Everyone is anxious from time to time, but anxiety disorders escalate this worry to levels that can make it difficult to function. If it seems like your anxiety has hijacked your life, you’re not alone — anxiety disorders are the most common mental health issue in the United States, affecting nearly one-third of the adult population at some point in their lives.
If you’re struggling with anxiety, the more you know about the issue, the better armed you are to fight back. With that goal, Dr. Matthew Goldenberg wants to take this opportunity to focus on anxiety — the different types, the symptoms, and how we can help you find relief from your constant worry and fear.
The most common anxiety disorders and their symptoms
Anxiety, stress, worry, fear, panic, and obsessions are all terms that get tossed around a lot. What is anxiety? Is anxiety mental? Is anxiety physical? Is it both?
Sometimes patients know and understand their anxiety and what to call it. Other times, a patient comes to our office and just knows something is wrong. So if you’re suffering from anxiety or you think you might have symptoms of anxiety but you’re not sure what to call it, we should begin with some basic terms and understanding.
Let’s first start with the five major types of anxiety disorders, which include:
1. Generalized anxiety disorder (GAD)
With GAD, you’re stuck in a near-constant state of worry and tension, even though there may be no identifiable problem or event causing your anxiety.
While GAD may present itself differently from one person to the next, there are some common symptoms, such as:
- Constant worry and a sense of doom
- Feeling restless
- Difficulty sleeping
- Trouble concentrating
- Heart palpitations
- Tiring easily
Of the nearly seven million adults who have GAD in the US, women outpace men two to one. GAD is probably the most common form of anxiety that patients present with. There is a strong genetic predisposition, which means it often runs in families.
2. Obsessive-compulsive disorder (OCD)
There are two parts to OCD, which affects about 1% of the population in the US.
You can present with one, or the other, or both:
- Obsessive thoughts — Theses are racing and irrational thoughts that dominate your thinking and are out of proportion to what most people normally experience. You might even recognize how out of proportion your thoughts are, but that doesn’t help to relieve your anxiety.
- Compulsive behaviors — This is when you act out on these thoughts, often to try to relieve stress or pressure that the thoughts create.
To illustrate these symptoms, let’s look at fear of contamination.
The O part of OCD: You have an overriding fear of germs and becoming sick. You likely recognize that most people aren’t this worried, and your fear is more extreme than most. However, that doesn’t bring the slightest relief to your fear of getting sick.
The C part of OCD: These thoughts may compel you to constantly wash your hands, to avoid touching things, or to steer clear of situations in which you fear contamination.
To be diagnosed with OCD you can have the O (obsessions) OR you can have the C (compulsions) OR you can have both. A common misperception is that you must have both to be diagnosed with OCD.
3. Social anxiety disorder
This anxiety disorder is a social phobia in which you’re excessively afraid of social situations where you may fear humiliating yourself, being judged negatively, or acting inappropriately. This fear prevents you from interacting with people comfortably. You may have physical symptoms like a racing heart, sweating, flushing of your face OR you may have mental thoughts like fear, worry, and ruminating thoughts, OR you may have both.
Approximately 15 million people have social anxiety in the US, and the issue affects both men and women equally.
4. Post-traumatic stress disorder (PTSD)
If you witness or experience a trauma and the effects of the experience linger as your brain is unable to properly process the event, you could have PTSD.
With PTSD, which affects 3.5% of the population in the US, you may have recurring thoughts, nightmares, or flashbacks about the event that compel you to avoid certain situations, people, or places. You may feel always on guard or easily startled. Combat-related PTSD is very common and sadly underdiagnosed.
You can also have PTSD from car accidents, childhood trauma, domestic abuse, and other situations where you feared you could be killed. Or you may have witnessed a situation where you feared someone might die, or you saw someone lose their life.
PTSD can lead to other symptoms, such as irritability, loss of interest, sleep issues, and depression.
5. Panic disorder
When you have a panic disorder, you experience frequent, unprovoked panic attacks that lead to:
- Racing or pounding heart
- Difficulty breathing
The overwhelming fear strikes out of nowhere and can effectively paralyze you during an attack. Panic attacks often last minutes and up to an hour, and can be completely debilitating. You can start to fear and worry about future panic attacks which drives your overall anxiety up and can lead to isolating out of fear of having another attack in a public or confined space.
Six million people in the US struggle with panic attacks, and women are twice as likely as men to develop a panic disorder.
Treating anxiety disorders
When anxiety is daily, when it’s keeping you from enjoying or doing the things you love, and when all you think about is your worried thoughts and not the world and people around you, it’s a good sign you need to get help.
Moderate to severe anxiety disorders can prevent you from functioning on even the most basic level. You know you can find a way to break free, but you may not know where to start.
Dr. Goldenberg has extensive experience helping his patients overcome anxiety disorders and, while there’s no one-size-fits-all solution, he addresses your symptoms and goals from a biological, psychological, and social perspective.
To start, Dr. Goldenberg meets with you for an initial psychiatric evaluation. During this hour-long appointment, he collects an extensive history to understand the specific type of anxiety you have and how it’s negatively impacting your life and functioning. One primary goal is to establish a diagnosis of anxiety and also to rule out other potential co-occurring conditions like depression, ADHD, insomnia, and addiction to make sure nothing is missed.
At the end of that initial appointment, a diagnosis is made and potential treatment options are discussed. These include both non-medication options and medication options. No patient is obligated to start medication just by meeting with Dr. Goldenberg. At the least, you leave your first appointment with a better understanding of two things: your diagnosis/diagnoses and your treatment options.
Dr. Goldenberg may recommend medication to get your anxiety under control. With this support and safety net in place, Dr. Goldenberg can help you find long-term coping mechanisms, stress reduction, and other tools that can help you manage your anxiety. Medication may also help if you’re already engaged in therapy.
At times patients hit a wall. The stress of digging into thoughts and memories that might be suppressed or repressed can keep you from making progress.
If you have a current therapist and feel like you’re not able to work through the issues needed to break free from your anxiety, consider speaking to Dr. Goldenberg about whether medication can help you better achieve your treatment goals in therapy.
Therapy isn’t one size fits all. Dr. Goldenberg has the experience and training needed to recommend specific modalities of psychotherapy, such as cognitive behavioral therapy (CBT), exposure response prevention (ERP), mindfulness, eye movement desensitization and reprocessing (EMDR), brainspotting, neuro and/or biofeedback, stress reduction, and/or lifestyle changes, to help reach your goal of overcoming your symptoms of anxiety. Dr. Goldenberg provides you with the tools and road map you need to take back control of your life.
In many cases where medications are employed, once your nervous system resets itself and you’ve engaged in therapy and other lifestyle/environmental changes, Dr. Goldenberg helps you gradually reduce your medication — typically after 4-6+ months — until you’re medication-free and able to effectively manage your anxiety on your own.
Having a plan to help you get off medication safely is just as important as helping you get medication started. Dr. Goldenberg works with patients who want to wean themselves from long-term anxiety medications.
You may realize you’ve been on the same medication for years and are ready for a change. Or maybe you just want to find out if being medication-free is possible, or how to make that happen. Dr. Goldenberg works with you to safely and gradually taper medications, so you can come off of them with your confidence and stability intact.
If you’d like to learn more about anxiety disorders and how Dr. Goldenberg can help you reclaim your life, please contact our office in Santa Monica, California, to set up a consultation. Call or request an appointment online today. Dr. Goldenberg not only serves patients all across the State of California, he’s also licensed in Alaska.