GAD presents with excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). The person has difficulty controlling the worry, and it’s associated with three (or more) of the following six symptoms:
To diagnose GAD, the symptoms should cause significant impairment in functioning (at work, socially, etc.) and should not be attributed to the use of any drugs or to underlying medical conditions like hyperthyroidism. Patients may also report somatic symptoms such as headache, chest tightness, GI symptoms, sweating, and palpitations.
Panic disorder is characterized by recurrent panic attacks, along with excessive worry about having another panic attack and maladaptive behavior changes to avoid another panic attack. It isn’t caused by an underlying medical condition or drug use.
A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes. It may be accompanied by symptoms such as palpitations, sweating, shakiness, shortness of breath, chest pain, dizziness, nausea, tingling numbness, derealization, depersonalization, fear of losing control, or fear of dying. It may be associated with GAD, depression, and substance abuse risk.
Specific phobia involves marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, snakes, receiving an injection, seeing blood, etc.) that lasts for 6 months or more. The fear is irrational and out of proportion to the actual danger posed by the object or situation. The object or situation is actively avoided, and the fear causes significant functional impairment at work, in social interactions, etc.
Social anxiety disorder is the phobia related to social situations like public speaking. Agoraphobia involves fear of open or closed spaces like crowds and public transport, with patients refusing to leave their homes in extreme cases.
OCD is a chronic disorder characterized by uncontrollable, recurring thoughts (obsessions) and/or behaviors (compulsions) that interfere with major areas of life, such as work, school, and personal relationships.
Obsessions are repeated thoughts, urges, or mental images that cause anxiety, as follows:
Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:
A person with OCD can’t control these thoughts or behaviors, even when the thoughts or behaviors are recognized as excessive (ego dystonic). They spend at least an hour a day on obsessions and compulsions, may feel brief relief from anxiety by following compulsions or rituals, and may have disruptions in social relationships or work due to OCD. It may be associated with tic disorder like Tourette syndrome.
In DSM V, trichotillomania is grouped with OCD. It is characterized by repetitive pulling out of one’s own hair.
Separation anxiety disorder is characterized by unusually strong fear or anxiety about separating from people the person feels a strong attachment to (like parents, grandparents, etc.). The distress is unusual, prolonged, and severe for the person’s developmental level. Children with this disorder may refuse to go to school and may report physical complaints such as abdominal pain or earache.
It is diagnosed when symptoms last for more than 4 weeks in children and more than 6 months in adults. Note that distress upon separation from a parent is normal for a child from the age of 8 months-15 months.
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