Anxiety and Phobic Disorders
My curiosity about ochlophobia and agoraphobia launched a week of reading research that carried me into information about anxiety disorders. Here we will study anxiety disorders with a focus on phobias.
Anxiety Disorders
About.com defines an anxiety disorder as “a condition characterized by extreme, chronic anxiety that disturbs mood, thought, behavior and/or physiological activity. The anxiety generally grows progressively worse without treatment.” WebMD breaks down the multi-faceted term “anxiety disorder” into several different types of anxiety disorders. Five of the major types are:
- generalized anxiety disorder - excessive and chronic pathological anxiety not stemming from any specific trigger
- panic disorder - sudden and recurring episodes of fear that manifest physical symptoms such as dizziness, shortness of breath, chest pain, heart palpitations or abdominal distress
- post-traumatic stress disorder - a traumatic event precipitates recurring symptoms such as situational avoidance, flashbacks, numbness, and hyperarousal
- obsessive compulsive disorder - recurring, distressing, unwanted thoughts often leading to one’s performance of compulsive tasks or rituals, the purpose of which is to relieve the perceived threat derived from the unwanted thoughts
- phobic disorder - persistent, unreasonable, intense fears of situations, circumstances, or objects; the fears provoke anxiety and avoidance
WebMD discusses specific phobias and social phobia as additional types of anxiety disorders. According to the Merck Online Medical Library these fall under phobic disorder. Compiling the information from various resources, a visual tree of anxiety disorders, including the branches of phobic disorders, might look like this chart below:
Merck explains that there are two classifications of phobic disorders: general and specific. A fact sheet on phobias at The British Psychological Society (BPS) calls the former classification “complex.” To muddy the waters more, some resources do not classify agoraphobia and social phobia as complex phobias, referring to these and specific phobias as three different types of phobic disorders. This would eliminate the third row in the above diagram. For the purpose of this article, we will examine the two types of phobic disorders.
Complex / General Phobic Disorders
Most often referred to as complex phobias, these disorders involve multiple anxieties. Many factors trigger feelings of fear or anxiety in this type of phobic disorder. It is interesting to note that these phobias also are overwhelmingly situational in nature. The two most common complex phobias are social phobia and agoraphobia.
Social Phobia / Social Anxiety Association (SP/SAA) has several situational examples of people suffering from social phobia. The gist of this disorder is that the phobic person feels others are watching, staring, and judging them, whether it is a situation with one person, such as a meeting with an authority figure, or several people, such as a staff meeting with colleagues or perhaps others milling about a mall where the phobic person is shopping. Left untreated, a social phobic progressively avoids the various situations in which he repeatedly feels severe anxiety brought on by his perception of others critically observing of him.
Agoraphobia as defined by the National Institute of Mental Health (NIMH) “involves intense fear and anxiety of any place or situation where escape might be difficult, leading to avoidance of situations such as being alone outside of the home; traveling in a car, bus, or airplane; or being in a crowded area.” Here we see examples of several triggering events, but the list is not comprehensive nor is the type of event what determines whether a person has this phobic disorder. The defining piece is that anxiety is brought on by having little or no control over escape or flight from certain situations. These situations might include some, all, or none of the examples listed in our definition. When agoraphobia is severe, progressive avoidance of triggering situations can lead the phobic person to becoming home-bound.
Simple / Specific Phobias
Referring back to our fact sheet at BPS, specific phobias are “an anxiety about a single object, situation or activity.” We all have things that provoke fear, but our level of anxiety surrounding these things generally is mild. To qualify as a specific phobia, the anxiety level is excessive and irrational, and the feared thing usually poses little or no danger. The resulting avoidance can inhibit leading a normal life.
In our diagram above there are five types of specific phobias. Some examples of the different types are as follows:
- animal - fear of dogs, cats, snakes, spiders, etc.
- natural environment - fear of heights, water, storms, etc.
- situational - fear of enclosed spaces, riding in a car, going through tunnels, flying, etc.
- blood / injection / injury - fear of blood, medical procedures such as blood tests or injections, or fear of injury
- other - phobias that do not fit into any of the above categories, such as fear of loud noises, fear of tripping down stairs, etc.
From this list we see there are many phobias which do not pose any real threat of danger, but may cause undue stress. If the anxiety level a person experiences is strong enough to effect regular avoidance of the object, situation or activity, then the individual may have a phobic disorder. It is important to note that a person can have more than one specific phobia, but this does not necessarily mean he has a complex phobic disorder.
Summary
We see five major types of anxiety disorders, of which phobic disorders are one type. Phobic disorders are broken down into complex and specific phobic disorders, complex phobias exhibiting multiple anxieties and specific phobias having only one anxiety causing factor. The presence of any phobia, whether complex or specific, may require treatment if avoidance of triggers inhibits normal life activities.
Choices for treatment are discussed in the article, “Phobia Treatment Options.”
