Panic Disorder (with or without Agoraphobia)
Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by a variety of physical symptoms that may include rapid heart rate, dizziness, tremor, nausea, chest pain, and shortness of breath. People who are experiencing panic attacks may fear that they are dying, or going crazy. Agoraphobia is avoidance of situations or places where panic attacks might occur, and where help or escape would be difficult or embarrassing.
People with panic disorders experience repeated panic attacks that occur “out of the blue.” Later in the course of the illness, they may have panic attacks that are triggered by certain places or situations. Often, people with panic attacks fear that their attacks are a sign of a severe medical illness, such as heart disease. Some people with panic disorder avoid places or situations in which they have had previous panic attacks, or where help might be unavailable. Panic disorder usually develops in late adolescence or early adulthood, but can also occur in children and older adults.
Social Phobia (also known as Social Anxiety Disorder)
Social phobia, or social anxiety disorder, is characterized by extreme anxiety and discomfort in social situations. In its most severe form, generalized social phobia, people have a great deal of difficulty engaging in a wide range of social activities, including speaking in public; dealing with authority figures, parties and other social events; extending invitations; eating in public; and meeting strangers.
People with social phobia often feel that they are being judged negatively by others. In anticipation of certain social activities, such as giving a public speech, they worry for days to weeks ahead of time, and can develop physical symptoms associated with this worry (e.g., gastrointestinal problems, insomnia, and headaches). Some people with social phobia have panic attacks when confronted with difficult social situations. After social events, people with social phobia sometimes ruminate about perceived blunders or mistakes. Not surprisingly, many people with social phobia avoid social situations that bring on these symptoms. Social phobia often first occurs in childhood or at the time of puberty.
Obsessive-compulsive disorder, OCD, is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Obsessions can include thoughts such as being contaminated by germs or disease, thoughts that something terrible might happen if a task is not done just right, superstitions about certain numbers or patterns, excessive religious thoughts, and fear of throwing something away that might be important. Often, compulsions are conducted in an effort to relieve the anxiety caused by the unwanted thoughts. Common compulsions include excessive washing or cleaning, ritualistic checking behaviors, hoarding, repeating certain phrases a particular number of times (or mentally repeating things to oneself a certain number of times), prayer rituals, and organizing things until they are 'perfect'. Obsessive-compulsive disorder appears to run in some families, and often first appears in childhood.
Trichotillomania/ Excoriation Disorder (Hair Pulling or Skin Picking)
Trichotillomania and excoriation disorders are characterized by compulsive habits related to plucking or pulling hairs or bits of skin. These behaviors can be consciously pursued or occur “absent mindedly,” but in either case result in anxiety regarding the physical signs of these behaviors, such as bald spots or scars. The pulling/ picking behaviors typically resist attempts to stop and tend to cause significant distress. These conditions sometimes arise in the context of other anxiety disorders, such as OCD or generalized anxiety. Treatment usually entails habit reversal training and, in some cases, medication management.
Post Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder, PTSD, occurs in some people after they experience a traumatic or life-threatening event. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. Following the trauma, people with PTSD have unwanted, intrusive memories or dreams about the event, or may even feel that they are re-experiencing the trauma. Some people become withdrawn or depressed, and feel “numb.” Usually, people with PTSD avoid situations that remind them of the trauma. Sometimes people with PTSD become very irritable, have trouble sleeping, and startle easily.
Generalized Anxiety Disorder (GAD)
Generalized anxiety disorder, GAD, is characterized by unrealistic and excessive chronic, persistent worry about several life events (e.g., health, finances). People with GAD often develop physical symptoms, such as headaches, fatigue, gastrointestinal discomfort, muscle tension and aches, and insomnia as a result of their chronic anxiety.
Some people have exaggerated fears of certain objects or situations. Usually, the individual with a phobia realizes that the fears are unrealistic or excessive, but still feels a need to avoid the object. Common specific phobias include a fear of:
- Driving over bridges
- Being in enclosed places
- Spiders, snakes, or other animals
- Needles or blood