It is not uncommon to experience stress and anxiety from time to time. Stress often occurs when a person feels overwhelmed with work, family, or other life demands. Frequent or tremendous amounts of stress can lead to feelings of anxiety.
Anxiety is a natural part of life and it can even be beneficial at times. For example, a small amount of anxiety during an exam may help you stay more focused and alert. Anxiety is also a trigger that can help keep you out of harm's way. The fight-or-flight stress response is a feeling of high anxiety that warns the body and mind that there is a potential for danger. For instance, if you have ever quickly avoided a car accident by swerving your car out of the way, you may have felt the rush of anxiety that guided you to respond.
Even though small amounts of anxiety can enhance performance in some tasks, chronic anxiety can lower a person’s quality of life. When anxiety affects one’s relationships, work performance, and other areas of life, there is potential that these anxious feelings are actually an indication of a mental health disorder.
The Diagnostic and Statistical Manual of Mental Health Disorders, 4th edition, text revised (DSM-IV-TR) is a handbook used by mental health professionals for diagnostic purposes. The DSM-IV-TR outlines the diagnostic criteria for all anxiety disorders. Listed here is an overview of these six main anxiety disorders as described in the DSM-IV-TR.
Panic disorder is characterized by the experience of persistent panic attacks that often occur without warning or cause. Panic attacks involve feelings of apprehension that are accompanied by frightening physical sensations, such as chest pain, shaking, and shortness of breath. Panic attacks typically peak within the first 10 minutes of the attack. However, some attacks can last much longer. Additionally, many people who experience panic attacks report having ongoing feelings of anxiety even hours after the attacks have subsided.
Agoraphobia is a condition in which a person experiences a fear of having a panic attack in a place or situation in which it would be embarrassing or difficult to escape. This fear can become so intense that it leads to avoidance behaviors, in which the person feels unable to go places where they believe this could occur. Avoidance behaviors can cause many restrictions in the person’s life that can limit their social and occupational aspirations.
Agoraphobia is currently diagnosed as occurring with or without panic disorder. Although it is not as common, it is possible to experience agoraphobia without a history of panic disorder. In these cases, the person often fears having some of the physical sensations of panic and anxiety in a place where it would be challenging or humiliating to escape from.
Specific phobia is characterized by an intense and relentless fear of certain events, objects, or situations. This fear is considered irrational, in that the distress the person feels is excessive and far outweighs the potential for any harm. When the person is in the presence of their fear, they quickly feel anxious and can even have a panic attack. Even though the person understands that their reaction is unreasonable, they are still unable to control their anxious response.
Specific phobia often leads to avoidance behaviors, in which the person stays away from their feared object or situation. This avoidance can significantly impact a person’s work, relationships, and overall quality of life. Some common phobias that can greatly impact a person’s life include a fear of heights (acrophobia), fear of thunder and lightening (astraphobia), and fear of enclosed spaces (claustrophobia).
Social anxiety disorder is marked with worry about how one is being perceived by others. The person fears being negatively evaluated and judged by others in social settings. The person is often concerned about behaving in a way that might make them feel embarrassed, including displaying indicators of nervousness, such as blushing.
This fear can be so intense that the person often avoids any social or performance-based situations in which they may be subjected to the scrutiny of others. When feeling fearful in social situations, the person often recognizes that their feelings are irrational. However, they will still feel overwhelming anxiety and can even experience panic attacks.
Obsessive-compulsive disorder (OCD) is another mental health condition characterized by anxiety and fear. OCD involves obsessions of a person’s thinking and compulsions of a person’s behaviors. Obsessions are relentless and intrusive thoughts, urges, or mental pictures that are upsetting and anxiety-provoking. In reaction to these obsessions, the person develops compulsions, or ritualistic behaviors and mental acts that the person feels obligated to do in order to keep the feared situation from happening or to neutralize the anxiety. For example, a person may have persistent thoughts about becoming ill (obsession), so they use repetitive hand washing (compulsion).
People with OCD will often recognize that their behaviors are irrational and illogical. However, they feel compelled to engage in behaviors that are often time-consuming and greatly interfere with their everyday life.
Post-traumatic stress disorder (PTSD) is a condition that can develop after a person has experienced a traumatic event in which they felt themselves or others were in danger of serious injury or death. Being in such a situation elicited feelings of overwhelming fear, shock, or defenselessness. After experiencing the traumatic event, the person will begin to recollect the trauma through intrusive thoughts and images, upsetting dreams, and flashbacks. They may also feel intense mental distress when exposed to cues that remind them of what happened.
People with PTSD will avoid many situations that remind them of the traumatic event. For example, the person may be unwilling to think or talk about the event. They may also experience other significant changes in their behaviors, including finding it difficult to express a full range of emotions, limiting their activities, and losing hope about their future. Additionally, people with PTSD experience increased states of arousal that can manifest as sleep issues, increased irritability, feeling constantly on guard, or a lack of concentration.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders,4th ed., text revised" 2000 Washington, DC: Author.