Anxiety Disorders: Diagnoses and Treatment

Anxiety Disorders

Anxiety disorders are disorders which are more common than any other mental disorders found in humans (Kessler et al., 1994). Anxiety disorders occur when individuals are fearful of certain things or situations and do not know the reason for this fear. The primary types of anxiety disorders are specific phobias (phobia of heights, phobia of lifts, hydrophobia etc.), panic disorders, obsessive compulsive disorders and other types of generalized anxiety disorders.

Diagnosis

Anxiety disorders are diagnosed on the basis of the behaviors of individuals when they face the situations in which they illustrate fear and anxiety. For instance, when an individual has an “intense, paralyzing fear of something” and the “fear is excessive or unreasonable” to the extent that “it interferes with life functioning”, then the person is said to have an anxiety disorder (Psychological Disorders, p. 498). An example of this is a person having the fear of flying on an airplane to the extent that he/she refuses to go next to it, is an anxiety disorder (Psychological Disorders, p. 499).

“Social phobia” is a condition when people have “inappropriate fears connected with social situations or performances in front of other people” (Psychological Disorders, p. 499). Similarly, “Agoraphobia” is a terrible type of anxiety disorder which refers to the “fear of the marketplace” (Psychological Disorders, p. 499). A “panic disorder” refers to a “panic attack” which is the “sudden, unpredictable, and overwhelming experience of intense fear or terror” without any legitimate cause or reason and is diagnosed by the symptoms of “impending doom, chest pain, dizziness or fainting, sweating, difficulty breathing, and a fear of losing control or dying” in the person (Psychological Disorders, p. 499).

“Generalized anxiety disorders” are “intense fears that are not attached to any particular object or circumstance” and is diagnosed by the “inability to relax, constantly feeling restless or keyed up, muscle tension, rapid heart beat or pounding heart, apprehensiveness about the future and sleeping difficulties” (Psychological Disorders, p. 499). Research affirms that generalized anxiety disorders may have a genetic basis (Mineka et al., 1998).

Another kind of anxiety disorder is the “obsessive-compulsive disorder or OCD” which is diagnosed through “repetitive ritualistic behaviors that a person feels compelled to perform” due to the terrible and frightening thoughts which occur in them. OCD can be diagnosed through the fervent actions of continually washing their hands or continually checking something again and again for several times. Examples include a man checking the time in his watch several times or a woman washing her hands and vessels continuously, not satisfied that they are thoroughly clean.

Stressful events in life also lead to several disorders and these include the ‘acute stress disorder’ which occurs immediately after a terrible experience has been witnessed and the ‘post-traumatic stress disorder’ which occurs a long time after a terrible experience has occurred (Oltmanns & Emery, 2001).

Treatment

Anxiety disorders and phobias are commonly treated with the help of several ‘behavior therapies’ which focus on “changing people’s behavior” (Psychological Disorders, p. 533). Behavior therapies are based on the premise that the behavior of all individuals “both normal and abnormal, is learned” (Psychological Disorders, p. 533). Behavior therapies are based on two important principles, ‘classical conditioning and operant conditioning’.

The classical conditioning approach uses two types of techniques to treat the anxiety disorders of individuals; “desensitization including extinction and flooding; and aversive conditioning” (Psychological Disorders, p. 534). Research indicates that the use of systematic desensitization offers great potential to help people overcome their fears and phobias because if the person is exposed to a frightening situation and does not experience the fear associated with it and the anxiety gradually declines (Wolpe, 1990). The therapist associates a new response of relaxation to the experience or stimulus which causes fear or phobia in the client and teaches the client to develop relaxation techniques when exposed to the stimulus. By practicing this several times, the client learns the new behavior of relaxing when the fearful situation is encountered and thus the phobia is reduced and gradually disappears.

Operant conditioning is also commonly used to correct certain unacceptable behaviors in which the therapists set behavioral goals and reinforce new behaviors, following which clients are rewarded or punished. When tokens or points are given to the clients for successfully implementing new acceptable behaviors, the techniques is called “token economy” and is commonly practiced in school and hospital settings (Psychological Disorders, p. 535). The operant conditioning behavior therapy in which the undesired behavior is treated by watching someone else perform the preferred behaviors is termed as ‘modeling’.

References

1. Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., Wittchen, H. U., & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.
2. Mineka, S., Watson, D. W. & Clark, L. A. (1998). Psychopathology: comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377 –412.
3. Oltmans, T.F. and Emery, R.E. (2001). Abnormal Psychology (3rd Ed). Prentice-Hall, Inc
4. Wolpe, J. (1990). The practice of behavior therapy. New York : Pergamon Press.