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Weekly Thoughts on Anxiety

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Types of Anxiety

By: Brian O'Sullivan, M.S., LMFT

The brain is wired to overreact, and as a result, we all experience anxiety to various degrees; however, clinical anxiety is different from the anxiety most people experience.

Clinical anxiety is defined in the Diagnostic Statistical Manual, created and maintained by the American Psychiatric Association. It's used to guide mental health professionals' assessment and conceptualization of anxiety experienced by a client.

These are the most common types of anxiety defined in the DSM:

Disclaimer: The resources provided here are not a substitute for therapy. The information presented is for educational purposes only and should not be construed as therapy, psychological advice, or be used for diagnosis. Nothing on this website establishes a therapist-patient relationship. For personalized guidance, please consult your physician or mental health provider.

Generalized Anxiety Disorder (GAD)

GAD is when someone constantly worries about different things without a clear reason. It's often described as a constant feeling of unease or being on edge. People who struggle with GAD might find it hard to control their worries, which can interfere with daily life.

Panic Disorder

Imagine sudden and intense fear, even when there's no real danger. That's what happens during a panic attack. People struggling with panic disorder might experience these attacks unexpectedly, making them feel scared that they might "go crazy" or have a medical emergency. Panic also involves fear and preoccupation with having another attack in the future. 

Social Anxiety Disorder (SAD)

SAD is when someone experiences a persistent fear of judgment and negative criticism from others. Often, people who struggle with social anxiety avoid social situations altogether or hold back in some ways when interacting with others can't be avoided. 

Specific Phobias

Some people have intense fears of specific things or situations, like heights, spiders, or flying. These fears can be so strong that they avoid them at all costs, negatively affecting their daily lives.

Agoraphobia

This is when someone feels anxious about being in places or situations where they might feel trapped, helpless, or embarrassed. It might make them avoid places like crowded areas or public transportation.

Separation Anxiety Disorder

Often seen in kids, this is when someone feels extremely anxious about being away from someone they're attached to, like a parent or caregiver. It can cause a lot of distress when they're apart.

Unspecified Anxiety Disorder

Similar to a mixtape with various songs, this is when someone feels anxious but their symptoms doen't fit neatly into a specific anxiety category. They might have a mix of different anxiety symptoms.

Other related diagnoses:

Obsessive-Compulsive Disorder (OCD) - OCD was once classified as an anxiety disorder in the DSM; however, recently, it was given its own category. OCD and anxiety have many similar qualities, and the treatment for both are very similar.

Somatic Symptom Disorder (Health Anxiety) - Although Somatic Symptoms Disorder is classified under Somatic Symptom and Related Disorders, just like OCD, the characteristics and treatments are very similar to that of anxiety disorders. People who struggle with this type of anxiety often worry a lot about their health, even when there's no serious reason to be concerned. They might frequently visit doctors or check for symptoms online.

The Benefits and Limitations of The DSM

Some therapists live by the DSM, using only these categories as a lens to conceptualize their clients and the issues they bring to therapy. Other therapists dismiss the DSM entirely, arguing that it puts stigmatizing labels on people and oversimplifies the human experience.

A middle perspective is the DSM is simply one tool in a therapist's and client's toolbox. It offers terms and labels for a collection of symptoms, which makes it easy to talk about and create a plan for recovery. Also, many people find relief when they are finally given a name for what they've been struggling with their entire lives.

Is the DSM right or wrong? Is it helpful or harmful? It depends on who you ask.  

Do I Have an Anxiety Disorder?

Throughout their work with a client, therapists are continually assessing their client's "level of functioning." That is, how much does the anxiety get in the way of someone's life (e.g., schooling, work, family, relationships, leisurely activities)? This is the main determining factor for someone receiving a diagnosis or not. 

The more anxiety impairs a person's ability to function day-to-day, the more likely they are to meet the criteria for an anxiety disorder.

Most people who open the DSM can relate to every anxiety disorder (and most other disorders) on some level. However, most people don't meet the criteria for a diagnosis due to their level of functioning.

In short, diagnosis is very subjective. There is no blood test, and it is based on a clinician's professional evaluation and interpretation of a client's symptoms and the DSM. If the same client visits five different clinicians, they may receive five different opinions that can be surprisingly different from one another.

Instead of asking the question, "Do I have an anxiety disorder?" I encourage people to instead ask themselves:

"How much is anxiety getting in the way of my life?"

"How would my life be different if anxiety was interfering less?"

"What would my life look like if I didn't try to change my anxiety?"

These questions are likely to be more productive because, one, they keep us focused on the most important aspects of anxiety work, and two, if someone seeks out help and receives the opinion they don't have an anxiety disorder, they are less likely to continue with the help and lose out on an opportunity to improve their life even more.

Knowing whether or not you meet the criteria for an anxiety disorder can be helpful for insurance, reimbursement, and getting clarification on the main issue. However, I encourage people to be cautious and not let it overshadow the primary purpose for engaging in therapy: Improving their lives. 

Self-Help

Types of Anxiety

By: Brian O'Sullivan, M.S., LMFT

The brain is wired to overreact, and as a result, we all experience anxiety to various degrees; however, clinical anxiety is different from the anxiety most people experience.

Clinical anxiety is defined in the Diagnostic Statistical Manual, created and maintained by the American Psychiatric Association. It's used to guide mental health professionals' assessment and conceptualization of anxiety experienced by a client.

These are the most common types of anxiety defined in the DSM:

Disclaimer: The resources provided here are not a substitute for therapy. The information presented is for educational purposes only and should not be construed as therapy, psychological advice, or be used for diagnosis. Nothing on this website establishes a therapist-patient relationship. For personalized guidance, please consult your physician or mental health provider.

Generalized Anxiety Disorder (GAD)

GAD is when someone constantly worries about different things without a clear reason. It's often described as a constant feeling of unease or being on edge. People who struggle with GAD might find it hard to control their worries, which can interfere with daily life.

Panic Disorder

Imagine sudden and intense fear, even when there's no real danger. That's what happens during a panic attack. People struggling with panic disorder might experience these attacks unexpectedly, making them feel scared that they might "go crazy" or have a medical emergency. Panic also involves fear and preoccupation with having another attack in the future. 

Social Anxiety Disorder (SAD)

SAD is when someone experiences a persistent fear of judgment and negative criticism from others. Often, people who struggle with social anxiety avoid social situations altogether or hold back in some ways when interacting with others can't be avoided. 

Specific Phobias

Some people have intense fears of specific things or situations, like heights, spiders, or flying. These fears can be so strong that they avoid them at all costs, negatively affecting their daily lives.

Agoraphobia

This is when someone feels anxious about being in places or situations where they might feel trapped, helpless, or embarrassed. It might make them avoid places like crowded areas or public transportation.

Separation Anxiety Disorder

Often seen in kids, this is when someone feels extremely anxious about being away from someone they're attached to, like a parent or caregiver. It can cause a lot of distress when they're apart.

Unspecified Anxiety Disorder

Similar to a mixtape with various songs, this is when someone feels anxious but their symptoms doen't fit neatly into a specific anxiety category. They might have a mix of different anxiety symptoms.

Other related diagnoses:

Obsessive-Compulsive Disorder (OCD) - OCD was once classified as an anxiety disorder in the DSM; however, recently, it was given its own category. OCD and anxiety have many similar qualities, and the treatment for both are very similar.

Somatic Symptom Disorder (Health Anxiety) - Although Somatic Symptoms Disorder is classified under Somatic Symptom and Related Disorders, just like OCD, the characteristics and treatments are very similar to that of anxiety disorders. People who struggle with this type of anxiety often worry a lot about their health, even when there's no serious reason to be concerned. They might frequently visit doctors or check for symptoms online.

The Benefits and Limitations of The DSM

Some therapists live by the DSM, using only these categories as a lens to conceptualize their clients and the issues they bring to therapy. Other therapists dismiss the DSM entirely, arguing that it puts stigmatizing labels on people and oversimplifies the human experience.

A middle perspective is the DSM is simply one tool in a therapist's and client's toolbox. It offers terms and labels for a collection of symptoms, which makes it easy to talk about and create a plan for recovery. Also, many people find relief when they are finally given a name for what they've been struggling with their entire lives.

Is the DSM right or wrong? Is it helpful or harmful? It depends on who you ask.  

Do I Have an Anxiety Disorder?

Throughout their work with a client, therapists are continually assessing their client's "level of functioning." That is, how much does the anxiety get in the way of someone's life (e.g., schooling, work, family, relationships, leisurely activities)? This is the main determining factor for someone receiving a diagnosis or not. 

The more anxiety impairs a person's ability to function day-to-day, the more likely they are to meet the criteria for an anxiety disorder.

Most people who open the DSM can relate to every anxiety disorder (and most other disorders) on some level. However, most people don't meet the criteria for a diagnosis due to their level of functioning.

In short, diagnosis is very subjective. There is no blood test, and it is based on a clinician's professional evaluation and interpretation of a client's symptoms and the DSM. If the same client visits five different clinicians, they may receive five different opinions that can be surprisingly different from one another.

Instead of asking the question, "Do I have an anxiety disorder?" I encourage people to instead ask themselves:

"How much is anxiety getting in the way of my life?"

"How would my life be different if anxiety was interfering less?"

"What would my life look like if I didn't try to change my anxiety?"

These questions are likely to be more productive because, one, they keep us focused on the most important aspects of anxiety work, and two, if someone seeks out help and receives the opinion they don't have an anxiety disorder, they are less likely to continue with the help and lose out on an opportunity to improve their life even more.

Knowing whether or not you meet the criteria for an anxiety disorder can be helpful for insurance, reimbursement, and getting clarification on the main issue. However, I encourage people to be cautious and not let it overshadow the primary purpose for engaging in therapy: Improving their lives.