Anxiety Disorders all share a unifying theme of experiencing intense anxiety that affects behaviors and thoughts. Anxiety Disorders are typically categorized based on the situation(s) that the anxiety occurs in and the primary types of symptoms experienced. It is possible to have multiple Anxiety Disorder diagnoses, or symptoms from several disorders without meeting diagnostic criteria for more than one. Below are several of the most common anxiety disorders that we treat.

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) involves persistent worrying about a variety of topics, such as school, work, health, relationships, and daily tasks. While everyone worries about similar topics at one point or another, the degree to which someone with GAD worries is excessive, causing significant distress and impairment. Individuals with GAD often find themselves unable to disengage from worry, overthinking, overpreparing, second-guessing themselves or changing decisions repeatedly, seeking a large amount of reassurance from others about the quality or correctness of choices they have made (or need to make in the future), and struggling to accept uncertainty/unknowns.

Additional symptoms may include:

• Restlessness (feeling “keyed up” or on edge)
• Irritability
• Fatigue and sleep difficulties
• Muscle tension
• Difficulty concentrating
• Nausea

Social Anxiety Disorder

Social Anxiety Disorder (previously called Social Phobia) refers to an intense fear of being evaluated or judged negatively by others. In response to this fear, people typically avoid common social situations, such as interacting with unfamiliar people or strangers, attending parties or social gatherings, going to work or school, and dating. When in social situations, people with Social Anxiety Disorder frequently engage in “safety behaviors” that, while providing temporary relief, worsen their anxiety in the long-run. Such safety behaviors might include selecting a position in social situations that will allow the person to avoid excessive scrutiny (e.g. sitting in the back of the room), avoiding eye contact, overpreparing for presentations or meetings, scripting conversations beforehand, looking at their phone to avoid being engaged in conversation, consuming alcohol, recreational drugs, or other substances to curb anxiety, or adopting the opinions of others in a conversation to avoid potential disagreement/judgement.

Separation Anxiety Disorder

Separation Anxiety Disorder is an excessive and developmentally inappropriate fear of being apart from a caregiver or loved one. While Separation Anxiety Disorder can impact adults, it is most commonly diagnosed in children. Symptoms of Separation Anxiety Disorder typically include a fear that something terrible will happen to a loved one when they are away (e.g., fear that a parent might get in a car accident on their way home from work) or worry that an unexpected event will lead to permanent separation (e.g., getting lost or kidnapped). This fear and worry is often accompanied by avoidance of activities that might involve separation (e.g., school refusal, refusal to go to sleep, or refusal to sleep independently from parents), physical anxiety symptoms, and recurring nightmares with a separation theme (e.g., a child dreaming about being kidnapped or lost in a store).

If your teen is having difficulty developing independence due to considerable anxiety whenever separated from caregivers, this diagnosis may be considered.

Panic Disorder

A panic attack occurs when a person suddenly and seemingly out of the blue experiences intense fear and related physiological symptoms, such as a racing heartbeat, shortness of breath, hyperventilation, trembling, feelings of choking, paresthesias (i.e., numbness or tingling sensations), dizziness, gastrointestinal symptoms (e.g., nausea), derealization (e.g., feeling as if in a dream), and depersonalization (e.g., feeling detached from oneself). This surge of intense fear typically reaches its peak within 10 minutes.

Panic disorder specifically develops when an individual: 1) worries persistently about having another panic attack or their consequences (e.g., losing control or having a heart attack) and 2) changes their behavior significantly in an effort to avoid having another panic attack (e.g., avoiding physical exercise or unfamiliar situations).

Panic Disorder can frequently result in Agoraphobia, as those who experience panic may become extremely avoidant of leaving their home for fear of having a panic attack while out.

Agoraphobia

Agoraphobia involves significant fear or anxiety related to situations that are difficult to escape if panic-related symptoms or other unpleasant/embarrassing symptoms (e.g., falling or incontinence) develop. Such situations might include public transportation (e.g., automobiles, buses, and planes), wide open spaces (e.g., parking lots, marketplaces, and bridges), enclosed spaces (e.g., shops, theaters, and cinemas), standing in line or in a crowd, or being outside of the home alone. These situations will almost always provoke intense fear in the person and are either actively avoided or endured with intense fear/anxiety.

Specific Phobia

A Specific Phobia refers to an intense fear of an object or situation that is excessive or unreasonable. The severity of this fear leads to functional impairment, meaning that it prevents the person from doing things that they need to do or would like to do. For instance, someone with a fear of dogs might avoid visiting family or friends who own dogs, while someone with a blood-injection fear might avoid completing recommended bloodwork or vaccination. Additionally, individuals with a Specific Phobia often make accommodations for their fear (e.g., someone with a fear of driving might ask their friend to drive them to all appointments).

Specific Phobias typically fall within the following categories:

• Animal Type (e.g. fear of dogs, snakes, or spiders)
• Natural Environment Type (e.g., fear of heights, storms, water)
• Blood-Injection-Injury Type (e.g. fear of seeing blood, receiving a blood test or shot, invasive medical procedures)
• Situational Type (e.g., fear of flying, elevators, driving, enclosed places)
• Other Types (e.g., phobic avoidance of situations that may lead to choking, vomiting, or contracting an illness; in children, avoidance of loud sounds like balloons popping or costumed characters like clowns)

Treatment

Treatment of all of the above may involve exposure therapy, Acceptance and Commitment Therapy (ACT), and/or other techniques of Cognitive Behavioral Therapy (CBT).

Medication may also be indicated as part of treatment. We will work together with your prescriber to ensure good treatment coordination and can make referrals to trusted providers as needed.

To learn more about anxiety disorders and their treatment, please visit the Anxiety and Depression Association of America.