Anxiety Disorders, including PTSD
by RI Editors
This research essay is part of our Peculiar Minds series.
Anxiety Disorders are broadly categorized into five general disorders:
- Generalized Anxiety Disorder
- Obsessive-Compulsive Disorder
- Panic Disorder
- Post-Traumatic Stress Disorder
- Social Anxiety Disorder
Generalized Anxiety Disorder is characterized by excessive worry. All of us worry to some degree about issues of family or money or work, but GAD sufferers worry about getting through each day, consistently feeling that things will always go awry. This is a slow-developing syndrome that usually begins in adolescence or early adulthood, and may worsen or ease as stresses ebb and flow. Symptoms, beyond pervasive worry, including difficulty relaxing or concentrating, easy startling, insomnia, muscle tiredness, aches, fatigue, difficulty swallowing, trembling/twitching, irritability, profuse sweating, light-headedness, and frequent urination.
Obsessive-Compulsive Disorder is characterized by a need to recheck things. Beyond an average sense of forgetfulness that causes us to check that we’ve done things, OCD sufferers feel compelled to repeat certain behaviors, thoughts, or routines, and become increasingly anxious in the process. For many people, obsessions and compulsions begin in the childhood or teen years and continue into adulthood, sometimes waning or increasing in severity. Symptoms include repeated thoughts or images (obsessions) regarding germs, dirt, intruders, violence, sexual acts, or tidiness. Repeated acts (compulsions) are difficult to control.
Panic Disorder is characterized by sudden and repeated attacks of fear. Fears often focus on disaster or losing control and feel to some sufferers like heart attacks. Attacks often begin in late teens and early adulthood, and more women than men suffer them. It takes on a life of its own as fears are compounded by the fear of having attacks in public places, often causing people to avoid places where an attack has previously occurred. Physical symptoms include pounding or racing heart, sweating, breathing problems, weakness or dizziness, hot or chill, tingly or numb hands, or chest or stomach pain. This form of anxiety does sometimes run in families, but no one knows why some do or do not develop the disorder.
Post-Traumatic Stress Disorder is sometimes experienced by people who have survived a traumatic event or a friend or family member has. Usually symptoms begin 3-6 months after the event, but for many they do not arise for years. Triggers, or stimuli that are interpreted by the sufferer as similar to the original trauma, cause subconscious fight-or-flight responses due to earlier damage to the adrenal response. While veterans are the most recognizable sufferers, PTSD can arise from physical and sexual assault, abuse, disasters, accidents, deaths of family members, and other serious incidents. Symptoms fall into three main groups: re-experience, avoidance, and hyperarousal. Re-experience includes flashbacks, nightmares, frightening thoughts; avoidance includes places or events, experiencing numbness, guilt or worry, and blocking the initial event; and hyperarousal includes excessive startling, difficulty sleeping, and being on edge. Dr. Barbara Rothbaum discusses PTSD on PBS’s This Emotional Life.
Children who experience PTSD may have slightly different symptoms, including bedwetting (after learning toileting), forgetting how or being unable to talk, acting out the event, or being unusually clingy. Older children may develop symptoms similar to adults, or become disruptive, disrespectful, or destructive. Excessive guilt for not preventing incidents or thoughts of revenge may cling to them.
Social Anxiety Disorder is characterized by a profound fear of being judged by others or being publicly embarrassed, and prevents sufferers from doing otherwise simple things in public (like signing a check or answering a question). SAD usually begins in childhood. Sufferers often avoid public places, worry for extended periods of time about upcoming events, have a difficult time making and keeping friends, blush or sweat or tremble in public, and may feel nauseous or sick when around other people. Social phobias sometimes run in families, but it’s hard to predict who will suffer the disorder.
The key in diagnosis for each of these fear/anxiety-related disorders is usually length of time suffered and number of episodes experienced. A variety of therapies are available. For more information about any of these conditions, you may wish to visit the Anxiety Disorders section at the National Institute of Mental Health page.
Despite widespread media coverage, people with anxiety disorders are no more likely than the general population to be violent.
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