Mood Disorders

Anxiety: Much To-Do About Everything

What is anxiety? And how do you know you have a clinical diagnosis? In this post, I share with you a few definitions of types of anxiety, and the ways clinicians make a determination as to how anxiety is categorized. The last thing you want to feel when you as someone for help is not knowing how you will be handled. There’s enough things to be frightened about; therapy for anxiety shouldn’t be one of them. Bonus: click on the link to see my cat demonstrate some of the principles of fear and recovery.

This article can also be found at, blogging about fitness, health, entertainment, and beauty.

The other day, I answered a knock at my front door and walked into a spider web. Without much thought to it, I reached my hand up to my face, pulled the sticky thread away, and finished my conversation with the person at the door. There is nothing remarkable about this story, unless you understand that I don’t like spiders.

I have, in fact, a moderate fear around spiders. The idea that we ingest some of these critters over our lifetime makes my stomach a little queasy. If I come across a picture of a hairy spider in a magazine, I get the “heeby jeebies” (my non-clinical description of the hairs on the back of my neck standing to a state of alertness, and a feeling of hyper awareness about my surroundings)

Cat Boo on YouTube
Video demonstrating trigger, anxiety response, response to stimulus, avoidance, recovery
“Cat Boo” by Imei Hsu and Charles-Monet

What exactly is anxiety (in the clinical sense), and when should someone consider seeking professional help to treat that anxiety? A quick hot-list of anxiety types and their symptoms can be found

What Are the Types of Anxiety Disorders?
There are several recognized types of anxiety disorders, including:

Panic disorder : People with this condition have feelings of terror that strike suddenly and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain, palpitations (irregular heartbeats), and a feeling of choking, which may make the person feel like he or she is having a heart attack or “going crazy.”

Obsessive-compulsive disorder (OCD) : People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.

Post-traumatic stress disorder (PTSD) : PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.

Social anxiety disorder : Also called social phobia, social anxiety disorder involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule.

Specific phobias : A specific phobia is an intense fear of a specific object or situation, such as snakes, heights, or flying. The level of fear usually is inappropriate to the situation and may cause the person to avoid common, everyday situations.

Generalized anxiety disorder : This disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.

As a clinician treating people with mood disorders, the way I can tell someone should seek professional treatment is whether the person is able to reasonably cope with feelings of anxiety. If the person is having to restructure his/her life in such a way that it is hurting a significant relationship, or s/he cannot cope or function with the anxiety during work or leisure, it’s very likely that the person needs to seek treatment. If he could have reduced that anxiety by himself, he would have done so much earlier. One element of anxiety that needs attention and treatment is the compulsive – almost instinctual in nature – factor in the way it manifests.

In an age of third-party payers, clinicians also look at the qualifiers of a diagnosis for Anxiety, using the qualifications as a screening test. Usually the presence of more than half of the qualifiers for a significant period of time is enough evidence for a diagnosis. The Diagnostic Statistical Manual (DSM) has been the accepted method used in the Western medical model to classify disorders and base evidence for a treatment plan. At Seattle Direct Counseling, I use the DSM IV as one way to help classify the type and extent of symptoms a person is experiencing, and if I am using a client’s third-party payer, I have no choice but to use this method of diagnosis and classification.

Clients can choose to take any number of online quizzes to help them better understand if they may have a problem with anxiety. The statements can help them realize they are not the only ones who feel this way. One example from

I also prefer a compassionate, positive approach to diagnosis. Instead of focusing only on what is going wrong with a client, I like to help him see what is going right. This philosophical approach is more Buddhist in nature, in that it helps clients discover positive features of their coping mechanisms, free of feelings of guilt or “wrong-doing”. I like to remind people that for the level of fear they are experiencing — whether those fears “make sense” or are irrational — their minds have come up with some pretty clever ways to try to feel better!

Life will never be without its anxiety-filled moments. However, it is possible to learn to move through them with more grace and ease, and to recover from traumatic events in ways that cause us to become stronger than we ever imagined.

By Imei Hsu

Imei Hsu is a mental health counselor, active retired RN, AIP Coach and PN1-NC, writer, triathlete and arts promoter in the Seattle area and through online services. With 30+ years in healthcare (22+ years in mental health), Imei has a commitment to helping people discover insight into their health, relationships, and connecting. She is the owner of Seattle Direct Counseling and the blog, a presenter and speaker on a variety of psychological topics, and a positive force on the Internet. She launched her personal project, My Allergy Advocate, in 2018. Imei is a two-time Ironman Finisher (Mont-Tremblant 2016, Ironman Canada 2018); she also finished her first ultramarathon in 2017 and has gone on to race the 100K distance while preparing for 100 Mile trail races and a backyard ultra. You can find her running everywhere and eating all the thingz, watching movies, camping under the stars, and cooking real food.

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