What Kind of Anxiety Do You Have?
Most people have their daily functioning really impaired because of these conditions.
Using Self Identification To Build A Better Understanding Of Your Anxiety
Everyone has anxiety, whether it’s about an upcoming exam, job interview, or date, we all get it. These are normal, situational anxieties. For some people, the anxiety can manifest into physical symptoms such as nausea or stomach ache. This can be normal, to some extent. In today’s day and age, everyone likes to glamourize anxiety.
Celebrities make it seem like suffering from anxiety is almost like having a new accessory. You may need to take a pill every now and then for your anxiety, but that doesn’t actually mean you have a diagnosis of an anxiety disorder. So what does it mean to have anxiety, clinically?
When a person becomes diagnosed with anxiety, it’s usually because they are having irrational anxieties and not situational anxieties, as previously described. There are actually many different types of anxiety disorders, let me run through some of them with you.
Generalized Anxiety Disorder (GAD)
GAD is a chronic condition, meaning it is long term. The anxiety is so bad that it may impair your daily functioning. In GAD your anxiety is about anything and EVERYTHING. People with GAD are the kind of people that start freaking out if you’re 5 minutes late to meet them. They will start thinking about the worst-case scenario; this is referred to as catastrophic thinking.
To be diagnosed with GAD you have to have anxiety for most days in the week for more than 6 months. You also must have at least 3 somatic symptoms (symptoms that have no cause and are psychological). These can be irritability, somatic pain, or changes in weight, sleep, or concentration.
The most important thing to understand about GAD is that the anxiety isn’t caused by anything specific, like being single or failing an exam. It has more to do with anxiety for no reason. The first-line treatment for GAD is psychotherapy followed by SSRI drugs (Prozac/fluoxetine). SSRI’s are the best choice because they are long-acting. Drugs like Atavan (Lorazepam) and other benzodiazepine drugs are not prescribed for GAD because they are short term and have a high risk of dependence.
Social Anxiety Disorder
People with social anxiety disorder have an exaggerated fear of embarrassment in social situations. Things like public speaking and urinating in public washrooms give them immense anxiety. This is not the initial anxiety you may get when you walk into a party where you don’t know anyone. I mean like palms are sweaty, knees weak, arms are heavy there’s vomit on your sweater already, mom’s spaghetti. Okay, that may be an exaggeration, but you get the point, it's very overwhelming.
These people were usually very shy growing up and didn’t get out of their comfort zone too often. If this starts to happen to someone in their 20s who was never like that before, it’s most likely due to things like substance abuse (marijuana), depression, trauma, or even the start of schizophrenia.
Treatment for social anxiety disorder is mainly cognitive behavioural therapy (CBT) and SSRIs concurrently. CBT aims to change behaviours or cognitive distortions one may have. It also teaches you different skills to control your emotions and coping strategies to deal with your current problems.
Panic Attacks
Panic attacks are not considered a disorder, because they are caused by triggers. These are the people you see in movies hyperventilating into a bag when they are trapped in an elevator. The symptoms of a panic attack include shortness of breath, trembling, unsteadiness, depersonalization (feeling detached from your thoughts), increased heart rate, numbness, tingling and sweating. It can almost feel like you are having a heart attack.
When these symptoms initially present due to scenarios such as being in an enclosed space, spiders, or writing an exam it is considered a plain old panic attack. Since this is considered an acute event, it is treated with Atavan because it is a fast-acting drug. If you take it the moment you feel a panic attack coming on, it can prevent the worsening of symptoms. There is less of a chance of becoming dependent, in this case, since the panic attacks aren’t constant. Treatment is given as needed (or in medical terms PRN).
Panic Disorder
Panic disorder is when you have panic attacks that come on with no apparent trigger. These are people that could be just in bed reading and start having the symptoms I mentioned earlier. When someone has panic disorder the panic attacks happen completely at random, there is no telling when one will start. A diagnosis of panic disorder requires attacks followed by more than 1 month of at least one of the following: persistent concern of additional attacks, worrying about the consequences of the attacks, and changing your behaviour because of the attacks.
Panic attacks are accompanied by a fear of dying or losing control. People with panic disorder are so concerned about having another attack they may start to develop something called agoraphobia. This is when you have an irrational fear about at least 2 of the following situations: lines, crowds, public transport, or open/enclosed spaces. People that have agoraphobia get really anxious being around other people, just the thought of going outside freaks them out.
Panic disorder is treated with CBT and SSRI drugs (like Prozac), used together it is the most effective treatment. In the setting of an actual attack, Atavan will do the trick, as previously stated.
Obsessive-Compulsive Disorder (OCD) and Obsessive-Compulsive Personality Disorder
A lot of people think they are OCD because they need things to be super organized. What most people perceive as OCD is actually obsessive-compulsive personality disorder (OCPD). Yes, it sounds almost identical but it is in fact different. In short, people with OCPD have a preoccupation with orderliness. They need control over everything, which can usually be at the expense of actually being efficient.
People with OCD are the type of person to rewrite an essay so many times, until it’s absolutely perfect, and then they miss the deadline. They hate group projects because nobody can do things right except them, so they don’t delegate tasks. This behaviour is in sync with their personality; this is called ego-syntonic in psychiatry. These behaviours are of no concern to them. More often then not people with OCPD are your typical student that has crazy intense color coded notes.
So what makes OCPD different from OCD? OCD is something called ego-dystonic, meaning that it is not in sync with your personality. People with OCD are concerned about these behaviours. Being OCD means you have intrusive unwanted thoughts that causes immense anxiety (obsessions). The only way for these people to prevent these obsessions is by performing repeated behaviours or mental acts (compulsions).
A common example is someone who is terrified their house may be broken in to so before they go to sleep they check all the doors, windows, and locks in the house 10 times. Another example is someone who is terrified of germs and getting sick, so they wash their hands 5 times after doing anything and need to shower several times a day.
Do you see the difference in OCD and OCPD? The main difference being that OCPD is in sync with your personality and OCD is not. The best treatment again is CBT with SSRIs.
There you have it, a rundown of some of the most common anxiety disorders. I’m going to say that probably 7/10 of you (I'm making this number up) probably don’t have any of these. Most people have their daily functioning really impaired because of these conditions. If some of this is starting to sound familiar though, you should really think about seeking treatment. Cognitive behavioural therapy really helps so many people with these disorders!
Originally published on The Modern Dynamic on March 28, 2019.
