Types of Anxiety Disorder

DSM-5 TR classifies anxiety disorders into the following types: 

• Separation Anxiety Disorder
• Selective Mutism
• Specific Phobia
• Social Anxiety Disorder
• Panic Disorder
• Generalized Anxiety Disorder
• Substance/Medication-Induced Anxiety Disorder

Generalized Anxiety Disorder (GAD) 

The first type we will focus on is generalized anxiety disorder (GAD). 

Generalized Anxiety Disorder (GAD), often referred to as free-floating anxiety or chronic anxiety disorder, is a mental health condition marked by persistent and intense feelings of fear that are vague and lack a clear source. This disorder lasts for at least six months or more and is not associated to any recent life changes or stressors. Those affected by GAD often find their anxiety to be excessive and challenging to regulate, frequently experiencing accompanying physical distress.  

Symptoms of Generalized Anxiety Disorder include: 

1. Persistent worry about the future and various life situations. 
2. Hypervigilance: Increased alertness to potential threats in the environment. 
3. Motor Tension: Physical signs of tension, such as strained facial expressions. 
4. Autonomic Reactivity: Symptoms include sweating, dizziness, racing heart, upset stomach, frequent urination, and elevated pulse and respiration rates. 

Phobia

Phobias are irrational fears of specific objects, situations, or activities, often leading to persistent avoidance of the feared stimuli. Individuals with phobic disorders are aware of their fears and can identify what they are afraid of. They do not need the actual presence of the feared object or situation to experience intense tension and discomfort. 

The criteria for diagnosing a phobia include: 

1. Immoderate Fear: The fear is disproportionate to the actual threat posed by the situation or object. 
2. Unexplainable: The fear cannot be easily explained or rationalized. 
3. Lack of Control: The fear is beyond voluntary control. 
4. Rejection of Situations: The fear leads to avoidance of the feared situation or object. 

Phobias typically have their onset in childhood or young adulthood, and rates of phobic disorders are about twice as high in females compared to males. 

Types of Phobias 

Phobias can be categorized into several types: 

Specific Phobias: A constant, irrational fear of a particular object, situation, or individual. 
Specific phobias can be further divided into: 

Social Phobia: Irrational fear of activities in the presence of others or interacting with others. 

Agoraphobia: Intense fear of feeling trapped and having a panic attack in public places. 

The onset of phobias can be indicated by several physical symptoms, including: 

• Hyperventilation 
• Sweating 
• Trembling hands and voice 
• Urinary urgency 

Risk Factors 

Understanding the causes behind phobias is essential. The primary causes include: 

Incident-Based Learning: In some cases, phobias can develop as a result of a specific incident or experience. This type of learning occurs when an individual faces a situation or object that triggers a strong fear response. With time, this fear can become generalized and lead to the development of a phobia. 

Imitative Learning: In some cases, people may learn to fear from situations after observing others exhibiting fear of that particular object.  

Informative Learning: People can develop phobias after being exposed to distressing information from other sources.  

Panic Disorder 

Before understanding panic disorder, it is essential to know what panic attacks are. 

What Are Panic Attacks? 

Panic attacks are characterized by a quick rise of intense anxiety that peaks within minutes. These attacks can be triggered by specific stimuli or occur spontaneously and unpredictably. During a panic attack, individuals may experience massive terror, even in the absence of real danger. 

Panic Disorder 

Panic disorder is a type of anxiety disorder identified by sudden, immense feelings of senseless terror. It leads to recurrent panic attacks, which are sudden episodes of intense fear. Individuals with panic disorder may experience strong physiological reactions to ordinary, non-threatening situations, leading to feelings of losing control. Individuals with panic disorders often live in constant fear of experiencing another panic attack. They may worry about dying, losing their sanity, or losing control. 

Panic attacks can last from a few seconds to several hours or even days. Common symptoms include: 

• Shortness of breath 
• Trembling or shaking 
• Sweating 
• Heart palpitations 
• Chest pain or discomfort 
• Nausea or abdominal pain 
• Fear of losing control or dying 

Risk factors 

Panic disorder is a complex condition influenced by various factors, including genetics, mental health, and life experiences. Understanding the key risk factors can help individuals identify their susceptibility and seek appropriate preventive measures or treatment if needed. 

Family History: Research indicates that people who have a close family member (such as a parent, sibling, or child) with panic disorder are 40% more likely to develop the condition themselves, compared to those without such a family history. 

Mental Health Conditions: People who already have mental health issues, like uneasiness, depression, or other psychiatric conditions, are at a higher chance of having panic attacks and developing panic disorder.  

Adverse Childhood Experiences: Adverse childhood experiences (ACEs) are negative events that occur during the formative years, typically between ages 1 and 17. These traumatic experiences can significantly impact an individual’s mental health and increase the risk of developing panic attacks or panic disorder later in life. ACEs may include physical, emotional, or sexual abuse, neglect, or household dysfunction. 

Separation Anxiety Disorder

Separation anxiety disorder is a mental health condition that can affect children, adolescents, and adults. It involves excessive anxiety when a person is separated from a loved one or caregiver. Individuals with this disorder experience extreme fear during separation, which can impact their functioning at school, work, or in other areas of life.

The major diagnostic criteria for SAD across different age groups include:  

• For children and adolescents, symptoms need to be present for a minimum duration of four weeks. 
• For Adults, it normally lasts for 6 months or more. 

Symptoms

• Extreme feelings of worry or fear when thinking of or witnessing separation from home or important attachment figures. 
• Constant worry about situations that might result in separation being abducted, having an accident, or falling ill. 
• Unwillingness to sleep away from home or to fall asleep without being close to a significant attachment figure. 
• Frequent dreams centered around subjects of separation. 
• Repeatedly expressing physical complaints (like headaches, stomachaches, nausea, or vomiting) when faced with separation or is expected. 

Risk Factors 

Major life challenges: Separation anxiety disorder (SAD) often develops after significant life challenges, such as the death of a loved one or pet, illness, changing schools, parental divorce, relocating, immigration, or undergoing natural devastation that results in being separated from the primary caregivers. 

Bullying: Being bullied as a child significantly increases the likelihood of developing separation anxiety disorder (SAD).  

Selective Mutism

Selective, here, means the specific situation, and mutism refers to the inability to speak. So basically, selective mutism altogether refers to the inability to speak in certain situations. 

Selective mutism is a condition in which a person is unable to speak in specific social situations, despite being able to communicate comfortably in other settings. This difficulty typically occurs in environments like school or during interactions with unfamiliar people and is not due to a desire to remain silent. 

For a diagnosis, the inability to speak must persist for at least one month (other than the first month of school). Individuals with selective mutism often experience significant anxiety that prevents them from speaking, making it challenging to express feelings or participate fully in social interactions. 

Importantly, selective mutism does not indicate a lack of knowledge or discomfort with language; rather, the difficulty arises from anxiety and hesitation, and it is not classified as a separate communication disorder. 

Symptoms of Selective Mutism include: 

Risk Factors

Disposition: Children who are slow to adapt to new situations or tend to withdraw from unfamiliar environments early in life are more prone to developing selective mutism. 

Family History: A family history of anxiety disorders, including selective mutism, can heighten the risk of a child developing the condition. 

Communication Issues: Problems with speech or language can contribute to the development of selective mutism, as these issues may increase anxiety in social settings. 

Hereditary Factors: Genetic predispositions can make some children more susceptible to anxiety disorders, including selective mutism. 

Substance/Medication-Induced Anxiety Disorder 

For individuals who are accustomed to using intoxicating substances, consuming them can feel relaxing and calming. However, when they decide to quit these habits to improve their lives, the withdrawal symptoms can be frightening and challenging to endure. 

This scenario can result in anxiety, known as substance or medication-induced anxiety disorder. 

Withdrawal from intoxicating substances, including alcohol, cigarettes, and illegal drugs, can lead to severe panic attacks and anxiety. Individuals who are dependent on these substances may experience significant distress during withdrawal, as their bodies react to the absence of the substance, they have become accustomed to. This can result in heightened anxiety levels and panic attacks that complicate the withdrawal process. 

Symptoms may include: 

1. Nervousness: Individuals may feel excessively anxious or jittery. 
2. Breathlessness: Difficulty breathing or shortness of breath can occur. 
3. Disturbed Sleep: Difficulty initiating, maintaining, or experiencing a restful sleep cycle. 
4. Concentration Issues: Difficulty focusing or maintaining attention on tasks. 
5. Gastrointestinal Distress: Symptoms such as nausea, stomach pain, or diarrhea. 

Nandini Jaiswal

Content creator at PsychOnPoint, Nandini is an M.A. student at Banaras Hindu University (BHU), Varanasi, majoring in Psychology. She works with PsyConnect and has a keen interest in psychology. Additionally, she enjoys writing and exploring various facets of human behavior through her academic and creative pursuits.

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