Anxiety Disorders

Therapy in Indianapolis, Zionsville, and Carmel, IN

When the anxiety-avoidance cycle dominates, as described on the page entitled Anxious? , personal distress can climb to levels hard to tolerate and everyday functioning is disrupted. Now anxiety has reached clinical levels. The National Institute of Mental Health estimates that during a 12-month period, 18% of the adult population has an anxiety disorder.

The symptoms of anxiety can take any or all of the following forms:
  • Physical - for example, shortness of breath, heart palpitations, trembling, and sweating
  • Cognitive - for example, worry, ruminative thinking, intrusive thoughts, reduced concentration
  • Emotional - for example, nervousness, restlessness, agitation, edginess. irritability, and panic
  • Behavioral - avoidance of upsetting situations or enduring them with much discomfort
The symptoms have been grouped by the American Psychiatric Association (2013) into disorders described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The following discussion uses this classification system.

Although anxiety has a wide variety of symptoms, they cluster into a few major categories. An anxiety episode can be intense, short-lived, and seem to come out of nowhere (Panic Disorder). Or its triggers may be clear, as when there are identifiable anxieties (Specific Phobias), such as fears of snakes, needles, and flying, or fear of more than one situation from which escape can be difficult (Agoraphobia), such as elevators and bridges. Some triggers involve other people in which there can be fear of being separated from significant others (Separation Anxiety Disorder) or fear of being negatively judged by others (Social Anxiety Disorder). However, a Generalized Anxiety Disorder seems to have no easily identifiable triggers because there is chronic, continuous worry about a number of everyday situations. In addition, the Other Specified Anxiety Disorder and Unspecified Anxiety Disorder categories do not meet the full criteria for any of the more fully defined diagnostic categories.

Depression often occurs along with anxiety, and there are diagnostic categories that include it. The DSM-5 has Adjustment Disorder with Mixed Anxiety and Depressed Mood and allows for the possibility of adding the specifier with anxious distress to any of the depressive disorders. The ICD-10-CM (2014), which the rest of the world uses for diagnosis, names two particular blends of anxiety and depression as eligible to be subsumed under the Other Specified Anxiety Disorders category - Anxiety Depression and Mixed Anxiety and Depressive Disorder.

When anxiety reaches clinical proportions, therapy can be considered. If you wish to look into this possibility, please contact me .


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Washington, DC: Author.

Goodheart, C. D. (2014). A primer for ICD-10-CM users . Washington, DC: American Psychological Association.

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