Anxiety Disorder

Anxiety, fear, worry, panic, and apprehension are very closely linked concepts. Technically, fear is a reaction to actual threat that activates your nervous system, and prepares you to deal with true danger. Anxiety involves similar sensations as fear without the presence of a real threat, yet you feel anxious anyway. In this program, unless we indicate otherwise, we use the term anxiety in a general way when we are referring to fear, worry, panic, or apprehension.

An Anxiety Disorder, and any clinical emotional problem, is diagnosed using a book called the Diagnostic and Statistical Manual of Mental Disorders currently in its fourth appended revision (DSM-IV TR). All told there are actually several Anxiety Disorders including Panic Disorder with or without Agoraphobia, Specific phobia (also know as Situational or Specific Phobia), Social Phobia (also know as Social Anxiety Disorder), Obsessive Compulsive Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder, Generalized Anxiety Disorder, Anxiety Disorder Due to a Medical Condition, Substance Induced Anxiety Disorder, and Anxiety Disorder Not Otherwise Specified.

What all of the above problems have in common is the presence of intense or strong anxiety. The DSM-IV TR classifies problems as disorders when a person experiences distress around the problem. So, if a person has anxiety without distress it is not a disorder. People have to be bothered or distressed by something to mark it as significant enough to seek help. If you are seeking help or distressed, the chances your anxiety is in the realm of “Anxiety Disorder” is increased. Normally the distress you feel around your anxiety motivates you to either run from or fight whatever is triggering the anxiety (known as the Fight or Flight response). So if you were outside hiking and saw a grizzly bear, your anxiety would almost immediately trigger your body to create a strong surge of adrenaline so you could get out of there. In this example the threat, the bear, is real. Anxiety then serves a helpful function in motivating and energizing you to leave. However, if you have anxiety and there is not an actual threat (but your mind and body are acting as if there was), then your anxiety is not serving a useful purpose and we can begin to think of it as a “Disorder”. For anxiety to be useful it needs to match the situation accurately. When there is a pattern of anxiety becoming active and serving no useful purpose, there is a mismatch between your anxious response and reality.

Another thing that most Anxiety Disorders have in common is that when the anxiety, panic, fearfulness, or worry strikes, it is hard to consistently control it (in other words, your anxiety can get the best of you). Due to this difficulty in control, the anxiety tends to repeat itself. A common feature of most of the Anxiety Disorders (but not all of them), is the tendency or compulsion to avoid situations, activities, and thoughts associated with the anxiety. In other words you do not go into a situation where you think you might become anxious and as a result you never learn to cope in the situation. The term for this phenomenon is Avoidance.