It’s normal to feel fear, restlessness, or insecurity in social situations. About 30% of people experience intense fear in social settings (Bados, 1992). These reactions help us respond appropriately to different scenarios, optimizing our behavior.
A certain level of anxiety can enhance motivation and performance, useful for new or important situations like job interviews or first dates. Anxiety typically causes moderate physiological responses such as flushing, sweating, slight tremors, palpitations, or dry mouth.
For most people, these feelings are temporary and fade within minutes. However, for those with anxiety disorders, the anxiety can persist long after the situation has passed or be disproportionately intense.
Anxiety Disorder Statistics
- Over 280 million people worldwide struggle with anxiety disorders.
- More than 60% of those affected are women.
- Most people develop anxiety disorders before age 21.
- In the US, over 30% of people experience an anxiety disorder at least once.
- 14% of Europeans aged 14-65 have anxiety disorders.
Types of Anxiety Disorders (Listed bellow)
Anxiety disorders include six distinct types, each characterized by excessive anxiety, persistent thoughts, and behavioral disturbances. They differ in the specific triggers or situations that induce them.
According to the American Psychological Association (APA), anxiety is “an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure.” These disorders often disrupt daily life, making it challenging to maintain a healthy social life, perform well at work or school, and sustain fulfilling relationships. The pervasive and unrealistic worry and tension cause significant distress, hindering normal functioning.
Common Symptoms
- Tachycardia (chest pain)
- Excessive sweating and hyperventilation (shortness of breath)
- Fatigue and difficulty concentrating
- Insomnia
- Trembling, nausea, and diarrhea
The Stigma Around Anxiety Disorders
Today’s culture often romanticizes anxiety, portraying it as a beautiful emotion to be embraced. This trend, seen on social media, TV, and merchandise, can downplay the seriousness of anxiety disorders, implying they aren’t real mental health conditions that need treatment. This misconception discourages people from seeking help.
Conversely, people with anxiety are often viewed as weak, lazy, overly emotional, or too sensitive, suggesting they should simply “snap out of it.” This harmful stereotype reinforces the stigma.
Anxiety disorders are real mental health conditions, and recovery is possible. Cognitive Behavioral Therapy (CBT) is highly effective, and sometimes medication is needed to reduce symptoms. However, medication should only be taken with a prescription.
Addressing and reducing the stigma surrounding anxiety disorders is crucial. Stigma can prevent individuals from seeking help, worsening their condition. It’s important to recognize that anxiety disorders are legitimate mental health issues that deserve attention and treatment. Education and open conversations about anxiety can help break down misconceptions and encourage those struggling to seek the support they need.
Causes of Anxiety Disorders
Several factors can trigger anxiety disorders, including:
- Family background: Genetic predisposition within families
- Personality traits: Shy, perfectionist, and insecure individuals are more prone
- Stressful life events: Such as sexual abuse, loss of a loved one, and workplace issues
- Physical disease: Conditions like hyperthyroidism, diabetes, and asthma
Anxiety disorders can also coexist with other mental health conditions (e.g., depression, eating disorders) or lead to substance abuse.
PANIC DISORDER
Panic Disorder experiences are characterized by high episodes of anxiety that are accompanied by intense somatic responses (body reactions).
Physiological responses are often experienced as signs of imminent danger to the person’s physical or mental integrity. This is the reason why a good part of panic attacks is attended in medical and hospital centers and not in psychological care services.
Anxiety responses have an adaptive function to the threat that activates various bodily systems that prepare the person to execute an action to protect themselves.
In panic attacks this adaptive reaction becomes excessive and loses its original function as there is no obvious threat to the person, but the reaction still occurs. After a while, this will develop in the fact that the person will react with fear to their own anxiety.
Often people mix between Panic Disorder and Agoraphobia.
Agoraphobia is the fear of being somewhere where it can be difficult to escape or to receive help. Agoraphobia is usually associated with episodes of intense anxiety that can take the form of a panic attack.
The main characteristic of phobias is the elevated, disproportionate fear response to a certain situation or object.
The person experiences a high-intensity emotional reaction that is accompanied by high discomfort when faced with said object or situation because they consider that the event has characteristics that can endanger their integrity. Faced with such danger, the person reacts by fleeing or avoiding being exposed to the stimulus (i.e. the feared object or situation).
When the person is away from the phobic element, they may still present fear due to apprehension or anxious expectation of a possible new encounter with the feared element.
Despite the high prevalence of phobias, compared to other anxiety disorders, it is unusual to seek for help and go to therapy to stop having this experience. What often happens is that the person will develop strategies to avoid the feared stimulus very easily and will ask for help only when there is no other option.
The good news is when the person goes to therapy, cognitive behavioral therapy is very efficient in helping with phobias.
Two examples of specific phobias are agoraphobia (i.e. fear of scenarios where immediate aid is unlikely) and selective mutism (i.e. inability to speak in specific situations).
SPECIFIC PHOBIAS
GENERALIZED ANXIETY DISORDER (GAD)
Many agree that the main symptom of generalized anxiety disorder (GAD) is concern. This concern is related to issues of daily life and this fact makes it difficult to diagnose because it has been observed (and described in various studies) that these concerns are not different from those of people without GAD.
In the GAD, we observed clinically the presence of chronic worry that lasts for more than six months (according to DSM IV-TR, APA 2000), feelings of insecurity, agitation and nervousness. These concerns can be related to any matter of daily life and this is why it affects multiple areas of the person’s life.
The person experiences a continuous and constant state of anxiety that rises as new sources of stress appear. Often the person will mostly find it difficult to relax and feel that there are always new worries to feed this state of tension, this will even lead to disrupting their sleep. In addition, the person can experience various body pain or discomfort.
The person experiences difficulty in regulating their emotions. GAD causes a significant deterioration in the quality of life of the person. It can cause a significant loss of relationships and social ties, it can alter work activity, as well as it can cause a deterioration of family ties.
Social Anxiety Disorder is often considered as a set of symptoms triggered by intense fear of exposing oneself to social situations.
The person experiences fear of being negatively evaluated, of behaving awkwardly, of being humiliated, of making a fool of themselves or of other people being able to detect their anxiety symptoms.
The central element is the distorted estimation that the person makes about the unfavorable evaluations that other people can make about their performance or about a personal characteristic. The person believes that these evaluations are for sure very negative and that they will have harmful consequences. This will influence the person to develop an anticipatory anxiety response to the possibility of re-facing social situations and making mistakes again.
Usually, the first symptoms of social phobia appear around adolescence at about 13-15 years. When it appears so prematurely it is usually accompanied by more serious symptoms and the course tends to be chronic and is usually preceded by shyness or social inhibition.
SOCIAL ANXIETY DISORDER (SAD)
POST TRAUMATIC STRESS DISORDER (PTSD)
Post-Traumatic Stress Disorder (PTSD) refers to behaviors that develop over a long period of time after the onset of a traumatic event – either experiencing it or witnessing it.
Symptoms can include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Most people who will go through a traumatic event will need time to recover from it, but when time (months or even years) and self-care doesn’t allow the person to get better or if the symptoms get worse (interfere in the person’s daily life), then we speak about PTSD.
Most of the time symptoms will fall into two categories: re–experimentation of the trauma and avoidance and/or escape behaviors. The person will have very intense reactions when exposed to stressors (situations, people) related to the traumatic event, or when thinking about it or visualizing it. They will most likely experience a very high intensity of horror and fear. This can also lead to the appearance of dissociative symptoms, such as de-realization or de-personalization.
Obsessive compulsive disorder (OCD) is a complex experience that has an important level of interference in the person’s daily life.
It is frequent for everyone to experience both obsessions and compulsive behaviors without this fact being a possible pathology factor (would you write without any trouble “I wish that X will die”).
Therefore, these are normal states of mind but when they are associated to a dysfunctional belief system about the obsession – compulsion the person begins to manifest discomfort and suffering.
The course of OCD is usually insidious, variable and with a tendency to become chronic, and consequently, it can significantly affect the functioning of the person in different areas of life.
The usual causal factors are related to stressors that appear acutely or when the person is subjected to a stressful life situation for a long time.
It has been observed that important changes in the person’s life such as maternity / paternity, a pathological grieving process, or some traumatic event can lead to the activation of cognitive patterns typical of OCD. This often will be obsessions or compulsions that will be considered as being necessary for the well-being of loved ones (e.g. if I do X then my son will be safe) or that will have an impact on the risk of a dangerous event (e.g. If I don’t do X then my mother will die).
OBSESSIVE COMPULSIVE DISORDER (OCD)
