Anxiety Disorders

Anxiety disorders are a group of mental illnesses that cause people to feel excessively frightened, distressed, or uneasy during situations in which most other people would not experience these same feelings. When they are not treated, anxiety disorders can be severely impairing and can negatively affect a person’s personal relationships or ability to work or study. In the most severe cases, anxiety disorders can make even regular and daily activities such as shopping, cooking or going outside incredibly difficult. Anxiety disorders can further cause low self-esteem, lead to substance abuse, and isolation from one’s friends and family.

Anxiety disorders are the most common mental illnesses in America: they affect around 20 percent of the population at any given time. Fortunately there are many good treatments for anxiety disorders. Unfortunately, some people do not seek treatment for their illness because they do not realize how severe their symptoms are or are too ashamed to seek help. Furthermore, these disorders are often difficult to recognize for friends, family and even some doctors.

What are the most common anxiety disorders?

Panic Disorder—Characterized by “panic attacks,” panic disorder results in sudden feelings of terror that can strike repeatedly and sometimes without warning. Physical symptoms of a panic attack include chest pain, heart palpitations, shortness of breath, dizziness, upset stomach, feelings of being disconnected and fear of dying. Some people with this disorder may experience unrealistic worry of having more panic attacks and become very ashamed and self-consciousness. This can result in some people feeling too afraid to go to certain places (e.g., airplanes, elevator), which can be very intrusive in their daily lives.

Obsessive-compulsive Disorder (OCD)—OCD is characterized by repetitive, intrusive, irrational and unwanted thoughts (obsessions) and/or rituals that seem impossible to control (compulsions). Some people with OCD have specific compulsions (e.g.,counting, arranging, cleaning) that they “must perform” multiple times each day in order to momentarily release their anxiety that something bad might happen to themselves or to someone they love. People with OCD may be aware that their symptoms don’t make sense and are excessive, but on another level they may fear that the thoughts have are having might be true.

Posttraumatic Stress Disorder (PTSD)—When people experience or witness a traumatic event such as abuse, a natural disaster, or extreme violence, it is normal to be distressed and to feel “on edge” for some time after this experience. Some people who experience traumatic events have severe symptoms such as nightmares, flashbacks, being very easily startled or scared, or feeling numb/angry/irritable/distracted. Sometimes these symptoms last for weeks or even months after the event and are so severe that they make it difficult for a person to work, have loving relationships, or “return to normal.” This is when a person may be suffering from PTSD. Many people with PTSD have difficulty discussing their symptoms because they may be too embarrassed or scared to recall their trauma. This is common in victims of sexual abuse and in combat veterans.

Phobias—A phobia is a disabling and irrational fear of something that really poses little or no actual danger for most people. This fear can be very disabling when it leads to avoidance of objects or situations that may cause extreme feelings of terror, dread and panic. “Specific” phobias center on particular objects (e.g., caterpillars, dogs) or situations (e.g., being on a bridge, flying in an airplane). Many people are very sensitive to being criticized and are ashamed of their phobias which can lead to problems with self-esteem.

Bipolar Disorder

Bipolar disorder is a chronic illness with recurring episodes of mania and depression that can last from one day to months. This mental illness causes unusual and dramatic shifts in mood, energy and the ability to think clearly. Cycles of high (manic) and low (depressive) moods may follow an irregular pattern that differs from the typical ups and downs experienced by most people. The symptoms of bipolar disorder can have a negative impact on a person’s life. Damaged relationships or a decline in job or school performance are potential effects, but positive outcomes are possible.

Two main features characterize people who live with bipolar disorder: intensity and oscillation (ups and downs). People living with bipolar disorder often experience two intense emotional states. These two states are known as mania and depression. A manic state can be identified by feelings of extreme irritability and/or euphoria, along with several other symptoms during the same week such as agitation, surges of energy, reduced need for sleep, talkativeness, pleasure-seeking and increased risktaking behavior. On the other side, when an individual experiences symptoms of depression they feel extremely sad, hopeless and loss of energy. Not everyone’s symptoms are the same and the severity of mania and depression can vary.

Depression

Major depression is a mood state that goes well beyond temporarily feeling sad or blue. It is a serious medical illness that affects one’s thoughts, feelings, behavior, mood and physical health. Depression is a life-long condition in which periods of wellness alternate with recurrences of illness.

Each year depression affects 5-8 percent of adults in the United States. This means that about 25 million Americans will have an episode of major depression this year alone. Depression occurs 70 percent more frequently in women than in men for reasons that are not fully understood. Without treatment, the frequency and severity of these symptoms tend to increase over time.

Insomnia

Many people experience “problems sleeping.” This can include “not getting enough sleep,” “not feeling rested,” and “not getting good sleep.” This problem can lead to difficulties functioning during the daytime and have unpleasant effects on a person’s work-life, social-life, and family-life. Problems sleeping can be secondary to a medical illness (e.g., sleep apnea) or a psychiatric illness (e.g., depression). In addition to effecting sleep itself, many medical and psychiatric illnesses (including depression, anxiety and bipolar disorder) can be worsened by sleep-related problems. Therefore it is important to discuss sleep with one’s physicians and to make an effort to get an appropriate amount of restful sleep on a nightly basis. Lifestyle choices, such as aerobic exercise and eliminating the use of caffeine and alcohol, are important and often overlooked aspects of improving sleep patterns.

Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mental illness that can be challenging for everyone involved, including the individuals with the illness, as well their friends and family members. BPD is characterized by impulsivity and instability in mood, self-image, and personal relationships. The treatments and longer-term studies of BPD offer hope for good outcomes for most individuals who live with BPD

Eating Disorders

Eating disorders are some of the most challenging mental illnesses. Untreated eating disorders can result in severe medical complications and even death in certain cases. As scientific studies suggest that nearly one-in-twenty people will experience symptoms of an eating disorder at some point in their lives, proper diagnosis and treatment of these complex conditions is of critical importance.

Eating disorders are often underdiagnosed which can delay necessary treatment. There is no specific test (e.g., x-ray or blood test) that can diagnosis an eating disorder. Rather, a diagnosis is made by a trained clinician based on the signs and symptoms of these illnesses. While many people may experience unhealthy eating habits and have concerns with their body image, people with eating disorders generally experience severe dysfunction due to their symptoms.

In general, treatment of these challenging mental illnesses involves a multi-disciplinary team of clinicians to help an individual dealing with an eating disorder. This usually includes a primary care doctor (e.g., pediatrician or internist), a nutritionist, a therapist, and a psychiatrist. Working together, members of the treatment team can help to meet the medical, nutritional and psychiatric needs of individuals with an eating disorder. In the vast majority of cases, psychopharmacological medications are not curative treatments for people with eating disorders. In certain cases, some people may find that medications are a helpful part of their treatment.