Individual Anxiety Disorders
- Panic Disorder (with and without agoraphobia)
- Specific Phobia
- Social Phobia (Social Anxiety Disorder)
- Obsessive-Compulsive Disorder (OCD)
- Generalized Anxiety Disorder (GAD)
- Post-traumatic Stress Disorder (PTSD)
Panic Disorder with Agoraphobia
Panic Disorder with Agoraphobia involves an abrupt, “out-of-the-blue” onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms:
- a feeling of imminent danger or doom
- the need to escape
- heart palpitations
- shortness of breath or a smothering feeling
- a feeling of choking
- chest pain or discomfort
- nausea or abdominal discomfort
- dizziness or lightheadedness
- a sense of things being unreal, depersonalization
- a fear of losing control or “going crazy”
- a fear of dying
- tingling sensation
- chills or heat flush
Suffers of panic disorder often develop a preoccupation and fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even during sleep. When the fear of a recurring attack interferes with normal functioning or severely restricts day to day life, agoraphobia may occur in approximately 35% of all cases of panic disorder. Agoraphobia refers to the preoccupation with being in a safe place where or avoiding situations where easy escape is not possible. As a result, sufferers of agoraphobia may avoid public and/or unfamiliar places. In severe cases, the sufferer may become confined to their home, experiencing difficulty traveling from this “safe place” or outside of their “comfort zone.”
The treatment of choice for panic disorder is usually a combination of medications, specifically serotonin reuptake inhibitors or SSRIs, and cognitive-behavior therapy (CBT). The specific form of CBT considered most effective is called Interoceptive Exposure, which helps decrease the sufferer’s fear of panic attacks and thus dramatically reduces them. In a study by Barlow & Craske (1989), 87% of the individuals that participated in the two of four treatments that involved interoceptive exposure were free of panic at the end of treatment and these results were maintained at a 2-year follow up. Another approach gaining increasing acceptance as the “third wave of CBT” utilizes the principles of “acceptance and mindfulness” ( referred to as ACT – “Acceptance and Commitment Therapy”) to helps the sufferer approach their uncomfortable feelings with an attitude of acceptance and willingness, and to experience these distressing thoughts and feelings without getting swept up by them.
Contact the center about a consultation or appointment for treatment of Panic Disorder. Our center offers an intensive cognitive behavioral program for panic disorder. You can read more about our intensive treatment program for panic disorder HERE.
Social Phobia — also known as “social anxiety disorder” — involves a persistent, intense, and chronic fear of being judged by others and of potentially being embarrassed or humiliated by one’s own actions. These fears can be triggered by perceived or actual scrutiny by others. While the fear of social interaction may be recognized by the person as excessive or unreasonable, considerable difficulty can be encountered overcoming it. Social Phobia involves excessive anxiety in social situations causing abnormally levels of distress and an impaired ability to function in at least some areas of daily life. The diagnosis can involve two types, specific social phobia, which involves fear in only some particular situations (such as public speaking or using public bathrooms — a condition called paruresis or “shy bladder syndrome“) or a generalized disorder, involving any or all social situations where one may be scrutinized. Approximately 13.3 percent of the general population may meet criteria for social phobia at some point in their lifetime, according to the highest survey estimate, with the male to female ratio being 1:1.5. Research has shown cognitive behavior therapy, whether individually or in a groups, to be effective in treating social phobia. The cognitive and behavioral components seek to gradually change ones habitual responses to the anxiety provoking situations. Medications can also help social phobia — specifically two classes of antidepressants are known to help: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
For an appointment for a consultation regarding social phobia, please contact the Center.
Specific Phobia is an unreasonable or irrational fear related to exposure to specific objects or situations. These excessive fear responses commonly focus on insects, animals, germs, thunder, heights, certain numbers, driving, public transportation, flying, dental or medical procedures, and elevators. As a result, the affected persons will often show signs of fear or express discomfort and tend to actively avoid direct contact with the objects or situations. The anxiety and avoidance are difficult to control and may significantly impair person’s functioning and even physical health. “In vivo exposure” (facing your fears directly in gradual, controlled steps) is the treatment of choice for phobias.
Contact the center about a consultation or appointment for a Specific Phobia.
Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable and often irrational worry about everyday things in a manner that is disproportionate to the actual source of worry. This excessive worry often interferes with daily functioning, as individuals suffering GAD typically catastrophise, anticipate disaster, and are overly concerned about everyday matters such as health issues, money, family problems, friend problems or work difficulties. They often exhibit a variety of physical symptoms, including fatigue, headaches, nausea, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, insomnia, and hot flashes. These symptoms must be consistent and ongoing, persisting at least 6 months, for a formal diagnosis of GAD to be introduced. Approximately 6.8 million American adults experience GAD.
While medications (SSRIs) may play an important role in the treatment of GAD, cognitive behavioral therapy (CBT) is the treatment of choice for GAD. The goal of the therapy is to change habitual internal responses to the negative thought patterns that lead to the patient’s anxiety. Elements of the therapy include exposure strategies to help the patient to gradually confront their anxieties, and to learn to experience the anxious thoughts and feelings without getting caught up in them. “Acceptance and mindfulness” approaches, such as ACT (“Acceptance and Commitment Therapy”) helps the sufferer to approach their uncomfortable feelings with an attitude of acceptance and willingness, and to experience these distressing thoughts and feelings without getting swept up by them.
CBT can be used alone or in conjunction with medication.
Contact the center about a consultation or appointment for Generalized Anxiety Disorder.
Post Traumatic Stress Disorder
Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to one or more terrifying events that threatened or caused grave physical harm. It is a severe and ongoing emotional reaction to an extreme psychological trauma. This stressor may involve someone’s actual death, a threat to the patient’s or someone else’s life, serious physical injury, or threat to physical or psychological integrity, overwhelming usual psychological defenses coping. In some cases it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, the two are combined.
The symptoms of PTSD include: persistent re-experiencing of the traumatic event in the form of “flashbacks” and nightmares. There is persistent avoidance of people, places and situations associated with the trauma, including discussions that may trigger flashbacks and re-experiencing symptoms. There is typically a strong fear of losing control. PTSD sufferers often experience symptoms of increased arousal including difficulty falling or staying asleep, heightened irritability, anger and hypervigilance. There usually is significant impairment in social, occupational, or other important areas of functioning (e.g. problems with work and relationships.)
Cognitive-behavioral treatment (CBT) that includes components such as exposure therapy (gradually and safely facing your fears — “baby steps” under therapeutic guidance), prolonged imaginal exposure (safely reliving the trauma using imagery), stress management training, in vivo exposure (facing the situations you avoid) and cognitive-restructuring (retraining your dysfunctional thoughts) has been demonstrated as highly effective for patients with PTSD. An new approach called ACT – “Acceptance and Commitment Therapy” is gaining increasing acceptance as the “third wave of CBT” for anxiety disorders including PTSD. ACT utilizes the principles of “acceptance and mindfulness” to helps the sufferer approach their uncomfortable feelings with an attitude of acceptance and willingness, and to experience these distressing thoughts and feelings without getting swept up by them.
Contact the center about a consultation or appointment for Post Traumatic Stress Disorder.