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Anxiety Disorders

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MY SPECIALTIESAnxiety Disorders

It is very common and even normal to feel afraid or anxious at certain times in our lives.

Anxiety can even help alert us to dangers and even help us to prepare or pay attention to our surroundings or the situation. However, the state of “being afraid” is typically what amounts to an anxiety disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) ^[1]. In other words, anxiety disorders help distinguish between the normal human reaction that is known as fear and the excessive amount of fear or anxiety that becomes an actual state of mind, which the person feels and can result in debilitating symptoms that cause problems for a person in one or more areas of his or her life that are important to the person.

Anxiety disorders can be frightening, in their own right, especially when you don’t know where to turn or who to talk to about the fear that you are experiencing and how it all started. Many in the medical and mental health professions believe that medication is the only answer or that if therapy is involved, it should be chosen from a few select choices based upon the specific diagnosis, which is why people who experience anxiety disorders feel so misunderstood. After all, the fear or anxiety must be “disproportionate to the situation or age inappropriate and hinder the person’s ability to function normally” in order to “qualify” as a disorder. The definition already suggests that many in the helping professions perceive that there is something “wrong” with the person who is seeking help, rather than seeing the person, as a person, who is suffering and in need of compassionate care and understanding.

Christ Himself warned us, throughout the Gospels, about anxiety as a state of “being afraid” when He said, “Do not be afraid.” In His compassion for us, He pointed out that He knows that we are afraid and yet He came into the world to show us how to overcome it by learning how to trust in God’s Providence, Mercy, and Justice. He didn’t say that we would never feel afraid. On the contrary, He knows that we will always be afraid without God and that it’s impossible for us not to feel afraid. Yet, He was sure to tell us, in a very specific way, the difference between feeling and being afraid. Pay attention. It’s the order of His speech that matters most. ^[2]

Anxiety is defined by the American Psychiatric Association as a “normal reaction to stress”. However, this demonstrates, at minimum, a lack of understanding about the cause of anxiety, the psychology of stress, and the role of trauma. Most secular psychotherapists don’t know a thing about God and they believe that they can rely solely on short-term psychotherapy models or that we are simply controlled by our brains and our bodies as if we are some sort of animals. The difference is that we are human beings who have language, the unconscious, and God the Father has given us a soul.

an anxious looking man slouching forwards with his hands over his head. Park bench setting

Anxiety Disorders are the Most Common Mental Illness in the United States ^[3]

If you have struggled with an anxiety disorder, you are not alone.

Fear can take on many forms and your personal situation and needs are unique and specific, so while there are diagnoses that you may have been assigned, your experience is different even if there is a collection of symptoms or perhaps even a similar history that you share with others. The most important thing to remember is that there is good news. Hope and help is available, which is not limited to medication.

I have experience working with all types of fear and anxiety, including those that are not specifically mentioned in the DSM-5-TR ^[4] and it’s my experience that unconscious anger is a common precursor to anxiety disorders that results from a previous life event(s). These life events are often related to abuse or other trauma, but not always. The only way to resolve the underlying cause of anger is with forgiveness.

The main categories of anxiety disorders that are specifically mentioned in the DSM-5-TR (excluding substance/medication-induced) include:

Generalized Anxiety Disorder

General excessive fear and worry about a number of life events or activities (such as work or school performance) lasting at least 6 months.

Panic Disorder

Recurrent unexpected panic attacks. A panic attack ^[5] is an abrupt surge of intense fear or discomfort that reaches a peak within minutes and includes specific symptoms that may also include culturally specific symptoms, which do not count towards the minimum four symptoms required. At least one panic attack has been followed by 1 month (or more) of one or both: persistent concern or worry about additional panic attacks or their consequences or a significant maladaptive change in behavior related to the attacks. Note: A Panic Attack Specifier can be added to other mental disorders if it does not meet the full diagnostic criteria.

Phobias, Specific Phobia

Specific fear or anxiety about a specific object or situation and typically lasts 6 months or longer. Fear or anxiety is often expressed differently in children.

Agoraphobia

Fear of two (or more) of specific situations that require the person to be in open or enclosed spaces outside of his or her home alone, with the fear, anxiety, or avoidance is persistent, typically lasting at least 6 months.

Social Anxiety Disorder (previously called social phobia)

Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others, typically lasts 6 months or longer.

Separation Anxiety Disorder

Developmentally inappropriate and excessive fear or anxiety concerning separation from those whom the individual is attached, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.

Note: The American Psychiatric Association, which publishes the DSM-5-TR states that related conditions include Post-Traumatic Stress Disorder (PTSD), Adjustment Disorder, Obsessive-Compulsive Disorder, Acute Stress Disorder, and Selective Mutism.

Catholic Psychotherapy for Anxiety Disorders

If you are committed to the therapeutic process and you are willing to acknowledge how anxiety is having an effect on your ability to function to your full capacity in areas of your life that are important to you, psychotherapy from a therapist with my background and training can be very effective. While some people who experience anxiety disorders have a general idea about when they started to feel anxious or afraid, many people do not understand the complex unconscious psychological conflicts that started their anxiety and even what causes them to cling to it as a form of self-protection.

Catholic Psychotherapy techniques can help you to understand the origins and put new language and meaning to things that you were not able to do on your own, so that you can begin to believe that you do not have to continue to be afraid. In addition to teaching you how to manage your anxiety, we can work towards resolving the underlying cause of your anxiety so that you can become free of the symptoms and experience real healing, so that you can grow spiritually and develop a closer relationship with God.

NOTES

^[1] Anxiety is defined by the American Psychiatric Association as a “normal reaction to stress”. However, this demonstrates, at minimum, a lack of understanding about the cause of anxiety, the psychology of stress, and the role of trauma.

[2] Recommended reading. Richmond, R. (1997-2022). Fear. Catholic Psychology in association with A Guide to Psychology and its Practice. Retrieved on February 3, 2023, from https://www.chastitysf.com/fear.htm

[3] American Psychiatric Association (2023). What are anxiety disorders? – Physician Review Philip R. Muskin, M.D., M.A. June 2021. Retrieved on January 15, 2023, from https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders

^[4]Castration anxiety is a psychoanalytic term, which Sigmund Freud described as a general fear about injury to your own body. Technically speaking, the loss of any body part can provoke the feeling of castration anxiety. Jacques Lacan, however, understood that Sigmund Freud’s sexual descriptions were just a screen covering up an even deeper anxiety. Castration, for Lacan, meant the horrifying recognition of our human fragmentation, the very fragmentation that the infant has to “cover up” through its identifications with the world as it builds up a coherent personality. Richmond, R. (1997-2022) Identity – and Loneliness: Encounter – and Trauma. A Guide to Psychology and its Practice. Retrieved on January 15, 2023, from https://www.guidetopsychology.com/identity.htm#2. Copyright © 1997-2022 Raymond Lloyd Richmond, Ph.D. Reproduced and adapted with permission by Raymond Lloyd Richmond, Ph.D. The material is copyrighted and may not be reproduced by any means.

^[5]Panic attacks and anxiety attacks are commonly confused, and the terms are all too often used interchangeably. The key difference between the two is that a panic attack begins abruptly without the person typically being consciously aware of ‘why’ they are having the attack. A person, who experiences anxiety attacks, is typically consciously aware of what causes the attack and so, it’s not something that begins abruptly, which implies without warning or an identifiable cause.