Anxiety and Mental Disorders
Anxiety can manifest in a variety of ways. The DSM-IV categorizes anxiety syndromes into the following diagnoses:
Signs of anxiety and avoidance are the major features of anxiety disorders, and these symptoms are not simply the result of other psychiatric disorders. There are many types of main anxiety disorders: panic disorder, phobic disorders, posttraumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, anxiety due to a general medical condition, and substance–induced anxiety disorder.
Two common forms of childhood anxiety are general anxiety disorder (GAD) and separation anxiety disorder (SAD). Most adult anxiety disorders begin in adolescence or young adulthood and are more common among women than men.
Adjustment Disorder
Adjustment disorders are very common and can affect anyone, regardless of gender, age, race, or lifestyle. It occurs when a person can't cope with a stressful event and develops emotional or behavioral symptoms. An adjustment disorder is a debilitating reaction, usually lasting less than six months, to a stressful (but not life- threatening) event or situation. The stressful event can be anything: it might be just one isolated incident, or a sequence of problems that wear the person down. The stress might be anything from a car accident or illness, to a divorce, or even a certain time of a year (seasonal depression).
A person can be diagnosed with adjustment disorder if his/her response to the stressor is more complex than what is considered to be normal and the level of distress is really severe, or the symptoms significantly interfere with a person's functioning in social live, at work, or in school. For instance, normal expression of grief in sorrow, is not considered an adjustment disorder. Symptoms include some (but not all) of the following: sadness, crying, hopelessness, anxiety, worry, withdrawal.
Panic Disorder
Panic attacks occur suddenly, manifest abruptly and usually reach a peak within 10 minutes. There are at least four or more symptoms that panic disorder may present:
pounding heart, palpitation or accelerated heart rate; trembling or shaking, sweating; feeling of shortness of breath, choking or suffocating; chest pain or discomfort; feeling lightheaded or faint, dizzy and nauseous; fear of losing control or going crazy; chills or hot flushes, fear of dying.
Panic attacks may be accompanied by agoraphobia, which is anxiety about being in places or situations from which there is no easy means of escape.
Generalized Anxiety Disorder
“In generalized anxiety disorder, the individual experiences long-term anxiety with no explanation for its cause; such a condition may be called free-floating, since it is not linked to a specific stimulus. The anxiety and worry are associated with three or more of the following six symptoms:
restlessness or feeling keyed-up or on edge; being easily fatigued; difficulty concentrating or mind going blank; irritability; muscle tension; or sleep disturbance.” (Columbia Encyclopedia)
Phobic Disorders
A phobia is a marked and persistent fear that is excessive or unreasonable. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situation-bound or situation-predisposed panic attack.
The individual with a phobic disorder can identify the stimulus that causes anxiety: such stimuli as enclosed space, heights, and crowds become imbued with greatly exaggerated anxiety and are carefully avoided by the phobic individual.
Obsessive-Compulsive Disorder
Patients with this disorder have either obsessions (mental acts, e.g., counting, praying, repeating words) or compulsions (physical actions, e.g., hand washing, ordering, checking), though not necessarily both. Obsessions are recurrent, persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate, and that cause marked anxiety or distress. These thoughts, impulses or images are not simply excessive worries about real-life problems.
The person recognizes them as products of his or her own mind and attempts to ignore or suppress them, or to neutralize them with some other thought or action. But extreme anxiety may be experienced if the person does not act upon compulsion or attempts to ignore the obsession.
Obsessive-compulsive disorder significantly interferes with the person’s live- occupational functioning, relationships or usual social activities.
Acute Stress Disorder and Posttraumatic Stress Disorder
Acute Stress Disorder and Posttraumatic Stress Disorder can occur as a result of exposure to events or episodes that may include serious injury, actual or threatened death, or a threat to the physical safety of self or others. Theses disorders may be characterized by specific reactions of a person, such as dissociation (e.g., being in a shock, feeling numb, unreal or detached), re-experiencing of the trauma (e.g., flashbacks dreams), avoidance of triggers that may cause recollection of the trauma, or increased arousal and anxiety.
Separation Anxiety Disorder
Very often separation anxiety disorder may begin in children around age six or seven and can be associated with school attendance. This type of separation anxiety disorder is called School Phobia. Children with separation anxiety disorder repeatedly demonstrate some of the following behaviors: excessive distress at leaving home or leaving the primary caregiver or they may feel miserable even at anticipation of leaving. They may experience extreme fear that something will happen to them that will prevent their return to the caregiver (e.g., getting lost or kidnapped). Children may have nightmares about separation from home and loved ones. Separation anxiety disorder may occur in older children when they refuse to leave parents or a caregiver to whom they have become attached. They experience excessive worry that something terrible will happen at home or to the caregiver while the child is away.
Differential Diagnosis
Some diseases have similar symptoms, and Differential Diagnosis is the method of determination of the distinguishing characteristics between similar diseases and finding out from which disease the patient is suffering.Differential diagnosis of anxiety should consider the following mental disease: affective disorders (depression, mania), psychotic disorders, attention-deficit/hyperactivity disorder, hypochondrias or other somatoform disorders, and severe personality disorders (e.g., avoidance personality disorder, borderline personality disorder).
There is a high degree of comorbidity between depression and anxiety disorders, and a health professional should always make inquires about depression in a patient with anxiety.
