Anxiety In The 20th Century

Anxiety In The 20th Century

The 20th century is a fascinating period of human history. Early in the century, the world witnessed the great war which we now call World War I, followed by the great depression, which ended with the start of the Second World War. It was the time full of fear and anxiety, and people all over the globe were anxious because of how these events were unfolding.  

The history of anxiety disorder is also quite fascinating. Though the social anxiety disorder is not a recognized diagnosis for a very long time, the concept of social anxiety dates back very far back in human history. As early as 400 BC, the ancient Greek physician Hippocrates describes the overly shy people as someone who “loves darkness as life” and “thinks every man observes him.” These shy people most probably have what we now know as a social anxiety disorder.

In the early 20th century, psychiatrists referred to generalized anxiety disorder as pantophobia and anxiety neurosis. These terms also designated panic attacks and apprehensive mental state. Doctors regarded Generalized anxiety disorder (GAD) as one of the numerous symptoms of neurasthenia, a vaguely defined illness. The GAD appeared as a separate diagnosis in the third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1980.

Here is the timeline of historical highlights and significant turning points in the history of anxiety disorder.

In 1907, Emil Kraepelin described the neurosis of terror. In the sixth edition of classic Psychiatrie, in the chapter on compulsive insanity, Kraepelin associated agoraphobia to the anxiety attacks with several symptoms. He also concluded that a reduction in the signs does not mean an improvement of agoraphobia, as this condition might persist indefinitely.

In 1950s South African psychiatrist, Joseph Wolpe did work in behavioral therapy that paved the way for later advances. He developed systematic desensitization techniques for the treatment of these phobias. The British psychiatrist Isaac Marks in 1960 proposed to consider social phobias as a distinct category separate from other types of phobias.

In 1967, while performing at the Central Park, Barbra Streisand forgot the lyrics to a song. She attributed this incident to her anxiety, for which later received treatment. The second edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS II), published by APA (AmericanPsychiatric Association) in 1968, describes social fears as a specific phobia of social situations or extreme anxiety of being overserved or scrutinized. The definition of social phobia was very narrow at this point in history.

The American Psychiatric Association (APA) published the 3rd edition of Diagnostic and Statistical Manual of Mental Disorders (DSM III), which listed the social phobia as an official psychiatric diagnosis. It describes social phobia like fear of performance situation and but not include cases like casual conversations. People who have other types of social anxiety come under the diagnosis of avoidant personality disorder, which is not the same as social phobia.

Clinical psychologist Richard Heimberg and psychiatrist Michael Liebowitz in 1985, started a call to action for more research on this social phobia. There was not sufficient research on this disorder upto that point, causing some to refer to the situation as “neglected anxiety disorder.” In 1987 APA published a revision to the third edition of the Diagnosis and Statistical Manual of Mental Disorders (DMS III), according to which this diagnosis now requires this condition to cause marked distress or interference, instead of just significant trouble. This change made it possible to diagnose avoidant personality disorder and social phobia in the same patient. Lastly, the term “generalized social phobia,” which refers to a more severe and pervasive form of this disorder, was also introduced.

In the 1990s, Donny Osmond, while performing at in Joseph and the Amazing Technicolor Dreamcoat, suffered from severe stage fright. The American Psychiatric Association published the fourth edition of the diagnosis and statistical manual of mental disorders (DSM IV), which replaced the term “social phobia” with “social anxiety disorder.” This term defines the broad and generalized nature of fears in this disorder. This new edition of DSM also states that this disorder is a “marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others.”

Panic disorder has a long history in the way people understand the anxiety and its symptoms. In the previous century, many mysteries around panic disorder have uncovered through clinical research, and those who suffer from this condition can now get proper diagnosis and treatment. With the increasing amount of research on this topic, the therapy is becoming more and more effective. As time moves forward, new methods of treatment for this condition will likely come to light. With advances in genetic testing, it is also possible that we might gain a better understanding of the significant causes of this disorder.

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