Anxiety Disorders 

Fear is a normal reaction to an external source of danger.  It is appropriate to the source of danger in its intensity and duration, and dissipates when action is taken to escape or avoid the source of danger.

Anxiety is a reaction to a real or imagined threat, a general feeling of uneasiness or dread.
Everybody has experienced some anxiety -- butterflies in your stomach, tension, or a pounding heart.  Anxiety that rouses you to action is the facilitating or motivating kind.  It gets you going. It helps you cope.

An anxiety disorder does just the opposite, it keeps you from coping and disrupts your daily life.  This kind of anxiety is the debilitating kind, it paralyses and immobilizes the person.  Anxiety involves tension, apprehension and terror about real or imagined danger... the source of which is unknown.  There are several types of anxiety disorders, each with its own distinct features.

An anxiety disorder may make you feel anxious most of the time, without any apparent reason. Or the anxious feelings may be so uncomfortable that to avoid them you may stop some everyday activities. Or you may have occasional bouts of anxiety so intense they terrify and immobilize you.

Situational Anxiety occurs in response to a specific stress and ends after the stress is removed.  Free-floating Anxiety involves apprehension that is not linked to any specific situation or event.

The degree of anxiety is much more a function of the individual's coping skills than the degree of stress. The risk of anxiety increases with stress, a family history of neurosis, fatigue or overwork, or the recurrence of situations that have been previously stressful or harmful.

Signs and Symptoms:

[Types of Anxiety Disorders] [Anxiety in Adolescents and Children]
[Treatment of Anxiety Disorders] [Anti-Anxiety Medications]   

Factoids

Mental Illnesses impose a multibillion dollar burden on the economy each year. Total economic costs amounted to $147.8 billion in 1990.  More than 31 percent of those costs are for anxiety disorder.
(The Economic Burden of Affective Disorders, Dorothy P. Rice, Sc.D., and Leonard Miller, Ph.D., 1993        

References and Links:
information on this page and the follow-up pages listed below has been taken with permission from:

American Psychiatric Association.  Public Information:  Let's Talk Facts            
        Pamphlet Series     
        http://www.psych.org/main.html

Diagnostic and Statistical Manual of Mental Disorders.  Vol. IV  American 
        Psychiatric Association.  1994
Drug Package Inserts
National Institute of Mental Health   
        http://www.nimh.nih.gov/about/index.cfm

National Mental Health Association.. Information Fact Sheets  
        http://www.nmha.org/
Physicians' Desk Reference, 1999.

What is social Anxiety?

Social anxiety is the fear of social situations and the interaction with other people that can automatically bring on feelings of self-consciousness, judgment, evaluation, and inferiority.

Put another way, social anxiety is the fear and anxiety of being judged and evaluated negatively by other people, leading to feelings of inadequacy, embarrassment, humiliation, and depression.

If a person usually becomes anxious in social situations, but seems fine when they are alone, then "social anxiety" may be the problem.

Social anxiety disorder (formerly termed "social phobia") is a much more common problem than past estimates have led us to believe.  Millions of people all over the world suffer from this devastating and traumatic problem every day, either from a specific social anxiety or from a more generalized social anxiety.

In the United States, epidemiological studies have recently pegged social anxiety disorder as the third largest psychological disorder in the country, after depression and alcoholism.  It is estimated that 7-8% of the population suffers from some form of social anxiety at the present time.  The lifetime prevalence rate for developing social anxiety disorder is 13-14%.

Specific and Generalized Social Anxieties

A specific social anxiety would be the fear of speaking in front of groups (only), whereas people with generalized social anxiety are anxious, nervous, and uncomfortable in almost all social situations.

It is much more common for people with social anxiety to have a generalized type of this disorder.  When anticipatory anxiety, worry, indecision, depression, embarrassment, feelings of inferiority, and self-blame are involved across most life situations, a generalized form of social anxiety is at work.

Symptoms of Social Anxiety Disorder
 
People with social anxiety disorder usually experience significant emotional distress in the following situations:
Being introduced to other people
Being teased or criticized
Being the center of attention
Being watched while doing something
Meeting people in authority ("important people")
Most social encounters, especially with strangers
Going around the room (or table) in a circle and having to say something
Interpersonal relationships, whether friendships or romantic
This list is certainly not a complete list of symptoms -- other feelings have been  associated with social anxiety as well.

The physiological manifestations that accompany social anxiety may include intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling, swallowing with difficulty, and muscle twitches, particularly about the face and neck.

Constant, intense anxiety that does not go away is the most common feature.

People with social anxiety disorder know that their anxiety is irrational and does not make "head" (i.e., cognitive) sense. Nevertheless, "knowing" something is not  the same thing as "believing" and "feeling" something. 

Thus, for people with social anxiety, thoughts and feelings of anxiety persist and show no signs of going away -- despite the fact that socially-anxious people "face their fears" every day of their lives. 

Only the appropriate therapy works to alleviate social anxiety disorder, the largest anxiety disorder, and the one that few people know anything about.

Therapy for Social Anxiety Disorder

The good news is that cognitive-behavioral therapy for social anxiety has been markedly successful. Research and clinical evidence alike indicate that cognitive-behavioral therapy, which should be comprehensive in nature, produces permanent changes in the lives of people. 

Social anxiety disorder can be overcome, although it takes both consistency and persistence.  But, barring cognitive problems (e.g., dementia, Alzheimer's Disease) everyone can make progress against social anxiety using the appropriate type of cognitive-behavioral therapy.  

At The Social Anxiety Institute, we call cognitive-behavioral therapy for social anxiety disorder "comprehensive" cognitive-behavioral therapy, to differentiate it from the general idea that cognitive concepts are simplistic and can be addressed by using only a few strategies. 

A successful therapy program for social anxiety disorder must address the dozens of cognitive methods, strategies, and concepts that will allow people's brains (i.e., their brain associations or neural pathways) to literally change.  The brain is continually learning, and irrational thoughts and beliefs c