A guide to the different types of anxiety, with explanation of the key features, symptoms and characteristics.
THE TYPES OF ANXIETY
The generally recognised types of anxiety are:
Generalised Anxiety - Generalised Anxiety Disorder
Social Anxiety - Social Anxiety Disorder (also known as Social Phobia)
Panic Attacks - Panic Disorder
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Prenatal Anxiety - Antenatal Anxiety (also known as Prepartum Anxiety)
Postnatal Anxiety (also known as Postpartum Anxiety
GENERALISED ANXIETY - GENERALISED ANXIETY DISORDER
As the name suggests, anxiety is experienced in a more general, rather than specific sense. This means that if you experience generalised anxiety, the anxiety can be about a broad range of situations, places or events, sometimes extensively so.
The apprehension, dread, fear and worry can come to affect much of a your life: work/university/college, relationships, social life, leisure life, finances, domestic matters, etc.
This means that with generalised anxiety you can feel anxious much of the time, without much relief or let up or feeling relaxed or at ease.
In many cases, you may not even be aware why you feel anxious about that thing.
In fact, I have had clients who couldn’t remember what is is like to feel relaxed and thought they were now incapable of relaxing. I was pleased to help them remember, experience and realise they could get back into a relaxed state of calm and balance.
Characteristic of generalised anxiety is:
A level of worry about things that others may consider unreasonable and excessive, i.e. out of proportion to the objects of the worry. These worries and the anxiety are in relation to many different things in a your life where you expect the worst.
SOCIAL ANXIETY - SOCIAL ANXIETY DISORDER
(ALSO KNOWN AS SOCIAL PHOBIA)
Social anxiety involves overwhelming anxiety and fear thinking about, and in, social situations.
This is much more than being a bit shy or nervous about social situations and social anxiety can be debilitating and significantly affect your social, leisure and/or professional life. It can manifest in any social situation where there is one or more other people present and is can also impact on everyday activities such as speaking on the phone or shopping.
Characteristic of social anxiety is:
In my experience of working with many clients with this issue, in addition to specifically affecting social situations, it is a sense of being in the situation but somehow disembodied from it, acute embarrassment and features such as over-analysing conversations. Particularly common physical symptoms of social anxiety are those such as flushing/blushing, feeling hot and sweaty and a churning stomach.
PANIC ATTACKS - PANIC DISORDER
Panic Disorder involves experiencing regular recurring panic attacks.
Panic attacks involve an abrupt onset of anxiety that rapidly escalates and is a very intense experience.
Panic attacks can often be unexpected and happen seemingly out of nowhere, although many clients I work with come to recognise triggers for the attacks.
An overwhelming and severe experience where you feel out of control, panic attacks can be an extremely frightening and distressing. In fact, especially when experiencing the first panic attack, many people I have met through my work believe they are going to die. It can certainly seem his way although it may be reassuring to know that having a panic attack does not mean you will die.
Panic attacks are usually relatively short lived, somewhere between 5 to 20 minutes but this can vary.
Another feature is that you may experience increased anxiety in anticipation of another panic attack and can come to fear the recurrence of panic attacks.
Characteristic of panic attacks is:
A very sudden onset of intense anxiety, feeling like you can’t quite catch your breath due to increased breathing rate, increased heart rate, feeling sick, a spaced out, disembodied experience and intense panic.
Agoraphobia is a fear of being in places that are not easy to escape from.
This can be more wide-wide-ranging than may first appear. Situations that may be difficult to get out of or make you feel trapped could involve, shopping centres, lifts, travelling on planes, ships, busses, trams, trains or as a car passenger, football or other large sports crowds, festivals, music concerts, theatres and so on.
Characteristic of agoraphobia is:
You avoid the types of places where you cannot easily get out of and feel extremely uneasy if in them, panicked, trapped, distressed and fearful. Often in my experience, people try to help manage this by taking a trusted friend or relative to accompany them.
Phobias are an intense fear reaction to a particular object, person, place or thing - a phobic stimulus.
Phobias are based on irrational fears which mean that most other people would not perceive that same thing to be something to be feared, or certainly not to the same extent. Even though you may know the phobic stimulus does not pose that level of danger to you, this does not reduce the phobia or fear and anxiety experienced.
Phobias, like other types of anxiety, involve activation of the fight or flight response and so you can experience fear along with increased breathing rates increased heart rate, feeling shaky and trembling, dizzy and a tight stomach. Phobias can involve an intense and acute experience somewhat similar, but not the same as, a panic attack.
Most clients I have worked with, prior to treatment, would do pretty much anything to avoid the phobic stimulus.
Some common phobias I have worked with clients to overcome are heights, spiders and injections, flying and motorway driving, but they can involve anything and I have certainly had clients with less common phobias too that other people consider unusual.
Characteristic of phobias is:
You do not usually experience anxiety otherwise and would lead a ‘normal’ life, except when exposed to the phobic stimulus. Depending on how often you encounter the phobic stimulus can affect how debilitating a phobia is to your life.
OBSESSIVE-COMPULSIVE DISORDER (OCD)
Obsessive-Obsessive-Compulsive disorder comprises two elements: obsessive thinking and compulsive behaviours.
Obsessive thoughts are usually intrusive, repetitive, negative thoughts or mental images that create anxiety, uneasiness and quite often in OCD, disgust.
Compulsive behaviours are behaviours, sometimes called ‘rituals’ that you repeatedly and excessively carry out in relation to the obsessive thoughts to try to reduce anxiety for a short time. Instead the obsessive behaviours come to reinforce the anxiety.
For example, someone with obsessions around cleanliness, germs and infection may excessively and repeatedly wash their hands and have other rituals around cleanliness. This can increase to the extent where the person will not go certain places for fear of germs and contamination and the cleanliness rituals may come to take so much time due to their repeated occurrence that they dominate the persons life.
Characteristic of OCD is:
The obsessive thoughts and compulsive behaviours and the relationship between them. They can really begin to dominate and control your life and become debilitating.
POST-TRAUMATIC STRESS DISORDER (PTSD)
PTSD is an anxiety condition brought about by being involved in or witnessing a terrifying, harrowing, dangerous or threatening experience or events.
It can cause numbness and insomnia as well as other common symptoms of anxiety or a chronic stress response.
Characteristic of PTSD is:
It involves mentally reliving the traumatic event in nightmares and in waking flashbacks.
ARE THERE ANY OTHER TYPES OF ANXIETY?
Yes. In addition to the more formal types above which come from psychiatric and psychological diagnostic classifications there are some types of anxiety that are increasingly recognised and common.
Health anxiety is an anxiety condition involving excessive worry about health, wellbeing and illness where you believe you are or will get ill.
Health anxiety involves you becoming extremely over-vigilant abut any perceived signs of illness. These signs are also exaggerated such that in the your mind they are much more serious and indicative of illness than they are to those who don’t experience health anxiety. This can include when you seeks reassurance from your doctor who tells them you is nothing wrong but you are only reassured for a short time, until the occurrence of yet another symptom, or don’t believe the doctor.
Commonly, health anxiety in the many clients I have worked with, focuses on conditions such as heart attack and illness such as cancer , but it can be in relation to any ill-health condition or illness.
In my experience of working with clients to help them overcome health anxiety, it is almost like a convergence of aspects of generalised anxiety with excessive worrying and a generally high level of anxiety and obsessive-compulsive disorder with the constant thoughts about illness, hyper-vigilance for symptoms and misinterpretation of these (as indicating serious illness) and then acting on these thoughts (reassurance seeking, checking symptoms on google or other search engines, going to the doctor).
Characteristic of health anxiety is:
Being anxious about being or becoming ill, hyper-vigilance to any perceived symptoms of ill-health, misinterpretation of such symptoms and reassurance seeking.
PRENATAL (ANTENATAL) ANXIETY
Prenatal or antenatal anxiety is called prepartum anxiety in the United States of America.
Prenatal anxiety is anxiety whilst pregnant and involves many of the common symptoms of anxiety, both physically (those of the fight or flight response such as increased breathing rate, increased heart rate, feeling hot and sweaty, feeling nauseous and light headed, churning or tight feelings in the stomach), emotionally (dread, apprehension, fear, lethargic) and psychological (irrationality, reduced concentration/focus, excessive worrying, intrusive negative thoughts).
Prenatal anxiety can commonly cause you to experience insomnia.
Prenatal anxiety leads to and involves thoughts and feelings of distress and of not being able to cope with the birth of your baby and afterwards.
I often mention to pregnant mothers that with all the changes they are going though in their bodies (such as hormonal changes), in practical circumstances (appointments, preparations for the baby) and emotionally and psychologically (the impact of impending parenthood and thoughts, joy and concerns around this) it is all too easy for anxiety to begin to increase and then become problematic. This is a much more common condition than is often appreciated.
Characteristic of prenatal anxiety is:
The development of problematic anxiety during pregnancy. This can be in relation to particular things or general but can often be centred around being unable to mange, cope or deal with the birth and baby after delivery.
Postnatal anxiety is problematic anxiety experienced following the birth of your baby, most often within a year of the birth. It is called postpartum anxiety in the United States of America.
Similarly to prenatal anxiety it involves physical symptoms of anxiety such as a churning stomach, feeling tense and agitated, unable to relax, unable to sleep, a sense of dread and with intrusive negative thinking and excessive worry.
Also like prenatal anxiety I often explain to mothers I work with who are experiencing postnatal anxiety that the combination of hormonal changes, changes of circumstances and routines, the constant demands of looking after a newb0rn, the associated stresses and other factors can easily combine so that anxiety increases and becomes problematic.
Characteristic of postnatal anxiety is:
The development of problematic anxiety within the first year following giving birth to your baby. It can continue from development of prenatal anxiety but this is not necessarily so.
Performance anxiety is anxiety related to a particular type of performance. The most common areas being:
Sports (sometimes called The Yips)
Music, especially live performance
Stage performance (Stage Fright)
Tests, exams, assessment and interviews
In my experience of working with many different clients with many different types of performance, including all of the above, the anxiety can develop from specific learning or experiences, but can also seem to come out of nowhere with no precipitating factors easily identifiable or present.
The anxiety experienced can occur in the lead up to performance and during, when it is a debilitating factor, reducing performance often with very profound effects. It can also come to affect other areas of life, but this varies between people as for many it never does.
Characteristic of performance anxiety is:
Symptoms of anxiety affecting a particular type of performance where this reduces ability, participation or enjoyment.