Guide
Guide | Reference

14  Anxiety, Threat, and Bodily Alarm

14.1 Summary

  • Heightened threat anticipation with bodily alarm and avoidance that feels out of proportion or hard to control.

14.2 Patient-Language Phrases

  • “I feel on edge all the time.”
  • “My heart races and I can’t catch my breath.”
  • “I keep thinking something bad will happen.”
  • “I avoid places because I might panic.”

14.3 Core Features

  • Persistent sense of threat or danger.
  • Bodily arousal (racing heart, tight chest, trembling).
  • Avoidance or safety behaviors.

14.4 Boundary Markers

  • What it is: threat-focused worry or fear that dominates attention.
  • What it is not: expected stress responses to clear, time-limited threats.

14.5 Quick Structure

  • Variants / Spectrum
    • Worry-dominant tension.
    • Panic surges with intense bodily alarm.
    • Specific fears or phobic avoidance.
    • Social or performance-related threat.
    • Health-focused threat and scanning.
  • Severity (0-4)
    • 0: No significant threat anticipation.
    • 1: Mild, situational, manageable.
    • 2: Moderate, recurring, interferes with focus or sleep.
    • 3: Severe, frequent avoidance or panic.
    • 4: Extreme, disabling or unsafe.
  • Time-course
    • Acute spikes tied to triggers.
    • Episodic panic with inter-episode worry.
    • Chronic, diffuse tension.
    • Fluctuating with stress load.
  • Functional impact
    • Work/school: reduced concentration or avoidance.
    • Relationships: withdrawal or reassurance seeking.
    • Self-care: disrupted routines or sleep.
  • Developmental expression
    • Early childhood: separation fears, somatic complaints.
    • School age: school refusal, performance anxiety.
    • Adolescence: social threat, panic, avoidance.
    • Late life: health or safety-focused threat.
  • Cultural/context notes
    • May present as somatic distress or spiritual framing.
    • Threat meaning is shaped by environment and exposure.