This article is the sixth in a series about anxiety.
Q: What are additional anxiety disorders?
A: Phobias are overwhelming and irrational fears that are quite common in adults. The following information is from the University of Maryland Medical Center. Most of the time people can either avoid or endure phobic situations. In some cases, however, the anxiety associated with the object of fear or the feared situation can be incapacitating.
Agoraphobia is the fear of being in open areas or public places. In its most severe form, agoraphobia is described as a paralyzing terror of being in places or situations from which there is no escape nor accessible help in case of attack. As a consequence, people with agoraphobia often devise complex plans to avoid feared situations and places.
The second phobia that can be incapacitating is social phobia, also called Social Anxiety Disorder. Social phobia is the overwhelming fear of being publicly scrutinized because of discomfort and shyness in social settings. The phobia often causes people to avoid social situations and is not due to physical or mental problems, such as stuttering, acne or personality disorders. Symptoms associated with social phobias vary in intensity, ranging from mild and tolerable to full-blown panic attacks.
Unlike panic attacks, social phobias are always directly related to social situations. Symptoms include shortness of breath, sweating, pounding heart, tremors and dry mouth. Social phobia can be broken down further into Generalized Social Phobia and Specific Social Phobias.
• Generalized Social Phobia is fear of being humiliated in front of others in nearly all social situations. People with Generalized Social Phobia are the most socially impaired and the most apt to seek treatment.
• Specific Social Phobia generally involves a phobic response to a particular event. Performance anxiety, “stage fright,” is the most common specific phobia. It occurs whenever a person has to perform in public. These individuals usually are comfortable in informal social situations. Specific phobias are irrational fears of specific situations or objects. They are quite common, mild and not serious enough to need treatment. The most common specific phobias are fear of animals (such as mice, snakes or spiders), flying, heights, water, injections, public transportation, confined spaces, dentists, storms, tunnels and bridges. When encountering the feared object or situation, the person has panicky feelings, sweating, difficulty breathing, rapid heartbeat and avoidance behavior. The majority of phobic adults recognize the irrationality of their fears and might choose to endure the intense phobias rather than disclose their disorders.
Obsessive-Compulsive Disorder is a disorder with unwanted, repeated, intrusive thoughts (obsessions) and behaviors (compulsions). Obsessions are recurrent and persistent mental thoughts, ideas or images. These obsessive thoughts can be mundane worries about whether or not one has remembered to lock the door to frightening and bizarre fantasies of behaving violently with a loved one. Compulsive behaviors are rigid, repetitive and self-directed routines intended to prevent the manifestation of an associated obsession.
These compulsive acts might be repeated checks to make sure doors are locked, stove burns are turned off, or calls to loved ones frequently to be sure they are safe. Some individuals have a fear of germs and wash their hands every few minutes or spend countless hours cleaning in order to avoid contamination.
A critical feature of Obsessive-Compulsive Disorder is an exaggerated sense of responsibility in which a person’s thinking centers on potential dangers and an urgent need to do something about them. More than half of those who have OCD have obsessive thoughts without any ritualistic compulsive behaviors. Even though people recognize their obsessive thoughts and behavioral rituals are senseless, they cannot control or stop them. OCD frequently accompanies depression or other anxiety disorders.
Some individuals have symptoms that lessen through time, whereby others have symptoms that worsen overtime. Children with OCD symptoms might be mistaken for having behavior problems. Taking too long to do homework because of perfectionism or refusing to do chores because of fear of germs might be misread as Opposition Defiant Disorder or deliberate passive-aggressive behavior from the child. Associated Obsessive Disorders that might be part of or associated strongly with OCD spectrum include:
• Body Dysmorphic Disorder. People with BDD are obsessed with the belief they are ugly or that parts of their bodies are abnormally shaped.
• Hypochondriasis is a disorder in which people have an excessive fear of having serious diseases.
• Anorexia Nervosa is an eating disorder that is frequently accompanied by OCD. The compulsive behavior focuses on restricting food and achieving thinness.
• Trichotillomania. People with this disorder continuously pull out their hair, leaving bald spots.
• Tourette syndrome. People with this syndrome have symptoms of jerky movements, tics and the uncontrollable utterance of obscene words.
Obsessive-Compulsive Personality, which is a personality disorder, is not the same as OCD. Obsessive-Compulsive Personality defines certain character traits, such as being a perfectionist, excessively conscientious, morally rigid or preoccupied with rules and order. These traits do not necessarily occur in persons with OCD.
• Next week’s article will continue the discussion about anxiety.
Judy Caprez is professor emeritus at Fort Hays State University.