Anxiety Disorders

All anxiety disorders are characterised by both physiological and psychological anxiety symptoms.  Body anxiety can cause increased breathing, heart-racing, hand-trembling and sometimes even sensations such as pins and needles. 

In one’s mind, anxiety-related thoughts often predict the worst possible outcome.  Those sensations and thoughts can lead us to engage in a variety of behaviours, which are meant to keep us safe or sane – but these behaviours have their own shortcomings and often contribute to the on-going problem. For example, if someone always avoids going to places with which they are not familiar, they cannot discover new pleasures or passions.

In all anxiety disorders, the anxiety causes significant stress, and affects social, psychological or work performance.

Examples of anxiety disorders are:

Obsessive Compulsive Disorder (OCD) - A condition characterised by obsessive thoughts (distressing thoughts which cause excessive anxiety) and compulsive behaviours, such as checking, counting or cleaning. One feels compelled to “control” the situation.  Usually people suffering from OCD spend at least 1 hour a day distracted by these thoughts or behaviours.

Social Anxiety - One feels excessively judged in social situations and is afraid of showing signs of anxiety which are assumed to have grave negative consequences.  Often certain social situations are avoided.

Post Traumatic Stress Disorder (PTSD) - Sufferers experienced a significant trauma in the past but still tend to experience spontaneous memories (flashbacks) or nightmares many months or even years afterwards.  Frequently, people avoid a range of situations, so as not to re-experience the trauma, either mentally or physically.  People find it difficult to feel close to their loved ones. Often they can feel similar physical sensations, such as pain or sounds, when those memories occur.

General Anxiety Disorder - A condition in which one excessively worries about a broad range of themes, such as the welfare of loved ones, work, or having done something wrongly.  The worry seems to be out of control.  Because of the excessive worries it becomes difficult to fall asleep and to relax. One feels on-edge all the time.  Other anxiety symptoms such as shaking or heart-racing can also be present, either constantly or intermittently.

Panic Disorder - A panic attack is a sudden surge of anxiety over a period of approximately 10 minutes. It is accompanied by physical symptoms, such as heart-racing, a dry mouth, butterflies in the tummy, shortness of breath, and thoughts of dying or losing control.  A variety of safety-seeking behaviours are often employed to avoid ‘the worst’ from happening.

Agoraphobia - Describes a condition in which panic attacks occur when outside. One does not leave the home and strictly avoids certain difficult situations or places, such bridges, buses or tubes.  Fears are often related to the loss of bodily functions. Life becomes more and more restricted because of the increasing amount of avoidance.

Specific Phobias - Often more related to natural hazards such as snakes, rats, dogs, the sight of blood or situations of perceived excessive risk - flying, lifts, enclosed spaces. Being in the phobic situation causes excessive anxiety and is mostly avoided.

CBT has largely contributed to the understanding and the treatment of most anxiety conditions.  For some problems, such OCD, CBT has been shown to be the only effective psychological treatment.

Dr TOM G WERNER  Psychiatrist & CBT-Therapist