- What is Anxiety?
- Generalized Anxiety Disorder
- Panic Disorder
- Social Phobia
- Obsessive Compulsive Disorder
- Posttraumatic Stress Disorder
- Specific Phobia
- What Causes Anxiety Disorders?
- Treatments for Anxiety
- Helpful Resources

What is Anxiety?
Anxiety is a general term used to describe feelings of stress and nervousness. Everyone feels anxiety from time to time. In many situations, such as before a big interview, or when facing potentially bad news, feelings of anxiety are to be expected and are perfectly normal. However, when anxiety continues despite the absence of an identifiable trigger, causes distress, or interferes with daily functioning, an anxiety disorder may be present. There are a number of different types of anxiety disorders. Some of the more common ones include the following:
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Generalized Anxiety Disorder
People with generalized anxiety disorder often have persistent and recurring worries about a wide range of topics, such as job, finances, relationships, and health. Others, or they themselves, may describe themselves as “worriers.” The source of the worry may jump from topic to topic—as soon as one worry is taken care of, another just pops up in its place. The feeling of worry is often accompanied by physical symptoms, such as sweating, dizziness, heart palpitations, and general fatigue.
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Panic Disorder
The essential feature of a panic disorder is the presence of “panic attacks.” During a panic attack, a person experiences a sudden and intense fear, often focused around losing control, going crazy, or dying. A number of physical symptoms usually occur along with the fear, such as a heart pounding, sweating, trembling, shortness of breath, a choking feeling, chest pain, nausea, dizziness, derealization, chills, or hot flashes. In the midst of a panic attack, the person will usually want to escape whatever situation they are in, hoping that will relieve the anxiety. Often, the mind begins to pair certain situations with having a panic attack, and the person begins to avoid those situations for fear of having another attack. The avoidance associated with the fear of having a panic attack is called Agoraphobia. Because the onset of the panic attack is so sudden and intense, and because there are so many physical symptoms, people often mistake a panic attack for a medical condition, and seek treatment through the emergency room or family doctor.
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Social Phobia
Social Phobia is a condition in which a person has a significant and persistent fear of social or performance situations. People with social phobia have intense fears of being judged or scrutinized. A minor social mistake will result in extreme feelings of embarrassment. Social phobia is more than just being “a little shy.” The fear of embarrassment can cause intense distress, and the avoidance of activities that often occurs with social phobia can significantly interfere with social, school, and occupational functioning.
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Obsessive-Compulsive Disorder
The essential features of an obsessive-compulsive disorder are the presence of either obsessions, compulsions, or both. Obsessions are persistent, intrusive, and uncomfortable thoughts, impulses, or images. The most common obsessions involves fears of contamination (e.g., fear of catching germs after shaking someone’s hands), repeated doubts (e.g., being unsure one locked the door or turned off the oven), needing to have things in a particular order, aggressive or violent images, or uncomfortable sexual images. The person experiencing the obsession knows that the fear is irrational, but this usually provides no relief. The only relief, albeit temporary, usually comes with performing a compulsion to “undo” the obsession. Compulsions are repetitive behaviors, most often performed to reduce the anxiety caused by the obsession. A person with an obsessive fear about germs, for example, will often repeatedly wash his or her hands. The obsessions may be performed to the point of causing harm (e.g., continuing to wash hands despite the fact that that the skin is now raw and painful from being washed too much). Despite knowing that the compulsive behavior is excessive, he or she often has the feeling of “not being able to stop myself.”
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Posttraumatic Stress Disorder
Following exposure to a traumatic event, such as a physical or sexual attack, a natural disaster, or military combat, a person may develop posttraumatic stress disorder, or PTSD. PTSD has several key features. First, the person may persistently “reexperience” the event by having distressing recollections or dreams about the event. They may experience extreme fear and discomfort when confronted with reminders of the event. Often, they will try to avoid talking about the event or any reminders of the event. People with PTSD may feel generally detached from others. They may also find themselves frequently “keyed up,” have difficulty sleeping and concentrating, be easily angered, and startle easily.
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Specific Phobia
A specific phobia is a significant and persistent fear of a particular object or situation. Exposure to the object or situation almost immediately provokes fear. The person will often avoid the feared object or situation, or if he or she must endure it, does so with great discomfort and fear. Common phobias are fears of closed spaces (e.g., elevators), flying, driving, heights, animals, and blood.
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What Causes Anxiety Disorders?
There are many theories about what causes anxiety disorders, and most likely the cause of any anxiety disorder is due to multiple factors. Some anxiety disorders, such as obsessive compulsive-disorder, seem to run in families. Brain-imaging and medication studies point to the presence of biochemical irregularities in the brain as being a causal factor in some cases. Behavioral theories focus on learning and “classical conditioning.” In another words, people learn to fear situations that are associated with discomfort. For example, once a person has had a panic attack in a restaurant, they “learn” to fear and avoid restaurants. Cognitive theories focus on the unrealistic or distorted thoughts that lead to anxiety. If a person focuses on every minor physical discomfort and begins to believe that the symptoms mean they are gravely ill, they will have chronic worries about their health. Finally, psychodynamic theories presume that unconscious thoughts and conflicts break through in the disguised form of the anxiety symptoms. People who have many compulsions, for example, may be searching for a way to feel safe and in control in the face of a childhood that was frequently unsafe and chaotic.
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Treatments for Anxiety
As there are many different anxiety disorders, there are many different types of treatment, including psychotherapy alone, medication alone, or a combination of both. A benefit of psychotherapy, either alone or with medication, is that the insights and tools you learn to manage your anxiety can be used and practiced throughout your lifetime, long after you stop psychotherapy. Psychodynamic psychotherapies will focus more on understanding the underlying psychological roots of the anxiety, while cognitive behavioral therapies will focus less on the roots and more on the current thoughts and behaviors contributing to the anxiety. The best course of treatment is dependent upon your situation and treatment preferences, and is best determined in consultation with a qualified mental health professional. For more information about how psychotherapy can help, please see "Learn about Psychotherapy with Dr. Susan Cook Maytorena" or feel free to contact me.
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Helpful Resources
--Anxiety Disorders Association of America
--American Psychological Association’s information page on anxiety
--HELPGUIDE.ORG
--National Alliance on Mental Illness