So the Diagnostic and Statistical Manual of Mental Disorders (DSM) is like the bible of psychology. This manual is published by the American Psychiatric Association (APA) and it basically gives all the information necessary for diagnosing all mental health disorders…minus the human element. What I mean by that is that while the manual lists the diagnostic criteria for disorders, the prevalence, statistics, and prognosis in addition to some treatment methods…it doesn’t tell you what the disorder really “feels” like from the inside. That is what I am attempting to do with this blog. But for starters I will give you some of the technical characteristics of anxiety.
Anxiety comes in many forms and while we all experience anxiety at some point in our lives, there is a line at which “normal” anxiety crosses over into maladaptive behavior (maladaptive behavior is a fancy word meaning you just can’t deal anymore or the problem limits normal living). Normal anxiety includes the things in life that make you understandably nervous like anticipating the birth of a child, or cold feet before you walk down the aisle, or starting a new job, or waiting for the doctor to call with results of a test. Anxiety is actually a really important response because it is the trigger for the fight-or-flight response in dangerous situations, which can save your life in those situations. Anxiety provoking situations may spur you to study harder for a difficult exam or remain alert when you hear a noise outside your house; it creates cautiousness in surroundings that may be dangerous. The key difference between “normal” anxiety and an anxiety disorder is the source and intensity and the resulting behavior. In real people terms…when it starts to suck so bad and happen so often that you feel like you’re in hell or you can’t deal with normal life it is probably becoming a problem!
General Anxiety Disorder (GAD) is characterized by general anxious feelings and can include “mild heart palpitations, dizziness, and excessive worry” (DSM-IV, 2004, Symptoms). These feelings are hard to manage for the affected person and are not tied specifically to one traumatic event or series of events. When the anxiety is tied to a specific event it may lead to a different type of anxiety disorder known as post-traumatic stress disorder (PTSD). More severe forms of anxiety may be classified as a Panic Disorder. The manual says that prognosis is good for the worst of the symptoms but the underlying fears are a little more complicated. Medication in combination with therapy can be helpful.
Panic disorder is probably what you think of when you hear the term panic attack or anxiety attack. This is a more acute (quick onset) attack characterized “by intense fear or anxiety, usually associated with numerous physical symptoms such as heart palpitations, rapid breathing or shortness of breath, blurred vision, dizziness, and racing thoughts” (DSM-IV, 2004, Symptoms). People sometimes think they are having a heart attack and sometimes even end up in the ER. Again medication and therapy can help and it is important for the individual to realize that the attack is not a physical problem but rather a psychological response. Prognosis again is good but if a person doesn’t seek treatment, the symptoms can progress into more severe behavioral responses (e.g. agoraphobia-fear of leaving the safety of one’s home).
And this leads me to obsessive compulsive disorder (OCD). Yep…anxiety is the root of OCD. OCD is often the root of comedic interpretation but it is truly debilitating to some people including some people I really love. The biggest thing with OCD is obsessions which are “persistent, often irrational, and seemingly uncontrollable thoughts” (DSM-IV, 2004, Symptoms) that lead to compulsions, which are behaviors that are intended to relieve or neutralize the obsession. The common thing people associate with OCD is hand washing or being a “germaphobe” so here is an example of what happens: a person becomes anxious that they are going to become sick from germs but this fear is over-exaggerated and extreme or irrational, they obsess about the thought of being dirty or infected, and compulse in the form of excessive hand washing. In real people terms you think about something so much to the point that you have to do something to relieve the thoughts and anxiety and you behave in a way that seems excessive or irrational to outsiders but more important it starts to interfere with normal daily life. That is oversimplifying the disorder but for this purpose I think it gets the point across. The compulsion, in the example-hand washing, provides a temporary relief from the obsessive thought that results from anxiety. These compulsions can greatly interfere with daily life.
So there is some technical stuff to just get your mind thinking about what anxiety is. What does all of that mean? It means that if you have anxiety it sucks whatever name you give it. It means there is a name for this “problem” but it doesn’t really make me feel better to know there is a name for what is wrong. It sort of makes me feel like…well…like I’m labeled.
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