Anxiety vs. Anxiety Disorders

In a nutshell, anxiety becomes an anxiety disorder when the anxiety that you are experiencing is greater than what you might expect in a given situation, and when it begins to interfere with some aspect of your life. For example, if your anxiety prevents you from forming desired relationships with people or meeting your responsibilities at work or school, this may be a sign that normal anxiety has shifted to a disorder of anxiety. In addition, if you find that you are engaging in unhealthy behaviors in an attempt to avoid or reduce your anxiety (such as drinking or using drugs), there is a good chance that you have a problem with anxiety.

There are six main anxiety disorders:

Specific Phobia
The first anxiety disorder is specific phobia. In this disorder, people experience such intense fear (even to the point of having a panic attack) when they come into contact with certain objects or situations that they take steps to avoid these objects or situations. Common specific phobias include acrophobia (fear of heights), odontophobia (fear of dentists), arachnophobia (fear of spiders), ophidiophobia (fear of snakes), and claustrophobia (fear of enclosed spaces).

Social Anxiety Disorder
Social anxiety disorder (also called “social phobia”) is another anxiety disorder, in which a person experiences intense fear and anxiety in social situations due to a fear of negative evaluation (for example, being judged). And, just as with specific phobia, this intense fear often results in the avoidance of these social situations. The most common type of situation that people fear in social anxiety disorder is public speaking; however, there are other situations that people with social anxiety disorder may also fear, such as eating in front of people, urinating in public restrooms, or writing in front of people

Panic Disorder
A person with panic disorder experiences frequent, out-­of-­the-blue panic attacks, as well as worry about the meaning or outcome of those panic attacks. For example, people with panic disorder might fear that a panic attack is a sign that they are dying or going crazy. As a result of these panic attacks, people with panic disorder often try to avoid activities or situations that might bring on symptoms of arousal, such as exercise or eating heavy meals. In extreme cases, people with panic disorder may fear leaving home, because it is the only place where they feel safe. If this happens, a person may be diagnosed with panic disorder with agoraphobia.

Obsessive-­Compulsive Disorder
This disorder has received a fair amount of attention in the media recently. In obsessive-­compulsive disorder (OCD), a person experiences intense, intrusive, and repetitive troublesome thoughts and ideas that might be viewed as strange and that are not about real-­life problems. These out-­of-­the-­ordinary thoughts and ideas are called obsessions. For example, people with this disorder may have persistent fears that they are going to accidentally poison their children, catch a disease, or harm someone else. As a result of these obsessions, people with OCD then engage in repetitive behaviors (or compulsions) to reduce the anxiety associated with those obsessions, such as excessive hand washing, ordering, checking, or performing mental rituals (such as counting).

Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is characterized by excessive, persistent, and uncontrollable worry about many different concerns. Sometimes people confuse GAD with OCD because both include the experience of repetitive thoughts. However, worry is different from obsession, because the worry in GAD is about real-­life or daily concerns, such as finances, work, and relationships. Worry in GAD is actually viewed as an attempt to avoid or distract a person from more-­upsetting and anxiety-­provoking thoughts and feelings

Post-­Traumatic Stress Disorder
Finally, post-­traumatic stress disorder (PTSD) is unique among the anxiety disorders, because it is the only one that requires people to have experienced some type of traumatic event before they can be diagnosed with it. PTSD is diagnosed when a person experiences a set of symptoms more than thirty days after exposure to a traumatic event. The symptoms of PTSD include intrusive thoughts and memories about the traumatic event (for example, flashbacks or feeling as if the event were happening all over again), avoidance of reminders of the traumatic event, difficulties experiencing positive emotions, feeling detached from others, and hyperarousal and hypervigilance (or always feeling on guard). If someone experiences these symptoms within one month after a traumatic event, we call the disorder acute stress disorder.

Sources: The Dialectical Behavior Therapy Skills Workbook for Anxiety

Obsessive-Compulsive Disorder (OCD): Symptoms

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.

You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.

Obsessive-Compulsive Disorder often centers around certain themes — for example, an excessive fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.

If you have Obsessive-Compulsive Disorder you may be ashamed and embarrassed about the condition, but treatment can be effective.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it’s also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social, school or work functioning.

Obsession symptoms

obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you’re trying to think of or do other things.

Obsessions often have themes to them, such as:

• Fear of contamination or dirt

• Doubting and having difficulty tolerating uncertainty

• Needing things orderly and symmetrical

• Aggressive or horrific thoughts about losing control and harming yourself or others

• Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

• Fear of being contaminated by touching objects others have touched

• Doubts that you’ve locked the door or turned off the stove

• Intense stress when objects aren’t orderly or facing a certain way

• Images of driving your car into a crowd of people

• Thoughts about shouting obscenities or acting inappropriately in public

• Unpleasant sexual images

• Avoidance of situations that can trigger obsessions, such as shaking hands

Compulsion symptoms

compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you’re having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they’re intended to fix.

As with obsessions, compulsions typically have themes, such as:

• Washing and cleaning

• Checking

• Counting

• Orderliness

• Following a strict routine

• Demanding reassurance

Examples of compulsion signs and symptoms include:

• Hand-washing until your skin becomes raw

• Checking doors repeatedly to make sure they’re locked

• Checking the stove repeatedly to make sure it’s off

• Counting in certain patterns

• Silently repeating a prayer, word or phrase

• Arranging your canned goods to face the same way