ANXIETY DISORDERS: Currently, anxiety disorders consist of several distinct disorders. 1. Panic disorder: This disorder is marked by acute onset of overwhelming fear, sense of impending doom, erroneous belief that they may die (from a heart attack, suffocation), lose their mind or faint. These individuals often flee to an emergency room for immediate treatment. Agoraphobia, or a fear of leaving the safe confines of one’s home can ensue. Once an individual has experienced panic attacks it is not uncommon to find them preoccupied with fears of recurrence (anticipatory anxiety) that dominates their day-to-day functioning. Oftentimes, fears of recurrence lead to significant lifestyle restriction as they avoid anything that might trigger a panic attack. 2. Obsessive compulsive disorder (OCD): Individuals with OCD suffer from obsessive thinking that can interfere with normal thinking. For example, obsessive fear of germs can interfere with the person’s current activities. Horrific thoughts occur, intrusive fears that seem real despite their irrationality (e.g., “could I lose control and attack someone/”). Indecisiveness can be a hallmark of the obsessive process. Compulsions are behavior rituals that handicap normal functioning. For example, the germ phobic person spends so much time washing hands in the morning that the are perennially late for work. 3. Social Anxiety Disorder: While appearing morbidly shy as young children, individuals with social anxiety disorder become dramatically handicapped in adolescence or early adulthood. Their obsessives worrying about what other people think of them and their fear of failure and humiliation in public leads to avoidance of social activities. It is not uncommon to learn about the young child who avoids going to school on days where he/she anticipates having to participate in a classroom activity. Self-esteem and confidence suffer. Alcohol abuse is commonly seen because of the tranquilizing role it plays in reducing interpersonal fear. 4. Generalized Anxiety Disorder (GAD): GAD, also known as the worry syndrome, is marked by pathological worry and rumination. Indecisiveness is noted commonly as the rumination makes it difficult picking a path of action. Relatively minor issues often trigger pathological worry and often results in physical distress, with muscle tension, shortness of breath and gastrointestinal upset common.