Characteristics of phobias, depression and OCD
Everyone experiences anxiety — it is a natural response to potentially dangerous stimuli. Phobias, however, are anxiety disorders characterised by extreme irrational fears that go beyond any real risk. These can be very enduring, lasting for many years. Around 10 per cent of people will suffer from a phobia at some point in their lives, with females having twice the incidence of phobias as males. Most phobias emerge in childhood, but lessen in strength during adulthood. Sufferers generally have insight into their phobias and know that their fears and reactions are irrational, but they cannot consciously control them. Phobias divide into:
• simple phobias, involving fears of specific things, like coulrophobia (fear of clowns). Simple phobias further divide into sub-types of animal phobias, injury phobias, situational phobias and natural environment phobias
• social phobias, involving being over-anxious in social situations, like giving public speeches
• agoraphobia, involving fear of leaving home or a safe place.
Characteristics of phobias
• Avoidance responses — efforts are made to avoid anxiety-producing situations.
• Disruption of functioning — severe disability to everyday working and social functioning occurs.
• Persistent, excessive fear — high levels of anxiety are produced by phobic stimuli.
• Fear from exposure to phobic stimulus — production of immediate fear response to phobic stimulus.
• Recognition of exaggerated anxiety — phobics are consciously aware that their anxiety levels are over-stated.
Fig 4.4 Coulrophobia is a fear of clowns
About 20 per cent of people will suffer from depression, with women twice as vulnerable as men, especially in adolescence, a time where many people experience body dissatisfaction and low self-esteem. Depression is a mood disorder characterised by feelings of despondency and hopelessness, generally occurring in cycles. The average age of onset is in one’s 20s and 10 per cent of people with severe depression commit suicide. There are 2 main types: unipolar depression, which is where a constant low mood is experienced, and bipolar depression, where sufferers swing between elevated (high) and despondent (low) moods. Depression is also broken down into endogenous depression, which is related to internal biochemical factors, and exogenous depression, which is related to stressful experiences. At least 5 symptoms (clinical characteristics) must be apparent every day for 2 weeks for depression to be diagnosed.
Characteristics of depression
• Loss of energy — sufferers experience reduced energy levels.
• Social impairment — reduced levels of interaction with friends and family occur.
• Loss of enthusiasm — sufferers experience a lessened interest in, and pleasure of, everyday activities.
• Sense of worthlessness — persistent feelings of reduced worth and inappropriate sensations of guilt are experienced.
• Reduced concentration — difficulties with paying and maintaining attention, as well as slowed-down thinking and indecisiveness, can be experienced.
• Poor memory — difficulties with retrieval of memories can occur.
About 2 per cent of people have obsessive—compulsive disorder (OCD), an anxiety disorder characterised by persistent, recurrent, unpleasant thoughts and repetitive, ritualistic behaviours. Obsessions are the things that sufferers think about, while compulsions are the behaviours they indulge in as a result of the obsessions. Obsessions generally comprise forbidden or inappropriate ideas and visual images that are not based in reality, like being convinced that germs lurk everywhere, and these lead to feelings of extreme anxiety. Common obsessions include contamination, fear of losing control, perfectionism, sex and religion. Female obsessions tend to be more about contamination, while male ones can concern sex and religion more. Compulsions consist of intense, uncontrollable urges to perform repetitive tasks in order to reduce the anxiety caused by obsessive ideas, such as constantly washing yourself to get rid of the germs. There is a realisation that the obsessions and compulsions are inappropriate, but they cannot be consciously controlled. OCD symptoms often overlap with those of autism and Tourette’s syndrome.
Characteristics of OCD
• Hinders everyday functioning — obsessive ideas create such high levels of anxiety that the ability to perform everyday actions is severely hindered.
• Social impairment — anxiety levels are so high that they limit the ability to conduct meaningful interpersonal relationships.
• Extreme anxiety — persistent inappropriate ideas and visual images create excessive levels of anxiety.
• Attentional bias — perception tends to focus primarily on anxiety-generating stimuli.
• Recurrent and persistent thoughts — constantly repeated, obsessive, intrusive thoughts and ideas are experienced.
Characteristics of mental disorders like phobias, depression and OCD allow clinicians to create ’checklists’ that permit them to diagnose which particular disorder an individual may be suffering from. Such characteristics are written up into diagnostic criteria, such as the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM).