Anxiety Disorders

I am a goal oriented therapist. If a person comes to me with anxiety problems, I will ask them what they want to get out of therapy. I will ask them what the end result will look like. Then I help the person accomplish the end result. There are many ways anxiety effects people, some of the common problems are listed below (Diagnostic and Statistical Manual of Mental Disorders, 5th Ed., 2013).

Separation Anxiety

  • excessive distress when separating from a loved one

  • excessive worry about a loved one being harmed or injured

  • excessive worry about experiencing a tragic event that may result in separation

  • refusal to go away from home, school, work, or otherwise away from presence of loved one

  • excessive fear of being alone

  • refusal to sleep away from attachment figure

  • repeated nightmares about being separated

  • physical pains when anticipating separation

Specific Phobia

  • marked fear or anxiety about a specific object or situation

  • the object or situation always causes anxiety

  • avoidance of the object or situation

  • the fear is out of proportion to actual danger

  • the anxiety lasts longer than six months

  • the anxiety causes problems in home, social, occupational, or other setting

Social Anxiety Disorder

  • fear or anxiety about social situations

  • fear of showing anxiety in a way that leads to rejection

  • fear of not meeting expectations or letting others down

  • social situations always provoke anxiety

  • social situations are endured with intense fear or anxiety

  • the anxiety is out of proportion to actual threat

  • the feeling has lasted longer than 6 months

  • the anxiety causes significant impairment in social, occupational, or other areas of functioning

Panic Disorder

  • Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, at which time four or more of he following symptoms occur.
    Note: the abrupt surge can occur from a calm state or an anxious state

    • palpitations, pounding heart, or accelerated heart rate

    • sweating

    • trembling or shaking

    • sensations of shortness of breath or smothering

    • feelings of choking

    • chest pain or discomfort   

    • nausea or abdominal distress   

    • feeling dizzy, unsteady, light-headed, or faint

    • chills or heat sensations   

    • paresthesias (numbness or tingling sensations)

    • derealization (feelings of unreality) or depersonalization (being detached from one-self)

    • fear of losing control or "going crazy"

    • fear of dying


  • Marked fear or anxiety about two or more of the following five situations:

    • using public transportation

    • being in open spaces

    • being in enclosed places

    • standing in line or being in a crowd

    • being outside of the home alone

The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms

  • the agoraphobic situations almost always provoke fear or anxiety

  • the agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety

  • the fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context

  • the fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more

  • the fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

Generalized Anxiety Disorder

  • excessive anxiety and worry, occurring more days than not for a least 6 months, about a number of events or activates

  • the individual finds it difficult to control the worry

  • The anxiety and worry are associated with three or more of the following six symptoms, with at least some symptoms being present for at least 6 months:
    Note: only one item is required in children

    • restlessness or feeling keyed up or on edge

    • being easily fatigued

    • difficulty concentrating or mind going blank

    • irritability

    • muscle tension

    • sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep.

  • the anxiety worry, or physical symptoms cause distress or impairment in social, occupational, or other areas important areas of functioning

Other Anxiety

  • anxiety that causes significant distress or impairment, but does not fit the full criteria for other categories

  • examples include

    • limited-symptom attacks

    • generalized anxiety not occurring more days than not

    • attack of nerves