Anxiety & Depressive Disorders

A brief look at some of the anxiety disorders and major depressive disorder

The most effective therapy for anxiety disorders is behavioral with secondary cognitive approaches, usually in-vivo exposure to the feared object or situation. The objective is to reduce the anxiety and manage the stress, so the somatic symptoms begin to diminish. The cognitive approach will focus on cognitive restructuring, focused cognitive therapy and psychoeducation about the fear/panic response. Techniques include anxiety management training, muscle relaxation, guided imagery, stress inoculation training, problem-solving, biofeedback, and exposure therapy.

Specific phobia
Specific phobia is a feared response in the company of an object or situation. The fear that is experienced is illogical because the fear is not related to any real danger. There are five subtypes of specific phobia. A) fear of animals, b) fear of natural environment or open spaces,     c) fear of blood-injection-injury, d) fear of situations, e) fear of other category (American psychological Association, 2013).

Social Anxiety Disorder

Social anxiety disorder consists of the fear of being embarrassed, humiliated, or being judged by others. Social situations trigger the anxiety or fear response; the individual will avoid these situations or endure them with great anguish. The fear is not in proportion to the event. The fear or anxiety must persist for six months and cause clinical, functional impairment to the individual.

Panic Disorder

Panic attacks involve intense fear, such as dying or losing control, coupled with physical symptoms. The attacks may be abrupt and peak within 10 minutes, lasting from minutes to hours. The symptoms are thought of as medical related by the individual experiencing the panic attack.

Symptoms include the following: Pounding heart, choking, sweating, trembling, nausea, sweating, dizziness, confusion, and a desire to flee the location. The attacks may come out of nowhere or triggered by crowds, stress, or the anticipation of another panic attack. After the initial panic attack, the person lives in fear that they will suffer another panic attack. A panic attack is not a disorder; it is a symptom. The panic disorder diagnosis results from the constant fear that another attack will occur.

Research has noted that there appears to be a genetic component to panic disorder with 15% of first degree relatives and 30% of monozygotic twins suffering from the disorder. The most common comorbid conditions include social anxiety disorder, major depressive disorder, specific phobias, and alcohol use disorder. ( APA, 2013).



The anxiety and fear are about being in enclosed spaces where escape may be challenging and or embarrassing if a panic attack occurs. Including the fear that help will not be there if a panic attack occurs. The person is said to have agoraphobia when they avoid public places. (APA,2013).

Generalized Anxiety Disorder (GAD)

GAD occurs when the person feels anxious all the time, and there is no real reason for the worry. The worry is excessive about almost anything, such as money, health, family, and work when there is no evidence for the individual to feel such concern. This disorder usually first occurs in children and teens and is more prevalent in women than men. Persons who suffer from GAD often feel a sense of dread that something awful will happen in the future. This is different from depression, where the person feels something bad “has” happened. Some of the symptoms of GAD are, inability to relax, tension and complaints of muscle aches, fatigue, and the individual may also find it difficult to concentrate. (APA, 2013).

Major Depressive Disorder

Individuals suffering from depression usually have a greater number of stressful life events occurring before the first episode of the disorder. Psychosocial stressors have less impact on later episodes. Major depressive disorder is two times more likely in adolescent and adult females than in males. The person feels unmotivated, sad, and emotionally drained. Profound psychomotor retardation, (moves slowly, heavy limbs) and agitation are the behavioral manifestations. The person suffering from this disorder will find it difficult to sleep, eat and function from day to day (APA, 2013). Twenty-five percent of the cases of major depressive disorder have a precipitating factor involved. In the elderly, approximately half of the cases are due to a precipitating event in the individual’s life. Psychotic symptoms could accompany major depressive disorder in some cases. Usually, the psychotic features are delusions that are mood congruent and rarely involve hallucinations.

American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders, Fifth Edition. Arlington, VA. American Psychiatric Association, 2013.