Chapter 4: Anxiety Disorders
Anxiety is a negative mood state that is accompanied by bodily symptoms such as increased heart rate, muscle tension, a sense of unease, and apprehension about the future. Anxiety is a normal human experience, but when it becomes extreme and impairs someone’s functioning, it enters the realm of possible mental illness.
A combination of biological, psychological, and specific vulnerabilities increase a person’s likelihood of developing an anxiety disorder.
Generalized anxiety disorder (GAD) is marked by excessive worry that is difficult or even impossible to turn off. This worry is accompanied by muscle tension, fatigue, agitation or restlessness, irritability, difficulties with sleep, or difficulties concentrating.
Unexpected panic attacks are core to panic disorder. In addition to the panic attacks, the person must also experience continued intense anxiety and avoidance related to the attack for at least one month, causing significant distress or interference in their lives. Sometimes people with panic disorder also develop agoraphobia, which is when they begin to avoid several places or situations, or still endures the situations but with a significant amount of anxiety.
Specific phobia occurs when someone has an irrational fear of a specific object or situation that substantially interferes with their ability to function. Four major subtypes of specific phobia are recognized: blood-injury-injection type, situational type, natural environment type, and animal type.
Social anxiety disorder involves severe anxiety in social situations where one can be evaluated. This anxiety must get in the way of the person’s daily life or otherwise severely impact their functioning. If the fear is specific to performance-based situations, this subtype of social anxiety can be diagnosed.
Obsessive-Compulsive Disorder (OCD) occurs when obsessive thoughts (intrusive thoughts that are unusual) and compulsions (activities that must be done) are present and they interfere with someone’s functioning. Less than 1% of Canadians have OCD. People with OCD often suffer from thought-action fusion or the idea that having a thought is directly linked with their potential for carrying out the thought.
Anxiety disorders are sometimes treated with anti-anxiety medications or antidepressants. Exposure-based cognitive behavioural therapies are very effective ways of treating anxiety disorders psychotherapeutically.
Body-dysmorphic disorder (BDD) is seen as a type of OCD focused on perceived defects or flaws in physical appearance. A key feature of these perceived defects or flaws is that they are not observable to others. It is common for individuals with BDD to also experience major depression.
BDD seems to be predicted by a combination of hereditary factors and environmental factors like teasing in childhood, negative social evaluations about one’s body, and childhood trauma.
Like OCD, BDD is treated with a specific type of CBT called exposure and response prevention.