Anxiety occurs along a continuum from daily worries to being completely debilitating. We are all familiar with the stress associated with starting a new job, speaking in public, or any other number of life events that cause temporary anxiety. Generally, we accommodate the short-term distress, and move on with our lives. This type of anxiety is more like a reasonable fear in that it is focused, and has potential for being very short-term. But, the following anxiety conditions with a brief description have a more significant and long-lasting impact:
Panic Disorder: Patients with this disorder experience terror and a loss of control. It is anxiety that has no apparent trigger stimuli, causes sensations of rapid heartbeat, sweating, and sometimes chest pain, a desire to seek safety, and a sense that either a heart attack or death is occurring, and has no rational explanation.
Obsessive-Compulsive Disorder (OCD): Patients with OCD have ongoing thoughts and fears that cause them to perform rituals and routines that they believe will protect them from something dreadful happening. The thoughts themselves are considered the obsession, and the rituals are the compulsions. The classic example is that of the person concerned with germs who washes their hands continually despite the risk of any real infection.
Post -Traumatic Stress Disorder (PTSD): The issue of PTSD can follow any event involving trauma, such as the death of a loved one, sexual assault, military combat, or natural disasters. PTSD patients suffer frightening memories, and develop a numbness to the world around them.
Social Anxiety Disorder: This disorder causes patients to be overly concerned and worried when in a social setting, fearing to be judged and being embarrassed or ridiculed.
Specific Phobias: This condition involves an intense fear of particular and specific objects or situations. For example, fear of snakes, flying, heights, elevators, with the fear being disproportionate to the actual object or situation.
Generalized Anxiety Disorder: This is a condition where the patient has an excessive and unrealistic worry about almost anything in life. It is a pervasive condition where anything can be a threat.
As a case manager, I have been involved with all of these anxiety conditions and can attest to the fact that these are really just the tip of the anxiety iceberg. With the next post we will begin to look at each of these illnesses and I will share composite vignettes to illustrate these examples of anxiety.