5 Types of Anxiety Disorders and How DBT Can Help

According to the U.S. Dept of Health & Human Services, there are 5 major types of anxiety disorders. These include: 

  • Generalized Anxiety Disorder
    Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.

  • Obsessive-Compulsive Disorder (OCD)
    Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.

  • Panic Disorder
    Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

  • Post-Traumatic Stress Disorder (PTSD)
    Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

  • Social Phobia (or Social Anxiety Disorder)
    Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation - such as a fear of speaking in formal or informal situations, or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

No matter which anxiety disorder you or a loved one might be facing, it’s important to note that over 18% of U.S. adults today are living with an anxiety disorder of some kind. This can lead to ongoing, significant distress through emotions such as fear that can cause panic attacks, isolation, insomnia, and restlessness along with symptoms like headaches, body aches, stomach pain, nausea and more. Living with an anxiety disorder can significantly decrease your quality of life and even lead to other mental health conditions, like depression. 

For patients who struggle with their anxiety disorder on a chronic level, many may be referred by a therapist to a specialized kind of Cognitive Behavioral Therapy (CBT) called Dialectical Behavior Therapy (DBT). That’s because for many patients with unmanageable symptoms, classic CBT techniques focused on altering behavior and thought patterns won’t lead to a full breakthrough. Instead, an approach grounded in both acceptance and change is necessary in order to solve for ongoing fear and anxiety… which is exactly where DB comes in. 

DBT focuses on acknowledging and supporting the suffer’s reality, rather than negating it, and then on cultivating coping skills rooted in an ability to “stay mindful” (focus on the moment, rather than the future). For most people, their anxiety is fueled by a ruminating fixation on the future or situations out of their control, which is why staying grounded and present, in addition to accepting reality, are critical to decreasing symptoms and emotional suffering. 

DBT covers four specific modules, all of which can help in decreasing symptoms of chronic anxiety. These include: 

  • Mindfulness: learning to be fully aware and present in the moment
  • Distress Tolerance: discovering how to tolerate emotional pain in difficult situations, rather than fight it
  • Interpersonal Effectiveness: learning how to ask for what you want and establish boundaries while maintaining self-respect and healthy relationships with others
  • Emotion Regulation: discovering how to decrease susceptibility to painful emotions and purposefully change emotions that don’t serve you.

The reason DBT has been seen to be so successful with anxiety over the years is likely due to it’s relentless focus on embracing both acceptance and change - acceptance of your reality, and a willingness to manifest positive change without fighting against what you have no control over. Since emotional distress and anxiety are heightened by attempts to control things we cannot determine, it makes sense that DBT is so effective for anxiety disorders. 

Anxiety disorders often encompass irrational fears, like a fear of dying without any immediate, perceived threat. DBT helps those living with chronic anxiety to work through skills related to cognitive and emotional coping and awareness, in order to improve emotional regulation. DBT can offer desperately needed relief from intense, emotional highs and lows, help sufferers to reduce harmful behavior patterns, and decrease symptoms overall. 

Each of the DBT modules can help with anxiety disorders. Here’s how: 

Mindfulness:

This module can help those struggling with anxiety to stay grounded and focused in their present reality. Staying mindful and present can help minimize stress and anxiety around circumstances and future worries. Meditation is a critical component of the mindfulness module, and this practice can be a pivotal tool for those suffering from panic attacks and the physical symptoms of anxiety such as heart racing episodes, sleep disorders, headaches, rapid breathing, nausea and more. 

Distress Tolerance:

This module includes skills like Radical Acceptance, which helps patients to tolerate panic-inducing thoughts and ruminations. Rather than fighting reality and aggravating anxiety by avoiding negative situations, thoughts and feelings, Radical Acceptance teaches the transformative effect of understanding and accepting situations before creating change. Self-soothing skills are a significant part of the distress tolerance module, and are very beneficial for those suffering from ongoing anxiety. 

Emotional Regulation:

This module can help mitigate the impact of mild or paralyzing anxiety (which can cause patients to miss out on life events, act out impulsively, or feel out of control) by developing coping skills that can stop unwanted emotions from starting, regulate or change emotions in the moment, and create a level of comfort with unavoidable emotions that can be a part of everyday life. 

Interpersonal Effectiveness:

This module helps anxious patients to diminish their worries and fears around relationships and social interaction. The goal of interpersonal effectiveness is to teach the skill of asking for what you want, saying no to what you don’t, and creating healthy boundaries out of self-respect. For many individuals with anxiety, initiating boundary setting or saying “no” can trigger intense worry, fear, and avoidance, so this module is critical to helping them improve.

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