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Anxiety

Most high achieving people have times when they feel stressed and/or worried. However, worry that is pervasive and interferes with functioning may reflect an anxiety disorder. Symptoms of some common anxiety problems are listed below. If you think you or one of your friends may be suffering from an anxiety disorder, the Counseling Center is available to help.

Diagnostic Criteria for Anxiety Disorders (DSM-IV)

Panic Attack      Specific Phobia       Social Phobia       Obsessive-Compulsive Disorder           

Post-traumatic Stress Disorder      Generalized Anxiety Disorder         

Panic Attack

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and usually reached a peak within 10 minutes:

  • palpitations, pounding heart, or accelerated heart rate
  • sweating
  • trembling or shaking
  • sensations of shortness of breath or smothering
  • feeling of choking chest pain or discomfort
  • nausea or abdominal distress
  • feeling dizzy, unsteady, lightheaded, or faint
  • derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • fear of losing control or going crazy
  • fear of dying
  • numbness or tingling sensations
  • chills or hot flashes

Panic disorder involves numerous panic attacks and avoidant behavior and fear of future attacks.

Specific Phobia

Marked and persistent (at least 6 months) fear that is excessive or unreasonable, cued by the presence of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).

  1. Exposure to the phobic stimulus almost invariably provokes and immediate anxiety response 
  2. The person recognizes that the fear is excessive or unreasonable.
  3. The phobic situation(s) is avoided or else is endured with intense anxiety or distress. 
  4. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

Social Phobia (Social Anxiety Disorder)

  1. Marked and persistent fear (at least 6 months) of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. 
  2. Exposure to the feared social situation almost invariably provokes anxiety.
  3. The person recognizes that the fear is excessive or unreasonable. 
  4. The feared social or performance situations are avoided or else are endured with intense anxiety or distress. 
  5. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

Obsessive-Compulsive Disorder

Either obsessions or compulsions:

Obsessions:

  • Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
  • The thoughts, impulses, or images are not simply excessive worries about real-life problems.
  • The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
  • the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind.

Compulsions:

  • Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
  • The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.
  • At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. 
  • The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.

Posttraumatic Stress Disorder

  • The person has been exposed to a traumatic event in which both of the following were present:
    1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self others.
    2. The person’s response involved intense fear, helplessness, or horror. 

The traumatic event is persistently reexperienced in one (or more) of the following ways:

  • Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
  • Recurrent distressing dreams of the event.
  • Acting or feeling is the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated).
  • Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
  • Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

  • efforts to avoid thoughts, feelings, or conversations associated with the trauma
  • efforts to avoid activities, places, or people that arouse recollections of the trauma
  • inability to recall an important aspect of the trauma
  • markedly diminished interest or participation in significant activities
  • feeling of detachment or estrangement from others
  • restricted range of affect (e.g., unable to have loving feelings)
  • sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

  • difficulty falling or staying asleep
  • irritability or outbursts of anger
  • difficulty concentrating
  • exaggerated startle response 
  • Duration of the symptoms is more than 1 month.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Generalized Anxiety Disorder

Excessive anxiety and worry (apprehension expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). 

The person finds it difficult to control the worry. 

The anxiety and worry associated with three (or more) of the following six symptoms (with at least some symptoms present for more than not for the past 6 months). 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 clinically significant distress or impairment in social, occupational, or other important areas of functioning.

National Institute of Health Anxiety Disorder Information

National Institute of Mental Health brochure Anxiety Disorders