Understanding the Different Types of Anxiety
Have you ever asked yourself “which anxiety disorder do I have?” It turns out there are many different types of anxiety, and understanding the difference can help you to work through it with your therapist. If you’re unsure about how the types of anxiety differ from one another, we’ve put together a simple guide below.
What Anxiety Disorder Do I Have?
Understanding the differences between anxiety disorders can be tricky at first. Luckily, psychologists Martin Seif and Sally Winston provide a really useful analogy to explain it. They propose a hypothetical scenario wherein 6 airline passengers who are about to board a plane are asked, and respond ‘yes’ to, the following questions:
Are you afraid to fly?
Are you anxious anticipating a flight?
Would you prefer to avoid flying if you can?
Are you feeling anxious right now?
Each of these 6 passengers has anxiety, although it doesn’t necessarily mean they have an anxiety disorder. Although they answered yes to the same questions, the reasons why, and their experience, are different. Therefore it’s important to understand the difference between the types of anxiety presentations.
General Anxiety Disorder
General Anxiety Disorder, or GAD, is primarily characterized by a persistent state of worry. Thoughts are typically relentless and rambling as they cycle through all kinds of “what if” scenarios. To illustrate this point, Seif and Winston provide the following example:
The passenger with GAD is “worried about the plane crashing and whether or not the pilot has a hangover, and whether or not that rattling sound underneath her seat is normal. But she is also worried that she may have a scratchy throat and what if it ruins her vacation, and what if the airline loses her baggage and what if the person who is supposed to pick her up gets stuck in traffic or forgets”.
As you can see, it is an ongoing state of worry about many different kinds of things going wrong. People with GAD also experience muscle tension, autonomic arousal, anxious mood, and episodes of panicky feelings.
People with panic disorder are afraid of panic itself. More specifically, they are afraid of having a panic attack, and what that might lead to.
The passenger with Panic Disorder is thinking “I don’t know if I can stand it when the doors close. I am going to feel trapped, I won’t be able to leave, I am going to get that unbearable overwhelming rapid heart rate and I won’t be able to breathe right and I don’t know if I can control my reaction and I could just either go crazy or even cause myself a heart attack. Are there straitjackets in case I lose control? What if I lose it and open the door in the middle of the flight? I wonder if there is a defibrillator on the plane?”
What stands out here is the sense that they will not be able to control themselves in the midst of a panic, leading to terrible outcomes. It is worth noting that people with panic attacks primarily fear the sensations associated with the panic attack, setting them apart from our next anxiety disorder.
Social Anxiety Disorder
Social Anxiety Disorder, or SAD, is defined by a sensitivity to the feeling of embarrassment or humiliation. This particularly relates to any situations in which they may be exposed to criticism or judgment, such as talking in public or giving a performance.
The passenger with SAD might look similar to the person with panic disorder on the surface, but underneath they are thinking “I am getting anxious and I feel like I might throw up and get pale and fidgety and the person next to me is going to turn to me and say ‘are you alright?’ and what if I can’t talk properly and by the time we get to our destination, everyone in the plane will know I’m a nutcase on this plane. I don’t know if I can keep my anxiety hidden”.
People with SAD can avoid specific social situations they associate with potential for humiliation or embarrassment, or in more severe cases, can be uncomfortable being around anyone other than direct family members.
Specific Phobia refers to a fear and avoidance of something specific. You may have heard of some kinds of specific phobias, such as claustrophobia (fear of confined spaces) or arachnophobia (fear of spiders).
The passenger with aviophobia (fear of flying), may experience similar thoughts and sensations as those with other anxiety disorders, but the key difference is that their anxiety is limited to and related to flying. He therefore, might be primarily focused on “plane safety, the possibility of weather making his flight more dangerous, how his children might survive his death, and the horror of the image of going down during the crash”.
Animal phobias are the most common type of specific phobia, with situational phobia also being common.
Obsessive Compulsive Disorder (OCD)
OCD consists of two components; obsessions and compulsions. Obsessions increase anxious distress in that they are repetitive thoughts or images which come to mind, accompanied by a strong urge to get rid of them. Compulsions are efforts made in an attempt to reduce anxiety, and can be, but are not always, actions and behaviors.
The passenger with OCD is thinking “I know that they clean the planes in a deep way with antibacterial solution every two weeks and that they spray room freshener into the air when they are on the ground because I did the research, but in between flights, they just pick up the trash. I have really been trying to keep my arms and hands off the seat rest because you never know who was sitting here and what germs they could have…and all of a sudden I am thinking I may have inadvertently touched the armrest when I was listening to the pilot announcement and OMG what if I get sick and transmit it to my kids?”
Not all who suffer from OCD have a fear of germs. What is worth noting here is the continual focus on the germs (the obsession) accompanied by the attempts she makes to lower her anxiety by avoiding them (the compulsion).
Post-Traumatic Stress Disorder
PTSD is the name for a collection of symptoms and responses to an event, or events, which are considered traumatic. It is not considered to be an anxiety disorder, although those with PTSD can still experience significant anxiety.
The passenger with PTSD had an “older brother who went down in a plane in Vietnam when she was a child. Every time she has to fly, she has weeks of dreams about fiery crashes, reliving that horrible moment when her mother told her that her brother was dead. She is hyperventilating right now, feels overwhelmed with fear and grief, and would rather be anywhere else. Half of her is presently on the plane and half of her is in the past.”
It is possible for people to experience a traumatic event, and not have PTSD, but still experience anxiety related to the event. For example, a person who has been in a car crash may be anxious about getting back into a car, without experiencing other key PTSD symptoms such as flashbacks or dissociation.
How To Overcome Your Anxiety Disorder
Anxiety is incredibly common in today’s society and it affects a whole variety of people. If you are experiencing anxiety, seeing a psychotherapist can help. Your therapist will be able to help you identify what kind of anxiety disorder you have, and educate you on how it works. They can also provide treatment options to lessen the symptoms and help you get more out of your day to day life. Remember that you don’t have to struggle with your anxiety alone, and plenty of people have seen fantastic results from getting therapy for their anxiety.
Shaun McMahon is a Melbourne based psychotherapist who offers support for people struggling with anxiety. He conducts sessions both in person and online, and is currently accepting new clients. If you are interested in learning more about how Shaun can help, you can arrange a FREE 15 minute consultation by clicking here.
Source: (2014) Seif, M. N., Winston, S. What Every Therapist Needs To Know About Anxiety Disorders: Key Concepts, Insights and Interventions. Routledge: London.