Panic Disorder And Agoraphobia
Have you ever gotten into a near-accident or been taken by surprise in some way? You may have felt a flood of physical sensations, such as a racing heart, shortness of breath, or tingling sensations. This alarm reaction is called the fight or flight response and is your bodys natural reaction to fear, preparing you to either fight or escape in response to threat or danger. Its likely you werent too concerned with these sensations, because you knew what was causing them. But imagine if this alarm reaction came out of the blue, for no apparent reason, or in a situation in which you didnt expect to be anxious or fearful. This is called an unexpected panic attack or a false alarm. Because there is no apparent reason or cue for the alarm reaction, you might react to the sensations with intense fear, maybe thinking you are having a heart attack, or going crazy, or even dying. You might begin to associate the physical sensations you felt during this attack with this fear and may start to go out of your way to avoid having those sensations again.
About 4.7% of the population has met criteria for PD or agoraphobia over their lifetime . In all of these cases of panic disorder, what was once an adaptive natural alarm reaction now becomes a learned, and much feared, false alarm.
What Is It Like Having Social Anxiety Disorder
In school, I was always afraid of being called on, even when I knew the answers. I didnt want people to think I was stupid or boring. My heart would pound and I would feel dizzy and sick. When I got a job, I hated to meet with my boss or talk in a meeting. I couldnt attend my best friends wedding reception because I was afraid of having to meet new people. I tried to calm myself by drinking several glasses of wine before an event and then I started drinking every day to try to face what I had to do.
I finally talked to my doctor because I was tired of feeling this way and I was worried that I would lose my job. I now take medicine and meet with a counselor to talk about ways to cope with my fears. I refuse to use alcohol to escape my fears and Im on my way to feeling better.
The Difference Between Fear And Phobia
The term phobia gets thrown around a lot these days, but having a fear and having a phobia arent exactly the same thing.
Essentially, fear is temporary phobia isnt.
Having a phobia creates a stumbling block in your life, and the fear it causes can be so strong that youll do anything to avoid the object of that phobia. Phobia that becomes debilitating is a type of anxiety disorder. Take, for example, a job offer. You made it through the hardest partlanding your dream positiononly to find out that your office will be on the 20th floor of an office buildingand you have a phobia of heights. In order to avoid being so high off the ground, you turn the position down and pass up a significant job opportunity because of your phobia.1
Phobias can be debilitating and crippling, and they can keep you from enjoying the things you love with the people you love. But it doesnt have to be this way. There is hope and help for people with phobias.
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Not All Anxiety Is A Disorder
Everyone experiences anxiety and fear at times these are normal and helpful human emotions that help us deal with danger. However, some people experience excessive and irrational anxiety and worries that become ongoing and distressing, and that interfere with their daily lives. This may indicate an anxiety disorder. Often there appears to be no obvious or logical reason for the way the person feels. This may make an anxiety disorder even more worrying to the sufferer.
How Many People Are Affected By Phobias
Approximately 5% of the general population suffers from at least one phobia, although there are large differences amongst countries. In the United States, nearly 9% of the population has been diagnosed with a specific phobia while, for example, that number drops to .2% in Northern Ireland. Approximately 4.6% of the worlds population suffers from a social phobia.
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How Is Anxiety Diagnosed
A mental health expert or medical doctor can diagnose anxiety. Theyll use different criteria based on the guidance of the DSM-5 to determine a diagnosis and recommend a treatment plan.
In addition to a lengthy physical examination and family history interview, your doctor will likely recommend a diagnostic test to assess your level of anxiety.
Some of the more common diagnostic tests include:
- Zung Self-Rating Anxiety Scale
Biological Correlates Of Adolescent Anxiety Disorders
Advances in genetics, imaging, and cognitive neuroscience provide the opportunity to combine discoveries in neuroscience with insights from clinical psychobiology. Current views of adolescent anxiety disorders are influenced by two limiting facts. The first is that the research on adolescents has been modeled on investigations of adults the second is that all current anxiety disorders are heterogeneous in their origin. This second fact means that investigators would profit from using biological variables to distinguish between patients with transient symptoms and those with more persistent disorders .
Autonomic Nervous System
Patients with an anxiety disorder often show perturbations in the HPA axis. Further, both rodents and nonhuman primates show changes in the hypothalamicâpituitaryâadrenal axis during acute stress, as well as after a stress experienced early in life . The strongest association between activation in the HPA axis and anxiety disorder is seen in PTSD . Although enhanced feedback sensitivity in the HPA axis is often associated with an anxiety disorder, unfortunately, some children with an anxiety disorder exhibit the opposite pattern of reduced feedback sensitivity .
A variety of techniques have been used to study anxiety disorder. These include MRI, fMRI, magnetic resonance spectroscopy , and electrophysiology.
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When Did Social Phobia Become Social Anxiety Disorder
If youre confused exactly when the diagnosis of social phobia became social anxiety disorder, then youre not alone. This subtle change in terminology has caused more than a little bit of confusion, Im sure.
The term social phobia was replaced with the term social anxiety disorder with the introduction of the fourth edition of the DSM in 1993.
As noted in the table above, this wasnt just a simple shift in the wording of the diagnosis. Prior to 1993, if you were being diagnosed for social anxiety, youd probably have either been diagnosed with social phobia or with avoidant personality disorder .
As of 1993, your diagnosis would have been social anxiety disorder, but with a specifier as to whether your fears were specific or more general .
Types Of Anxiety Disorders
Anxiety becomes a disorder when its irrational, excessive and when it interferes with a persons ability to function in daily life. Anxiety disorders include:
- Generalised anxiety disorder
- Social phobias fear of social situations
- Specific phobias for example a fear of open spaces or enclosed spaces
- Panic disorders frequent and debilitating panic attacks.
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What Are The Three Types Of Phobias
There are three main types of phobias, and all of them fall under the category of anxiety disorders: specific phobias , social anxiety disorder, and agoraphobia.6,9 What they have in common, according to Mazza, is an intense emotional reaction that is not commensurate with what is actually happening in the environment, and the avoidance of the stimuli is what maintains the intense, emotional reaction.
Here are the differences between the types of phobias:
Treatment Of Specific Phobic Disorders
Some people do well without treatment because the situation or object they fear is easy to avoid. Bats and caves are examples. If situations or objects are commonly encountered, treatment is often needed.
Exposure therapy, a type of psychotherapy, is the treatment of choice. Exposure therapy involves exposing people gradually and repeatedlyâin their imagination or sometimes in realityâto whatever triggers their fear. People are also taught relaxation and/or breathing techniques to use before and during exposure. Exposure therapy is repeated until people become very comfortable with the anxiety-provoking situation. A therapist can help ensure that the therapy is carried out correctly, although people can do it on their own.
Exposure therapy helps more than 90% of people who do it faithfully. It is almost always the only treatment needed for specific phobias. Even people with a phobia of blood or needles respond well to exposure therapy. For example, such people might begin the exposure by just visiting a doctor’s office . The next day , they might sit in an exam room with no intention of getting any blood drawn. The next step might be allowing a needle to be brought close to their skin. Exposure may increase quickly or slowly, but eventually people should allow blood to be drawn.
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What Else Should I Ask My Healthcare Provider
If you have an anxiety disorder, ask your provider:
- Whats the best treatment for me?
- Do I need medication? What type?
- How long should I take medication?
- What type of psychotherapy will work best?
- What else can I do to manage my symptoms?
- What other conditions am I at risk for?
A note from Cleveland Clinic
An anxiety disorder can make it difficult to get through your day. Anxiety disorder symptoms include feelings of nervousness, panic and fear. You may also have physical symptoms such as sweating and a rapid heartbeat. But you dont need to live like this. Several effective anxiety disorder treatments are available. Talk to your healthcare provider to figure out your diagnosis and the best treatment plan. Often, treatment combines medications and therapy. Anti-anxiety medications and antidepressants, together with CBT, can help you feel your best.
Last reviewed by a Cleveland Clinic medical professional on 12/17/2020.
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How Do I Know If My Child Has An Anxiety Disorder
Anxiety-related problems in children share four common features. The anxiety:
- Is typically a fear or fixation that interferes with the ability to enjoy life, get through the day or complete tasks.
- Is puzzling to both the child and parents.
- Does not improve after logical explanations to address the worries.
- Is treatable.
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When Does It Occur
The signs of social phobia occur mainlyalready in adolescence, very rarely manifesting in adulthood. Anxiety may also manifest in a pupil, where answering in front of a class, doing a test, or meeting with new people may lead to the child wishing to leave school.
Anxiety and stress exhaust human energy and may result in the desire to separate, to be alone. It makes it difficult to build close relationships, including friendships. If being alone occurs more frequently than an anxious person wishes, its time to recognize the problem and deal with it.
Theres no efficient prevention for social anxiety disorder. Several studies have shown that to avoid reoccurrence, the effect of psychotherapy is somewhat more permanent than the use of medications alone.
Is Anxiety A Mental Illness
Anxiety itself is not a mental illness. Yet, sensations of intense fear, anxiety, nausea, or aversions can indicate an underlying mental illness or anxiety disorder. These can lead to a host of varying symptoms. Intense fears, phobias, and aversions can be a sign of any of the aforementioned types of anxiety disorders. All of which can greatly affect the mental health of the suffering individual. Anxiety disorders are mental health disorders.
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What Is Generalized Anxiety Disorder
With GAD, you may feel extreme and unrealistic worry and tension even if theres nothing to trigger these feelings. Most days, you may worry a lot about various topics, including health, work, school and relationships. You may feel that the worry continues from one thing to the next.
Physical symptoms of GAD can include restlessness, difficulty concentrating and sleeping problems.
Whats The Difference Between Social Anxiety And Social Phobia
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Social Anxiety Disorder : Social Phobia Disorder
Social anxiety is a fear of humiliation or of being judged by others, and an avoidance of social situations where attention centers on the individual . According to the Social Anxiety Institute, social anxiety has become the third largest psychological disorder, following depression and alcoholism . Commonly, victims of this social phobia have problems pursuing social environments, interactions, and relationships . The failure to fulfill daily requirements
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How Is Social Anxiety Disorder Treated
First, talk to your doctor or health care professional about your symptoms. Your doctor should do an exam and ask you about your health history to make sure that an unrelated physical problem is not causing your symptoms. Your doctor may refer you to a mental health specialist, such as a psychiatrist, psychologist, clinical social worker, or counselor. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist.
Social anxiety disorder is generally treated with psychotherapy , medication, or both. Speak with your doctor or health care provider about the best treatment for you. If your health care provider cannot provide a referral, visit the NIMH Help for Mental Illnesses web page at www.nimh.nih.gov/findhelp for resources you may find helpful.
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How Anxiety Disorders Affect People
For people dealing with anxiety disorders, symptoms can feel strange and confusing at first. For some, the physical sensations can be strong and upsetting. For others, feelings of doom or fear that can happen for no apparent reason can make them feel scared, unprotected, and on guard. Constant worries can make a person feel overwhelmed by every little thing. All this can affect someone’s concentration, confidence, sleep, appetite, and outlook.
People with anxiety disorders might avoid talking about their worries, thinking that others might not understand. They may fear being unfairly judged, or considered weak or scared. Although anxiety disorders are common, people who have them may feel misunderstood or alone.
Some people with anxiety disorders might blame themselves. They may feel embarrassed or ashamed, or mistakenly think that anxiety is a weakness or a personal failing. Anxiety can keep people from going places or doing things they enjoy.
The good news is, doctors today understand anxiety disorders better than ever before and, with treatment, a person can feel better.
How Do You Know You Have Social Anxiety
Are you wondering if you have social anxiety? If you identify with a lot of what Ive talked about with respect to social phobia and social anxiety, you might be wondering if this applies to you.
If you have social anxiety, you typically experience intense fear and discomfort in a variety of social situations. You may even find yourself avoiding those social interactions as a result of your fears.
Your fear can be so overwhelming that it impacts your life significantly if this is the case, its important to seek help from a professional.
Its also important to note that many introverts suffer from social anxiety at one point in their lives. This means you may feel comfortable talking to friends, but then more anxious around people you dont know very well.
These are just some of the signs of potential social anxiety. Its important to remember the issue is complicated. While you may experience all of these things, its not necessarily always social anxiety at play, but other concerns may also be present.
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What Causes Anxiety Disorders To Develop
Anxiety disorders are not one-size-fits-all diagnoses. They can develop based on a number of factors. Research has shown that these triggers can include things such as: traumatic life events, genetics, personality, chemical imbalances, and more. In some cases, studies believe anxiety disorders may be hereditary concluding that anxiety may be biological.
Panic Attacks And Panic Disorder
Panic disorder is characterized by repeated, unexpected panic attacks, as well as fear of experiencing another episode. Agoraphobia, the fear of being somewhere where escape or help would be difficult in the event of a panic attack, may also accompany a panic disorder. If you have agoraphobia, you are likely to avoid public places such as shopping malls, or confined spaces such as an airplane.
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Social Anxiety Disorder As A Form Of The Stage Fear
If you compare the symptoms of the stage fear described in one of my previous posts with the symptoms of SAD, youll see a number of similarities.
For example, a practitioner of the Georgia Dias describes the stage fear as stress from the unreleased energy accumulated in the body, which becomes difficult to tolerate when entering the stage or a danger zone. An excessive amount of unreleased energy is interpreted by the body as fear and panic.
According to Witt and Benke , the stage fear is primarily a fear of speaking in front of an audience. Just as public performance anxiety is divided into subtypes, the stage fear is also viewed in various public speaking contexts.
Brodsky describes the stage fear as fear before or during the presentation, incapability of coping with the increasing stress during the presentation. According to Barlow , the fear of public speaking is the feeling of having no control over a major event in the future. However, the idea of failure can be drastic to an individuals self-esteem.
Hart develops this idea further, adding that people react to situations related to the fear of public speaking with the fight-or-flight response. This means that our physiological system prepares us for either fighting or escaping. Although performing on stage doesnt pose a physical danger, the possibility of failure is something that greatly affects the performers self-esteem. It brings out a similar reaction that occurs when ones life stumbles.