I have been reviewing the psychology of fear and anxiety in my last few posts, discussing their similarities and differences.
Excessive fear and anxiety, however, can be a sign of an anxiety disorder. In today’s post, I will explain what an anxiety disorder is and then briefly describe the variety of anxiety disorders, all eleven of them.
To understand anxiety disorders, we need to learn a little about the Diagnostic and Statistical Manual (DSM), which is published by the American Psychiatric Association. Mental health professionals use this manual, which lists the diagnostic criteria for several hundred mental disorders, to diagnose disorders in their clients.
The DSM is updated every few years. What changes in a new edition? Some disorders are eliminated, new ones are created, and the criteria for some disorders are modified. The latest edition of the manual, DSM-5, was published in 2013.
What is an anxiety disorder?
So what is an anxiety disorder, according to DSM-5?
Anxiety disorders differ from developmentally normative fear or anxiety by being excessive or persisting beyond developmentally appropriate periods [my emphasis]. They differ from transient fear or anxiety, often stress-induced, by being persistent (e.g., typically lasting 6 months or more), although the criterion for duration is intended as a general guide….Since individuals with anxiety disorders typically overestimate the danger in situations they fear or avoid, the primary determination of whether the fear or anxiety is excessive or out of proportion is made by the clinician, taking cultural contextual factors into account….Each anxiety disorder is diagnosed only when the symptoms are not attributable to the physiological effects of a substance/medication or to another medical condition or are not better explained by another mental disorder.¹
The difference between the various anxiety disorders has to do with the “types of objects or situations that induce fear, anxiety, or avoidance behavior, and the associated cognitive ideation.”¹
Eleven anxiety disorders
So what are the major types of anxiety disorders? While anxiety can be a feature of many disorders, including obsessive-compulsive disorder and post-traumatic stress disorder (both were listed under anxiety disorders, in the previous edition of the DSM), DSM-5 lists only the following eleven types of disorders in the anxiety category:
- Separation anxiety disorder: Being overly fearful of separating from attachment figures (e.g., one’s parents).
- Selective mutism: Failing to speak in some situations though capable of speaking in others.
- Specific phobia: Being excessively fearful of certain objects or situations (e.g., animals, blood, etc).
- Social phobia: Being overly fearful of interacting with others in social situations.
- Panic disorder: Experiencing unexpected panic attacks and as a result constantly worrying about the occurrence of more attacks in the future.
- Agoraphobia: Being excessively fearful of certain situations (e.g., crowds), worrying that, should a panic attack or other similar distressing events occur, escape will be difficult.
- Generalized anxiety disorder: Being overly anxious in various domains (e.g., personal relationships, work, school).
- Substance/medication-induced anxiety disorder: Intense anxiety that results from substance withdrawal or medication use.
- Anxiety disorder due to another medical condition: Here the anxiety symptoms are the physiological consequence of a medical condition (e.g., an overactive thyroid).
- Other specified anxiety disorder: This is a category for anxiety symptoms that do not meet the full criteria for any of the above disorders.
- Unspecified anxiety disorder: Same as above, but this category is used in cases that the health provider can not (or chooses not to) specify the reason the full criteria are not met.
In case that you have concerns about yourself meeting the criteria for a particular disorder, I recommend you refrain from searching for a disorder’s detailed criteria online and self-diagnosing, and instead make an appointment with your mental health provider. A good health provider will obtain full history and rule out a number of other conditions before providing you with a diagnosis. You may want to also obtain a second opinion, just to be sure.
But what then? What treatment options are there?
Starting next week, I will begin a series of posts on treatments for fear and anxiety. I will discuss how various therapies work, and will also talk about medications.
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.