There’s more than one kind of anxiety. Here, experts provide an overview of panic disorder, social anxiety, OCD, and more.
September 20, 2017
“Anxiety” is often used as a catch-all term for worrisome thoughts. But the reality is, there’s more than one type of anxiety—and each has different symptoms.
Identifying the types can be tricky, in part because it’s possible to experience more than one at the same time. “A lot [of the types] overlap in my clinical practice,” says Elizabeth Ochoa, PhD, a chief psychologist at Mount Sinai Beth Israel in New York City. Someone with generalized anxiety disorder may also suffer from panic attacks, for example; while a person who has social anxiety could also exhibit symptoms of OCD.
To shed light on the various types of anxiety, we asked experts to highlight the unique signs to look for. Below is an overview of the five most common disorders.
But if you suspect you (or a loved one) might suffer from anxiety, an evaluation from a mental health professional can help you find out for sure, and determine the best course of treatment.
This is probably the most uncomfortable type of anxiety, says Ochoa. It’s characterized by brief surges of very intense, overwhelming worry or fear. A person’s triggers may be obvious (stress is a common one), or unknown.
While a panic attack starts in the mind, the physical symptoms are all too real: They may include heart palpitations, sweating, difficulty breathing, shaking, chest pain, and nausea. (This Is Us actor Sterling K. Brown’s powerful portrayal of a panic attack showed how scary and debilitating these episodes can be.)
Another characteristic of panic attacks is derealization: “[People will] feel like things are not real, or feel detached from oneself,” says Ben Michaelis, PhD, a New York City-based clinical psychologist and founder of the YouTube channel One Minute Diagnosis.
Many people will experience at least one panic attack in their lives, likely during a period of acute stress. But if you get panic attacks more frequently, or they start interfering with your life (causing you to avoid places where you had an attack in the past, for example), you might be suffering from a panic disorder.
Cognitive behavioral therapy can help you learn coping strategies, and pinpoint your triggers.
Everyone feels nervous in social settings from time to time (think dinner with your S.O.’s parents, or an awkward networking event). But people with social anxiety are highly self-conscious around others, and experience an intense fear of being observed and judged that can result in physical symptoms like sweating, blushing, and nausea.
“They worry that their behavior will humiliate or embarrass themselves, offend others, and lead to rejection,” says Michaelis. “But their fear or anxiety is not proportional to any actual threat.”
Any social situation can become extremely stressful. “People with social anxiety are constantly worried that they’ll create a negative perception,” says Ochoa. The thought of their own anxiety can actually breed more anxiety, too. “They often worry that their anxiety will be knowable.”
The disorder can make it tougher to develop interpersonal relationships, she says. When seeking help, try to find a psychiatrist or psychologist who has experience working with people with social anxiety.
Generalized anxiety disorder
This type of anxiety affects 6.8 million adults in the United States every year, according to the Anxiety and Depression Association of America. But while common, generalized anxiety disorder (GAD) isn’t the same thing as occasionally feeling anxious. “Everyone has instances of extreme anxiety from time to time,” says Ochoa. “It’s notable when it interferes with your day-to-day functioning.”
People with GAD experience severe, irrational concern about specific triggers. Ochoa explains that the anxiety often stems from real-life, everyday factors and circumstances, such as health, finances, and family. These are all normal things to feel anxious about, of course. But for people with GAD, the level of anxiety is hugely out of proportion to the cause.
“They’re excessively anxious about a number of events, and have difficulty controlling such worry to the point that it impacts their lives,” says Michaelis.
People with GAD can also develop symptoms like fatigue, tense muscles, or difficulty sleeping and concentrating.
OCD is a little different from the other major anxiety types, says Ochoa. “It stands alone,” she explains, because while anxiety often involves an avoidance of triggers (such as skipping a cocktail party), people with OCD engage in repetitive behaviors tied to a particular phobia. But OCD is often considered a form of anxiety because people with the disorder usually feel intensely anxious when they aren’t able to perform certain behaviors.
“A person with OCD experiences either obsessions, compulsions, or both,” says Michaelis. “Obsessions are recurrent unwanted or intrusive thoughts, urges, or images that cause anxiety and distress; and compulsions are repetitive behaviors or acts that a person does in order to suppress an unwanted thought or urge.”
A few common symptoms of the disorder include compulsive hand-washing, obsessive cleaning, so-called “checking” behaviors (returning home to see if you’ve turned off the stove, for example), or performing counting tasks (often driven by a superstition, like “I have to count when walking up stairs or something bad will happen”). The compulsions are typically driven by fear of germs or contamination, or mental images of violent scenes.
Post-traumatic stress disorder
Like OCD, PTSD is different from other types of anxiety disorders. “Anxiety is clearly a component of [PTSD], but it’s much more complicated,” says Ochoa.
People develop PTSD after experiencing a highly stressful, life-threatening event, such as military combat, a serious injury, or sexual violence (although it’s important to note that not everyone who survives situations like these gets PTSD). The disorder often causes “re-experiencing” symptoms—or flashbacks to the initial trauma and upsetting, intrusive thoughts that can interfere with relationships and daily functioning.
“They become distressed when exposed to cues that resemble the traumatic event,” says Michaelis. “For example, if a person lived through a horrific hurricane, a windy day may trigger aspects of the traumatic event.”
Other people with PTSD may feel constantly on edge, have trouble sleeping, or generally experience negative feelings. The good news is that with therapy, it is possible to recover from PTSD and move on.