Dupont Circle panorama

Depression and anxiety disorders
from Treatment Plans and Interventions for Depression and Anxiety Disorders
by Robert L. Leahy, Ph.D., and Stephen J. Holland, Psy.D.

Depression has a variety of symptoms, such as loss of energy, loss of interest in activities and in life, sadness, loss of appetite and weight, difficulty concentrating, self-criticism, feelings of hopelessness, physical complaints, withdrawal from other people, irritability, difficulty making decisions, and suicidal thinking. Many depressed people feel anxious as well. MOREARROW

Insomnia is one of the more troubling experiences for depressed and anxious patients. Some people experience difficulty falling asleep (onset insomnia or anxiety), while others wake several times during the early morning hours (early-morning insomnia or depression). Usually, as depression and anxiety lift, insomnia decreases and sleep is more restful. MOREARROW

Panic Disorder and Agoraphobia: Almost everyone feels anxious at times. But a panic attack involves such a high level of that it can feel as if you are having a heart attack, going insane, or losing control of yourself. During a panic attack, you may have physical symptoms such as shortness of breath, tingling sensations, ringing in your ears, a sense of impending doom, trembling, a feeling of choking, chest pain, sweating, and heart pounding. You should see your physician in order to rule out medical causes for these symptoms, such as hyperthyroidism, caffeine addiction, mitral valve prolapse, or other causes. A panic attack, however, can produce the same physical symptoms as these medical conditions. When a person has recurring, unexpected panic attacks, is afraid of having more or worried about their meaning, and makes changes in his or her behavior as a result, the person is said to have panic disorder. Many patients who have panic disorder also experience agoraphobia. Agoraphobia is fear of places or situations where a panic attack may occur or from which escape might be difficult. MOREARROW

Generalized Anxiety Disorder: All of us worry about things that might happen. We may have a restless night of sleep. But people with generalized anxiety disorder (or GAD) have physical symptoms that interfere with their normal lives. These problems may include restlessness, fatigue, problems with concentration, irritability, muscle tension, and/or insomnia. In addition, these individuals worry about a variety of events, such as health, financial problems, rejection, and performance, and they find it difficult to control their worry. Many people with GAD feel that their worry is “out of control” and that it will make them sick or make them go insane. MOREARROW

Social Phobia is the fear of one or more social situations. Commonly feared situations include public speaking, meeting new people, being at parties, asking for dates, eating in public, using public restrooms, speaking to people in authority, and disagreeing with others. People with social phobia are afraid they will act in ways that will make other people think badly of them. They often fear that others will see some sign of anxiety, such as blushing, trembling, or sweating. People with social phobia usually try to stay away from the situations that make them anxious. When they cannot, they tend to feel very anxious or embarrassed. Sometimes they may have panic attacks. Social phobia is a severe, disabling form of shyness and can cause problems in people’s lives. MOREARROW

Posttraumatic Stress Disorder (or PTSD) is a common reaction to very stressful or traumatic events. Many different kinds of events can lead to PTSD, including being in a car accident; being raped or being the victim of another crime; being physically or sexually abused; living through a disaster such as a flood or a bombing; or seeing someone else die. People with PTSD have three main types of problems or symptoms: reliving the trauma, avoiding, and signs of physical stress. MOREARROW

Specific phobia is a fear of a particular object, animal, or situtation. The fear is great enough that you wish to avoid the situation or experience it only with considerable anxiety. Fears and phobias are very common. In a recent national survey, 60% of the people interviewed reported that they feared some situation or thing. The most common fears were fears of bugs, mice, snakes, bats, heights,
water, public transportation, storms, closed spaces, tunnels, and bridges. Many people reported that they feared several things and that they consciously avoided them. In fact, over 11% of the people indicated that their fears qualified as specific phobias. That is, their fears were persistent and associated with intense anxiety; they avoided or wanted to avoid certain situations; they realized that their fears were excessive or unreasonable; and their fears resulted in distress and difficulty in their normal lives. MOREARROW

Obsessive-compulsive disorder: People with OCD have obsessions, compulsions, or both. “Obsessions” are thoughts, mental pictures, or impulses that are upsetting but that keep coming back. “Compulsions” are actions that people feel they have to perform to keep from feeling anxious or to prevent something bad from happening. Most people with OCD suffer from both obsessions and compulsions. Common obsessions include: fears of getting a disease, touching poisons, hurting or killing someone, forgetting to do something, doing something embarrassing or immoral, such as shouting obscenities. Compulsions are also called “rituals.” Common compulsions include: excessive washing or cleaning, checking, repeating actions, hoarding or saving things, putting objects in a set pattern. Most people with OCD know that their fears are not completely realistic. They also feel that their compulsions do not make sense. However, they find themselves unable to stop. OCD is a common problem. During any 6-month period, over 4 million people in the United States suffer from OCD. One person in every 40 will have OCD at some point during his or her life. OCD can cause serious problems. People with OCD often spend hours a day doing rituals. This makes it hard to work or take care of a family. Many people with OCD also avoid places or situations that make them anxious. Some become homebound. Often they have family members help them perform their rituals. MOREARROW