ever heard a really good joke about polio?or made a casual reference to someone having hepatitis? or maybe teased your buddy by sayinghe has muscular dystrophy? of course you have never done that, becauseyou are not a terrible person. you'd never make fun of someone for having a physicalillness, but folks make all kinds of offhand remarks about people having mental illnessesand never give it a second thought.
crash diets harmful, how often have you heard a person say thatsomeone's psycho, or schizo, or bipolar, or ocd? i can pretty much guarantee that thepeople who used those terms had no idea what they actually meant. we've talked about how psychological disordersand the people who have them have often been stigmatized. but at the same time, we tend to minimizethose disorders, using them as nicknames for
things that people do, think, or say, thatmay not exactly be universal, but are still basically healthy. and we all do it, but only because we don'treally understand those conditions. but that's why we're here, because as we godeeper into psychological disorders, we get a clearer understanding of their symptoms,types, causes, and the perspectives that help explain them. and some of the most common disorders havetheir root in an unpleasant mental state that's familiar to us all: anxiety. it's a part of being human, but for some peopleit can develop into intense fear, and paralyzing dread, and ultimately turn into full-fledgedanxiety disorder. defining psychological disorders again: adeviant, distressful, and dysfunctional pattern
of thoughts, feelings, or behaviors that interfereswith the ability to function in a healthy way. so when it comes to anxiety, that definitionis the difference between the guy you probably called phobic because he didn't like spacemountain as much as you did, and the person who truly can't leave their house for fearof interacting with others. it's the difference between the girl who'steased by her friends as being ocd because she does her laundry every night and the girl whohas to wash her hands so often that they bleed. starting today, you're going to understandall of those terms you've been using. we commonly equate anxiety with fear, butanxiety disorders aren't just a matter of fear itself. a key component is also what we do to getrid of that fear.
say someone almost drowned as a kid and isnow afraid of water. a family picnic at the river may cause thatanxiety to bubble up, and to cope, they may stay sequestered in the car, less anxiousbut probably still unhappy while the rest of the family is having fun. so, in clinical terms, anxiety disorders arecharacterized not only by distressing, persistent anxiety but also often by the dysfunctionalbehaviors that reduce that anxiety. at least a fifth of all people will experiencea diagnosable anxiety disorder of some kind at some point in their lives. that is a lotof us. so i want to start out with a condition thatused to be categorized as an anxiety disorder
but is now considered complex enough to bein a class by itself, obsessive-compulsive disorder or ocd. you probably know that condition is characterizedby unwanted repetitive thoughts, which become obsessions, which are sometimes accompaniedby actions, which become compulsions. and it is a great example of a psychologicaldisorder that could use some mental-health myth busting. being neat, and orderly, and fastidious doesnot make you ocd. ocd is a debilitating condition whose suffererstake normal behaviors like, washing your hands, or double checking that you turned off thestove and perform them compulsively. and they often use these compulsive, even ritualisticbehaviors to relieve intense and unbearable anxiety.
so, soon they're scrubbing their hands every five minutes, or constantly checking the stove, or counting the exact number of steps theytake everywhere they go. if you're still unclear about what it meansfor disorders to be deviant, distressful and dysfunctional, ocd might help you understand. because it is hard to keep a job, run a household,sit still, or do much of anything if you feel intensely compelled to run to the kitchentwenty times an hour. and both the thoughts and behaviors associated withocd are often driven by a fear that is itself obsessive, like if you don't go to the kitchenright now your house will burn down and your child will die which makes the condition thatmuch more distressing and self-reinforcing.
there are treatments that help ocd including certainkinds of psychotherapy and some psychotropic drugs. but the key here is that it is not a descriptionfor your roommate who cleans her bathroom twice a week, or the guy in the cubicle next toyou, who only likes to use green felt tip pens. and even though ocd is considered its ownunique set of psychological issues, the pervasive senses of fear, worry, and loss of controlthat often accompany it, have a lot in common with other anxiety disorders. the broadest of these is generalized anxietydisorder or gad. people with this condition tend to feel continuallytense and apprehensive, experiencing unfocused, negative, and out-of-control feelings.
of course feeling this way occasionally iscommon enough, but feeling it consistently for over six months - the length of time required fora formal diagnosis - is not. folks with gad worry all the time and arefrequently agitated and on edge, but unlike some other kinds of anxiety, patients often can'tidentify what's causing the anxiousness, so they don't even know what to avoid. then there's panic disorder, which affects about1 in 75 people, most often teens and young adults. it's calling card is panic attacks or suddenepisodes of intense dread or sudden fear that come without warning. unlike the symptoms of gad which can be hardto pin down, panic attacks are brief, well-defined,
and sometimes severe bouts of elevated anxiety. and if you've ever had one, or been with someonewho has, you know that they call these attacks for good reason. they can cause chest pains and racing heartbeat,difficulty breathing and a general sense that you're going crazy or even dying. it's asawful as it sounds. we've talked a lot about the body's physiologicalfight or flight response and that's definitely part of what's going on here, even thoughthere often isn't an obvious trigger. there may be a genetic pre-disposition topanic disorder, but persistent stress or having experienced psychological trauma in the pastcan also set you up for these attacks.
and because the attacks themselves can bedownright terrifying, a common trigger for panic disorder is simply the fear of havinganother panic attack. how's that for a kick in the head? say you have a panic attack on a bus, or youfind yourself hyperventilating in front of dozens of strangers with nowhere to go tocalm yourself down, that whole ordeal might make you never want to be in that situationagain, so your anxiety could lead you to start avoiding crowded or confined places. at this point the initial anxiety has spunof into a fear of anxiety which means, welcome you've migrated into another realm of anxietydisorder, phobias.
and again this is a term that's been misusedfor a long time to describe people who, say, they don't like cats, or are uncomfortableon long plane trips. simply experiencing fear or discomfort doesn'tmake you phobic. in clinical terms, phobias are persistent,irrational fears of specific objects, activities, or situations, that also, and this is important,leads to avoidance behavior. you hear a lot about fears of heights, orspiders, or clowns, and those are real things. they're specific phobias that focus on particularobjects or situations. for example, the chesapeake bay bridge inmaryland is a seven-thousand meter span that crosses the chesapeake bay, if you want toget to or from eastern maryland that's pretty
much the only way to do it, at least in acar, but there are thousands of people who are so afraid of crossing that bridge thatthey simply can't do it. so, to accommodate this avoidance behavior,driver services are available. for $25 people with gephyrophobia, a fear of bridges,can hire someone to drive themselves, and their kids, and dogs, and groceries across the bridgein their own car, while trying not to freak out. but other phobias lack such specific triggers,what we might think of as social phobia, currently known as social anxiety disorder, is characterizedby anxiety related to interacting or being seen by others, which could be triggered bya phone call, or being called on in class, or just thinking about meeting new people.
so you can probably see at this point howanxiety disorders are related and how they can be difficult to tease apart. the same thing can be said about what we thinkcauses them. because much in the same way anxiety can showup as both a feeling like panic, and a thought, like is my kitchen on fire, there are also two mainperspectives on how we currently view anxiety as a function of both learning and biology. the learning perspective suggests that thingslike, conditioning, and observational learning and cognition, all of which we've talked aboutbefore best explain the source of our anxiety. remember our behaviorist friend, john b. watsonand his conditioning experiments with poor
little albert, by making a loud scary noiseevery time you showed the kid a white rat, he ended up conditioning the boy to fear anyfurry object, from bunnies, to dogs, to fur coats. that conditioning used two specific learning processesto cement itself in little albert's young mind. stimulus generalization, expanded or generalizedhis fear of the rat to other furry objects, the same principle holds true if you were,like, attacked by your neighbours mean parrot and subsequently fear all birds. but then the anxiety is solidified throughreinforcement, every time you avoid or escape a feared situations, a pair of fuzzy slippersor a robin on the street, you ease your anxiety, which might make you feel better temporarily,but it actually reinforces your phobic behavior,
making it stronger. cognition also influences our anxiety, whetherwe interpret a strange noise outside as a hungry bear, or a robber, or merely the wind,determines if we roll-over and keep snoring, or freak out and run for a kitchen knife. and we might also acquire anxiety from otherpeople through observational learning. a parent who's terrified of water may endup instilling that fear in their child by violently snatching them away from kiddiepools or generally acting anxious around park fountains and duck ponds. but there're also equally important biologicalperspectives. natural selection, for instance,
might explain why we seem to fear certain potentiallydangerous animals, like snakes, or why fears of heights or closed in spaces are relativelycommon. it's probably true that our more wary ancestorswho had the sense to stay away from cliff edges and hissing serpents were more likelyto live another day and pass along their genes, so this might explain why those fears canpersist, and why even people who live in places without poisonous snakes would still fearsnakes anyway. and then you got the genetics and the brainchemistry to consider. research has shown for example that identicaltwins, those eternal test subjects, are more likely to develop phobias even if they'reraised apart.
some researchers have detected seventeen differentgenes that seem to be expressed with various anxiety disorders. so it may be that some folks are just naturallymore anxious than others and they might pass on that quality to their kids. and of course individual brains have a lotto say about how they process anxiety. physiologically, people who experience panicattacks, generalized anxiety, or obsessive compulsions show over-arousal in the areasof the brain that deal in impulse control and habitual behaviors. now we don't know whether these irregularitiescause the disorder or are caused by it, but
again, it reinforces the truism that everything thatis psychological is simultaneously biological. and that holds true for many other psychologicaldisorders we'll talk about in the coming weeks, many of which have names that you've alsoheard being misused in the past. today you learned what defines an anxietydisorder, as well as the symptoms of obsessive compulsive disorder, generalized anxiety disorder,panic disorder and phobias. you also learned about the two main perspectiveson the origins of anxiety disorders, the learning perspective and the biological perspectiveand hopefully you learned not to use "ocd" as a punch line from now on. thanks for watching, especially to all ofour subbable subscribers who make crash course
available to them and also to everyone else. to find out how you can become a supporterjust go to subbable.com/crashcourse. this episode was written by kathleen yale,edited by blake de pastino, and our consultant is dr. ranjit bhagwat. our director and editor is nicholas jenkins,the script supervisor is michael aranda who is also our sound designer and the graphicsteam is thought cafe.
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