Anxiety And Dissociative Disorders

Anxiety disorders are the most common of all psychiatric disorders. An individual with one of these disorders experiences physiologic, cognitive, and behavioral symptoms of anxiety. The physiologic manifestations are related to the “fight-or-flight” response and result in cardiovascular, respiratory, neuromuscular, and GI stimulation. The cognitive symptoms include subjective feelings of apprehension, uneasiness, uncertainty, or dread. Behavioral manifestations include irritability, restlessness, pacing, crying and sighing, and complaints of tension and nervousness. The common theme among anxiety disorders is that the individual experiences a level of anxiety that interferes with functioning in personal, occupational, and social areas.

Anxiety experienced in response to a traumatic event may interrupt the formation of memories related to the event and disrupt learning processes resulting in dissociation. Disassociation can be initially viewed as an adaptive defense against painful memories or feelings of helplessness. When aspects of disassociation interfere with the ability of the individual to function socially, vocationally or interpersonally, then such dissociative aspects may be considered a disorder.

In most situations of disassociation the response to a traumatic event is not consciously connected to memories of the event. Such dissociative disorders are characterized by an alteration in conscious awareness, which includes forgetfulness and memory loss for past stressful events. Other dissociate methods of withdrawing from anxiety-producing stimuli are depersonalization (a feeling of disconnection from one's self) and derealization (a feeling of being disconnected from the surrounding environment). The individual may also develop what appear to be distinctly different personalities.

Anxiety Disorders

• Panic disorder without agoraphobia
• Panic disorder with agoraphobia
• Agoraphobia without history of panic disorder
• Specific phobia
• Social phobia
• Obsessive-compulsive disorder (OCD)
• Posttraumatic stress disorder (PTSD)
• Acute stress disorder
• Generalized anxiety disorder
• Anxiety disorder due to a general medical condition
• Substance-induced anxiety disorder
• Anxiety disorder not otherwise specified

Dissociative Disorders

• Dissociative amnesia
• Dissociative fugue
• Dissociative identity disorder
• Depersonalization disorder
• Dissociative disorder not otherwise specified