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What is an Anxiety Disorder?

Presented by 
Dianne Ruth, PhD

There are a range of warning signs that a person may be in serious psychological trouble. Some examples include overwhelming distress in your marriage or family interactions, substance abuse, pervading loneliness, anxiety or depression that is interfering with work, or relationships ... your self-confidence and self-esteem is affected ... you have sexual problems, unexplained physical problems ... an inability to set or attain goals.

If in doubt, consult a professional of your choice, or talk with me about your concerns and I will help you decide if life coaching/holistic counseling is more appropriate to help you deal with your issues.

Imagine a continuum or line. One end is labeled "Optimal Mental Health"; the other end is labeled "Total Dysfunction." The area somewhere between the two extremes is where most of us fall. The exact dividing line is often subjective and somewhat blurry.

Simple life coaching is not generally appropriate for the list of disorders which follow below; psychotherapy with a trained and credentialed professional is recommended. 

One possible exception to this rule is if the complaint can be resolved with life coaching/holistic counseling strategies, in which case, the issue may not have been clinically based after all.

An example might be of a person who has a fear of public speaking. On the one hand, their fear may be so disabling as to be diagnosed as "Social Phobia."  

Alternately, the fear may simply be lots of nervousness. In this event, life coaching/holistic counseling may help you become more comfortable and confident when in front of an audience. 

Winston Churchill had a lisp and a stutter. He was so nervous before giving a speech that he sometimes fainted. Yet he was one of history's greatest speakers.

The following twelve conditions listed below are defined as clinically diagnosable disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV™).

Because Panic Attacks and Agoraphobia occur as part of several of the following disorders, characteristics for Panic Attack and for Agoraphobia are listed separately at the beginning.

A Panic Attack occurs during a distinct period where there is the sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. During these attacks, symptoms such as shortness of breath, rapidly beating heart, chest pain or discomfort, choking or smothering sensations, and fear of "going crazy" or losing control are present.

A Panic or Anxiety Disorder that is due to the direct physiological effects of a substance such as excessive caffeine, prescription or over-the-counter medications, substance abuse, or a physical condition such as heart problems, tumors, hyperthyroidism, or epilepsy is not generally a psychologically diagnosable condition. 

If a physiological condition is the cause of panic or anxiety, a consultation with your physician is strongly urged. Life coaching/holistic counseling may then be helpful to comply with your physician's recommendations. Go to "What Causes Anxiety?" for more information on panic and anxiety.

Agoraphobia is anxiety about, or avoidance of, places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a Panic Attack or panic-like symptoms.

Included is anxiety when outside the home or being home alone; being in a crowd of people; traveling in an automobile, bus, or airplane; or being on a bridge or in an elevator. These types of situations are either avoided or endured with intense distress or require the presence of a companion.

Panic Disorder Without Agoraphobia is characterized by recurrent unexpected Panic Attacks about which there is persistent concern. Panic Disorder Without Agoraphobia is featured by both recurrent unexpected Panic Attacks and Agoraphobia. It can occur "out of the blue; it can happen when a situation or place sets it off.

For example, some experiences include excessive apprehension about separation from a loved one, anticipation of a catastrophic outcome from a mild physical symptom or medication side effect, a fear of having an undetected life-threatening illness, and so on.

Agoraphobia Without History of Panic Disorder is distinguished by the presence of Agoraphobia and panic-like symptoms without a history of unexpected Panic Attacks.

For example, an individual may be afraid to leave home because of a fear of becoming dizzy, fainting, and then being left helpless on the ground.

Specific Phobia (formerly Simple Phobia) is indicated by the presence of clinically significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behavior.

For example, an individual may fear air travel because of a concern about crashing, may fear dogs because they might bite, may fear driving because of concerns about being hit by other vehicles on the road. Also, individuals may be afraid of blood, injury, heights, spiders, loud noises, closed-in situations that may cause the person to lose control and start screaming, etcetera. 

Social Phobia (Social Anxiety Disorder) is determined by the existence of clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behavior.

Common associated features of Social Phobia include hypersensitivity to criticism, negative evaluation or rejection; difficulty being assertive; and low self-esteem or feelings of inferiority. The individual may have an intense fear public speaking; they may avoid eating, drinking, or writing in public because of a fear of being embarrassed by having others see their hands shake.

Obsessive-Compulsive Disorder is evidenced by obsessions which cause marked anxiety or distress and/or by compulsions which serve to relieve anxiety.

Obsessions are persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress. Some common obsessions are repeated thoughts about contamination, repeated doubts such as worry about having left a door unlocked, or a need to have things in a particular order.

Compulsions are repetitive behaviors such as hand washing, ordering, checking or mental acts such as praying, counting, or repeating words silently.

Post-traumatic Stress Disorder is defined by the re-experiencing of an extremely traumatic, shocking and upsetting event accompanied by symptoms of increased arousal and by avoidance of stimuli or triggered responses associated with the trauma.

Some examples of traumatic events include military combat, violent personal assault, sexual assault, physical attack, robbery, mugging, being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. This is by no means a complete list of possibilities.

Acute Stress Disorder is recognized by symptoms similar to those of Post-traumatic Stress Disorder that occur immediately in the aftermath of an extremely traumatic event.

Symptoms of despair and hopelessness may be experienced; inappropriate guilt may exist. Individuals with this disorder are at increased risk for the development of Post-traumatic Stress Disorder.

Generalized Anxiety Disorder is identified by at least six months of persistent and excessive anxiety and worry.

For example, an individual may feel distress and constant worry, have difficulty controlling the worry, or experience related impairment in social, occupational, or other important areas of functioning. Adults with Generalized Anxiety Disorder often worry about everyday, routine life circumstances such as possible job responsibilities, finances, the health of family members, misfortune to their children, or minor matters such as household chores, car repairs, or being late for appointments.

Anxiety Disorder Due to a General Medical Condition is distinguished by prominent symptoms of anxiety that are judged to be a direct physiological consequence of a general medical condition.

A variety of general medical conditions may cause anxiety symptoms including endocrine conditions, respiratory conditions, metabolic conditions, and neurological conditions.

Substance-Induced Anxiety Disorder is determined by prominent symptoms of anxiety that are judged to be a direct physiological consequence of a drug of abuse, a medication, or toxin exposure.

Substance-Induced Anxiety Disorders arise only in association with intoxication or withdrawal states.

Anxiety Disorder Not Otherwise Specified is included for labeling disorders with prominent anxiety or phobic avoidance that do not meet criteria for any of the specific Anxiety Disorders defined.

This is often a situation in which there is an Anxiety Disorder present; however, there is an inability to determine whether it is primary, due to a general medical condition, or substance induced.

NOTE:  The above examples are not intended to cover all the criteria for analysis, assessment and evaluation of an individual with complaints of distress and anxiety. They are simply for your review as an introduction to this field. To receive a psychologically or psychiatrically appropriate diagnosis, please contact a qualified professional.

Traditional psychotherapy only has a 20 percent success rate. I have a 92 percent success rate, and over 33 years experience.

  What Causes Anxiety?

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Need help?

If you encounter any difficulty while attempting to understand the various categories of Anxiety Disorders, and you wish to have some additional guidance, please feel free to contact me via email, Dianne Ruth, PhD, or call me directly at (619) 275-2775 or my toll free number at 1-888-223-1485 for assistance.