Anxiety Disorders

Types of Anxiety Disorders

There are several different types of anxiety disorders, each of which is intense enough to cause significant distress or impairment in social or occupational functioning:

Specific Phobia: Recurrent intense fear about a specific object or situation (“stimulus”) that is out of proportion to the actual danger associated with the stimulus. This fear is intense enough to cause significant distress or impairment in social or occupational functioning.

Social Anxiety Disorder: Ongoing fear or anxiety about social situations where the person feels judged, scrutinized, or negatively judged by others. Common situations include social activities such as conversations, meeting new people, eating or drinking in front of others, and performing in front of others.

Panic Disorder: Repeated, unexpected abrupt attacks of intense fear that reach a peak within minutes, and which are accompanied by intense physical symptoms such as rapid heart rate, sweating, shortness of breath, choking sensations, chest pain, abdominal pain or nausea, dizziness, hot flashes, numbness and tingling, feelings of unreality, fear of losing control, or fear of dying.

Agoraphobia: Fear of using public transportation, being in open or enclosed spaces, in line or a crowd, or outside the home alone. The fear is accompanied by the thought that escape might be difficult or help might not be available if they developed feelings of panic or other incapacitating or embarrassing symptoms. This fear is so great that the person avoids these situations, requires a companion, or endures the situations with intense fear or anxiety.

Generalized Anxiety Disorder: Continual fear and worry over at least a six-month period about a number of different situations, events, and activities. The person cannot control the worry and experiences physical symptoms of anxiety.

Substance/Medication Induced Anxiety Disorder: Panic or anxiety attacks that develop soon after using substances or medications or withdrawing from substances or medications. These symptoms are not better understood by the presence of an anxiety disorder or other mental disorder or physical disorder.
Other Anxiety Disorders: Anxiety disorders that do not fit the criteria for the above disorders.

Psychotherapy for Anxiety Disorders

Anxiety disorders are very treatable with psychotherapy. Your psychologist will discuss your specific type of anxiety disorder as well as any other diagnoses that you may have to choose the best psychological treatment plan. The following types of therapy are most commonly used to treat anxiety disorders:

Cognitive Behavior Therapy (CBT): This type of therapy helps you identify negative patterns of thoughts and cognitive distortions, which negatively color the way you view the world, yourself, and others. CBT focuses on identifying negative patterns of thoughts and beliefs that contribute to your anxiety disorder and then replacing them with healthier, more adaptive ways of thinking and functioning.

Behavior Therapy: Behavior therapy focuses more directly on modifying your behavior in situations that are associated with your anxiety symptoms. An example is Exposure Therapy, in which you work with your therapist to gradually and safely expose yourself to situations that trigger anxiety and learn to overcome your anxiety and distress.

Interpersonal Therapy (IPT): IPT addresses interpersonal situations that are associated with your anxiety. By directly addressing these situations, and helping you learn better, more effective ways of coping with the interpersonal problems in your life, you may find more effective ways of controlling or even eliminating your anxiety.

Psychodynamic Therapy: Psychodynamic therapy addresses the origins of your anxiety in past and current life experiences. Psychodynamic therapy is more open-ended than other types of treatment and allows you and your therapist to explore experiences as far back as your early childhood that may be related to your current anxiety symptoms.

Group Therapy for Anxiety Disorders: Group therapy is an especially effective treatment for anxiety disorders, and many types of anxiety disorders are related to difficulties interacting with other people.

Family and Couples Therapy for Anxiety Disorders: Family and couples therapy can be beneficial in addition to individual therapy for the treatment of anxiety disorders. Family members are provided psychoeducation about your condition and learn improved communication skills to learn how to be more helpful and how to avoid being harmful when supporting you.

Medications for Anxiety Disorders

Research has shown that, for some anxiety disorders, the addition of medication to psychotherapy is not more effective than psychotherapy alone. For other anxiety disorders, the combination of medications plus psychotherapy often produces significantly better results. Patients with a more severe case of an anxiety disorder are also more likely to benefit from the addition of medications to their psychological treatment plan.

While there is a wide range of medications that are useful in the treatment of anxiety disorders, the most commonly used are SSRIs, SNRIs, and NDRIs. Different medicines may work better for various diagnoses, and the choice of medication will be determined by other diagnoses that you may have. Pharmacogenomic testing through The Arroyos laboratory service may be recommended to better match your medications with your genetic profile. Arroyos doctors avoid using addictive medications such as benzodiazepines for all patients whenever possible when treating anxiety disorders, and especially so for patients who have problems with drugs and alcohol.

How to Help a Loved One

If you have a loved one who is suffering from anxiety, it is important to talk with them right away about your concerns. They may be embarrassed about their condition, have difficulty putting their feelings into words, feel hopeless or worthless, or be preoccupied with feelings of guilt or even suicidal thoughts. They may be housebound and unable to come to the office for an appointment. Let them know that you care and that you are confident that they can feel better if they speak to a trained professional. Please call us if they are willing to schedule an intake appointment. If they are unwilling or unable to get help, they may need to be hospitalized. If they are expressing thoughts of hurting themselves or someone else, this is an emergency. Call 911 or take them to the nearest emergency room.