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It’s normal to feel your heart beat faster or your face flush before getting up to speak in front of a room of 50 people. But if you’re coming up with excuses to avoid the speaking engagement altogether or you find yourself hyperventilating in the bathroom before you take the stage, that may be a sign of something more — such as an anxiety disorder.
Anxiety disorders come in many shapes and sizes, with triggers ranging from specific situations to more general stressors. The good news? No matter the root cause, anxiety is highly treatable, and with the right approach, you can manage it and live a normal, fulfilling life.
Here’s what to know about the different types of anxiety disorders and when it’s time to seek professional help for your anxiety symptoms.
[READ: Stress vs. Anxiety: Understanding the Key Differences]
What Is an Anxiety Disorder?
Occasional stress, worrying or nervousness is a normal part of life that everyone experiences at some point or another. However, if you’re experiencing excessive amounts of anxiety that interfere with routine activities, such as going to work or school or socializing, for a persistent amount of time, then your symptoms may be characterized as an anxiety disorder.
“Anxiety disorders have this kind of core element of using avoidance to decrease fear as a short-term coping strategy that ultimately ends up being maladaptive,” says Dr. David Merrill, a geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California.
While avoiding the situation(s) that makes you anxious can work in the short term, it’s not a long-term solution. If you are coping with an anxiety disorder, you’re far from alone. Anxiety disorders affect an estimated 40 million adults in the U.S. annually, accounting for about 19% of the population, making it the most common mental illness in the country, according to the National Alliance on Mental Illness.
It’s also not uncommon for someone who has an anxiety disorder to have depression, or vice versa, as well.
On the plus side, once you know what’s going on, there are many evidence-based treatments available for anxiety disorders, Merrill says. That can include medications, psychotherapy approaches and modifying behaviors to ultimately lessen symptoms and overcome their functional deficits, Merrill says.
[READ: Types of Therapy: Choosing the Right One for You.]
Common Types of Anxiety Disorders
There are several types of anxiety disorders, and among the most common are:
— Generalized anxiety disorder
— Panic disorder
— Specific phobias
— Agoraphobia
— Social anxiety disorder
— Separation anxiety disorder
— Selective mutism
Generalized anxiety disorder
If you constantly worry that disaster could strike at any point in nearly every aspect of your life, you may well be suffering from generalized anxiety disorder.
People with generalized anxiety disorder may worry about their finances, their health, their family, work and school. If they pause to confront their anxious thoughts, they can often see those feelings may be overblown and irrational, but they’re incapable of calming their mind and stopping themselves from thinking about worst-case scenarios. This can lead to symptoms such as irritability, trouble concentrating, headaches and stomach discomfort.
Having GAD interferes with everyday activities, involving persistent fear, anxiety or dread that causes you to avoid activities or events causing distress. The disorder affects nearly 7 million adults in the U.S., or about 3% of the adult population, reports the Anxiety and Depression Association of America.
[READ: What Is High-Functioning Anxiety?]
Panic disorder
People who suffer from panic attacks are overcome with an overwhelming sense of fear, in which the body’s fight-or-flight system kicks in — as if you’re being chased by a bear.
The following symptoms may accompany a panic attack:
— Heart racing or pounding
— Hyperventilation
— Narrowing vision
— Shakiness
— Sweating
Although these reactions are your body’s natural defense system, it can feel like your world is coming to an end and leave you feeling terrified. Some panic attacks feel so intense that people experiencing one end up in the emergency room.
Sometimes panic appears with no apparent trigger, whereas other times it’s prompted by a specific stressor or phobia. Many people often worry about when their next attack will strike, causing them to avoid specific situations that could trigger one.
[See: Tips to Support Someone Having a Panic Attack.]
Specific phobias
Many people have trepidation about certain situations like flying or undergoing an MRI, but most overcome their discomfort and get on that plane or into that tube.
However, specific phobias can affect someone’s ability to live their daily life, causing moderate to severe distress and impacting a person’s ability to function. People with phobias often go out of their way to avoid the object, place or situation causing distress — such as if a parent entirely avoided taking their child to the park due to a fear of snakes lurking in the grass.
According to the ADAA, specific phobias often focus on:
— Animals or insects
— Heights
— Modes of transportation, such as flying or driving
— Dental or medical procedures
— Illness and/or germs
Agoraphobia
Agoraphobia is similar to specific phobias but broader in that it encompasses fear of leaving one’s home and venturing outside what is considered their “safe zone.” Someone with agoraphobia avoids situations where they might experience a panic attack or be unable to escape.
For example, people with agoraphobia might avoid places such as:
— Shopping malls
— Public transportation
— Open spaces like parking lots
— Enclosed spaces like movie theaters
Agoraphobia affects almost 2% of the general population, disproportionately affecting women, notes one review. People with panic disorder are at a higher risk for agoraphobia; approximately 1 in 3 people with panic disorder will develop agoraphobia, according to the Encyclopedia of Psychotherapy.
Social anxiety disorder
Previously known as social phobia, social anxiety disorder is characterized by dread of social situations because of irrational fears of humiliation, embarrassment or rejection. Those with social anxiety often feel self-conscious and can experience physical symptoms of anxiety, such as a racing heart, blushing, sweating or stomachache.
Someone with social anxiety may avoid social situations entirely or endure them with great angst. This can affect not only their social life, but also their professional or academic life because they may avoid a classroom discussion or workplace team project.
Separation anxiety disorder
People with a separation anxiety disorder have feelings of angst or worry about being far away or separated from someone they’re close to, fearing that something bad might happen to their loved one when they’re apart. SAD is more common in children than adults.
In children, SAD is usually centered around separation or anticipated separation from a parent or guardian, whereas in adults with the disorder, the attachment figure may be a spouse or romantic partner, children or a parent.
Selective mutism
Like SAD, selective mutism is most common in children, usually affecting young children entering school age. With this anxiety disorder, the individual affected is able to speak — typically speaking freely and comfortably at home — but they freeze or experience excessive shyness in public settings, such as at school, notes the Selective Mutism Association. About 70% of children with selective mutism also meet the criteria for a social anxiety disorder, SMA adds.
Diagnosing the disorder factors in several criteria:
— The individual demonstrates consistent failure to speak in particular social settings.
— The duration lasts at least one month.
— Mutism interferes with everyday life, such as achievement in school or social interaction.
— Mutism isn’t attributable to not knowing the spoken language.
— The lack of speaking isn’t better explained by another disorder.
Anxiety Symptoms in Related Mental Illnesses
Anxiety symptoms can often overlap with those seen in other closely related mental health conditions, such as obsessive-compulsive disorder and post-traumatic stress disorder.
OCD
People with OCD experience anxiety-driven obsessions (unwanted, intrusive thoughts) and compulsions (repetitive behaviors to ease their distress). They may say, ‘I’m so anxious,’ but they’re anxious about how contaminated their hands are or about an intrusive thought of harming someone.
“That’s an OCD symptom, not a symptom of generalized anxiety disorder,” says Jon Hershfield, director for the Center for OCD and Anxiety at Sheppard Pratt in the Greater Baltimore area.
OCD is in its own category with other closely related conditions, including body dysmorphic disorder, hoarding disorder, trichotillomania (hair-pulling disorder) and excoriation disorder (chronic skin picking).
“Oftentimes with OCD, people get misdiagnosed unless they have obvious physical manifestations, like they’re washing their hands too much or they’re checking too much,” he says. “But there’s a whole world of OCD that happens only in the head where people are having unwanted intrusive thoughts about their morality or their religion or sex or violence.”
PTSD
Anxiety is also a core feature of post-traumatic stress disorder, often presenting as constant feelings on edge, an exaggerated startle response and hypervigilance, along with panic attacks, flashbacks and avoidance behaviors. However, PTSD is under a category called trauma and stress disorders, which includes various conditions that can develop out of someone experiencing a trauma or traumatic event, Hershfield says.
Overlapping conditions
Anxiety disorders, OCD and PTSD include having unwanted thoughts, unwanted sensations, memories or experiences that might trigger unhealthy or harmful responses.
Hershfield notes that these disorders can both inform and cause one another. For example, you could have GAD where you have a persistent worry about work, finances and relationships, which leads to ruminating in those thoughts, feeling uncomfortable about them and experiencing sleep disruptions; as it gets more severe, you might notice that to deal with your anxiety, you’re doing rituals like making sure you check the stove and turn it off a certain number of times — crossing into symptoms of OCD.
“Part of the challenge of doing good clinical work is making sure that you are treating the right thing,” Hershfield says.
When to See a Doctor for Your Anxiety Symptoms
It’s likely time to visit the doctor if your symptoms hit two markers: disrupting everyday activities and lasting a prolonged period of time.
Disruption
In general, the field of psychiatry differentiates between anxiety symptoms and having an anxiety disorder based on whether symptoms are disrupting function, Merrill says. In adults, for instance, this could mean you’re not able to fill expected roles in the workplace or your primary relationship or even go about daily life tasks, such as shopping, managing finances or attending school or after-school activities for a child.
“If there’s some functional deficit that starts to creep up in terms of professional attention, medical care or psychologic care, that’s usually a marker for when it rises to the level of needing guided help of scheduled appointments and providers,” Merrill says. “As opposed to if you’re looking for optimizing performance or self-help or you want to get a health coach to make it so you’re top of the game.”
Persistence
You should also see a doctor if your symptoms aren’t going away.
“If it’s present most days for an extended period of time, that’s not tied to a specific situation or trigger, then that’s typically when it’s one of the markers of needing to get professional help where that can be figured out, not just a one-off or one period,” Merrill confirms.
He adds that it’s time to seek out somebody who specializes in types of mental health conditions and treatment if your symptoms are:
— Intense
— Hard to manage
— Affecting your health
— Impairing your daily life
— Impacting your relationships
— Feeling out of control
Diagnosing Anxiety Disorders
Anxiety disorders and other mental health conditions often share overlapping symptoms, making it difficult to pinpoint an accurate diagnosis. These disorders can also co-occur, further complicating the diagnostic process. However, getting an accurate diagnosis is important for ensuring the right treatment approach is implemented.
“Diagnosing somebody is very important and very delicate — it just takes a certain amount of time,” Hershfield says. “So the question of how can we do this quickly and safely is a bit tricky because you can’t always do it quickly.”
For example, someone may come in with symptoms of OCD, where it clearly presents as OCD on the surface. However, “after a week or so of working with them, I realize there’s also an underlying trauma condition,” Hershfield explains. “I’m not going to know that from the first setting.”
Therefore, patience and persistence are both essential during a mental health diagnosis. It also comes down to trust and how quickly the clinician can form a trusting environment and build a relationship with the patient, getting the patient to believe that their main interest is reducing their suffering and not pathologizing or judging them.
“Different people learn to trust people at different rates,” Hershfield says. “One, are they going to tell you about it? Two, are they going to describe it for you in a way that makes sense that you can accurately diagnose them with OCD?”
He adds that this is why it often takes more than a decade for some of those experiencing anxiety disorder or other mental health disorder symptoms to actually get specialized care.
Be careful with using the internet for diagnosing anxiety disorders
In this digital age, it’s also important to be wary of information you encounter online, particularly while scrolling social media.
“It can be useful for some and ordinarily dangerous for others,” Hershfield says.
For many, social media platforms like TikTok may be the first place they’re recognizing that something might be wrong — like realizing sleep disturbance is a sign of depression. But don’t assume the internet is going to keep giving you help in the long term.
As Hershfield says, “Use the internet just long enough to get to my website, and then come into the office.”
Seeking help from trained medical professionals is essential for properly managing serious mental health conditions, such as anxiety disorders, and improving your symptoms in the long run.
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7 Types of Anxiety Disorders: What Type Do You Suffer From? originally appeared on usnews.com
