Anxiety Disorders

You can find heaps of information online about Anxiety Disorders, a broad term referring to the Category of Mental Disorder where fear, apprehension that something bad will happen, worry, panic and physical distress frequently occurs. Most of this online information is a regurgitation of symptoms from the classification ‘bible’ DSM-5, which lists the features of different diagnoses like the ingredients of a cookbook! Despite these ‘descriptions’ being easily available, all the publicity about how common ‘anxiety’ is has led to any state of high anxiety as being perceived as a homogenous condition – as if there is just one type of ‘anxiety’.  A big reason for how dissatisfied many people are with the quality of information available about anxiety disorders is that the DSM-5 classification system does not provide any ‘explanations’ or ‘causes’ and hence there is a lack of education about causes to the general public. Even Psychiatrists have not categorised causes in a way that is easily understood by the public, beyond using the term ‘biopsychosocial’ amongst ourselves, which refers to the biological, psychological and social factors contributing to any individual case of any disorder. Because we have failed to adequately educate the public about these causes, I have ‘given a go’ to fill this gap in my eLearning education program!  
 

In fact, there are 9 different ‘types’ of ‘Anxiety’ that we psychiatrists diagnose to help treat our patients. And an individual with ‘Anxiety’ might have a mixture of more than one cause. Hence, those with more severe types of Anxiety often get the best outcomes from combinations of approaches – a management package – sometimes by more than one type of Help-Provider. Despite this, the treatment approach many people receive is too often dictated by the setting where the person goes for help or the type of Help-Provider a person seeks help from: some Help-Providers only offer medication, others only psychotherapy, some only life coaching, some only positive lifestyle factors. Whilst in many cases that may be adequate, what if it doesn’t adequately facilitate  recovery? 

Because each type of anxiety tends to have a dominant cause, I’ve gone ‘Beyond DSM-5’ to divide all the common 6 Categories of Disorder (Mood, Anxiety, Personality, Psychotic, Substance Use and Eating Disorders) into 3 Explanatory SubTypes that reflects how most psychiatrists conceptualise mental health problems. 
 

For Anxiety Disorders, I have placed each of the 9 different types of ‘Anxiety’ into 1 of their 3 causative subtypes: 
1.     The Mind subtype due to an underdeveloped or immature capacity for decision-making and coping skills and unhelpful scripts. This tends to explain 2 anxiety diagnoses: (1) Dissociative Disorder  (a.k.a. Borderline traits, Complex PTSD, Hysteria, Nervous breakdown) and (2) PTSD-Mind Subtype  (a.k.a. adjustment disorder with anxiety features, acute stress disorder, acute PTSD, nervous breakdown, post traumatic avoidance features, post traumatic shock, shell shock)
2.     The Body subtype is due to ‘runaway feedback loops’ causing physical distress due to anxiety, pain, fatigue or nausea. This covers 5 diagnoses: (3) Panic Disorder with Agoraphobia (4) GAD (a.k.a. over-worriers, sensitive and anxious temperaments) (5) Social Anxiety Disorder (a.k.a. social phobia) (6) Health Anxiety (a.k.a. hypochondriasis)  (7) PTSD-Body Subtype (a.k.a. post traumatic arousal features, shell shock)
3.     The Brain subtype is due to malfunctions, injuries & glitches. This explains 3 diagnoses: (8) OCD (a.k.a.Obsessive Compulsive Disorder) (9) PTSD-Brain Subtype (a.k.a.  post traumatic memory features)
 
Ok, but what is the common mechanism that leads to high anxiety? Well, you tip into Anxiety when what I call your ‘panic button’ is pressed and remains stuck, triggering adrenalin release, physical distress and fear of panic attacks and avoidance of physical distress.... This may activate one of two ‘Anxious Scripts’: to ‘Fight’ or ‘Flight’. I have depicted all of this information  pictorially, conversationally and pragmatically in eLearning... 

 

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