ANXIETY DISORDERS:

GAD, PHOBIA, PANIC DISORDERS & OCD

 WORRY ANXIETY STRESS
(Thinking) (Feeling) (Bodily Response)

• Tension (Past)
• Apprehension (Future)
• Palpitation
• Hyper ventilation
• Trembling
• Decreased concentration
Anxiety or fear-related disorders (ICD-11)
Anxiety and fear-related disorders are characterized by excessive fear and anxiety and related
behavioural disturbances, with symptoms that are severe enough to result in significant distress or
significant impairment in personal, family, social, educational, occupational, or other important areas
of functioning. Fear and anxiety are closely related phenomena; fear represents a reaction to
perceived imminent threat in the present, whereas anxiety is more future-oriented, referring to
perceived anticipated threat. A key differentiating feature among the Anxiety and fear-related
disorders are disorder-specific foci of apprehension, that is, the stimulus or situation that triggers the
fear or anxiety. The clinical presentation of Anxiety and fear-related disorders typically includes
specific associated cognitions that can assist in differentiating among the disorders by clarifying the
focus of apprehension.
 Anxiety or fear related disorders

Anxiety
Disorder

PANIC
GAD PHOBIA DISORDE
R

Social
Phobia/Social Specific
Agoraphobia
anxiety Phobia
disorder
 GENERALISED ANXIETY DISORDER
• It is marked by excessive exaggerated anxiety and worry about every day
life events for no obvious reasons.

• People with GAD may anticipate disaster and may be overly concerned
about any issues.

• The anxiety tends to be free floating in nature or more of a general

apprehension.

• According to ICD-11, Generalised anxiety disorder is characterized

by marked symptoms of anxiety that persist for at least several
months, for more days than not, manifested by either general
apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused
on multiple everyday events, most often concerning family, health,
finances, and school or work, together with additional symptoms such
as muscular tension or motor restlessness, sympathetic autonomic
over-activity, subjective experience of nervousness, difficulty
maintaining concentration, irritability, or sleep disturbance. The
symptoms result in significant distress or significant impairment in
personal, family, social, educational, occupational, or other important
areas of functioning. The symptoms are not a manifestation of
another health condition and are not due to the effects of a substance
or medication on the central nervous system.
PANIC DISORDER
• It is characterised by recurrent unexpected panic attacks not
restricted to particular stimuli or situations.

• The focus of apprehension is the concern about recurrence of

unexpected panic attacks.

• According to ICD-11, Panic disorder is characterized by

recurrent unexpected panic attacks that are not restricted to
particular stimuli or situations. Panic attacks are discrete
episodes of intense fear or apprehension accompanied by the
rapid and concurrent onset of several characteristic symptoms
(e.g., palpitations or increased heart rate, sweating, trembling,
shortness of breath, chest pain, dizziness or lightheadedness,
chills, hot flushes, fear of imminent death). In addition, panic
disorder is characterized by persistent concern about the
recurrence or significance of panic attacks, or behaviors
intended to avoid their recurrence, that results in significant
impairment in personal, family, social, educational,
occupational, or other important areas of functioning. The
symptoms are not a manifestation of another health condition
and are not due to the effects of a substance or medication on
the central nervous system.
 PHOBIA
• A phobia is an overwhelming and debilitating fear of an object, place,
situation, or animal.
• They are more prominent than fear.
• It develops when a person has unrealistic sense of danger about a situation or
object.
• It often leads to avoiding the source of the anxiety to an extent of restricting
the day to day life.
AGORAPHOBIA • According to ICD-11, Agoraphobia is characterized by marked
and excessive fear or anxiety that occurs in response to multiple
situations where escape might be difficult or help might not be
available, such as using public transportation, being in crowds,
being outside the home alone (e.g., in shops, theatres, standing
in line). The individual is consistently anxious about these
situations due to a fear of specific negative outcomes (e.g., panic
attacks, other incapacitating or embarrassing physical
symptoms). The situations are actively avoided, entered only
under specific circumstances such as in the presence of a
trusted companion, or endured with intense fear or anxiety. The
symptoms persist for least several months, and are sufficiently
severe to result in significant distress or significant impairment
in personal, family, social, educational, occupational, or other
important areas of functioning.
 SOCIAL ANXIETY DISORDER
• According to ICD-11, Social anxiety disorder is
characterized by marked and excessive fear or anxiety
that consistently occurs in one or more social situations
such as social interactions (e.g., having a conversation),
being observed (e.g., eating or drinking), or performing
in front of others (e.g., giving a speech). The individual
is concerned that he or she will act in a way, or show
anxiety symptoms, that will be negatively evaluated by
others. The social situations are consistently avoided or
else endured with intense fear or anxiety. The symptoms
persist for at least several months and are sufficiently
severe to result in significant distress or significant
impairment in personal, family, social, educational,
occupational, or other important areas of functioning.
SPECIFIC PHOBIA
• According to ICD-11, Specific phobia is characterized
by a marked and excessive fear or anxiety that
consistently occurs when exposed to one or more
specific objects or situations (e.g., proximity to certain
animals, flying, heights, closed spaces, sight of blood or
injury) and that is out of proportion to actual danger.
The phobic objects or situations are avoided or else
endured with intense fear or anxiety. Symptoms persist
for at least several months and are sufficiently severe to
result in significant distress or significant impairment
in personal, family, social, educational, occupational, or
other important areas of functioning.
 OBSESSIVE COMPULSIVE DISORDER
• According to ICD-11, Obsessive-Compulsive Disorder is
characterized by the presence of persistent obsessions or compulsions,
or most commonly both. Obsessions are repetitive and persistent
thoughts, images, or impulses/urges that are intrusive, unwanted, and
are commonly associated with anxiety. The individual attempts to
ignore or suppress obsessions or to neutralize them by performing
compulsions. Compulsions are repetitive behaviors including
repetitive mental acts that the individual feels driven to perform in
response to an obsession, according to rigid rules, or to achieve a
sense of ‘completeness’. In order for obsessive-compulsive disorder
to be diagnosed, obsessions and compulsions must be time consuming
(e.g., taking more than an hour per day), and result in significant
distress or significant impairment in personal, family, social,
educational, occupational or other important areas of functioning.
• 6B20.0 Obsessive-compulsive disorder with fair to good insight
All definitional requirements of obsessive-compulsive disorder are met. Much of the time, the
individual is able to entertain the possibility that his or her disorder-specific beliefs may not
be true and is willing to accept an alternative explanation for his or her experience. At
circumscribed times (e.g., when highly anxious), the individual may demonstrate no insight.

• 6B20.1 Obsessive-compulsive disorder with poor to absent insight

All definitional requirements of obsessive-compulsive disorder are met. Most or all of the
time, the individual is convinced that the disorder-specific beliefs are true and cannot accept
an alternative explanation for their experience. The lack of insight exhibited by the individual
does not vary markedly as a function of anxiety level.

• 6B20.Z Obsessive-compulsive disorder, unspecified

THE END