Types of Anxiety Disorders

Anxiety is a commonly used phrase across the world. However, the key component is to understand its core meaning. Many psychologists define anxiety in simpler language: constant worry or anticipation regarding events happening in the far future. Sometimes, this worry or anticipation can be about specific events, places, persons, or objects. On the other hand, it can be generic. Working to overcome anxiety works best when one accepts that they have anxiety issues and can identify the type of anxiety they experience. 

The various types of anxiety disorders are:

1. Generalized anxiety disorder

In generalized anxiety disorder, the person experiences anxiety about numerous events. There is no specific event, place, or person which triggers the anxiety. There is a lot of anticipation about upcoming events. The person is constantly having thoughts and mental images about it and finds it difficult to control the worry. It is often out of proportion.

DSM-5 criteria of generalized anxiety disorder:

• The individual experiences excessive worry about all future events. This worry lasts for about six months.
• The individual cannot control the fear.
• The following symptoms are present for six months.
• Easily fatigued
• Difficulty concentrating or mind going blank
• Restlessness or on edge
• Irritability
• Muscle tension
• Sleep disturbance

2. Panic disorder

In panic disorder, individuals experience severe, unexpected panic attacks; they may think they are dying or losing control. The individual develops anxiety over the possibility of having another attack or about its consequences. Few individuals might not report a concern about another attack but still change their behaviour to indicate the distress caused by the attack. They avoid going to certain places or neglect their duties around the house.

DSM-5 criteria of panic disorder:

• Recurrent unexpected panic attacks are present.
• At least one of the attacks has been followed by one month or more of one or both of the following: 
  • The individual experiences constant worry about upcoming panic attacks.
  • There is a noticeable change in an individual’s behaviour.

3. Agoraphobia

Agoraphobia is the fear and avoidance of situations in which a person feels unsafe or unable to escape to get home or to a hospital in the event of developing panic symptoms or other physical symptoms. Individuals develop agoraphobia because they never know when the symptoms might get triggered. In severe cases, individuals with agoraphobia are unable to step out of the house. 

DSM-5 criteria for agoraphobia:

• Excessive anxiety about social settings such as public transport, open spaces, enclosed spaces, standing in line or being in a crowd, or being outside the home alone.
• The situations frequently provoke fear or anxiety.
• These situations are actively avoided, require a companion’s presence, or are endured with intense fear or anxiety.
• The anxiety is out of proportion to the situations and the sociocultural context.
• The fear, anxiety, or avoidance is persistent, usually lasting six months or more.

4. Specific phobia

It is an irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function. Individuals develop fear about things which are not harmful, such as visiting the dentist or have an exaggerated fear of something only slightly dangerous, such as driving a car or flying. 

DSM-5 criteria for specific phobia:

• Significant anxiety about some specific object or a person.
• The situations are anxiety provoking.
• The individual avoids these specific situations or contact with that object. 
• The anxiety is out of proportion compared to the actual danger posed by the specific object or situation and the sociocultural context.
• The anxiety lasts for six months.

5. Social anxiety disorder (social phobia)

There is marked anxiety focused on one or more social or performance situations. Individuals with just performance anxiety usually have no difficulty with personal social interaction, but when they must perform in front of people, anxiety takes over and they focus on the possibility that they will embarrass themselves. Anxiety-provoking reactions include blushing, sweating, and trembling. 

DSM-5 criteria for social anxiety disorder (social phobia) are:

• Significant anxiety about being judged by others in social settings.
• The individual fears that they will be negatively evaluated.
• Social situations are causing anxiety.
• Social situations are avoided.
• The fear or anxiety is exaggerated.
• The fear, anxiety, or avoidance lasts for six months.

Do’s and don’ts of dealing with anxiety

Let us look at a few techniques that one should do while dealing with anxiety:

Do’s

1. Look for help- talk to your trusted ones, friends, health professionals, or a counsellor. There are online helpline numbers available for people to reach out to.
2. Breathing exercises- a trusted first-aid kit for dealing with anxiety is practising breathing exercises. In this case, one needs to start by taking deep breaths. Practise this till your breathing comes to a regular rate. After that, repeating the mantra ‘everything will be fine’ will help in calming.
3. Physical Exercises- doing physical outdoor activities can help divert one’s thoughts and provide a window to think. Activities like swimming and yoga can help to relax.
4. Eat healthily- sometimes, we need to alter our food intake or content of foods. For example, consuming a lot of caffeine might be risky for individuals who experience anxiety daily. Hence, it is important to consider what and how much we eat.

Don’ts

1. Do not do everything at once – chunk down the goals. Take one step at a time.
2. Don’t focus on the things you cannot change –Focus on what you can control.
3. Don’t avoid situations that make you anxious – Expose yourself gradually to reduce anxiety instead of avoiding it altogether.
4. If you feel lonely, always tell yourself you are not alone and look around for someone to reach out to.
5. Don’t depend on unhealthy coping mechanisms- drinking, smoking, gambling, etc.

Treatment for anxiety disorders

Medications

• Anti-anxiety medications- benzodiazepines help reduce anxiety. They are short-term help and can be used to build up tolerance.
• Antidepressants- these medications help to improve mood and reduce stress. Antidepressants take time to work.
• Beta-blockers are used to reduce physical symptoms of anxiety.

Psychotherapy

All clients with anxiety disorder require attention to their emotional problems and physical symptoms triggered by anxiety. Psychoeducation becomes an integral part of the entire treatment plan. With cognitive behaviour therapy, one goes down on the roots of the anxiety triggers. Identifying the roots can help to keep track of emotional patterns further. 

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