Agoraphobia

Contrary to popular belief, agoraphobia is not the fear of open spaces, but more a fear of not being able to escape a place if a panic attack occurs. These situations often present themselves in areas where large numbers of people congregate -- such as malls and sporting events -- hence the popular misconception. However, people suffering from agoraphobia also tend to avoid bridges, tunnels, elevators, highways without shoulders, and roads with infrequent exits. In response to their fears, people with agoraphobia will restrict themselves to places where they feel safe. This may include taking a particular route to work, or only visiting the homes of select relatives and friends. In the most extreme cases, agoraphobia can render a person unable to leave his or her own home.

The symptoms of agoraphobia are similar to those of panic disorder. In fact, the two anxieties often affect the same person. Like other anxieties, the symptoms vary in degree. They can be brought on not only by a given situation, but also by the thought of a known anxiety-causing situation occurring again. Some people with agoraphobia do not experience anxious symptoms as long as somebody is with them; however, this creates other fears such as that of being alone and losing control in public. Agoraphobia most often begins in people in their mid-20s.

Posttraumatic Stress Disorder

Affecting more than 5 million Americans each year, posttraumatic stress disorder (PTSD) occurs as the result of exposure to situations and events where severe physical harm either occurred or was threatened. This may include experiencing or witnessing war situations, natural disasters, rape, mugging, physical abuse, and sexual abuse. Symptoms of PTSD are often triggered by an object or event that reminds the person of the trauma. The person may then re-experience the ordeal in the form of flashbacks, nightmares, or terrorizing thoughts. These, in turn, can produce symptoms such as emotional numbness, sleep disturbances, irritability, feelings of intense guilt, and an excessive startle reaction to loud noise. In order to be diagnosed with PTSD, symptoms must last for more than one month.

PTSD can begin at any age and generally begins to show up within three months after experiencing a trauma, although this is not always the case. Like other anxieties, severity and duration of the symptoms vary with each individual, and other illnesses and disorders may occur along with PTSD. For example, almost 50% of people with PTSD also experience depression. Substance abuse, headache, stomach and immune system problems, chest pain, and dizziness are also common, co-occurring conditions.

Anxiety Disorders Treatment

For all of the aforementioned psychiatric illnesses and disorders, treatment can be very successful. For anxiety disorders such as agoraphobia, social phobia, and panic disorder, antidepressant medicines and/or cognitive behavioral therapy are most commonly used. As a person undergoes cognitive behavioral therapy, he or she is taught how to identify thinking patterns that may lead to anxiety attacks. Since many of these thinking patterns are deeply ingrained, practice is often needed to notice and change them. This form of therapy also teaches patients how to calm themselves during an attack, and to "desensitize" themselves to feelings of unease or terror. For posttraumatic stress disorder, group therapy and exposure therapy are also useful.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by intense, recurrent, unwanted thoughts and rituals that are beyond the person's control. Examples of these rituals can include hand washing, counting, checking, hoarding, repeating, cleaning, and the endless rearranging of objects in order to ensure they are in precise alignment. To the person affected, these rituals and thoughts are recognized as senseless and distressing, but extremely difficult to control. If the person does not perform these rituals, anxiety increases dramatically and the person becomes concerned that something terrible will happen because of his or her neglect.

While anxiety disorders generally affect women more often than men, OCD affects both genders equally. However, the degree to which OCD affects each person varies. For some it is mild, but for others, it can control their lives if left untreated. This disorder is typically first seen in adolescence or early childhood. OCD is sometimes accompanied not only by depression, but also eating disorders,substance abuse, attention deficit disorder (ADD), and other anxiety disorders. Other illnesses that might be linked to OCD include hypochondria, Tourette's syndrome, trichotillomania, and body dysmorphic disorder. OCD affects more than 3 million Americans in any given year.

Treating OCD

Treatment is less straightforward for patients with OCD. Some patients benefit from medicines alone, while others only respond to behavior therapy. For patients with OCD, however, traditional therapy that seeks to offer insight into a patient's problem is not effective. A different approach called exposure and response prevention has been shown to help many patients with OCD. In this form of therapy, a patient deliberately and voluntarily confronts the object or idea that prompts obsessive-compulsive behavior. This can be done directly or through the patient's imagination. Once exposed, a therapist will then offer support and structure as the patient confronts the object or thought. An example of this might involve a compulsive hand washer being encouraged to touch an object and then urged to avoid washing for several hours. This sort of encouragement is then increased in a step-by-step manner until the patient is able to control the anxiety and rituals.

Complications of Depression and Anxiety

Left untreated, depression and anxiety may cause both physical and mental complications. Suicide is not uncommon among people with depression or anxiety disorders. Attempts to "self-medicate" the disorder may lead to substance abuse and alcoholism. Social anxiety can become so intense that agoraphobia develops, making it difficult to leave the house.

Treating the anxiety disorder or depression may prevent and resolve some complications associated with the disease. Other mal-adaptive coping behaviors, such as alcoholism, often require separate treatment and may continue long after the disorder that caused them.

next: The Relationship Between Depression and Anxiety