Anxiety disorders
- Generalized Anxiety Disorder
Generalized anxiety disorder is chronic, excessive worry lasting six months or more with physical symptoms such as tension, restlessness and poor sleep. It is treated with SSRIs or SNRIs, cognitive behavioral therapy, or both, with buspirone and hydroxyzine as alternatives. Most people improve substantially within 8 to 12 weeks, and treatment is available in person or by telehealth. - Obsessive-Compulsive Disorder
OCD involves intrusive, unwanted thoughts and repetitive behaviors or mental rituals performed to relieve the anxiety they cause. It is treated with SSRIs at higher doses than for depression, exposure and response prevention (ERP) therapy, or both. For OCD that does not respond, Deep TMS is FDA-cleared and antipsychotic augmentation is an option. Most patients improve within six months. - Panic Disorder
Panic disorder involves recurrent unexpected panic attacks, sudden surges of intense fear with physical symptoms, followed by persistent worry about future attacks or avoidance. It is treated with SSRIs or SNRIs and cognitive behavioral therapy that includes interoceptive exposure, with most people seeing major improvement within 12 weeks. Panic attacks are not medically dangerous. - Social Anxiety Disorder
Social anxiety disorder is a persistent fear of being judged or embarrassed in social situations, leading to avoidance that limits work, school and relationships. It is treated with SSRIs or venlafaxine, cognitive behavioral therapy with graded exposure, or both, and beta blockers such as propranolol for specific performance situations. Most people improve substantially within 12 to 16 weeks. - Specific Phobias
A specific phobia is an intense, lasting fear of a particular object or situation, such as flying, needles or heights, that leads to avoidance. The most effective treatment is exposure-based cognitive behavioral therapy, which resolves most phobias within one to eight sessions. Medication plays a small supporting role. Treatment is brief, and results are usually durable. - Agoraphobia
Agoraphobia is persistent fear and avoidance of places where escape might be hard or help unavailable, such as crowds, transit, stores or being out alone. It is treated with cognitive behavioral therapy using graded exposure, often with an SSRI for severe anxiety. Most people regain mobility within three to four months, and telehealth allows care to start from home. - Separation Anxiety Disorder
Separation anxiety disorder is excessive, persistent fear of being apart from attachment figures, affecting children, teens and adults. It is treated primarily with cognitive behavioral therapy that includes gradual exposure to separations, plus parent coaching for children. SSRIs such as sertraline are added for moderate to severe cases. Most children improve within 12 to 16 weeks of treatment, and adults respond to the same approach. - Body Dysmorphic Disorder
Body dysmorphic disorder is a distressing preoccupation with perceived appearance flaws that others barely notice, accompanied by repetitive checking, grooming or comparing. It is treated with cognitive behavioral therapy designed for BDD and with SSRIs at higher doses for 12 or more weeks. Most people improve substantially with treatment, while cosmetic procedures rarely help and often worsen symptoms. - Body-Focused Repetitive Behaviors
Trichotillomania (hair pulling) and excoriation disorder (skin picking) are body-focused repetitive behaviors that cause visible damage and distress despite repeated attempts to stop. First-line treatment is habit reversal training within a comprehensive behavioral approach, typically 8 to 12 sessions. N-acetylcysteine and, in some cases, SSRIs or olanzapine add modest benefit. Most people reduce the behavior substantially within two to three months. - Illness Anxiety Disorder
Illness anxiety disorder is persistent fear of having or developing a serious illness despite minimal or no symptoms, lasting at least six months, with repeated checking, reassurance seeking or avoidance of medical care. It is treated with cognitive behavioral therapy for health anxiety and, when needed, SSRIs. Most patients improve substantially within three to four months.
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