
While fear is a feeling we have about an immediate perceived danger, anxiety is usually a fear about the future. This may be related to something temporary and specific, like a job interview, or it can be generalized and seem to be about nothing in particular, just a general ongoing feeling of dread. We all feel some degree of fear and anxiety, but when it becomes severe and ongoing it can disrupt our lives.
You might experience anxiety as:
· Irritability
· Restlessness
· Lack of concentration
· Impulses to ‘fight or flight’
· A sense of impending doom
· Intense worry
· Repetitive and out of control negative thoughts.
In extreme cases, involving panic attacks, you may feel your very life is in immediate danger, or as though you are actually dying. Physical symptoms can include:
· Shortness of breath
· Palpitations
· Sweating
· Muscle tension
· Stomach ache
· Fatigue
· Insomnia
· Headaches
· Tremors and twitches
The Diagnostic and Statistical Manual of Mental Disorders (DSM) identifies eleven basic subtypes of anxiety disorders, most of which are addressed in separate sections. Criteria for generalized anxiety are as follows:
A. At least 6 months of "excessive anxiety and worry" about a variety of events and situations. Generally, "excessive" can be interpreted as more than would be expected for a particular situation or event. Most people become anxious over certain things, but the intensity of the anxiety typically corresponds to the situation.
B. There is significant difficulty in controlling the anxiety and worry. If someone has a very difficult struggle to regain control, relax, or cope with the anxiety and worry, then this requirement is met.
C. The presence for most days over the previous six months of 3 or more (only 1 for children) of the following symptoms:
1. Feeling wound-up, tense, or restless
2. Easily becoming fatigued or worn-out
3. Concentration problems
4. Irritability
5. Significant tension in muscles
6. Difficulty with sleep
D. The symptoms are not part of another mental disorder.
E. The symptoms cause "clinically significant distress" or problems functioning in daily life. "Clinically significant" is the part that relies on the perspective of the treatment provider. Some people can have many of the aforementioned symptoms and cope with them well enough to maintain a high level of functioning.
F. The condition is not due to a substance or medical issue
The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not code Panic Attacks as a disorder, but does give the following criteria for including them as accompanying other disorders:
A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:
1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. De-realization (feelings of unreality) or depersonalization (being detached from oneself)
10. Fear of losing control or going crazy
11. Fear of dying
12. Parathesias (numbness or tingling sensations)
13. Chills or hot flushes
If you are seeking help because you suffer with anxiety, I will help you understand where it is coming from and what you can do to overcome it. This will involve finding ways for you to regulate your physical reactions, your thoughts, and your environment, so as to restore and maintain a sense of calmness.
|