Feeling worried? Anxiety disorders in the DSM

Psychology 101

We need fear and anxiety for survival. They act as alert signals that warn us of possible dangers and that cause adrenaline to be pumped through our bodies and keep us alive in a dangerous situation. Anxiety, more specifically, focuses on internal and unknown threats. Everyone experiences anxiety at times and to varying degrees, but when our coping mechanisms are out of sync with the stressors in our lives, we may experience an anxiety disorder and the resulting stress. Anxiety disorders are the most common psychiatric disorder, with one in four people in the US being diagnosed with such a disorder.

Psychologists often use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to differentiate between normal anxiety caused by everyday stress and anxiety disorders requiring treatment. Normal anxiety is characterized by a hazy feeling of unpleasant uneasiness. This feeling may or may not be accompanied by physical symptoms, such as restlessness, perspiration, headache and minor stomach discomfort. Think about the last time you stood up in front of a crowd to speak, or wrote a test. You probably experienced at least some of these feelings and symptoms. But then they went away after the scary event, didn’t they?

So, which anxiety disorders are included in the DSM?anxiety disorder and worry

  • Panic Disorder
  • Agoraphobia
  • Specific Phobia
  • Social Phobia
  • Obsessive Compulsive Disorder (OCD)
  • Posttraumatic Stress Disorder (PTSD)
  • Acute Stress Disorder
  • Generalized Anxiety Disorder (GAD)


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Panic Disorder

A patient with Panic Disorder reports repeated and surprise panic attacks – attacks that sneak up on them and may last for 20 to 30 minutes at a time. Panic attacks bring with them feelings of impending doom and the body reacts to this extreme anxiety with sweating, palpitations, nausea, dizziness, choking or trembling. For one month following such an attack, the person will worry about having another attack and the consequences that will follow the attack. They may even change their behaviors as a result.

AgoraphobiaToo scared to leave the house

Agoraphobia is characterized by a fear of places from which escape may prove difficult, not just tiny spaces as is commonly believed. Interestingly, Agoraphobia is often a result of Panic Disorder, because the person becomes scared of having an unexpected panic attack in a public place and not being able to get away. Agoraphobics often only go around with friends or family members who will help them if they have a panic attack, and some refuse to leave their homes.  

Specific Phobia

Specific Phclown for specific phobiaobia, as its name implies, is an excessive and unreasonable fear of a specific object or situation. This is the most common disorder amongst women, and is likely to be accompanied by a history of mood/anxiety/substance-related disorders. The person may become excessively afraid of an animal, something in the environment (e.g. heights), blood/injections/injuries, situations (e.g. riding in elevators), or pretty much anything else, such as choking, loud noises, or people dressed in costumes.

The person must have this phobia for at least 6 months for it to be considered a psychological disorder. There must be immediate anxiety in reaction to the object or situation, and a panic attack may even occur. The person knows that their fear is unrealistic, but they still try to avoid the object/situation nonetheless and at whatever cost. Many doctors treat specific phobia with exposure therapy – by exposing the patient to the source of fear in an attempt to desensitize them and decrease their anxiety. Self-hypnosis may also be taught as a relaxation tool.

Social Phobia

Social Phobia brings with it a fear of embarrassment in social situations. The patient experiences persistent fear of being exposed to unfamiliar people or the scrutiny of others. The person realizes that the fear is irrational, but their avoidance of such situations regardless may interfere with work, relationships and their social life. Most patients report the start of symptoms in late childhood or their early teens, and more females experience this anxiety than men.

Obsessive Compulsive Disorder (OCD)

OCD consists of obsessions (mental ideas, sensations or thoughts) and/or compulsions (behaviors, such as counting and checking). A person with OCD is aware that these compulsions and obsessions are irrational, but they are unable to stop.

Such obsessions and compulsions cause the person anxiety and interfere with their normal routine of work, family, etc.OCD hand washing

Typical OCD symptom patterns include a fear of dirt and germs, an obsession of self-doubt and checking (for example, “Did I switch off the stove?”), intrusive thoughts of a negative act (for example, sexual or aggressive), and an obsession with symmetry. Interestingly, hoarding may also be a symptom pattern of OCD.

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Posttraumatic Stress Disorder (PTSD)

After being exposed to a traumatic event in which a person experiences death or injury, even if these are only threatened and do not actually happen, the person may develop PTSD. Symptoms include cutting oneself off emotionally and distress when exposed to aspects of the traumatic event. The victim may avoid thoughts, feelings, activities, and feelings that may remind them of the event. They may experience difficulty sleeping, irritability, and find it hard to concentrate. PTSD can start up to 30 years after the stressful event, and its effects depend on the person – each person is affected differently by things that happen to them.

Acute Stress Disorder

Acute Stress Disorder has many of the same symptoms as PTSD after a traumatic event, and the person re-experiences the event persistently through images, thoughts, dreams, illusions or flashbacks. The difference is that Acute Stress Disorder only lasts for 2 days to 4 weeks after a trauma.

Generalized Anxiety Disorder (GAD)Agoraphobia stress anxiety disorder

GAD is characterized by excessive worry and anxiety regarding events or activities. Such anxiety is felt for most days over a 6-month time period. The person finds the worry difficult to control, and they may experience physical symptoms such as muscle tension, become easily tired, have difficulty sleeping and concentrating, and be very restless.

** Please note that this article does not attempt to provide self-diagnosis options for any anxiety disorder. It is merely a guide to the DSM classification criteria for anxiety disorders, and is to be used for interest or informational purposes only. If you think that you or someone you know has an anxiety disorder, it is important to seek the help of a registered professional. **

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