Anxiety / PTSD

Anxiety/ Panic Disorder/ Social Phobia/ Performance Anxiety/ PTSD

Anxiety disorders are the most prevalent mental health concern in the US affecting 40 million people ages 18 and older (32% of adolescents are thought to have some form of anxiety.) Anxiety disorders are highly treatable, however only about 37% of those suffering reach out for help. A complex set of risk factors contribute to the development of anxiety disorders including genetics, personality and life events.

Anxiety disorders come in many forms: generalized anxiety disorder is characterized by uncontrollable worry and fear, insomnia, poor concentration, a high startle response, indecisiveness, and physical manifestations including headaches, heart palpitations and nausea. Women are twice as likely to suffer as men. GAD often co-occurs with major depression.

Sometimes anxiety turns into panic attacks which are episodes of intense fear that trigger severe physical reactions, such as sweating, facial flushing, dizziness and heart pounding, when no clear danger is apparent. Many describe panic attacks as a feeling of having a heart attack, a sense of the rooms closing in on them, or even an impression they are dying. Again, women are twice as likely as men to suffer.

Social phobia (or other phobias) can be characterized by a person having an irrational fear of social interaction (or flying, spiders, dying, etc.). Symptoms include intense blushing in front of others, having a shaky voice, crying or trembling, stomach, nausea, vomiting and avoidance or dread associated with the feared stimuli. Men and women are equally affected and it takes on average 10 years for people to reach out for help.

Performance anxiety or “stage fright” is specifically related to an intense fear of performing in front of others. This often shows up in sports, work or school, or public speaking in general. Performance anxiety can prevent you from doing what you love and can hold you back from advancing in your career. It can also affect your self-esteem and self-confidence.

Obsessive Compulsive Disorder affects men and women equally and is diagnosed based on those who have repeated unwanted thoughts or sensations (obsessions) or the urge to do something over and over (compulsions). Ruminations, compulsive handwashing, counting, behaviors centering around symmetry and orderliness are examples of OCD.

PTSD falls under the umbrella of anxiety disorders and is based on experiencing or witnessing a traumatic event such as a car accident, rape, natural disaster, childhood sexual, physical or emotional abuse, or domestic violence. Symptoms of PTSD are flashbacks to the event, nightmares, hyper- or hypo-arousal to stimuli that remind you of the event and avoidance of situations that consciously or unconsciously remind you of the event. Complex PTSD (CPTSD) is not based on a singular trauma but is repeated trauma over months or years. Examples are growing up in an alcoholic home, experiencing bullying in school, being pressured to make perfect grades or be the best in sports, or suffering from chronic neglect. Symptoms of CPTSD include all of the above classic symptoms of PTSD, but also entrenched changes in beliefs and feelings about yourself, others and the world at large, avoidance of relationships with other people, a total lack of trust in others, intense shame, preoccupation with revenge against the abuser or projections of the abuser, lack of emotional regulation such as rage, and beliefs that the world is very dangerous. (See the EMDR tab on this page for more information about PTSD).