Agoraphobia often occurs with panic disorder. It is the feeling of intense anxiety that a person experiences when they are in a place they feel they cannot easily escape. For example, a person who had a panic attack at the grocery store may worry that they will have another panic attack at the grocery store, at the mall, at a restaurant or any other public place where they cannot easily escape.
This fear causes them to avoid public places and stay inside safe places. Some commonly avoided places include: bridges, tunnels, elevators, highways without shoulders, limited access roads with infrequent exits, or crowded places. In extreme cases, an agoraphobic will not leave their home.
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed disorder in children. ADHD is characterized by inability to focus, extreme restlessness, and impulsivity. These symptoms persist into adulthood and can cause difficulty in school, work, and relationships. Successful treatment for ADHD includes both medication and behavior therapies that target the symptoms of the disorder. In addition, involvement of the family and school, if applicable, is important to help address the wide impact this disorder has on a person’s life.
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Formerly called manic-depressive disorder, bipolar disorder describes the condition of alternating periods of low and high moods. Typically, individuals experience periods of elevated moods, impulsive behavior, and increased energy levels. Individuals may experience racing thoughts and a decreased need for sleep. At times, symptoms may manifest themselves in a manic state during which individuals are more talkative, easily distracted, and have an inflated self-esteem.
These periods of mania are often alternated with either “normal” level emotions or periods of sadness or severe depression. Bipolar disorders have been shown to have a strong genetic component and are often found in families with a history of depression, suicide, anxiety, and bipolar disorder. Given the strong genetic link for bipolar disorder, medication is often necessary to help stabilize a person’s emotions. As the person’s moods level off, psychological therapy addressing his/her emotions, behavior, and thoughts is often effective.
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Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a form of psychological treatment based on the research of Aaron Beck and Albert Ellis.
The basic focus of this therapy is to change an individual’s thoughts in order to change his or her emotions and behaviors. Essentially, the client is taught to identify and challenge his/her negative thoughts that are contributing to maladaptive behavior or unpleasant emotions. This process is called “Thought Challenging.”
A few common negative thoughts that are challenged in therapy are: “There is nothing good in my life” and “This is never going to end.” These cognitive distortions are challenged and replaced with healthier and adaptive thoughts that promote positive emotions and behavior in a person’s life. Specifically, their negative thoughts are replaced with: “There are many positive things in my life” and “Things will get better.” In addition, some common coping skills and techniques taught within the CBT framework include positive self-talk, problem solving, and relaxation skills.
Thought to be the common cold of mental illness, nearly 17% of adults will be diagnosed with depression during their lifetime. Moreover, women are 70% more likely than men to be diagnosed with depression. Not to be confused with feeling sad, depression is characterized by chronic and severe depression lasting a minimum of two weeks and interfering with the person’s ability to function at home, at school, or at his/her job.
Depression can result in negative feelings, behaviors, thoughts, and physical symptoms. Some symptoms of depression include tearfulness, fatigue, lack of enjoyment in previously pleasurable activities, inability to concentrate, feelings of guilt, irritability, hopelessness, changes in appetite, and difficulty sleeping. Some people may also experience thoughts of suicide. It is important to note that depression is not a sign of weakness. Moreover, people with depression often cannot just “get over” despite being told to do so by people in their lives.
Depression is thought to be caused by both environmental and genetic factors. Individuals raised in pessimistic and discouraging families are prone to depression. Environmental factors such as a chronic illness, school stress, family crisis, financial strain, serious loss, and relationship problems can also contribute to the development of depressive symptoms. There is also compelling evidence suggesting a strong genetic link to depression. Individuals with family members who are depressed are more likely to develop depression themselves. It is important to note, however, that even individuals with no family history of depression may experience depression in their lifetime. Finally, researchers have identified chemical imbalances and different patterns of brain activation in depressed individuals. Taken together, these different causes of depression are linked with personality traits such as low self-esteem, inability to cope with stress, and negative thoughts about the world, the future, and themselves.
Research has demonstrated that Cognitive Behavior Therapy (CBT) is the most effective treatment of depression because it addresses the negative thoughts, feelings, and behaviors associated with depression. When an individual is unable to function due to severe physical, emotional, and behavioral symptoms of depression, medication may be necessary to help the person feel ready to make the changes.
Visit NIMH.nih.gov to learn more.
Dialectical Behavioral Therapy
Dialectical Behavioral Therapy (DBT) was developed by Marsha Linehan in the early 1990s and is considered a form of CBT. It was initially developed to treat Personality Disorders, but it was soon found to be effective with various populations, age groups, and disorders. In particular, it has been found useful in treating irrational thinking, impulsive behavior, mood swings, and interpersonal problems.
Finding the balance between acceptance and change is the important underlying concept that forms the foundation of DBT. The term “dialectical” in the name is based upon its definition which is an awareness of opposing choices (i.e., acceptance versus change). Radical Acceptance describes the cathartic process by which an individual accepts his/her current situation for what it is – the good and the bad. Change through DBT comes about through four skill areas: mindfulness, emotion-regulation, distress tolerance, and interpersonal effectiveness. For example, mindfulness techniques are a set of positive distraction skills such as deep breathing and focusing on the five senses.
Evidence-Based Treatment Modalities
Evidence-based treatments have been proven by medical science and clinical research to have positive outcomes. Evidence-based treatment modalities include: Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Motivational Interviewing.
Originally developed by Miller (1983) to treat alcoholism and drug use, “Motivational Interviewing” has gained popularity as a way to engage and promote positive change in a wide variety of patients. This treatment, often used in conjunction with CBT, focuses on addressing the resistance or ambivalence displayed by clients. It is described as a collaborative effort in which the therapist elicits the client’s thoughts about change while emphasizing the client’s autonomy and ability to change. The therapist works with the client to develop discrepancies between where the client currently is and where they want to be. The goal is to evoke and get rid of a self-motivated desire in the client to change. The therapist and client then work to develop an action plan to bring about the desired change in the client’s life.
Obsessive Compulsive Disorder
Obsessive compulsive disorder (OCD) is an anxiety disorder in which the person experiences either obsessions or compulsions that interfere with his/her normal life.
Obsessions are defined as persistent ideas, thoughts, or impulses that intrude on a person’s thoughts, and cause significant distress in his/her life. Compulsions are repetitive behaviors that are performed in an effort to reduce anxiety. (Typically the anxiety is caused by obsessions).
Approximately 2% of the general population will develop an obsessive compulsive disorder during their lifetime. OCD can develop in childhood, but most often it develops in adolescence or young adults. Most people with OCD spend a lot of time during the day dealing with either obsessions, compulsions, or both. These obsessions and compulsions significantly interfere with their normal life functioning which is the main reason why people will seek treatment.
For more information, please visit OCFoundation.org.
According to the American Psychiatric Association, personality disorders represent severe and chronic symptoms that cause distress and impairment at home, school and work. Some common symptoms include odd or eccentric behavior, dramatic, emotional, or erratic behavior, or anxious and fearful behavior. Personality disorders are further characterized by an unhealthy and rigid thinking across all areas of a person’s life. Although these symptoms persist for years across a wide variety of situations, many treatments have been shown to be very effective with these disorders. In particular, Dialectical Behavior Therapy (DBT) was developed and has shown good success treating Borderline Personality Disorder.
Learn more about personality disorders at MayoClinic.com.
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic Stress Disorder (PTSD) is a collection of symptoms that occurs following the experience or witnessing of life-threatening events. Rape, military combat, natural disasters, terrorist incidents, fires, serious accidents, and/or sexual/physical abuse are examples of traumatic events. A person may not experience PTSD immediately after the event. “It may become chronic and maladaptive as time passes and the person is no longer in a life-threatening situation. Symptoms range from mild and manageable to extreme and debilitating. People who suffer from PTSD often relive the experiences through nightmares and flashbacks, frequently have difficulty sleeping, and often feel detached or estranged from others. They feel extremely tense and anxious in many different situations and are often always expecting something bad to happen to them or those around them. Furthermore, individuals with PTSD are twice as likely to utilize health care services each year for the treatment of circulatory, digestive, muscular, skeletal, nervous, and respiratory problems. Many people with PTSD report feeling like they are “running from their past.” They also feel hopeless and unable to change their situation. These maladaptive responses or symptoms of PTSD in turn can negatively impact families, work, health, and social relationships.
It is important for people with PTSD to realize that there is hope. PTSD can be successfully treated. Treatment often involves learning ways to relax and decrease feelings of stress and anxiety, learning better sleeping habits, and when appropriate, talking about the trauma in a way that decreases the negative feelings associated with it. Therapy can also be helpful for families or loved ones of an individual diagnosed with PTSD.
Visit PTSD.va.gov to learn more about PTSD.
Social anxiety or social phobia is a persistent fear of social situations and embarrassment. It may be occur in anticipation of giving a speech or interacting with strangers at a party. In some extreme cases, social anxiety results in panic attacks.
People with social anxiety cannot control their fears even though they realize that they are exaggerated or even unwarranted. They begin to avoid social situations in which they need to interact or perform in front of people, and this tends to interfere with their normal life.
Most people experience social anxiety to some degree but they manage their fears and learn to overcome the anxiety by exposing themselves to social situations. Other people may learn to avoid situations that make them feel anxious and may not feel that their life style is inhibited. However, when social anxiety becomes more severe and interferes with a person’s ability to participate in normal activities such as school or work, then psychiatric treatment becomes necessary.
See WebMD.com to learn more.