Agoraphobia

Agoraphobia is an anxiety disorder where you have an intense fear of certain situations, including:
•Leaving your home
•Being in public spaces
•Using public transport
•Being in crowded spaces

You might find that these situations make you feel very distressed, panicked and anxious. You may avoid some situations altogether. This can affect your day-to-day life.

Agoraphobia can make it difficult to make an appointment with your GP to talk about your symptoms. You might not feel able to leave your house or go to the GP surgery. You can always ask for a telephone appointment if you are worried you have symptoms of agoraphobia. A GP will make a diagnosis by asking you questions about your symptoms. You may need to see a specialist doctor called a psychiatrist for further assessment to get a formal diagnosis.

Body dysmorphic disorder (BDD)

If you have body dysmorphic disorder (BDD), you will worry a lot about how you look or a particular part of your body. Although other people may not really notice or see it the same way, it will make you feel very distressed. For example, you may think you have an odd body shape compared to other people or that a scar makes you look unattractive. BDD is not the same as being vain or self-obsessed.
BDD can make you do things that take up a lot of time, like:
•Stare at your face or body in the mirror
•Compare your features with other people’s
•Cover or conceal yourself excessively with makeup
•Consider plastic surgery when you do not need it

BDD can lead to depression. Some people with BDD have suicidal thoughts or feelings.

If you think you have BDD, you should speak to your GP. If they feel you have BDD and this is causing you problems with everyday life, then they should discuss treatment options with you. The GP could arrange for a mental health worker who is experienced in BDD to see you.

Generalised anxiety disorder (GAD)

If you have generalised anxiety disorder (GAD), you can feel worried all the time and this can seem seems out of your control. It may feel as though there is no real reason for your worry. You might feel ‘on edge’ and very alert to your surroundings a lot of the time.

This can affect your day to day life. For example, you might find that it affects your ability to work, travel places or even leave the house. You might also get tired easily or have trouble sleeping or concentrating. You might also experience physical symptoms, such as muscle tension, sweating, feeling sick, stomach cramps (or ‘butterflies’) and a fear of fainting.

It is common to have other conditions such as depression or other anxiety disorders if you have GAD.

It can be difficult to diagnose because it does not have some of the more noticeable symptoms of other anxiety disorders. Your doctor is likely to say you have GAD if you’ve felt anxious most days for over six months.

Hair pulling (Trichotillomania)

Trichotillomania is a condition where you feel the urge to pull out strands of your hair. This can be from your head (usually the top of the scalp) or from other places such as your arms, eyelashes, legs or pubic area. You will find it difficult to stop yourself carrying out this action. It is linked to obsessive compulsive disorder (OCD).

You might experience a build-up of tension, which you relieve by pulling out the strand of hair. You might not even be aware that you’re doing it.

It can be difficult to stop, which can lead to hair loss. This in turn can make you feel guilty, embarrassed and affect how you feel about yourself.
Your GP may look at the following to diagnose your condition:
•You repeatedly pull your hair out, which causes noticeable hair loss.
•You feel increasing tension before you pull your hair out.
•You feel relief or pleasure when you have pulled your hair out.
•There is no underlying medical condition causing you to pull your hair out, such as a skin condition.
•Pulling your hair out causes you distress or affects your everyday life, such as your relationships or your work.

Obsessive-compulsive disorder (OCD)

An obsession is an unwelcome thought or image that repeatedly enters your mind and is largely out of your control. These can be difficult to ignore. You may not want these thoughts and they can be disturbing, which can make you feel distressed and anxious.

Compulsions are things you think about or do repeatedly to relieve the anxiety from your obsessive thoughts.

You might believe that you or someone close to you might come to harm if you do not do these things. You may realise that your thinking and behaviour is not logical but still find it very difficult to stop.

There are different types of OCD, which include:
•Contamination
•Checking
•Intrusive thoughts
•Hoarding

When you first see a healthcare professional like a GP about your symptoms, he or she will ask you about them. This helps them to find out if you have OCD, how severe your symptoms are and what treatment will be best for you.

Panic disorder (panic attacks)

A panic attack makes you feel anxious and frightened. It happens suddenly and feels intense. You also have physical symptoms. These can vary but can include shortness of breath, feeling sick, sweating, trembling and feeling like you have a fast heartbeat. You may feel so anxious that you think you might be dying or having a heart attack.
For some people, certain situations cause panic attacks. For example, if someone has a fear of small spaces and has to board a plane, they may have a panic attack then.

Panic disorder is where you have regular panic attacks and there is no particular trigger. This can make you worry about when you might have another attack. If this happens, you may get a diagnosis of panic disorder.

Post-traumatic stress disorder (PTSD)

You can develop post-traumatic stress disorder (PTSD) if you experience a traumatic or frightening event. It can develop a short time after the event, or sometimes months or years later. Types of situations that can cause PTSD include:
•Being a victim of serious violent crime
•Witnessing a violent attack on someone else
•Witnessing a death
•Being involved in military combat
•Situations working for the emergency services
•Surviving a severe accident, such as a road traffic accident
•Being held hostage
•Experiencing natural disasters, such as an earthquake

PTSD causes feelings of intense fear, helplessness and horror. You can have panic attacks, nightmares and flashbacks (seeing images or visions of the past event in your mind).

To get a diagnosis of PTSD, you will usually have to show symptoms for more than a month. You may feel less able to socialise, work or carry out everyday activities.

Selective mutism

Selective mutism is an anxiety disorder that stops children being able to speak in social situations. It can also cause problems later on when they become an adult. A doctor may refer a child to a speech therapist for support.

If you still have problems or symptoms as an adult, you should try and make an appointment with your GP. An advocacy service could help. You can find out more about advocacy in section 6 of this factsheet.

You can find more information on selective mutism on NHS Choices.

Skin-picking

Skin-picking is a condition where you will repetitively pick at your skin. This can cause damage to your skin, including bleeding, bruising and sometimes permanent marks. You will usually pick the skin on your face, but might also pick other areas of the body. You will find it difficult to stop yourself doing it.

It seems that skin-picking can relieve tension and stress. However, often the relief is short-lived, and you will feel the urge to continue picking. You may not be aware that you are doing it. It is linked to obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD) as it shares similar symptoms.

Because skin-picking leaves visible marks, you might go to lengths to hide these using makeup or clothing.

Your GP may arrange for you to see a specialist mental health doctor like a psychiatrist for diagnosis.

Social anxiety disorder

Social anxiety disorder (sometimes known as social phobia), means you will have an intense fear or dread of social or performance situations.

Some common situations where you may experience anxiety are:
•Speaking in public or in groups
•Meeting new people or strangers
•Dating
•Eating or drinking in public

You will be worried that you will do something or act in a way that is embarrassing or humiliating.

You might feel very aware of the physical signs of your anxiety. This can include sweating, a fast heartbeat, a shaky voice and blushing. You may worry that others will notice this or judge you. As a result you might find that you try to avoid such situations completely. You might realise that your fears are excessive, but will find it difficult to control them.

Your GP will ask you questions about your symptoms, and might ask you to fill out a questionnaire. This will help them find out what how anxious you feel in social situations.

If you feel that it would be difficult to visit your GP, you can ask for a telephone appointment.

Toilet-related anxiety

This is a fear of using toilets in either your own home, someone else’s home or in public spaces. This can lead to difficulty and embarrassment when needing to use the toilet.

You may fear that other people can hear you using the toilet, worry about the cleanliness of the toilet, or worry about being able to use the toilet at all.