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Copyright © 2017 Connexion Psychological Practice Ltd.

Anxiety / Phobia

What Are Anxiety Disorders?

Everyone feels anxious now and then. It’s a normal emotion. For example, you may feel nervous when faced with a problem at work, before taking a test, or before making an important decision. Anxiety disorder are different, though. They are a group of mental illnesses, and the distress they cause can keep you from carrying on with your life normally.

For people who have one, worry and fear are constant and overwhelming, and can be disabling. But with treatment, many people can manage those feelings and get back to a fulfilling life..

All anxiety disorders share some general symptoms:

  • Panic, fear, and uneasiness;

  • Sleep problems;

  • Not being able to stay calm and still;

  • Cold, sweaty, numb or tingling hands or feet;

  • Shortness of breath;

  • Heart palpitations;

  • Dry mouth;

  • Nausea;

  • Tense muscles; and

  • Dizziness.


Types of Disorders

Panic Disorder

People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.

Panic disorder symptoms include:.

  • Sudden and repeated attacks of intense fear;

  • Feelings of being out of control during a panic attack;

  • Intense worries about when the next attack will happen; and

  • Fear or avoidance of places where panic attacks have occurred in the past.



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

People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.

Social anxiety disorder symptoms include:

  • Feeling highly anxious about being with other people and having a hard time talking to them;

  • Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others;

  • Being very afraid that other people will judge them;

  • Worrying for days or weeks before an event where other people will be;

  • Staying away from places where there are other people;

  • Having a hard time making friends and keeping friends;

  • Blushing, sweating, or trembling around other people;

  • Feeling nauseous or sick to your stomach when other people are around.


Specific Phobias

A specific phobia is excessive and persistent fear of a specific object, situation or activity that is generally not harmful. Patients know their fear is excessive, but they can’t overcome it. These fears cause such distress that some people go to extreme lengths to avoid what they fear. Examples are fear of flying or fear of spiders.



Separation Anxiety
A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person’s age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.


Generalized Anxiety Disorder
People with generalized anxiety disorder (GAD) experience excessive anxiety and worry, often about health, family, money, or work. This worrying goes on every day, possibly all day. It disrupts social activities and interferes with work, school, or family.


GAD is diagnosed in adults when they experience at least three of the symptoms below on more days than not for at least six months; only one symptom is required in children.

  • Restlessness or feeling wound-up or on edge;

  • Being easily fatigued;

  • Difficulty concentrating or having their minds go blank;

  • Irritability;

  • Muscle tension;

  • Difficulty controlling the worry;

  • Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep).   (Source: DSM-5)

Researchers don’t know exactly what brings on anxiety disorders. Like other forms of mental illness, they stem from a combination of things, including changes in your brain and environmental stress, and even your genes. The disorders can run in families and could be linked to faulty circuits in the brain that control fear and other emotions. anxiety disorders often co-exist with other related conditions, such as depression or obsessive-compulsive disorder.



Obsessive-Compulsive Disorder (OCD)

What is it like to have OCD?
“I couldn’t do anything without my rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times because three was a good luck number for me. It took me longer to read because I’d have to count the lines in a paragraph. When I set my alarm at night, I had to set it to a time that wouldn’t add up to a ‘bad’ number.”

“Getting dressed in the morning was tough because I had to follow my routine or I would become very anxious and start getting dressed all over again.” I always worried that if I didn’t follow my routine, my parents were going to die. These thoughts triggered more anxiety and more rituals. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me. I couldn’t seem to overcome them until I got treatment.”


What is OCD?
OCD is a common, chronic (long-lasting) disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over in response to the obsession.

While everyone sometimes feels the need to double check things, people with OCD have uncontrollable thoughts that cause them anxiety, urging them to check things repeatedly or perform routines and rituals for at least 1 hour per day. Performing the routines or rituals may bring brief but temporary relief from the anxiety. However, left untreated, these thoughts and rituals cause the person great distress and get in the way of work, school, and personal relationships.

What are the signs and symptoms of OCD?
People with OCD may have obsessions, compulsions, or both. Some people with OCD also have a tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking, facial grimacing, shoulder shrugging, or head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds.

Obsessions may include:

  • Fear of germs or contamination

  • Fear of losing or misplacing something

  • Worries about harm coming towards oneself or others

  • Unwanted and taboo thoughts involving sex, religion, or others

  • Having things symmetrical or in perfect order

Compulsions may include:

  • Excessively cleaning or washing a body part

  • Keeping or hoarding unnecessary objects

  • Ordering or arranging items in a particular, precise way

  • Repeatedly checking on things, such as making sure that the door is locked or the oven is off

  • Repeatedly counting items

  • Constantly seeking reassurance


What causes OCD?
OCD may have a genetic component. It sometimes runs in families, but no one knows for sure why some family members have it while others don’t. OCD usually begins in adolescence or young adulthood, and tends to appear at a younger age in boys than in girls. Researchers have found that several parts of the brain, as well as biological processes, play a key role in obsessive thoughts and compulsive behavior, as well as the fear and anxiety related to them. Researchers also know that people who have suffered physical or sexual trauma are at an increased risk for OCD.

Post-Traumatic Stress Disorder (PTSD)
PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.

It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are not in danger.

Signs and Symptoms
Not every traumatized person develops ongoing (chronic) or even short-term (acute) PTSD. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.


A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.


To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

  • At least one re-experiencing symptom;

  • At least one avoidance symptom;

  • At least two arousal and reactivity symptoms;

  • At least two cognition and mood symptoms.

Re-experiencing symptoms include:

  • Flashbacks - reliving the trauma over and over, including physical symptoms like a racing heart or sweating;

  • Bad dreams;

  • Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.


Avoidance symptoms include:

  • Staying away from places, events, or objects that are reminders of the traumatic experience

  • Avoiding thoughts or feelings related to the traumatic event

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.


Arousal and reactivity symptoms include:

  • Being easily startled;

  • Feeling tense or “on edge”;

  • Having difficulty sleeping;

  • Having angry outbursts.

Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

Cognition and mood symptoms include:

  • Trouble remembering key features of the traumatic event;

  • Negative thoughts about oneself or the world;

  • Distorted feelings like guilt or blame;

  • Loss of interest in enjoyable activities.

Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.


It is natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

Do children react differently than adults?
Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children (less than 6 years of age), these symptoms can include:

  • Wetting the bed after having learned to use the toilet.

  • Forgetting how to or being unable to talk.

  • Acting out the scary event during playtime.

  • Being unusually clingy with a parent or other adult.


Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviours. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

Treatment for Anxiety Disorder
It is most important for Anxious people to feel safe as there is not much they can do when they feel that they can't breathe or can’t rest and calm down. So, treatment need to be slow but effectively helping the anxious people to calm down and find their own grounding and safety. This may take some time for them to practice and slowly build up trust in the therapy that the therapist really understands their suffering and they can rely on the therapist’s guidance and help.

At Connexion we are here to help you:

  • Experience how to reach a sense of calmness and relaxation in your body.

  • Understand the message your anxiety symptoms are signalling to you and through understanding and acceptance, you will find the symptoms slowly fade away.

  • How to regulate your emotions especially the negative ones rather than just avoid, deny or defend them.

  • Learning to express your inner needs and vulnerabilities to reach support and connection with people you cared.

  • Taking baby steps to be genuine with your real self and learning to share with others your true self.