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Know About

Combined Type

Adults with ADHD have experienced hyperactive, impulsive and / or inattentive symptoms that caused impairment before they reached 7 years of age. However, because many adults are unaware that they have had ADHD since childhood and therefore have not been diagnosed, contacting a health care provider may be best if the following symptoms are experienced for at least 6 months in two or more settings, such as home and work.

Keep in mind that that although these symptoms are part of normal human characteristics, those with ADHD have them to an extreme degree and have great difficulty controlling them.

Combined Type

A neurological disorder characterized by having symptoms of both the hyperactive-impulsive type and inattentive type.

The hyperactive-impulsive type includes the following symptoms:

Hyperactivity:

  • Inner restlessness, “Always on the go,” “Feeling revved up”, fidgety when not moving
  • Inability to relax until exhausted
  • Unhappy and discontent when inactive or doing quiet activities such as reading or watching television

Impulsivity:

  • Impulsiveness range from minor, such as interrupting conversation or intruding on others, to major such as suddenly starting or stopping relationships (multiple marriages, separations)
  • Making reckless decisions without recognizing possible consequences
  • Have problems waiting; waiting to do something causes great discomfort
  • Have problems with self-control
  • Short temper with short-lived explosive outbursts
  • Moods can shift from normal to depressed or excited, and these changes can be reactive or spontaneous
  • Drastic shifts in emotional responses impairs problem solving ability

The inattentive type includes the following symptoms:

  • Distractible
  • Difficulty focusing on a conversation; “constantly aware of thing going on around the person, even when the individual is trying to filter them out”
  • Difficulty finishing tasks that they are not interested in, switching from one task to another. (However, they may become obsessed for activities that they find enjoyable.)
  • Disorganized
  • Poor time management
  • Forgetfulness, often misplacing or losing things

With the combined type of ADHD, the symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and changes over time.

ADHD is often accompanied by depression, anxiety disorders, schizophrenia, and personality disorders. Substance abuse may also develop for some as a way to cope with the disorder. These serious mental health illnesses must also be included in the treatment plan.

“It’s like being fully charged all the time, or at least until you’re exhausted you’re ready to pass out…..I get an idea which I have to act on, and right when I’m doing it, a second idea happens, and what do you know, I have to act on that one too. And a third one comes zooming in. It’s like everything is happening all at once, and it becomes difficult to prioritize. Soon, people describe you as not being able to finish anything, “disorganized,” and “unmotivated.” It’s not that I don’t try, in fact, I try very hard.”

“When people talk to me, I doodle. I know they get annoyed because they think I’m not paying attention. But I have to so that I won’t spill over. Tapping my fingers, biting my nails, singing a song, looking everywhere, I have to do these things to keep me from spilling over.”

Predominantly Inattentive Type

Adults with ADHD have experienced hyperactive, impulsive and / or inattentive symptoms that caused impairment before they reached 7 years of age. However, because many adults are unaware that they have had ADHD since childhood and therefore have not been diagnosed, contacting a health care provider may be best if the following symptoms are experienced for at least 6 months in two or more settings, such as home and work.

Keep in mind that that although these symptoms are part of normal human characteristics, those with ADHD have them to an extreme degree and have great difficulty controlling them.

Predominantly Inattentive Type

A neurological disorder characterized by symptoms of inattention including:

  • Distractible
  • Difficulty focusing on a conversation; “constantly aware of thing going on around the person, even when the individual is trying to filter them out”
  • Difficulty finishing tasks that they are not interested in, switching from one task to another. (However, they may become obsessed for activities that they find enjoyable.)
  • Poor planning and organizational skills
  • Poor attention to details
  • Often late or hurried
  • Forgetful, often misplacing or losing things
  • Daydreams excessively
  • With the inattentive type of ADHD, the symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and changes over time.

ADHD is often accompanied by depression, anxiety disorders, schizophrenia, and personality disorders. Substance abuse may also develop for some as a way to cope with the disorder. These serious mental health illnesses must also be included in the treatment plan.

“By the time I got help, I was looking for my fourth job within the last 12 months. According to my previous bosses, I didn’t have the focus to get the work done. During meetings, I couldn’t understand what people were saying; there was just too much going on outside in the halls. I would make careless mistakes in my reports, forget about things I needed to do and would fail to meet deadlines. With my treatment, I am hoping that this time will be different.”

Predominantly Hyperactive-Impulsive Type

Adults with ADHD have experienced hyperactive, impulsive and / or inattentive symptoms that caused impairment before they reached 7 years of age. However, because many adults are unaware that they have had ADHD since childhood and therefore have not been diagnosed, contacting a health care provider may be best if the following symptoms are experienced for at least 6 months in two or more settings, such as home and work.

Keep in mind that that although these symptoms are part of normal human characteristics, those with ADHD have them to an extreme degree and have great difficulty controlling them.

Predominantly Hyperactive-Impulsive Type

A neurological disorder characterized by symptoms of hyperactivity including:

  • Inner restlessness, “Always on the go,” fidgety when not moving
  • Inability to relax until exhausted
  • Unhappy and discontent when inactive or doing quiet activities such as reading or watching television

A neurological disorder characterized by symptoms of impulsivity including:

  • Impulsiveness range from minor, such as interrupting conversation or intruding on others, to major, such as suddenly starting or stopping relationships (multiple marriages, separations)
  • Making reckless decisions without recognizing possible consequences
  • Waiting to do something causes great discomfort
  • Have problems with self-control
  • Short temper with short-lived explosive outbursts
  • Moods can shift from normal to depressed or excited, and these changes can be reactive or spontaneous
  • Drastic shifts in emotional responses impairs problem solving ability

With the hyperactive-impulsive type of ADHD, the symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and changes over time.

ADHD is often accompanied by depression, anxiety disorders, schizophrenia, and personality disorders. Substance abuse may also develop for some as a way to cope with the disorder. These serious mental health illnesses must also be included in the treatment plan.

“I remember times when I would get so irritated in the check-out line in the grocery that I would end up shouting at the cashier by the time it was my turn. I just couldn’t stand still….I would feel so wired and revved up that even having a quiet dinner in the house would stress me out….until I sought help. Now, my husband and I can actually take simple evening stroll in the park and enjoy ourselves. I still can’t believe it. We’re taking it one day at a time. “

Binge-Eating Disorder

The most common of the eating disorders, binge-eating is also referred to as compulsive overeating or food addiction.  It is somewhat similar to bulimia, however, binge eaters do not purge by vomiting or the use of laxatives after an episode.  Its symptoms include:

  • Frequent episodes of eating what others would consider an abnormally large amount of food, even when not physically hungry
  • Unable to control what or how much is being eaten
  • Eating much more rapidly than usual
  • Eating until uncomfortably full
  • Feelings of disgust, depression or guilt after overeating
  • Fluctuations in weight
  • Diminished interest in sex
  • Frequent dieting

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

People with binge eating disorder often eat as a coping mechanism for stress, low self-esteem, depression, anger, boredom, or even loneliness.  They often eat alone or in secrecy because they are embarrassed at the quantity of food eaten.  After a binge, they often feel self-disgust, which can lead to another episode, creating a cycle of bingeing.

Binge eating can often lead to weight gain, which can progress to obesity, posing additional dangerous health risks to the individual.

Binge eating disorder can be complicated by other medical conditions including type II diabetes, high blood pressure, high cholesterol, gallbladder disease, heart disease and certain types of cancer.  These serious mental health and medical illnesses must also be included in the treatment plan.

“It’s been almost a year now that I’ve been eating alone and preferably in my home.  Eating with friends or family is not really my thing.  I guess I eat “normal” when I’m with them but when I get home, I just have to eat again, and more.  And being full doesn’t really stop me from stuffing myself.  I just can’t stop.  My sister told me once that I eat for 8 people…or more… and that’s why I’m 205 lbs. at 5’4”. I don’t care, I don’t have a boyfriend. Who would want me in the first place anyway?”

Bulimia Nervosa

It is an illness that involves a cycle of binge eating followed by purging, and like anorexia, bulimia is greatly influenced by weight and body shape. Purging in most cases is done by self-induced vomiting.  This can occur several times a week or even within a day and lasts for a period of months. Bulimia’s symptoms include:

  • Episodes of bingeing and purging
  • Lack of control over eating during an episode
  • Self-induced vomiting
  • Misuse of laxatives, diuretics, enemas, diet pills or other medications
  • Fasting or excessive exercise
  • Depression
  • Anxiety

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

Binge episodes are often used as a coping mechanism for stress, depression, and self-esteem issues.  During an episode, an individual with bulimia will binge on sweet, high calorie foods and will consume an amount of food far greater than what he or she would normally eat during a short period of time.  The person cannot control how much is eaten nor stop in the middle of a binge, resulting in feelings of shame and disgust with oneself.

The purging relieves the individual of the guilt from binging and restores a sense of relief and control.  Purging is usually done in secrecy in order to conceal the behavior from family and loved ones.

Bulimia is difficult to detect since most people with this disorder maintain a normal body weight and hide their purging from those around them.  They consider their behavior embarrassing, thus, making it difficult for them to seek treatment.

Bulimia is often accompanied by depression and anxiety disorder. Furthermore, these are complicated by other medical conditions including erosion of tooth enamel, tooth decay, swollen cheeks due to enlargement of the salivary / parotid glands, dehydration, constipation, esophageal tears, gastric rupture,  ulcers of the stomach and esophagus, metabolic acidosis from diarrhea and  metabolic alkalosis from vomiting.  These serious mental health and medical illnesses must also be included in the treatment plan.

“I’m not sure why I do it.  I found myself eating a dozen doughnuts, too many cupcakes, chocolate bars, whipped cream, ice cream, potato salad, jelly bean…I just couldn’t stop eating…I felt so bad that I knew I had to let it out of my body.  I remembered to turn on the faucet in the bathroom so nobody would hear me while I vomited.  And whatever I didn’t vomit, the laxative took care of. I felt much better afterwards.”

Anorexia Nervosa

It is an illness characterized by having a severe preoccupation with being thin.  Anorexia nervosa is accompanied by an immense fear of gaining weight and an obsession with one’s body image.  Its symptoms include:

  • Refusal to maintain a normal body weight
  • Intense fear of gaining weight or becoming fat
  • Depression
  • Anxiety
  • Irritability
  • Insomnia
  • Diminished interest in sex
  • Suicidal thoughts
  • Using or abusing laxatives, diet pills, or diuretics to control weight
  • Extreme dieting, fasting, or exercising excessively

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

Anorexics are likely to equate being thin with social acceptance, largely due to cultural ideals and media influences on society. Even when emaciated, they will still perceive themselves as being overweight.

Anorexics will derive a sense of fulfillment from losing weight, and will perceive weight gain as failure.  Control of one’s body through weight is a significant theme in anorexics, to the point where it will interfere or hinder one’s daily activities.

The individual will repeatedly weigh themselves, measure body parts, and count every calorie ingested. The restriction of caloric intake and starvation is usually the method of weight loss. Calorie restriction can be so extreme, that some individuals will only consume 200 calories a day, a number far below the recommended daily intake.

Anorexia is often triggered by a single traumatic event, sexual abuse, or extended periods of stress.  On the surface, it may appear to be only an obsession with weight.  However, there are many underlying emotional issues that need to be resolved as well.

Anorexia nervosa is often accompanied by depression, substance abuse and anxiety disorder. Furthermore, these are complicated by other medical conditions including brittle hair and nails, dehydration, constipation, anemia, loss of energy, loss of menstrual periods, osteopenia (low bone density), heart failure and liver disease, which can lead to death.  These serious mental health and medical illnesses must also be included in the treatment plan.

“I can’t believe I gained 2 pounds!  I’m so fat I hate myself.  My friends said I’m too thin but at 5’8” tall, I’m at my best at 103 pounds. Now I’m at 105.  I don’t understand it…I stick to my 500-calorie a day diet.  Maybe I should skip dinners…that should do it.”

Warnings of Suicide

Warning Signs of Suicide
All mentions of suicide, death, or violence must be taken seriously. If you, a friend or a loved one displays any of the following warning signs of suicide, please contact your mental health professional immediately or go to the emergency room for help.

  • Talking about killing oneself
  • Making verbal suicide threats such as “Maybe I won’t be around,” “ It would be better if I wasn’t’ here,” or “I want out”
  • Always talking or thinking about death
  • Talking about hopelessness and helplessness
  • Having a “death wish,” displaying risky behavior can lead to death such as running through red lights or driving recklessly fast
  • Unexpected shift from being very sad, to being very calm, to appearing to be happy
  • Depression
  • Previous suicide attempts
  • Lack of interest in future plans
  • Visiting or calling people to say goodbye
  • Putting affairs in order, writing a will, giving away prized possessions

Previous suicide attempts increases the risks for future suicides and completed suicides. The more detailed a suicide plan, the greater the risk that the person will carry out the suicide.

Bipolar Disorder

Used to be called manic depressive disorder, bipolar disorder is characterized by extreme mood changes alternating between 2 opposites or poles: extreme highs (mania) and extreme lows (depression).

Being in the manic state includes the following symptoms:

  • Excessive happiness, hopefulness, excitement, feelings of euphoria, “feeling on top of the world”
  • Markedly, increased energy, activity, and restlessness
  • Easily distracted
  • Unusual irritability, shifting suddenly from being joyful to being angry and hostile
  • Decreased need for sleep, may last for days with little or no sleep without feeling tired
  • Racing thoughts, jumping from one idea to another
  • Increased talking, rapid talk
  • Grandiose notions, tendency to make grand and unattainable plans, delusions of grandeur, false ideas of one’s intelligence, greatness and powers
  • Increased sexual desire, high sex drive
  • Uncharacteristically poor judgment such as spending sprees, quitting the job, foolish business ventures
  • Increased risky behaviors such as impulsive sexual indiscretion, drug abuse particularly cocaine, alcohol and sleeping medications
    Mania is diagnosed if the person experiences 3 or more of the above symptoms, and they last most of the day, almost everyday for at least 1 week.

Being in the depressed state includes the following symptoms:

  • Persistent sad, anxious or “empty” mood
  • Sleeping too much or too little, insomnia, middle of the night or early morning waking
  • Reduced appetite or weight loss, or increased appetite or weight gain
  • Loss of interest or pleasure in activities that were once enjoyed, including sex
  • Difficulty concentrating, remembering or making decisions
  • Decreased energy, fatigued
  • Feelings of worthlessness, guilt, helplessness
  • Feelings of hopelessness
  • Agitation, restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain
    Thoughts of death, dying or suicide – with or without a plan, suicide attempts.

Major depression is diagnosed if the person experiences 5 or more of the above symptoms, and they last most of the day, almost everyday for at least 2 weeks. See Major Depression.

In many cases of bipolar disorder, the symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

Bipolar disorder is difficult to diagnose since people in a manic state can be very productive. For instance, a writer in this state may write prolifically, causing him to avoid treatment to risk a spiral for his work. The high levels of energy and state of euphoria may feel too good to the individual, which may lead to a denial that there is an illness.

The changes in moods occur in cycles. As the person affected by bipolar gets older, the mood swings become closer together. In between poles, people with bipolar disorder can perform normal activities, such as hold a steady job, stay in school or completing their daily routines.

Although not as prevalent as major depression, bipolar disorder also causes chaos in the lives of the family and friends who care about the individual affected by the disorder. Loved ones may find it difficult to adjust and accept that an individual who was once very productive and energetic may shift into an individual who is depressed and cannot perform even normal daily tasks and responsibilities.

Depression is often accompanied by substance abuse and addiction. These serious mental health illnesses must also be included in the treatment plan.

“It’s difficult for me to have romantic relationships or even friendships with people. My partner is suffering because she couldn’t handle my extreme mood swings. I guess it’s difficult to live with someone who is, in one period, be on top of the world, a high-performing employee who thinks nothing can stop him… and then for months, be in complete depression when simply getting out of bed, much less, talking to or seeing anybody is so hard. I feel that my friends are starting to stay away from me… I’m so angry and irritable sometimes that I can’t help being rude and obnoxious.”

Major Depression

Listed under mood disorders, major depression is one of the most severe types of depression.   Also known as major depressive disorder, clinical depression or unipolar depression, it interferes with normal activities such as working, studying, eating, sleeping, playing and other activities previously considered as pleasurable.  Major depression includes the following symptoms:

  • Persistent sad, anxious or “empty” mood
  • Sleeping too much or too little, insomnia, middle of the night or early morning waking
  • Reduced appetite or weight loss, or increased appetite or weight gain
  • Loss of interest or pleasure in activities that were once enjoyed, including sex
  • Difficulty concentrating, remembering or making decisions
  • Decreased energy, fatigued
  • Feelings of worthlessness, guilt, helplessness
  • Feelings of hopelessness
  • Agitation, restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain
  • Thoughts of death, dying or suicide – with or without a plan, suicide attempts

In many cases of major depression, the symptoms impair the social, occupational, and personal functioning of the individual.

Major depression is diagnosed if the person experiences 5 or more of the above symptoms, and they last most of the day, almost everyday for at least 2 weeks.

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

A debilitating depression can occur only once but more commonly recurs several times during the course of life.  If left untreated, depression can worsen and last for years.  It can cause needless suffering, and can even lead to suicide.

Depression is often accompanied by substance abuse and addiction. These serious mental health illnesses must also be included in the treatment plan.

“I’ve been feeling empty for the past 5 weeks.  I think my mom worries that I’m sleeping 16 hours a day.  She asks my friends if I’m taking drugs…I’m not.  I just feel tired all the time.  Come to think of it, I like sleeping.  At least I don’t feel sad when I sleep.  I used to be an A student but I can’t concentrate on schoolwork anymore.  I guess I don’t care.  Even my friends bug me about not going out with them for our Saturday dates in the mall.  I don’t want to go window shopping for clothes especially after gaining 15 pounds.  I don’t know, I guess life just sucks.  Sometimes, I think it’s better off without me.”

Obsessive Compulsive Disorder

Having persistent, intrusive, upsetting, irrational thoughts (obsessions) and using repetitive rituals (compulsions) to control or temporarily alleviate the anxiety produced by these obsessions.

Common obsessions are on germs or dirt which could lead to the compulsion of repetitive hand washing.  Another is an obsession with intruders which could lead to the compulsion of locking and relocking door locks many times before going to bed.  Another is having difficulty throwing things out which leads to hoarding or accumulating unneeded items.

Healthy individuals may have daily routines but the difference from those affected by OCD is that these rituals impede with daily living and the repetition is distressing.  Awareness of the repetitive behavior varies from one person to the next.

In many cases, this disorder impairs the social, occupational, and personal functioning of the individual.

“Getting dressed in the morning was tough, because I had a routine, and if I didn’t follow the routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming my parents. That was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me.”

“On my way to work, I would start thinking that maybe, I didn’t turn off my oven.  Part of me knew that I already checked it several times before leaving the house.  But I just couldn’t help going back to see if the oven dial is on ‘Off.’  My boss already spoke to me about being late to work but I just couldn’t help going back.  I knew my rituals didn’t make sense and I’m embarrassed about them.  I didn’t think I could overcome them until I began therapy.”

Panic Disorder

Sudden panic attacks characterized by feelings of overwhelming terror and impending doom, accompanied by physical symptoms including:

  • Palpitations
  • Sweatiness
  • Weakness
  • Faintness
  • Dizziness
  • Sense of choking
  • Shortness of breath
  • Nausea
  • Chest Pain
  • Sense of unreality
  • Numbness or tingling
  • Hot flushes or chills

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

Panic attacks can occur any time, even during sleep.  An attack usually peaks within 10 minutes, but some symptoms may last longer.  For some, they may just have one attack and have it not followed by another.  Not everyone who experiences panic attacks will develop panic disorder.

Panic disorder is a mental health illness that can be successfully treated.  If help is not sought, people’s lives can become so restricted they cease to enjoy normal activities, such as going out to restaurants, driving, or shopping for fear that they will have a panic attack.  Those who have experienced a full-blown and debilitating episode need to seek treatment before they begin to avoid places or situations wherein an attack happened.

Panic disorder is often accompanied by other serious mental health illnesses such as depression and / or substance abuse, which must also be included in the treatment plan.

“For me, a panic attack is almost a violent experience. I feel disconnected from reality. I feel like I’m losing control in a very extreme way. My heart pounds really hard, I feel like I couldn’t breathe, and there’s an overwhelming feeling that things are crashing in on me.”

“You may genuinely believe you’re having a heart attack, losing your mind, or are on the verge of death.  I really thought I was going to die, it was awful.”

General Anxiety Disorder

Unrealistic and excessive worry over a myriad of daily problems for a period of at least 6 months accompanied by physical symptoms including:

  • Muscle tension
  • Easy fatigue
  • Restlessness
  • Difficulty in sleeping
  • Irritability
  • Difficulty in concentration
  • Edginess
  • Gastrointestinal discomfort or diarrhea

With general anxiety disorder, or GAD, the anxiety or physical symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

When anxiety level is mild, people affected by GAD can go about their social functions and keep their jobs.  However, if the anxiety becomes severe, people affected by GAD can experience great difficulty performing the simplest of daily tasks.

GAD is often accompanied by other anxiety disorders, depression, and / or substance abuse, which must also be included in the treatment plan.

“I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”

Post-Traumatic Stress Disorder

For post-traumatic stress disorder or PTSD to be diagnosed, an individual needs to have experienced a sudden, unexpected, horrific experience wherein one was afraid for the safety of one’s life causing trauma.  The individual also felt fear, helplessness and horror.  PTSD includes the following symptoms, which last for at least a month:

  • Flashbacks or “you can’t stop remembering” and nightmares
  • Emotional detachment or numbness, especially to those people they used to be close to
  • Irritability
  • Jumpiness — “jumping out of their skin”
  • Hypervigilance or always looking around as if scanning the surroundings for danger
  • Trouble falling or staying asleep due to this high state of arousal
  • Poor concentration
  • Avoidance behavior such as avoiding places related to the trauma

In severe cases, the symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

Sudden traumatic events can happen to people individually, such as in car accidents, sexual assault, domestic violence, death of a loved one, witnessing a life-threatening event, discovery of a serious illness like cancer or having had a heart attack.  Or, they can affect people as a group, such as in natural disasters including earthquakes, tornadoes, and floods.  In addition, traumatic events can affect people indirectly, such as in the terrorist attacks on the World Trade Center, especially with the media exposure.

The probability of having PTSD is significantly increased when the intensity of the trauma is high and the length of exposure to the trauma is long.

PTSD is often accompanied by other anxiety disorders, depression and substance abuse. These serious mental health illnesses must also be included in the treatment plan.

“I was raped when I was 25 years old. For a long time, I spoke about the rape as though it was something that happened to someone else. I was very aware that it had happened to me, but there was just no feeling.”

“Then I started having flashbacks. They kind of came over me like a splash of water. I would be terrified. Suddenly I was reliving the rape. Every instant was startling. I wasn’t aware of anything around me, I was in a bubble, just kind of floating. And it was scary. Having a flashback can wring you out.”

“The rape happened the week before Thanksgiving, and I can’t believe the anxiety and fear I feel every year around the anniversary date. It’s as though I’ve seen a werewolf. I can’t relax, can’t sleep, don’t want to be with anyone. I wonder whether I’ll ever be free of this terrible problem.”

Social Anxiety Disorder

Also known as social phobia, it is having an overwhelming fear of and excessive self-conscious in situations that require social interaction. It is a chronic fear of being judged or watched by others, for instance, standing in front of a group or talking to others, and is accompanied by physical symptoms including:

  • Blushing
  • Profuse sweating
  • Difficulty talking
  • Nausea

With social anxiety disorder, the anxiety or physical symptoms impair the social, occupational, and personal functioning of the individual.

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

With social anxiety disorder, the phobia can be limited to one situation, for instance, going to school, eating with others, or talking to people.  Or, it can be so broad that the only time the individual does not feel anxiety is when around family members only.

Social anxiety disorder is often accompanied by other anxiety disorders, depression.  Substance abuse may develop for some as a way to handle their anxiety.  These serious mental health illnesses must also be included in the treatment plan.

“I feel fear in any occasion that I need to be around people. The other day, while waiting for a dressing room, I felt as though all eyes were focused on me.  The sales lady, the line of women waiting with me – were they all looking at me?  What were they saying about me?…about the suit that I chose?  As I waited, I started feeling sick to my stomach.  My palms were getting sweaty, my face felt clammy.  The lady next to me asked me a question but all I heard was my heart pounding.  I was anxious enough on my way to the mall.  But right then, I just couldn’t wait to get out.”