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Anxiety Disorders

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Anxiety is a normal emotion that everyone experiences from time to time. Anxiety can be protective, with alerting us to dangerous situations, driving us to complete tasks, or pushing us towards success. However, for some anxiety can become overwhelming and paralyzing. Worry can be constant, consuming our every thought. Anxiety can exhaust our minds and bodies leading to physical fatigue, stomach aches, head aches, muscle aches, or other physical manifestations. Anxiety may begin to occur with no identifiable trigger or be out of proportion to the situation. When your anxiety begins to make it hard for you to function in your daily life, it is time to seek an evaluation to determine if you need help. Our psychiatric nurse practitioners are skilled at determining if your anxiety requires treatment and will engage you in a discussion of treatment options if needed. 

There are several types of anxiety disorders. Each anxiety disorder has different symptoms. Anxiety disorders can occur in children, teenagers, and adults. How anxiety symptoms are experienced does differ depending on age.

  • Social Anxiety Disorder - Symptoms persisting for 6 months or more of:

    • Fear or anxiety about social situations in which the individual is exposed to possible scrutiny by others.  For children this fear and anxiety occurs in peer settings, not just during interactions with adults.

    • The individual fears that their actions or anxiety will be negatively viewed by others 

    • Social situations almost always provoke fear or anxiety.

    • The social situations are avoided or endured with intense fear or anxiety.

Social anxiety may make it difficult for you to create new friendships, advance in your career, or even maintain your friendships. You may find yourself doubting that your friends actually enjoy your company leading to avoidance. You may spend excessive amounts of time thinking over and over about social situations even if nothing negative occurred. 

  • Generalized Anxiety Disorder – Symptoms persisting for 6 month or more of:

    • Excessive anxiety and worry occurring more days than not​ about a number of events/activities

    • Difficulty controlling the worry

    • Anxiety/worry are associated with restlessness, nervousness, fatigue, poor concentration, irritability, muscle tension, or sleep disturbance

    • The anxiety, worry, or physical symptoms cause impairment in functioning

This involves ongoing and disproportionate worrying, usually about everyday challenges like chores, job or        school responsibilities, your health or that of your family, or appointments. This can cause lots of physical symptoms tension and stress it induces, like problems sleeping or concentrating and feeling easily fatigued or restless.

  • Panic Disorder – Symptoms occurring after one attack in the following month including:

    • Persistent ​concern or worry about additional panic attacks or their consequences

    • A change in behavior in attempt to prevent an attack (such as avoiding unfamiliar places or situations that create anxiety)

Panic disorder is characterized by recurring panic attacks. Panic attacks can be triggered by certain stimuli or seemingly at random and can feel so severe that you may think you’re having a heart attack. Symptoms like shortness of breath, chest pain, trembling or shaking, numbness or tingling, and sweating, among other physical responses. Recurring panic attacks or daily fear of panic attacks often mean a person has panic disorder.

  • Specific Phobias –Symptoms persisting for 6 month or more of: 

    • Fear/anxiety about a specific object or situation  which almost always when presented with this object/situation​

    • The object/situation is actively avoided

    • The fear, anxiety, or avoidance causes impairment socially, at work, or in other circumstances 

This widely known anxiety disorder is diagnosed when a person is overly afraid of a specific object, situation or activity. The person is often, although not always, aware that their fear is unwarranted or over-the-top, but they can’t control their irrational response. Phobias of spiders, flying, and snakes are common.

  • Agoraphobia – Symptoms persisting for 6 months or more of: 

    • Fear of using public transportation, being in open spaces, being enclosed in places, standing in line or being in a crowd, being outside of the home alone.

    • Fear is created in the above situations due to worry that escape will be difficult or help might not be available creating panic like symptoms

    • The agoraphobic situation always provokes fear/anxiety

    • The triggering places and situations are actively avoided or require the presence of a loved one

    • The fear/anxiety is out of proportion to any danger

Agoraphobia is an intense fear of being in places or situations that might cause or be difficult or embarrassing to leave in the event of a panic attack. This fear can cause them to avoid public places and situations like using public transportation, being in a crowd, or being outside the home at all by themselves. Agoraphobia often co-exists with panic attacks

  • Separation anxiety disorder- Symptoms occur persistently for 4 weeks in children and 6 months in adults:

    • Recurrent excessive distress when experiencing or anticipating separation from home or major attachment figures​

    • Persistent and excessive worry about losing or harm to major attachment figures such as illness, injury, disaster, or death

    • Persistent refusal to go out, away from the home, to work or school due to fear of separation 

    • Fear of being alone, nightmares about being alone, or refusing to sleep with out the major attachment figure

    • Physical symptoms, such as nausea, headache, stomach ache, when away from the major attachment figure

  • Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations.

Additional Resources 

Top 12 Books to Help with Anxiety

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