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Ch. 7 The A Team (Anxiety Disorders)

So far I have been fairly non-specific regarding the anxiety symptoms that I have described. That’s for good reason. I want you to understand the beast in general before taking a look into its more hardcore forms. In this chapter I am going to describe the anxiety disorders to you. These are psychological disorders that are clinical in nature. I need to stress to you that you should not and really cannot diagnose yourself. Leave that to the professionals… we need jobs too. I know it’s difficult because you are a hypochondriac and can just look up the symptoms, but trust me on this one. You are more than just a checklist. The following disorders are not an exhaustive list, nor are they presented in their pure technical definitions. There are a lot of different criteria for determining these disorders and I really just want you to get the gist of it.

Let’s start with generalized anxiety disorder (GAD). GAD is really a pain in the ass, because it is pretty hard to pin down. A hallmark feature of GAD is that it is non-specific. Unlike some of the other disorders that I will talk about, there is typically no identifiable stressor that is causing anxiety. Instead you basically have a persistent sense of fear and worry and become overly concerned with everyday matters to the point that the worry interferes with your ability to function well in life. If you have GAD, you will likely have a difficult time making decisions or remembering important things. Think of it this way. Remember how I told you anxiety is like a fire before? Well, with GAD you are basically roasting yourself like some low and slow BBQ. Woody Allen is someone that comes to mind as being on the highly neurotic side of this disorder. Everything is a big deal and all big deals lead to stress.

One of the shitty things about GAD is the associated physical symptoms. Panic attacks, which I will talk more about in a sec, are terrible, but they are also awesome in that they usually come and go in a matter of minutes. With GAD you aren’t so lucky. You have many of the same features of a panic attack, typically to a lesser degree, but for a really long period of time. Your body isn’t designed to be under that sort of stress reaction for those extended periods and so you may find that you constantly have an upset stomach, muscle soreness, difficulty sleeping, constant fatigue etc. It’s not fun.

Next up on the A team, we have panic disorder (PD). Now this is one that has constantly changing criteria, so I won’t get too wildly granular with this description. The general idea has to do with those panic attacks that we talked about earlier in the “Your Body is an Asshole, too” chapter. Basically, when you have PD, you experience those panic attacks where you have strong physical symptoms combined with intense fear and discomfort. They tend to peak at around 10 minutes and then cool down. The party isn’t over after that, though. The defining feature of PD is that after you have a panic attack, you suffer from intense fear of having another one.

PD really sucks because you can start to have anxiety symptoms outside of legit panic attacks because you are so afraid of having another one and not being able to cope. It’s really a lose/lose situation, because being so preoccupied about the potential of future attacks makes you more sensitized and vulnerable to them occurring. If you fear them, they shall come.

You are probably familiar with phobias. They are pretty straight forward, but people misuse the term quite a bit. To have a phobia does not mean that you dislike something strongly. For a specific phobia, it means that when you are in the presence of the feared object, animal, location etc., you experience intense fear and apprehension. I don’t mean you get uncomfortable. I mean you freak the hell out. Another feature of phobias is that you know you are crazy. You know that the amount of fear and discomfort you feel about this thing is in no way proportional to the actual situation.

There are different subtypes of phobias. For instance, there is blood and injection phobia, where you pass out every time you visit the Red Cross. There is also social phobia, which is essentially an intense fear of social situations in which you feel like you have to be on stage and be judged by everyone else even though no one really cares wtf you’re doing. This is sometimes classified as a disorder in its own right (social anxiety disorder), but the main bad stuff that you are going to feel is a sense of overwhelming embarrassment or humiliation in most or all social situations.

Next up is obsessive compulsive disorder (OCD). I’m just going to throw this out there. The world has no idea what OCD is. Most of what you see on TV or hear people say (“oh that’s just my OCD”) is referring to OCPD, or obsessive compulsive personality disorder. Basically people who are so anal and finicky that it’s super annoying. OCD is a bit more serious.

As you might guess, the two major components of OCD are obsessions and compulsions. Obsessions are disruptive thoughts or images that pop into your head and persist there. These can get really disturbing, like imagining yourself crushing kittens or people you love dying. They are repetitive in nature and generally cause serious psychological discomfort. Compulsions are what you might be more familiar with. They are urges to perform very specific or ritualistic acts. A classic example is stepping on every crack (or every 3rd crack) on the sidewalk. These are often linked to the obsessions in a causal way, even though no real cause and effect relationship exists between them. In the previous example, a person with OCD might feel that they MUST step on each crack in the sidewalk otherwise a plane will fall out of the sky and kill everyone inside. Someone else might have to step back and forth 10 times before entering or leaving a house otherwise the home will get robbed. OCD can also exist with only obsessions or only compulsions, but these forms are much less common.

The last anxiety disorder that I’m going to talk about is called post traumatic stress disorder (PTSD). You have probably heard of this one in regards to the military. Troops in the armed forces are one of the most likely populations to get PTSD and it’s a huge problem in the United States right now. Basically PTSD is when you experience or witness some really fucked up stuff and it messes up your head.

The traumatic event doesn’t have to be just combat but it can also include things like natural disasters, physical abuse, or rape. The group of symptoms that come along with PTSD is pretty distinct. If you know someone who has PTSD, you will know exactly what I’m talking about. The person with PTSD is likely going to have some sort of re-experiencing of the traumatic event either in the form of flashbacks or dreams. They deserve to forget, but their douchebrain keeps going, “Nope! Time to live it all over again.” They are also likely to be on edge and hypervigilant. This means that they are always looking for signs of danger and startle a lot more easily than other people. Emotional symptoms are also common with PTSD. These are a little different from person to person. Some become very withdrawn and anti-social, while others explode outward in anger and rage. I fucking hate PTSD. If you did your time and had to live through something so terrible, your brain really should do you a solid and just let you move on. Sigh… So those are the main villains in our anxiety story. They all deserve to die. Luckily for you, they are most certainly manageable. Many people have had success on their own, with therapy, with medication, or some combination thereof and have been able to change their lives and conquer their anxiety disorders. Don’t give up hope if you fit the profile for one of these. Your journey starts now.