Anxiety disorders

What are these disorders?

Anxiety disorders share several common characteristics, including fear, apprehension of negative consequences, or excessive and prolonged distress. Sufferers experience unpleasant physical symptoms including sweating, heart palpitations, trembling, diarrhea and difficulty breathing. People living with an anxiety disorder generally avoid situations, objects or sensations that provoke anxiety-related thoughts and symptoms, which can make the disorder very incapacitating. Avoiding sources of anxiety contributes to the disorder’s persistence, because by avoiding opportunities to confront their fear, a person is unable to tell that the fear is disproportionate.

To date, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes seven anxiety disorders:

Specific phobia

  • A person is afraid of heights and avoids taking elevators or flying in planes at all costs.
  • A person is afraid of being bitten by dogs and avoids being around people with dogs, parks, or crowds.

Social anxiety disorder

  • A person fears the judgement of others and avoids oral presentations at all costs.
  • A person is afraid of being ridiculed and avoids taking up new activities.

Generalized anxiety disorder

  • A person constantly worries about their work or courses and is convinced that they will fail while they are actually doing quite well.
  • A person is always worried about their safety and that of their loved ones (fear of burglary, car accidents, etc.) for no good reason, which prevents them from sleeping.

Panic disorder

  • A person under stress has a panic attack that provokes an intense fear of death and loss of control, and an intense fear of having another attack.

Agoraphobia

  • A person has a panic attack on the subway and avoids taking the subway or even the bus for fear that it will cause another attack.
  • A person has a panic attack at the mall and then avoids the mall and other crowded areas for fear that they will provoke another attack.

Separation anxiety disorder

  • A person experiences excessive anxiety when they are required to go on a business trip, has nightmares that their family will be wiped out by a fire or other disaster, and is unable to bear the thought of this separation.

Selective mutism

  • A person (often a child) is overwhelmed by anxiety in social situations and systematically refuses to speak in these contexts.

How does this impact loved ones?

In order to adapt, avoid or reduce the anxiety experienced, many people will develop strategies such as:

  1. avoiding situations/places that cause anxiety
  2. keeping certain people close by for safety
  3. creating an exit plan
  4. remaining constantly aware of their environment
  5. being hypersensitive to the physical symptoms of anxiety
  6. attempting to control the environment, their thoughts, their behaviour or the behaviour of others

These strategies can be hard on the people around them. It can be difficult for family and friends to empathize and understand the sources of this anxiety, which can seem disproportionate and exaggerated. In an attempt to offer reassurance, they may accompany their loved one in certain situations to make them feel safe or run errands on their behalf. It can be disturbing for friends and family to see that their loved one’s anxiety diminishes their potential, interferes with their relationships or causes major distress.


What about seniors?

Anxiety can occur at any age, but certain factors strongly predict anxiety in seniors, such as developing a chronic illness, being a caregiver, losing independence or experiencing a change in social and family roles. Different sources of anxiety are not specific to any particular age group. However, some, such as a pervasive fear of falling or a disproportionate fear that something is going to happen to their loved ones, are much more prevalent among seniors.

Because anxiety in seniors is associated with physical or social changes that occur with aging, it is too often trivialized and perceived as “normal” while it is not. Finally, it is important to note that anxiety is frequently accompanied by depression among seniors.

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