What problems do we treat?

Anxiety disorders are common and treatable problems that affect many children, adolescents, and adults. There are a number of different anxiety problems described below. Anxiety disorders can be caused by a combination of biological and/or environmental factors like many other disorders such as heart disease or diabetes. Anxiety disorders are real and persistent health problems that affect more than one in every ten Americans at some point during their lifetime. 

We also work with clients who have other clinical problems that may or may not be related to anxiety, including trichotillomania, misophonia, and hyperacusis. 

Unfortunately, only about one-fourth of those with anxiety and related disorders ever get professional help. Realizing that you or someone you care about may need help for an anxiety disorder is a critical first step that too many people never take.

Here is a description of a number of anxiety and related disorders for which you can get psychological treatment at our clinic.

Anxiety Disorders

Generalized Anxiety Disorder

Adults or children who experience GAD report overwhelming and uncontrollable worries about several different situations in their lives (such as work, school, friends, finances). These worries make it difficult for people to engage in the tasks at hand and are often out of proportion to the actual likelihood or impact of the feared event. People often experience symptoms such as feeling restless, having a difficult time relaxing, difficulty concentrating, being irritable, muscle tension, and trouble sleeping or concentrating. 


Separation Anxiety Disorder

Children who experience SAD have overwhelming fears about being separated from a loved one (such as a parent). SAD must begin before the child is 18 years of age. Children will sometimes become extremely upset when attachment figures are going to leave (even for a short time) and may also worry about harm befalling the parent (such as a bad car accident) or fear being kidnapped. Children with SAD can be reluctant or refuse to go to school or to sleep away from home. Children often report stomachaches, headaches, or nausea when separation occurs or is anticipated (such as before school or at the end of a vacation).


Panic Attacks

An adult or child who has panic attacks experiences sudden feelings of overwhelming fear or danger and the desire to escape from wherever the attack occurs. These attacks are generally brief (less than 30 minutes total) and are accompanied symptoms such as fear of losing control, dying or "going crazy," sweating, shaking, feeling short of breath, feeling smothered, racing heart, feelings of choking, nausea, chills, or tingling. Panic attacks can occur "out of the blue" or in the presence of certain situations (like when driving, going to a crowded place).


Panic Disorder

People who have panic disorder experience panic attacks and worry or concern about possible future panic attacks. Some people with panic disorder believe that these attacks are symptoms of  undetected health conditions (such as a heart attack) or that the attacks are evidence that they are "going crazy."


Agoraphobia

Agoraphobia means "fear of the marketplace," and people who experience agoraphobia have anxiety about being in places or situations from which it might be difficult or embarrassing to escape. Many people experience fear of panic attacks in certain situations (like crowded places, bus, plane, or train travel, being on a bridge), but some people experience anxiety without panic attacks.


Obsessive Compulsive Disorder

People who have OCD experience upsetting thoughts, images, impulses, or ideas (obsessions) that cause anxiety or distress and engage in behaviors or rituals to reduce that anxiety (compulsions). Common obsessions include thoughts of contamination, doubts about whether something was done (locking the door, unplugging the iron, fear that someone was just injured), need to have things in order, upsetting aggressive or horrifying thoughts (to hurt a child, shout an obscenity in church), or sexual imagery. These obsessions are not usually related to real life problems (such as jobs, finances, etc). Common compulsions include repetitive behaviors (washing hands, checking, arranging things) and thoughts (such as praying, counting, repeating words silently). Both adults and children have OCD, and children often are not aware that their fears are unreasonable.


Post-Traumatic Stress Disorder

Adults and children who experience PTSD have developed symptoms of fear, helplessness, or horror after experiencing a trauma that involved actual or threatened death or serious injury, threat to one's physical integrity (such as in the case of rape or sexual or physical assault), or witnessing such an event. This trauma can also include learning about an unexpected or violent death, serious harm, or threat of death or injury to a loved one or close associate. People who have PTSD often experience nightmares, feelings that the event is reoccurring, strong reactions to symbols of the event. Following the trauma, people sometimes try to avoid reminders of the trauma and appear to "shut down" emotionally, and people with PTSD experience symptoms such as exaggerated startle response, difficulty concentrating, irritability, or being "hyper aware" of their surroundings.


Social Phobia

Adults and children who experience social phobia have intense fear of social situations where they might be embarrassed. Some people experience anxiety in most social situations (like starting or maintaining conversations, participating in group activities, talking to authority figures) and some experience more specific fears such as of public speaking or eating in front of others. People with social phobia often fear these situations because of beliefs that others will judge them to be weak, stupid, "crazy," or foolish.


Specific Phobia

Adults and children who have specific phobias experience overwhelming fear about a specific thing or situation, despite knowing that these fears may be excessive. Often, people experience physical symptoms like those that occur in panic attacks in the presence of the feared thing or situation. People experience specific phobias about animals and insects, things in the natural environment like storms or heights, situations related to blood, injections, or other medical procedures, situations such as tunnels, air travel, bridges, elevators, or other situations such as vomiting, contracting an illness, or costumed characters.

Related Problems

Trichotillomania

Children and adults who have trichotillomania repeatedly pull out hairs from one or several parts of the body. Often, the urge to pull hair is experienced as a building, "itchlike" tension, and the experience of pulling results in a sense of relief. Sometimes, hair pulling is experienced as an unintentional habit, and people will "catch" themselves doing it when distracted. People sometimes pull hair in short episodes throughout the day or sometimes in long periods that can last for hours.


Hyperacusis

People with hyperacusis are unusually sensitive to ordinary sounds.  They might find sounds such as a dishwasher running, TV playing at a normal level, or even quiet talking to be extremely uncomfortable.  Hyperacusis often leads people to avoid places that have unpredictable noise (like work environments), or to wear ear protection when they go out.


Misophonia

Misophonia is a strong negative reaction to sounds that do not bother most people.  The bothersome sounds mentioned most often involve noises made by other people, particularly chewing food, lip smacking, breathing sounds, nail picking, and speaking.  Common responses to the sounds are disgust, anger, stress, or annoyance/irritation.  People with misophonia will often avoid the sounds that bother them, for example, they cannot eat a meal with their family, or they endure it with great distress.


This page does not reflect an official position of Virginia Commonwealth University
© Michael A. Southam-Gerow 2003-16 
Virginia Commonwealth University,  Center for Psychological Services and Development, and the Department of Psychology