Anxiety problems

Panic disorder and/or agoraphobia

Panic disorder is characterized by recurring panic attacks and may be accompanied by Agoraphobia (anxiety about being in places or situations from which escape might be difficult or embarrassing).

Kim describes her panic attacks as a “sudden wave of anxiety”.  At first these anxiety episodes happened out of the blue, but soon enough she started to notice them happening in the shopping mall, parking garages and sometimes when she’s driving in rush hour.  . Her anxiety flares up when she feels she might become trapped , or might not be able to get help if she needs it. She can t go anywhere without her cell phone and always carries a water bottle in case she has a panic attack. Now she only travels a limited distance from her home, and as a result she recently missed her niece s wedding. 

Social anxiety

Social anxiety (also known as social phobia) is characterized by excessive shyness and/or a fear of being judged by others.

Mark was a particularly shy boy growing up.  He managed to get through university, although participating in class was difficult.  He’s now in his first job, and he tends to keep himself to himself and avoids the lunchroom.  Turning down extra work from his boss is virtually impossible for Mark, and he has recently begun to resent his job.  Outside of work his social life is limited and he feels quite lonely.  His fear of negative judgement and rejection contributes to his social isolation.  He would like to have more meaningful connections with people, although the idea initiating conversations is terrifying.

Obsessive compulsive disorder

Obsessive compulsive disorder (OCD) is characterized by obsessions (recurring thoughts) and/or compulsions (repetitive actions or “rituals”).

Janet is known for always being late for work, but only those very close to her know the real reason for this.  Janet’s morning routine consists of an elaborate set of rituals that she has to complete before she can comfortably leave her home.  Her obsessive thoughts about accidentally causing harm lead her to repetitively check her appliances, faucets, doors and windows.  Sometimes she needs to turn around on the way to work just to make sure that she hasn’t forgotten something that could lead to a negative consequence.   

Generalized anxiety

Generalized anxiety disorder is characterized by excessive and uncontrollable worry. Among other symptoms, individuals may experience restlessness, irritability and muscle tension.

Alice describes herself as a “worry wort”.  She worries incessantly about bad things that might happen.  Worrying interferes with her sleep as she finds it difficult turning off her thoughts at night.  During the day she often feels edgy and irritable.  She likes to plan ahead for any potential problems.  She’s not comfortable with uncertainty.  Her anxiety is often triggered by a simple “what if…?” question. 

Posttraumatic stress

Posttraumatic stress disorder (PTSD) may develop following a severe traumatic event. Individuals may experience a feeling of numbness and lack of reality, recurrent thoughts, flashbacks or nightmares.

Last year Mike was involved in a serious car accident.  Since then, he’s felt nervous about driving, and tends to avoid driving at night.  When he’s reminded of the accident, he experiences the same feelings of fear as if it were happening to him again.  Even without the reminders, he notices himself being on edge and jumpy.  He doesn’t feel as sociable as he did before the accident, and very much wants his life back to how it was previous to the accident.

Phobias

Specific phobia is characterized by an excessive fear of an object or a situation which, when avoided, significantly impairs one’s life in some way.

Emily has always had a fear of vomiting.  Although she has only vomited a couple of times in her life, she becomes very anxious if she feels remotely nauseous.  She has started to avoid certain foods in case they do not agree with her.  She is nervous at public events where people are eating and drinking.  Up until recently her fear has not significantly interfered with her life.  Now she would like to start a family, but she doesn’t know how she will handle morning sickness.

Health anxiety

Health anxiety (hypochondriasis) is characterized by a preoccupation with the idea or thought that they are currently ill, or may be in the future.  The worry is typically accompanied by checking the body and seeking reassurance from medical specialists.

Isabella often visits her doctor’s office for headaches and tingling in her hands.  Each time her doctor sends her for tests, but nothing is ever found.  Although these negative results make her feel better, the reassurance tended to be short-lived, as soon enough new concerns arise.  Isabella finds it difficult to relax until she is certain that she is not critically or terminally ill.   Whenever she returns home from the doctor’s office she notices something new, and the cycle begins again. .

Separation anxiety / school refusal

Separation anxiety involves excessive anxiety when a child is expecting to be separated from home or a loved one (such as a parent or a caregiver).  This can lead to difficulty developing and maintaining friendships and decreased school attendance and performance.

Tommy is a seven-year-old who often pleads for his mom to not go out in the evening.  He also demands that he go everywhere that she goes when leaving the house to run errands.  He frequently complains of stomach aches on school mornings and asks to stay home from school.  While he used to have many friends, since his problem started he has declined going over to other children’s homes to play. 

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