Four Classes of Anxiety Disorders
There are 11 distinct anxiety disorders in the official diagnostic manual and 9 additional types of obsessive-compulsive disorders.
It can start to get overwhelming to try to figure out where your personal anxiety fits into all that.
But in a lot of ways, the anxiety disorders are more similar than they are different.
So rather than having 20 different distinct labels, it’s helpful to have a broader classification.
In today’s article, I’ll share with you four different classes of anxiety disorders that relate the conditions based on the anxiety’s primary focus.
CATASTROPHIC ANXIETY DISORDERS
Anxiety disorders in this class are focused on catastrophes happening.
Thoughts like “I’ll die” or “Someone I love is going to die” or “Irreparable damage is going to happen” are common.
Examples of anxiety disorders in this class are separation anxiety disorder and specific phobias.
Separation anxiety disorder is more common in children than adults and describes when a child is irrationally afraid of being separated from their parents (or other caretakers).
Separation anxiety is appropriate and expected for children of a certain age (e.g., toddlers), but typically children grow out of this and come to learn that their parents will come back.
Some children develop a fear that their parents are going to get sick or hurt, that they’ll be involved in some sort of disaster, or that they’ll die.
They also sometimes fear that they themselves will be the victim — they’ll be kidnapped, get lost, or get really sick.
Central to these fears is concern about a catastrophe.
Specific phobias are fears of specific objects or situations.
So, claustrophobia, arachnophobia…all the phobias.
In general, people with phobias believe that something catastrophic is going to happen if they come into contact with whatever it is that they fear.
EVALUATION ANXIETY DISORDERS
The next class of anxiety disorders are the ones that are concerned with being evaluated or judged.
Thoughts like “They don’t like me,” “I’m gonna mess this up,” and “I don’t fit in” are common.
Examples of anxiety disorders in this class are social anxiety disorder and selective mutism.
Social anxiety disorder is a fear of being judged or scrutinized.
It’s commonly seen in situations when a person has to talk to other people (like meeting new people or having conversations) or when a person has to perform (like give a speech) or when a person is being watched (like when they’re eating or writing or typing).
People with social anxiety are concerned they’ll be judged or rejected if their anxiety shows, and they’re especially worried about being embarrassed or humiliated.
Selective mutism is another anxiety disorder that is more common in children than adults.
In this condition, children won’t talk in certain situations.
These children know how to talk, and sometimes they’ll be super chatty in situations where they’re comfortable, but in situations where they’re nervous, they can’t get their words out.
They’re often uncomfortably shy, and it’s thought that a fear of messing up or doing something wrong motivates their fear of speaking.
LOSS OF CONTROL ANXIETY DISORDERS
The next class of anxiety disorders are the ones that are concerned with losing control, especially of their anxiety.
Thoughts like “I’ll go crazy,” “I’ll have a panic attack if I take the bus,” and “I’m a little dizzy…I’m probably having a heart attack” are common.
Examples of anxiety disorders in this class are panic disorder and agoraphobia.
Panic disorder is a condition in which people have panic attacks…repeatedly and unexpectedly.
During a panic attack, the person will experience a really quick surge of fear, and it’ll peak within about 10 minutes and then start to recede.
The panic attacks just come out of the blue, for no reason.
Importantly, people with panic disorder don’t just have panic attacks — they also become afraid of having more panic attacks.
So they try to prevent future panic attacks by keeping themselves from doing things they’d normally do.
Basically, they’re afraid of losing control of themselves and their anxiety, so they avoid certain activities in an attempt to maintain control.
Agoraphobia often comes out of panic.
People with agoraphobia are specifically afraid of having a panic attack in certain situations where they wouldn’t be able to escape if they had a panic attack…so things like planes, bridges, movie theaters, crowds, or even just being away from home alone.
Essentially, they’re afraid of losing control of themselves and then becoming embarrassed or incapacitated by a panic attack, so they just avoid leaving home or going to the places where they think they might have a panic attack.
UNCERTAINTY ANXIETY DISORDERS
The next class of anxiety disorders are the ones that are concerned with uncertainty.
Thoughts like “I can’t stand not knowing,” “I need to know how this is gonna work out,” and “I can’t remember if I locked the door” are common.
Examples of anxiety disorders in this class are generalized anxiety disorder and OCD.
Generalized anxiety disorder is a condition in which a person worries…hard…about lots of things.
They worry constantly — about money, safety, health, work performance, relationships, everything.
While the worries all sound different (Will I be able to afford this? What if I get sick? Should I be doing more to protect my kids? Did I turn off my flat iron?), what they all have in common is uncertainty or doubt.
OCD is the ultimate uncertainty condition, and some have even called OCD “the doubting disease” because doubt is such a cornerstone of the condition.
With compulsions like handwashing, the uncertainty can be whether there are germs on your hands.
With compulsions like checking the oven, the uncertainty is whether you actually turned it off.
With hoarding compulsions, the uncertainty is whether you’ll ever need these useless items again.
OCD can manifest in infinite ways, but the single thread is uncertainty.
ANXIETY DISORDERS OVERLAP
These categories of anxiety disorders don’t have hard boundaries.
You might have noticed as you read through them that some types of anxiety might overlap with some other categories.
For example, social anxiety disorder was in the Evaluation category, but those folks also sometimes predict catastrophes (e.g., “I’m gonna mess up this speech and get fired) or fear losing control of themselves and embarrassing themselves socially.
The reason it’s categorized as an Evaluation disorder is because evaluation is its primary concern.
HOW TO GET YOUR ANXIETY DIAGNOSED
Because the categories overlap somewhat, you might have felt like your own anxiety could fit in multiple categories.
That doesn’t necessarily mean there’s anything wrong or that your anxiety is extra severe…it might just mean you have different types of anxiety or that your anxiety is kinda squishy.
If you’re looking for some clarification, I always recommend checking in with a psychologist to get a credible opinion about what might be going on.
Take my therapy worksheets along with you so you can get the most out of your therapy sessions.
If you have anxiety, chances are you’re an overthinker. And it probably keeps you up at night.
Next week, I’ve got 10 questions to ask yourself so you can stop overthinking.
In the meantime, beef up your other anxiety coping skills with my favorite ways to manage anxiety without medication and my tips on how to rewire your anxious brain. I’ll see you next week to work on the overthinking.
Talk to you soon,
Dr. Finch
P.S. Remember, this is education, not treatment. Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you. See the disclaimer for more details.
Hayden C. Finch, PhD, is a practicing psychologist based in Des Moines, Iowa, and Little Rock, Arkansas, dedicated to helping you master your mental health.
