Phobias: Phobias are attempts to compartmentalize fear into a few situations that can be avoided. By attaching all the panicky feelings onto a few situations, the person can avoid those situations and go on with life. Unfortunately, phobias can take on a life of their own and take over more and more of a person’s life. A fear of dogs can, for example, be fairly easy to manage—just don’t go near dogs. But a fear of flying may limit social and business opportunities.

Some of the more common phobias include claustrophobia (fear of closed spaces), agoraphobia (fear of public places, sometimes related to panic attacks), and acrophobia (fear of heights).

Case Study: Hannah, age 55, was in a major car accident 20 years ago during a cross-country trip. Ever since, she has been unable to drive on major highways. Although she does drive, she goes to great lengths to travel only on back roads and scenic routes. She is able to go where she wants to go but it often takes much longer to get there than it should. Hannah has developed a phobia about highway driving.

Obsessive-Compulsive Disorder: Although classified as an anxiety disorder, obsessive-compulsive disorder (OCD) differs from these disorders in significant ways. It is the one anxiety diagnosis that seems to have a clear biological cause. Unlike the other kinds of anxiety disorders, talk therapy alone isn’t much help. Medication is also necessary.

OCD is a disorder in which the mind is flooded with involuntary thoughts, or in which an individual feels compelled to repeat certain acts over and over again (for example, hand washing). This disorder can interfere significantly with everyday living, and usually leads to concern or resentment among friends, family, and co-workers.

A person who suffers from OCD doesn’t want the thoughts and doesn’t want to do the behaviors. Unfortunately, he or she really can’t help it. About half the people with OCD report that it began in childhood; most others start in adolescence or early adulthood. OCD affects approximately two percent of the general population.

Case Study: Bert is 40 years old and works on an assembly line in a brush factory. He is terribly afraid of being contaminated by germs. He avoids shaking hands with others. He won’t eat in the cafeteria. He has trouble leaving the bathroom because he isn’t sure he has washed his hands well enough. Bert is suffering from obsessive compulsive disorder.

Acute Stress Disorder: Acute stress disorder can occur within a month of experiencing or witnessing a traumatic event. It lasts from two days to no more than four weeks. Either during the event or in the month following it, the individual develops at least three of the following symptoms: numbing of feelings or emotional detachment; being “in a daze;” memory gaps or a kind of selective amnesia for the event or details of the event; or a sense of feeling unreal. The person re-experiences the trauma through dreams, nightmares, flashbacks, or a sense of reliving the experience. He or she may become extremely upset by anything that reminds him or her of the event and may go to great lengths to avoid anything that might trigger a reminder. Symptoms of anxiety may occur or increase, including sleep disturbance, difficulty concentrating, restlessness, and hyperalertness. All this makes it very difficult for the person to manage relationships, job or school, or the tasks of everyday life.

Case Study: Two weeks ago, Leo, age 25, was hunting with his best friend when his friend tripped over a root and accidentally shot himself to death. He doesn’t remember exactly how he got himself and his friend’s body out of the woods. Every night he has nightmares about not being able to save him, making it almost impossible to sleep. He can’t concentrate or stay focused during conversations. Most of the time, he says he feels numb. But when asked to talk about what happened, he gets very upset. Leo is suffering from acute stress disorder.