unable to speak.

3) Panic Disorder

In this condition feelings of panic or terror strike the person without any fore warning and has a sudden onset; the attacks may even repeat themselves on numerous accounts. Panic attacks are described as a fear of disaster or of losing control even when there is no actual danger.  At times, a strong physical reaction may accompany the panic attack, and the person may feel like they are having a heart attack. Panic attacks can occur at any time, and many people with panic disorder live with the constant fear of the possibility of another attack.

Symptoms of panic attacks may include: racing heartbeat, difficulty breathing, feeling as though you "can't get enough air", terror that is almost paralyzing, dizziness, lightheadedness or nausea trembling, sweating, shaking choking, chest pains hot flashes, or sudden chills, tingling in fingers or toes ("pins and needles"), fear that you're going to go crazy or are about to die.

A person diagnosed with panic disorder may often become discouraged as they feel they are unable to carry out daily tasks, such as going to school, getting groceries, due to impending possibility of another attack. It should be noted that not everyone who experiences panic attack has a full blown disorder.

Though, the exact causes of panic disorder are unclear, there seems to be a connection with major life changes that are potentially stressful, and it also seems to have a genetic predisposition; i.e. if a close family member has been diagnosed with a panic disorder, it increases ones chances of being diagnosed with the same.

4) Social Anxiety Disorder

Someone with social anxiety may experience symptoms of anxiety or fear in social situations, e.g. meeting new people, job interviews, answering a question in class, or having to talk to someone in a queue, eating or drinking in front of others or using a public restroom. The person is generally afraid of being judged, humiliated or rejected by those in their surroundings whether or not the individual holds any significance in their life.  It transforms into social anxiety disorder when, the fear grows to an extent where it begins to interfere with daily routine such as going to school. Sometimes individuals end up staying away from places or events where they think they might have to do something that will embarrass them.

The disorder spans over at least 6 months, and as a result one may have difficulty is everyday tasks. Social anxiety disorder generally starts during adolescence in people who are extremely shy and, without treatment it can last for many years or a lifetime, preventing a person from reaching his or her full potential.

5) Specific Phobias

Specific phobias can be defined as an intense, irrational fear of certain thing or situation. That is, those who have specific phobias experience excessive and unreasonable fear in the presence of or in anticipation of a specific object, place, or situation. Such an extent of fear can disrupt daily routines, limit work efficiency, reduce self-esteem, and place a strain on relationships since people will do whatever they can to avoid the fearful situation, place or object.

Though some phobias can develop in childhood, most arise unexpectedly, usually during adolescence or early adulthood. Onset of phobias is sudden and may occur in relation to situations or objects that did not cause any discomfort previously. It should be noted that though people with phobias realize that their fear is irrational, even thinking about it can often lead to extreme anxiety. Some common specific phobias can be of animals, insects, germs, heights, thunder, driving, public transportation, flying, dental or medical procedures, and elevators and the like.

6) Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) refers to chronic episodes of extreme worry and tension without any clear provocation, it is much more than the normal anxiety people experience day to day. GAD involves anticipating disaster, often worrying excessively about health, money, family or work. Sometimes, though, just the thought of getting through the day brings on anxiety resulting in restlessness, irritability, poor concentration and even insomnia.

7) Agoraphobia

Agoraphobia can simply be defined as an extreme and intense fear of being in crowds, public places, or open areas. It is a type of anxiety disorder in which an individual fears and often avoids places or situations that might cause them to panic or make them feel trapped, helpless or embarrassed. Even the most ordinary tasks such as walking through a market can result in panic for the fear that there is no escape. Agoraphobia in extreme cases can result in avoidance of situations by not leaving the house at all.

[1] Morrison, J. (2014).  DSM-5 made easy: The Clinician’s guide to Diagnosis. New York: Guilford Press.   

[2] Anxiety. (n.d.). Retrieved from http://www.apa.org/topics/anxiety/   

[3]American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.


Note: If you relate to any of the above mentioned symptoms regularly, over a long period of time (dependent on the type of anxiety disorder), it can be helpful to connect with a mental health professional


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