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Anxiety

Anxiety and Phobia Basics

Anxiety disorders are real. Anxiety disorders are more than just "nerves". They are characterized by feelings of panic, fear, and discomfort that arise with no clear cause, in situations that are not usually stressful or dangerous. In many cases, anxiety disorders arise for no obvious reason and often without warning. The feelings of anxiety can happen over and over again, unless treatment is received. If left untreated, an anxiety disorder can make everyday life miserable.

Anxiety disorders are common. More than 19 million American adults live with anxiety disorders, which include generalized anxiety disorder (GAD), phobias (including social phobia), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and panic disorder.

Anxiety disorders can interfere with having a full, productive life. People with anxiety disorders may experience extreme responses to non-threatening situations, and these reactions can create lives filled with chronic anxiety, terror or discomfort. However, with therapy and/or medication, people can have full and productive lives.

Anxiety disorders are linked to depression. The life-changing impact of anxiety disorders may trigger depression - and it's also true that depression may generate anxiety disorders. Two out of three people with depression also have symptoms of anxiety. About 80% of depressed individuals suffer psychological anxiety symptoms: unrealistic apprehension, fears, worry, agitation, irritability, or panic attacks. Some 60% of people with depression have anxiety-related physical symptoms: headaches, irritable bowel syndrome, chronic fatigue, and chronic pain, among others. Approximately 65% of those with depression experience sleep disturbances, about 20% feel agitated, 25% have phobia, approximately 17% report generalized anxiety symptoms and 10% suffer panic attacks.

Anxiety disorders are very treatable. Like depression, the most common and successful ways to treat anxiety disorders, are antianxiety medication, psychotherapy or a combination of the two.

The Major Anxiety Disorders

Generalized Anxiety Disorder (GAD)

is usually the diagnosis if you experience six months or more of continual, extreme worry and tension that is not based on real concerns. Subjects include health, loved ones, finances, and jobs. Sometimes, the "worry" is nameless, taking the form of a constant feeling of dread.

Obsessive-Compulsive Disorder (OCD)

is marked by obsessions - repeated, upsetting thoughts and images - that you cannot control by yourself. To combat these images and thoughts and ease anxiety, a person with OCD spends time in repetitive rituals (compulsions), such as hand washing, checking and re-checking, and following rigid procedures.

Panic Disorder

is most often characterized by the presence of panic attacks, which are feelings and symptoms such as a pounding heart, chest pain, sweating, trembling, shortness of breath, numbness and fear of dying. Panic attacks happen fast, appear out of the blue and take place over and over again. There is usually no physical cause for these attacks.

Phobias

are deep-seated fears that are extreme, irrational and upsetting to a person's life. A person may experience a phobia to a specific object or situation that isn't usually harmful - such as claustrophobia (fear of confined spaces), and acrophobia (fear of heights). Social phobia is fear of being watched, embarrassed or humiliated while doing something in public, such as public speaking, eating, or writing. Agoraphobia is the fear of places or situations from which escape might be hard, like being in a crowd.

Post-Traumatic Stress Disorder (PTSD)

is the long-term, severe and continuing reaction a person may experience following a disaster (such as a fire or earthquake) or a very traumatic experience (war, rape, or sexual abuse). PTSD often occurs in people after they have experienced or witnessed one or more acts of violence. Symptoms include nightmares, loss of sleep, and flashbacks. PTSD interferes with concentration and the ability to enjoy life.

Phobia

Social Phobia (Social Anxiety Disorder)

Social phobia, also called social anxiety disorder, involves overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work or school, and other ordinary activities. While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation.

Social phobia can be limited to only one type of situation-such as a fear of speaking in formal or informal situations, or eating, drinking, or writing in front of others-or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people. Social phobia can be very debilitating-it may even keep people from going to work or school on some days. Many people with this illness have a hard time making and keeping friends.

Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, nausea, and difficulty talking. If you suffer from social phobia, you may be painfully embarrassed by these symptoms and feel as though all eyes are focused on you. You may be afraid of being with people other than your family.

People with social phobia are aware that their feelings are irrational. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout. Afterward, the unpleasant feelings may linger, as they worry about how they may have been judged or what others may have thought or observed about them.

Social phobia affects about 5.3 million adult Americans. Women and men are equally likely to develop social phobia.10 The disorder usually begins in childhood or early adolescence,2 and there is some evidence that genetic factors are involved. Social phobia often co-occurs with other anxiety disorders or depression. Substance abuse or dependence may develop in individuals who attempt to "self-medicate" their social phobia by drinking or using drugs. Social phobia can be treated successfully with carefully targeted psychotherapy or medications.

Social phobia can severely disrupt normal life, interfering with school, work, or social relationships. The dread of a feared event can begin weeks in advance and be quite debilitating.

Specific Phobias

A specific phobia is an intense fear of something that poses little or no actual danger. Some of the more common specific phobias are centered around closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood. Such phobias aren't just extreme fear; they are irrational fear of a particular thing. You may be able to ski the world's tallest mountains with ease but be unable to go above the 5th floor of an office building. While adults with phobias realize that these fears are irrational, they often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.

Specific phobias affect an estimated 6.3 million adult Americans and are twice as common in women as in men. The causes of specific phobias are not well understood, though there is some evidence that these phobias may run in families. Specific phobias usually first appear during childhood or adolescence and tend to persist into adulthood.

If the object of the fear is easy to avoid, people with specific phobias may not feel the need to seek treatment. Sometimes, though, they may make important career or personal decisions to avoid a phobic situation, and if this avoidance is carried to extreme lengths, it can be disabling. Specific phobias are highly treatable with carefully targeted psychotherapy.

Phobias aren't just extreme fears; they are irrational fears. You may be able to ski the world's tallest mountains with ease but feel panic going above the 5th floor of an office building.

National Institute of Mental Health

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