I. What, Why and How? (Part 2)

These differences are often difficult to distinguish clearly, so in addition to doing your own research, it may be helpful to talk with a professional. Below are a few examples of the different types of anxiety disorders:

Panic Attack:

A physical reaction to intense fear which can involve chest pains, shortness of breath, heart palpitations, or even fainting, symptoms which can sometimes be mistaken for a heart attack.

Panic Disorder:

An anxiety disorder which is characterised by unexpected bouts of intense fear and feelings of unreality. These bouts are often coupled with panic attacks.

Alan's Story

Alan is a stock broker and leads a highly stressful life. He is often in a rush, and is sometimes aggressive when making deals. He drinks, smokes and overeats and indulges in self-pity when things do not go well. As soon as the opening bell of the stock market rings, he is off, rushing around to deal with the day’s business. One day, he was on his mobile phone yelling at a client while driving home from work, when a feeling of terror suddenly came over him for no apparent reason. He was so scared he had to park and stopped driving. The fear continued even though he had made the stop. His heart started to pound and he began to hyperventilate. He was unable to calm down which made matters worse. He thought he was having a heart attack. Fortunately - and ironically - the same client he was screaming at on the phone realised what was happening and called an ambulance. Alan was rushed to the hospital. After the doctors examined him, they told him he was very lucky, it was not a heart attack. His lifestyle and recent behaviour all pointed to one thing - a panic attack.

The doctors told Alan that he needed to find ways to minimise his stress and to take better care of himself since the life he was leading was so full of anxiety that it probably led to his first panic attack. They warned him that if he did not change his lifestyle, he would suffer from further panic attacks. Unfortunately he did not listen, and carried on as before. Not surprisingly, it happened again during an important meeting with investors. Intense fear came over him while he was making a presentation and he started to experience the same symptoms: disorientation, a pounding heart, uncontrollable breathing, and hyperventilating. Someone, somehow, helped him to calm his breathing to regain control. After this second episode, the panic attacks kept recurring and more frequently. This time, when Alan went to see his doctor, he was diagnosed with a panic disorder.

Generalized Anxiety Disorder，GAD:

A disorder in which people generally experience excessive amounts of worry and anxiety, and cannot focus on any aspect of their lives.

Wendy's Story

Wendy was always called a “worrier” by her friends and family, so she never thought her worrying was a problem. However, it did become one as she got older. On the train to a friend’s house, she would worry that the train would collide with a car or that she would arrive late even though it was just a casual and informal visit. When she went to a restaurant with a friend, she would worry about making the wrong choice on the menu, and would spend 20 minutes deciding what to order. When she had two new job offers, she was so nervous and undecided about choosing the right one that she ended up losing the better offer, and was left with the job that gave her a lower salary. None of her worries stemmed from negative experiences in the past. She was just a “worrier”, like everyone had called her as a child. Wendy came to notice that all of her seemingly minor anxieties about work, dinner, and even the travelling home were not so minor after all. She began to see that these worries were affecting her life and increasingly preventing her from making the right decisions.

Phobia:

Anxiety disorder involving intense, unrealistic fear of simple things or situations. A phobia often stems from a terrifying experience at a very young age or fearful situation.

Mandy's Story

Mandy,when she was four,had a profound and frightening experience with an Irish terrier. After that, she was afraid of all dogs. She could spot one from a long distance away and would break away from her mother to run to the opposite side of the park. By the time she was twenty and looking for her first apartment, she would refuse to view any in buildings that were ‘pet friendly’. When she did finally find a place, the mere sound of a dog barking in her neighbour’s apartment made her move out again. Mandy even refuses to visit her best friend’s home now that her friend has a dog.

Social Phobia

An anxiety disorder in which people have a fear of being judged, embarrassed or humiliated in social situations, to the extent where it interferes with the person’s daily life.

Mark's Story

Mark is in his mid-forties and has few friends. He hardly ever attends parties or events when he has been invited. On the few occasions when he has met new people, he is nervous, anxious, and tense around them. His acquaintances do not really stay in touch with him, and gave up inviting him out altogether as he always has an excuse for not being able to come. He even tries to get out of family events and birthday and then would feel guilty for not going. Mark does sometimes attend, reluctantly, but only when pressurised by his parents. Once there, he is tense when he talks to his family members, and feels as if everyone is watching him while he eats, waiting for him to choke on his food or spill his drink. He is always uncomfortable when he is around groups of people.

Obsessive-Compulsive Disorder (OCD):

An anxiety disorder in which unreasonable thoughts or fears cause repetitive behaviours in order to relieve the thoughts or fears. These behaviours can go on for at least an hour, and can happen daily.

Gordon's Story

Gordon is a computer technician working at a large software firm. He has a fear of getting ill from other people’s lack of hygiene. His workspace is spotless because he is forever cleaning his desktop and computer. When he visits other people’s workstations to repair their computers, he wears gloves and sometimes a face mask. When he is done, he then washes his hands over and over again, so much so that they almost hurt. He is aware that his colleagues feel insulted by his actions but for him, the gloves, face mask and hand washing are the only things that can stop his daily fears of contamination and illness.

Post-traumatic Stress Disorder (PTSD) ：

Anxiety disorder in which a person develops an intense fear, horror or helplessness that continues for over 3 to 6 months after the onset of trauma. These intense feelings often interfere with daily life, and symptoms of panic attacks, flashbacks and insomnia may also be experienced.

Neil's Story

Neil is a soldier posted overseas on active combat duty. He returned home from his tour of duty, apparently uninjured. He seemed happy enough at the beginning to be home with his wife and away from the chaos of war. But around seven months after his return, he seemed to undergo a change and became more withdrawn. He started to wake up in the middle of the night, terrified after having had a nightmare about one of his fellow soldiers being disfigured by a roadside bomb, or watching a convoy trucks being blown up by a landmine. These flashbacks would stay with him at work, and the intense fear that it might disrupt his concentration was enough to start a panic attack. He eventually was completely unable to sleep at night, because he did not want to relive the traumatic experiences he had started to remember.

Acute Stress Disorder (ASD)：

Anxiety disorder characterised by the development of severe anxiety, terror, and flashbacks of a traumatic event within one month after the event.

Luke's Story

Luke was asleep next to his girlfriend in their apartment when a major earthquake struck. He was only lightly injured, but his girlfriend was pinned down by falling debris and nearly died from her injuries. He tried, unsuccessfully, to rescue her before escaping from the ruins of the building. Although his girlfriend was eventually saved and survived, her legs were badly broken and she remained in hospital for a long time. Luke only spent a night in the hospital under observation before being released. A few days after he was released from the hospital, he started to have nightmares and experienced changes in his behaviour. Night after night, he would have nightmares about his girlfriend’s injuries. At school, vivid memories of a shaking building and falling debris trapping him and his girlfriend in bed would overwhelm him. The memories would become so intense that he would feel like running away from his desk and diving for cover - even though there had been no aftershocks and the school building was perfectly safe. Now, whenever he drives or walks across a bridge, he experiences intense fear that the bridge will collapse under him, mirroring what he saw on the TV.

Substance-Induced Anxiety Disorder:

Extreme stress, panic or irritability that is induced by food, drink, medications or illicit drugs.

Jenny's Story

Jenny likes to party hard and often. When she does, she drinks heavily and is open to “trying new things" - uppers, downers, and other pills. At one of her house parties, someone brought along some white pills supposedly for livening up and getting everyone on their feet to dance and have fun. Jenny decided to take four of these pills, and swallowed them with a cocktail mix of vodka, orange juice and Red Bull. Instead of having a good time, she suddenly felt fear and panic. Her heart started to beat rapidly and she felt unable to breathe. Her best friend found her in the kitchen, all tense and scared, and took her to hospital for emergency treatment. After the doctors examined her, they told her the panic she experienced was induced by the drugs she took, and warned her about how dangerous it was to take pills that were not medically prescribed.

As you can see from the above scenarios, everyone is different, and everyone’s experience with anxiety varies. If you are concerned that you may have an anxiety disorder, you should talk to a professional about your concerns, but you should also do your own research, so that you can assess the type and extent of your anxiety from a position of knowledge. Your anxiety may not be as serious as you think, and even if it is, there are many options for you to help yourself and get help from people who can support you.

If you have already been diagnosed with an anxiety disorder, then you may well be on the right path to taking control of your life and freeing yourself from anxiety. As you will see in the exercise below, you have many options to obtain help and support for your symptoms, as well as proactively care for yourself.