Dr. Daniel B. Nicholas
December 9, 2012

An interesting way to consider anxiety disorders was recently suggested to me at a recent Harvard Medical School training course. In essence, anxiety disorders can be divided into 3 different levels of mental arousal.

  1. Anxiety disorders characterized by continuous arousal or chronic hyperarousal or worry include generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD).In GAD, the content of the worry tends to be of a realistic nature but the brain is constantly generating, repeating worrisome thoughts (Automatic Negative Thoughts or ANTS) that are not useful in problem solving.

    OCD is another state of continuous, mental hyperarousal that involves appraising a senseless thought, as a realistic threat, coupled with avoidance behaviors.

  2. Discontinuous arousal anxiety states occur for limited periods of time. They typically occur in response to either internal or external cues.A specific phobia is an intense level of anxiety that is typically triggered by an external stimuli. The level of anxiety tends to reduce when the person is no longer in the presence of the stimuli.
  3. Discontinuous and/or Continuous arousal states. Panic disorder tends to be stimulated by internal cues like sensations or thoughts and can be time-limited or more continuous. For some, the negative thoughts, feelings and internal sensations may reduce over a relatively short period of time. Many people extend their worry, as they experience anticipatory anxiety about when the next attack will come. Agoraphobia occurs when the panic disorder is accompanied by avoidance of specific external situations.Post Traumatic Stress Syndrome (PTSD) is another condition that involves both continuous and discontinuous arousal states. In this condition, the brain experiences both chronic and acute states of anxiety.

Research has identified specific therapy protocols to help people to successfully manage each of these anxiety states and the distressing internal sensations they cause. These strategies work quite well to help quiet the mind, build distress tolerance, reduce distress and provide a greater sense of control.

Learning to eliminate your anxiety states is a necessary step in the process of developing mastery of your state of mind. Look for future posts about treating anxiety states, increasing mastery in everyday living, increasing flow and engagement, and developing virtues and character strengths.