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HomeCo-occurring Disorders

Anxiety-related disorders

Anxiety is the 'fight or flight' response to danger. It allows a person to deal with something that is perceived as a threat. It is necessary for survival.

But when anxiety is triggered unnecessarily, continues beyond the immediate threat, or causes a person to restrict his or her life, it may develop into a disorder.

Anxiety disorders include:

Fact sheets (PDFs) are available for each of these disorders. They detail symptoms, causes, and treatment.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) can occur after a person experiences a very traumatic event, including a natural disaster, a serious accident, a crisis such as 9/11, military combat, or physical or sexual abuse.

PTSD often leaves one feeling vulnerable, out of control, and as if one's life is in danger. These feelings are persistent, strong, and do not disappear over time on their own. Everyday life, work, and relationships can be negatively affected.

In addition to a traumatic life event, each of these types of symptoms are usually present in a PTSD diagnosis:

  • Re-experiencing the event in intense memories, dreams, flashbacks, or upset feelings when stimuli triggers trauma-related memories
  • Avoidance of people, places, or things reminiscent of the traumatic event, numbing, or detachment
  • Increased arousal or anxiety, typically in the form of constant fear or tension, restlessness, sleeplessness, irritability, poor concentration, feeling of being on guard or vigilant, and having an exaggerated startle response.
Download a fact sheet about post-traumatic stress disorder (PDF)

Panic disorder

Panic disorder results from having panic attacks, or episodes of extreme fear and terror that last anywhere from a few minutes to an hour. People who have experienced a panic attack often describe it as being the most intense, frightening, and confusing thing that has ever happened to them.

They may have felt like they were having a heart attack, dying, or going crazy -- and as a result, they tend to avoid the place or scenario in which they first experienced the panic attack. This high level of anxiety can greatly interfere with everyday functioning; people with panic disorder may completely shut themselves off from the outside world by avoiding normal everyday activities.

Symptoms of panic attacks include:

  • Rapid or pounding heart
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Choking or smothering sensation
  • Chest pain
  • Chills or hot flashes
  • Feeling unreal or disconnected or detached from oneself
  • Feeling unsteady
  • Faintness
  • Fear of losing control, going crazy or dying
  • Numbness or tingling sensations
Download a fact sheet about panic disorder (PDF)

Social anxiety

Social anxiety disorder or social phobia causes intense anxiety about the social interactions and public events of everyday life.

People with social anxiety disorder have a persistent fear of being looked at, criticized or rejected by others. They are afraid of embarrassing or humiliating themselves. They feel like others are watching them or constantly judging them. They worry about saying the wrong thing and coming off as foolish.

Symptoms include:

  • Intense anxiety in social situations
  • Excessive fear of being scrutinized or negatively judged by others
  • Avoidance of social situations

The physical effects of these symptoms include:

  • Confusion
  • Pounding heart
  • Sweating
  • Shaking 
  • Blushing
  • Muscle tension
  • Upset stomach
  • Diarrhea

Common anxiety-producing situations for those with social anxiety disorder include:

  • Eating or drinking any beverage in front of others
  • Writing or working in front of others
  • Being the center of attention
  • Talking on the telephone
  • Interacting with people, including dating or going to parties
  • Asking questions or giving reports in groups
  • Using public toilets
Download a fact sheet about social anxiety (PDF)

Generalized anxiety disorder

People with generalized anxiety disorder excessively worry about everyday events. They are unable to let go of their concerns even though they realize they are unwarranted. Concerns over health, money, family, work, or the potential for disaster are most common. When an over-exaggerated level of worry occurs for at least six months, a diagnosis of generalized anxiety disorder is made.

Symptoms of generalized anxiety disorder include:

  • Restlessness
  • Feeling of being keyed up, on edge
  • Feeling a lump in your throat
  • Difficulty concentrating 
  • Fatigue
  • Irritability
  • Muscle tension
  • Trouble falling or staying asleep
Download a fact sheet about generalized anxiety disorder (PDF)

Obsessive compulsive disorder

Obsessive compulsive disorder (OCD) affects one's ability to process information and interferes with one functioning. It is often described as though the mind is stuck on "repeat" or on a loop with one constantly recurring thought or urge. A person with OCD cannot let a thought go in spite of reasoning or efforts to stop.

These thoughts and urges lead to excessive behaviors such as repeated checking, ordering, or arranging of objects; hand washing for hours; or ritually repeating actions a certain number of times. These behaviors can affect normal functioning at work, school, home, and in relationships.

Symptoms of OCD can be divided into obsessions and compulsions.


  • Recurring thoughts, images or impulses, seemingly outside of one's ability to control them
  • Uncomfortable feelings, such as fear, disgust, doubt, or a sensation that things have to be done in a way that is "just so"
  • Excessive concerns about contamination or harm, the need for symmetry or exactness, or forbidden sexual or religious thoughts


  • Repetitive behaviors or mental acts that a person feels driven to perform
  • Behaviors aimed at reducing the negative feelings (fear, disgust, doubt, guilt)
  • Repeating behaviors in specific ritualistic ways
  • Typical compulsions include cleaning, repeating, checking, ordering and arranging, hoarding or mental compulsions (silently praying or repeating words).

People with OCD recognize the irrational nature of their thinking and behavior, but feel unable to control either.

Download a fact sheet about obsessive compulsive disorder (PDF)

Other common co-occurring disorders include mood-related disorders and severe mental illness.

Also of interest

Types of disorders
Other mental illnesses found in co-occurring disorders include:

Effective treatment
Co-occurring substance use and mental health disorders need to be treated at the same time.

Peer support and other resources
Peer support groups, advocacy groups, and public policy agencies can help you and your clients learn more about behavioral health.

Frequently asked questions
Find answers to frequently asked questions about co-occurring disorders.

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