Anxiety Disorders are the most common form of psychiatric disorders and affect about 40 million American adults age 18 years and older in a given year. Anxiety Disorder are much more than anxious feelings or stress.
Generalized Anxiety Disorder
It’s normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of Generalized Anxiety Disorder.
There may be times when your worries don’t completely consume you, but you still feel anxious even when there’s no apparent reason. While uncomfortable these feelings are normal. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen. Worries can shift from one concern to another and may change with time and age.
If your anxiety, worry or associated physical symptoms cause you significant distress in social, work or other areas of your life you may need psychiatric evaluation and treatment.
Generalized anxiety disorder symptoms can vary. They may include:
- Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events;
- Your anxiety and worry persist for several months;
- Over thinking plans and solutions to all possible worst-case outcomes;
- Perceiving situations and events as threatening, even when they aren’t;
- Difficulty handling uncertainty;
- Indecisiveness and fear of making the wrong decision;
- Inability to set aside or let go of a worry;
- Inability to relax, feeling restless, and feeling keyed up or on edge;
- Difficulty concentrating, or the feeling that your mind “goes blank”;
- Physical signs such as fatigue, insomnia, or muscle tension.
Occasional anxiety attacks have many of the symptoms of Generalized Anxiety Disorder, are very distressing and usually the result of an identifiable trigger or stress, such as starting a new job or being in an uncomfortable situation. By themselves they are not enough to make a diagnosis of an anxiety disorder.
Anxiety disorders commonly occur along with other psychiatric or physical illnesses, including alcohol or substance misuse, which may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.
Effective therapies for anxiety disorders are available, and research is uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment right away.
Panic disorder is a real illness and is characterized by Panic Attacks that are different from anxiety attacks. Panic attacks are not a response to a stress or uncomfortable situation. They come on without warning, peak quickly and stop after a short time. No one can predict when or where an attack will occur, and between episodes many worry intensely and dread the next attack.
People having panic attacks sometimes believe they are having heart attacks, losing their minds, or on the verge of death, and often go to the ER for help.
People with Panic Attacks have:
- sudden attacks of terror, usually accompanied by a pounding heart, sweatine;, weakness, faintness, or dizziness. that occur without an obvious cause
- physical symptoms such as flushing or chills; tingling or numbness tingle;
- nausea, chest pain, or smothering sensations;
- a sense of unreality, a fear of impending doom, or a fear of losing control;
- a fear of one’s own unexplained physical symptoms;
- can’t predict when or where an attack will occur, and between episodes many worry intensely and dread the next attack.
Obsessive-Compulsive Disorder (OCD)
A diagnosis of OCD requires the presence of obsessive, intrusive thoughts that are associated with focused-repetitive behaviors and rituals that are time-consuming (more than one hour a day), cause major anxiety, or distress, and impairs work, social or other important function.
Obsessions are recurrent and persistent thoughts, impulses, or images that cause distressing emotions such as anxiety or disgust if not acted upon. Many people with OCD recognize that the thoughts, impulses, or images are a product of their mind and are excessive or unreasonable. Yet these intrusive thoughts cannot be settled by logic or reasoning. Most people with OCD try to ignore or suppress such obsessions or offset them with some other thought or action. Typical obsessions include excessive concerns about contamination or harm, the need for symmetry or exactness, or forbidden sexual or religious thoughts.
Compulsions are repetitive rituals, behaviors or mental acts that a person feels driven to perform in response to or satisfy an obsession. The behaviors are aimed at preventing or reducing distress or a feared situation. In the most severe cases, a constant repetition of rituals, for example showering or eating may fill the day, making a normal routine impossible. Compounding the anguish these rituals cause is the knowledge that the compulsions are irrational. Although the compulsion may bring some relief to the worry, the obsession returns and the cycle repeats over and over.
Some examples of compulsions:
- The need to repeatedly check things, touch things or count things, especially in a particular sequence and common obsessions include frequent thoughts of violence and harming loved ones or have sexual themes;
- Preoccupation with order and symmetry, have difficulty throwing things out so they accumulate, or hoard unneeded items;
- Cleaning to reduce the fear that germs, dirt, or chemicals will “contaminate” them some spend many hours washing themselves or cleaning their surroundings. Some people spend many hours washing themselves or cleaning their surroundings.
- Some people utter a name or phrase or repeat a behavior several times. They know these repetitions won’t actually guard against injury but fear harm will occur if the repetitions aren’t done.
- Checking to reduce the fear of harming oneself or others by, for example, forgetting to lock the door or turn off the gas stove, some people develop checking rituals. Some people repeatedly retrace driving routes to be sure they haven’t hit anyone.
- Ordering and arranging to reduce discomfort. Some people like to put objects, such as books in a certain order, or arrange household items “just so,” or in a symmetric fashion.
Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. A person with agoraphobia experiences this fear in two or more of the following situations:
- Using public transportation
- Being in open spaces
- Being in enclosed places
- Standing in line or being in a crowd
- Being outside the home alone
The individual actively avoids the situation, requires a companion or endures with intense fear or anxiety. Untreated agoraphobia can become so serious that a person may be unable to leave the house. A person can only be diagnosed with agoraphobia if the fear is intensely upsetting, or if it significantly interferes with normal daily activities.
Social Anxiety Disorder
A person with social anxiety disorder has significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions. People with this disorder will try to avoid the situation or endure it with great anxiety. Common examples are extreme fear of public speaking, meeting new people or eating/drinking in public. The fear or anxiety causes problems with daily functioning and lasts at least six months.
A Harvard trained Psychiatrist, Dr. Kittay sees patients who need Psychiatric care for Depression, Anxiety, Bipolar Disorders, PTSD and ADHD.
Dr. Michael J. Kittay, MD, Harvard Trained Psychiatrist
- Harvard Trained Psychiatrist providing Comprehensive Psychiatric Care for Adults
- Experienced and Skilled Diagnostician and Psycho-pharmacologist
- Psychiatric management of Depression, Anxiety, Post-Traumatic Stress, ADHD, Bipolar, Eating and other Mental Health Disorders
Our Approach to Psychiatric Treatment
- The initial psychiatric evaluation is a comprehensive consultation that includes taking a thorough medical and psychiatric history. You will complete testing for psychiatric disorders including mood, anxiety, bipolar, PTSD and ADHD.
- This in-depth evaluation guides diagnosis which guides treatment. Because it may take several weeks before psychiatric medications work, a correct diagnosis and choosing the right medication is especially important. Otherwise it will be difficult to know if a medication will be effective or if it is being dosed properly. Getting it right the first time means you feel better sooner.
- We are as concerned as you are about which medications and how much medication you are taking. We are careful to prescribe the least number of medications at the lowest doses that will be effective. You are always part of the team who makes medication decisions.
- We recommend evidence based non medication strategies to compliment medications. This helps speed up the recovery process and minimizes the use of medications.
- Our goal is to make you the best version of yourself possible.