Anxiety problems are among the most common of all mental health problems and result in significant suffering, disability, and economic loss. Anxiety disorders are characterized by the experience of fear and anxiety that results in high levels of distress and impairment in functioning.
The most common types of anxiety problems are:
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is characterized by chronic and extreme worry combined with persistent feelings of tension, nervousness or anxiousness. People with GAD often describe themselves being anxious and worried all of the time. They are always expecting something bad to happen and planning for the worst. They describe themselves as feeling “restless,” “keyed-up,” or “on edge.” The chronic anxiety of GAD is often associated with sleep difficulties, irritability, difficulty concentrating, muscle pain, tension headaches and stomach problems.
People with GAD often feel a sense of doom or dread. Even though they realize that their extreme anxiety is out of proportion to the reality of the situation, they find it difficult to control their worry.
Some people with GAD only worry about one thing. However, most people with GAD describe themselves as being “worried all the time about everything,” including health, relationships, work, school, finances, and the future.
By definition, GAD is a chronic problem. In order to be diagnosed with GAD a person has to have a worry problem that has interfered with their life and caused them significant distress for more than six months.
GAD can be a serious problem and the symptoms often occur along with symptoms of depression and other anxiety problems. Fortunately, GAD can be successfully treated with cognitive behavioural therapy (CBT). The first step towards effective CBT for GAD is a proper and thorough differential diagnostic assessment by a psychiatrist or psychologist.
Social Anxiety Disorder
People with social anxiety disorder have an intense fear of becoming extremely anxious and being judged, embarrassed or humiliated in social and performance situations that may include:
- Public speaking
- Giving presentations
- Talking to strangers
- Making small talk
- Being the centre of attention
- Being observed while working, eating, drinking, or learning
- Talking on the phone in the presence of others
- Walking into a room late
- Asserting themselves with people in authority
- Dating
Many healthy people are shy or introverted. However, people with social anxiety disorder are more than “just a little shy.” They experience excruciating self-consciousness and panic attacks in social and performance situations. They are “painfully shy” and can be constantly worried and stressed about being embarrassed or humiliated. The dread of social and performance situations can start days, weeks, or months in advance. As a result, people avoid situations that they would like to be a part of and feel bad about this loss of social and occupational functioning. They often suffer from low self-esteem and are often also depressed.
Some people with social anxiety have specific fears, usually about public speaking or other kinds of performance such as music or dance. Other people experience a more generalized fear across a number of social and performance situations.
Social anxiety disorder leads to significant impairment in social and occupational functioning. For example, people with social anxiety are more likely to drop out of school and some people with social anxiety are too anxious to ask anyone out on a date.
Social anxiety disorder is a serious but treatable condition. Cognitive behavioural therapy (CBT) is the treatment with the best evidence for the treatment of social anxiety disorder. Because social anxiety can be secondary to other conditions and can also occur with substance use and other anxiety problems, the first step towards effective treatment is a proper and thorough differential diagnostic assessment by a psychiatrist or psychologist.
