Exploring the Spectrum: Understanding Different Types of Anxiety

Exploring the Spectrum: Understanding Different Types of Anxiety

Featured Painting Title: Diving Psyche

By Mark

"This is how it feels to be schizophrenia: disjointed."



Types of anxiety disorders

There are many different types of anxiety disorders. The main ones are generalised anxiety disorder, panic disorder and agoraphobia, phobic disorders, post-traumatic stress disorder, and obsessive-compulsive disorder. It is not unusual for a person to have more than one of these anxiety disorders. 


Generalised anxiety disorder (GAD)

Some people experience long term anxiety across a whole range of situations and this interferes with their life. These people have generalised anxiety disorder. The main symptoms of generalised anxiety disorder are overwhelming, unfounded anxiety and worry (about things that may go wrong or ones inability to cope) accompanied by multiple physical and psychological symptoms of anxiety or tension occurring more days than not, for at least six months. People with generalised anxiety disorder worry excessively about money, health, family and work, even when there are no signs of trouble. The anxiety appears difficult to control. Other characteristics can include an intolerance of uncertainty, belief that worry is a helpful way to deal with problems and poor problem-solving. Generalised anxiety disorder can make it difficult for people to concentrate at school or work, function at home and generally get on with their lives.


Panic disorder and agoraphobia

Some people have short periods of extreme anxiety called a panic attack. A panic attack is a sudden onset of intense apprehension, fear or terror. These attacks can begin suddenly and develop rapidly. This intense fear is inappropriate for the circumstances in which it is occurring. Other symptoms, many of which can appear similar to those of a heart attack, can include racing heart, sweating, shortness of breath, chest pain, dizziness, feeling detached from oneself and fears of losing control. Once a person has had one of these attacks, they often fear another attack and may avoid places where attacks have occurred. The person may avoid exercise or other activities that may produce physical sensations similar to those of a panic attack.

It is important to distinguish between a panic attack and a panic disorder. Having a panic attack does not necessarily mean that a person will develop panic disorder. A person with panic disorder experiences recurring panic attacks and, for at least one month, is persistently worried about possible future panic attacks and the possible consequences of panic attacks, such as a fear of losing control or having a heart attack. Some people may develop panic disorder after only a few panic attacks, while others may experience many panic attacks without developing a panic disorder. Some people with panic disorder go onto having agoraphobia (described below) where they avoid places where they fear they may have a panic attack.

Agoraphobia involves avoidance of situations where the person fears they may have a panic attack. The focus of their anxiety is that it will be difficult or embarrassing to get away from the place if a panic attack occurs, or that there will be no one present who can help. This leads them to avoid certain situations for fear of a panic attack occurring. Some may avoid only a few situations or places, for example crowds, enclosed places such as shopping malls, or driving. Others may avoid leaving their homes altogether.

Agoraphobia is thought by many to mean a fear of open spaces or a fear of leaving the house. While these symptoms may occur with agoraphobia, the person cannot be said to have agoraphobia unless they have a fear of panic attacks.


Phobic disorders

A person with a phobic disorder avoids or restricts activities because of fear. This fear appears persistent, excessive and unreasonable. They may have an unreasonable strong fear of specific places, events or objects and often avoid these completely.

Social phobia is the fear of any situation where public scrutiny may occur, usually with the or humiliating. The key fear is that others will think badly of the person. Social phobia often develops in shy children as they move into adolescence. Commonly feared situations include speaking or eating in public, dating and social events.

Specific phobias are phobias of specific objects or situations. The most common fears are of spiders, insects, mice, snakes and heights. Other feared objects or situations include an animal, blood, injections, storms, driving, flying, or enclosed places. Because they only involve specific situations or objects, these phobias are usually less disabling than agoraphobia and social phobia.


Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder can occur after a person experiences what they perceive to be a traumatic event. What is perceived as traumatic will vary from person to person. Common examples of traumas that many people find traumatic include involvement in war, accidents, assault including physical or sexual assault, mugging or robbery, or family violence), and witnessing something terrible happen. Mass traumatic events include terrorist attacks, mass shootings, warfare and severe weather events (cyclone, tsunami and bushfire).

A major symptom is re-experiencing the trauma. This may be in the form of recurrent dreams of the event, flashbacks, intrusive memories or unrest in situations that bring back memories of the original trauma. There is avoidance behaviour, such as persistent avoidance of things associated with the event, emotional numbing, which may continue for months or years, or reduced interest in others and the outside world. Also, persistent symptoms of increased emotional distress occur (constant watchfulness, irritability, jumpiness, being easily startled, outbursts of rage, insomnia).

It is common for people to feel greatly distressed immediately following a traumatic event. This is called acute stress reaction and the person usually gets over it within a month. If their distress lasts longer than a month, they may have post-traumatic stress disorder. Only some people who experience acute stress disorder will go on to develop a mental illness such as post-traumatic stress disorder or depression. A person is more likely to develop post-traumatic stress disorder if their response to the event involves intense fear, helplessness or horror.


Obsessive-compulsive disorder (OCD)

This type of anxiety disorder is the least common but it is a very disabling condition. Obsessive compulsive disorder often begins in adolescence and may be a lifelong illness. Obsessive thoughts and compulsive behaviours accompany feelings of anxiety. Obsessive thoughts are recurrent thoughts, impulses and images that are experienced as intrusive, unwanted and inappropriate, and cause marked anxiety. Most obsessive thoughts are about fear of contamination, symmetry and exactness, safety, sexual impulses, aggressive impulses and religious preoccupation.

Compulsive behaviours are repetitive behaviours or mental acts that the person feels driven to perform in response to an obsession in order to reduce anxiety. Common compulsions include washing, checking, repeating, ordering, counting, hoarding, or touching things over and over.


Mixed anxiety, depression and substance misuse

Many people with anxiety problems do not fit neatly into a particular type of anxiety disorder. It is common for people to have some features of several anxiety disorders. A high level of anxiety over a long period will often lead to depression, so that many people have a mixture of anxiety and depression.

Substance misuse frequently occurs with anxiety disorders as a form of self-medication to help cope. However, alcohol and other drug misuse can lead to increased anxiety.

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