Anxiety

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Description and incidence: Of the 40 million Americans age 18 and older who suffer from an anxiety disorder, approximately 3.1%, or 6.8 million, suffer from Generalized Anxiety Disorder (GAD). The essential characteristic of GAD is excessive uncontrollable worry about everyday things. This constant worry affects daily functioning and can cause physical symptoms. GAD can occur with other anxiety disorders, depressive disorders, or substance abuse. The focus of GAD worry can shift, but usually centers on issues like career, finances, and the health of both self and family. It can also include more mundane issues such as chores, car repairs, and being late for appointments. The intensity, duration, and frequency of the worry are disproportionate to the issue and interfere with the sufferer's performance of tasks and ability to concentrate. Sufferers tend to be irritable and complain about feeling on edge, are easily tired, and have trouble sleeping. Physical symptoms of GAD include:muscle tension sweating nausea gastrointestinal discomfort or diarrhea cold, clammy hands difficulty swallowing jumpiness Diagnosis: GAD is often difficult to diagnose because it lacks some of the dramatic symptoms, such as unprovoked panic attacks, that are seen with other anxiety disorders. For a diagnosis to be made, excessive, persistent worry must be present more days than not for at least 6 months. Obsessive Compulsive Disorder (OCD) Description and incidence: Approximately 2.2 million Americans age 18 and older, or about 1.0%, suffer from Obsessive Compulsive Disorder (OCD), characterized by uncontrollable obsessions and compulsions that the sufferer usually recognizes as excessive or unreasonable. Obsessions are recurring thoughts or impulses that are intrusive or inappropriate and cause the sufferer anxiety. Some common obsessions are:Thoughts about contamination – for example, when an individual fears coming into contact with dirt, germs, or "unclean" objects. Persistent doubts – for example, whether or not one has turned off the iron or stove, locked the door, or turned on the answering machine. An extreme need for orderliness. Aggressive impulses or thoughts – for example, being overcome with the urge to yell “fire” in a crowded theater. Compulsions are repetitive behaviors or rituals. Performing these rituals neutralizes the anxiety caused by obsessive thoughts, but relief is only temporary. Compulsions are incorporated into the person's daily routine and are not always directly related to the obsessive thought; for example, a person who has aggressive thoughts may count floor tiles in an effort to control the thought. Some of the most common compulsions are:Cleaning: Sufferers concerned with germs and contaminations tend to clean constantly – for example, repeatedly washing their hands, showering, or constantly cleaning their home. Checking: Individuals may check several or even hundreds of times to make sure that stoves are turned off and doors are locked. Repeating: Some repeat a name, phrase, or action over and over. Slowness: Some individuals may take an excessively slow, methodical approach to daily activities; they may spend hours organizing and arranging objects. Hoarding: Hoarders are unable to throw away useless items, such as old newspapers, junk mail, even broken appliances; sometimes hoarding reaches the point that whole rooms are filled with saved items. Diagnosis: To diagnose OCD, physicians must determine whether obsessions and/or compulsions consume a considerable amount of the sufferer's time – at least one hour every day – and interfere with one's ability to concentrate. Also, it is not uncommon for a sufferer to avoid certain situations; for example, someone obsessed with cleanliness may be unable to use public rest rooms. Onset is usually gradual and most often begins in adolescence or early adulthood. Unlike adults, children with OCD do not realize that their obsessions and compulsions – which are most frequently of the washing, checking, and ordering variety – are excessive. Panic Attack Definition: A panic attack is the abrupt onset of an episode of intense fear or discomfort that peaks in approximately 10 minutes and includes at least 4 of these symptoms:a feeling of imminent danger or doom the need to escape palpitations sweating trembling shortness of breath or a smothering feeling a feeling of choking chest pain or discomfort nausea or abdominal discomfort dizziness or lightheadedness a sense of things being unreal;depersonalization fear of losing control or "going crazy"fear of dying tingling sensations chills or hot flashes There are 3 types of panic attack:Unexpected: the attack "comes out of the blue" without warning and for no discernable reason. Situational: situations in which an individual always has an attack (e.g., when entering a tunnel). Situationally predisposed: situations in which an individual is likely to have a panic attack, but does not always have one (e.g., one who sometimes has attacks while driving). Panic Disorder Description, diagnosis, onset: 6 million Americans age 18 and older, or about 2.7%, are estimated to have panic disorder, diagnosed when an individual suffers at least 2 unexpected panic attacks followed by at least 1 month of concern over having another attack. Sufferers are also prone to situationally predisposed attacks. The frequency and severity of the attacks varies from person to person. One individual might suffer from repeated attacks for weeks, while another will have short bursts of very severe attacks. Sufferers often worry about the physical and emotional consequences of their panic attacks. Many become convinced that the attacks indicate an undiagnosed illness and will submit to frequent medical tests. Even after tests come back negative, people with panic disorder will remain worried that they have a physical illness. Some individuals will change their behavior patterns, avoiding the scene of a previous attack, for example, in hopes of avoiding another attack. Age of onset of panic disorder varies from late adolescence to mid-30s. Relatively few suffer from the disorder in childhood. Agoraphobia Description: Agoraphobia often, but not always, coincides with panic disorder. Agoraphobia is characterized by the fear of having a panic attack in a place from which escape is difficult. Many sufferers refuse to leave their homes, often for years at a time. Others develop a fixed route, or territory --the route between home and work, for example -- from which they cannot deviate. It becomes impossible for these people to travel beyond what they consider to be their safety zones without suffering severe anxiety. Posttraumatic Stress Disorder (PTSD) Description and incidence: Of the 40 million Americans age 18 and older who suffer from an anxiety disorder, approximately 3.5%, or 7.7 million, suffer from Posttraumatic Stress Disorder (PTSD). PTSD can result from exposure to traumas such as a serious accident, a natural disaster, or a criminal assault. When the aftermath of a traumatic experience interferes with normal functioning, the person may be suffering from PTSD. It can occur at any age, from childhood to old age, although it occurs less frequently in the elderly. Young children who have suffered a trauma may have dreams of the event, which, within a few weeks, turn into general nightmares. Children will often relive the event through play. Traumatic stress can be cumulative over a lifetime. The increasing stress of living in the 21st century, on both a global and personal level, has considerably elevated the number of people who suffer from this disorder. Responses to trauma include feelings of intense fear, helplessness, and/or horror. There are 3 types of generally recognized stressors:Threatened death or serious injury to one's person;Learning about the death, near death, or serious injury of a family member or close friend;Witnessing the death, near death, or serious injury of another person. Symptoms: Symptoms usually begin within 3 months of a trauma, although there can be a delayed onset, and 6 months can pass between trauma and the appearance of symptoms. In some cases, years can pass before symptoms appear, in which case they are often triggered by the anniversary of the trauma or by another traumatic event. Symptoms, which may vary in frequency and intensity over time, include:Re-experiencing the event, which can take the form of intrusive thoughts and recollections or recurrent dreams;Avoidance behavior, in which the sufferer avoids activities, situations, people, and/or conversations that he associates with the trauma;General numbness and loss of interest in surroundings, which can also present as detachment;and Hypersensitivity, including inability to sleep, anxious feelings, overactive startle response, hypervigilance, irritability, and outbursts of anger. In addition to these symptoms, children may exhibit physical symptoms such as headaches and stomach aches. Diagnosis: For PTSD to be diagnosed, symptoms must be present for more than one month and be accompanied by a drop-off in the ability to socialize or work, or in other areas of functioning. Specific (Simple) Phobia Description and incidence: Approximately 19.2 million American adults age 18 and older, or 8.7%, suffer from specific phobia. Specific phobia is characterized by excessive fear of an object or a situation, exposure to which causes an anxious response such as a panic attack. Adults with phobias recognize that their fear is excessive and unreasonable but they are unable to control it. The feared object or situation is usually avoided or anticipated with dread. Diagnosis: Specific phobia is diagnosed when an individual's fear interferes with his daily routine, employment (e.g., missing out on a promotion because of a fear of flying), social life (inability to go to crowded places), or if having the phobia is signific