Symptoms

We can offer help

If you suffer from:

Anxiety disorders

Anxiety means that you experience a kind of threat in combination with a feeling of losing control. If this anxiety is disproportional to the actual danger you’re in and impairs your normal daily functioning, then you might be suffering from an anxiety disorder. In The Netherlands, an average of 10.1% of all people between the ages 18-64 in the Netherlands annually suffer from anxiety-related problems and 19.6% of all Dutch people have had an anxiety disorder at some point in their lives. Symptoms may be: avoiding certain situations, elevated alertness levels and a need for control, excessive focusing on major past events, uncertainty or anxiety related to social situations.

Below you will find a description of the most prevalent anxiety disorders.

Anxiety disorders

  • Panic disorder

    panic attack is a sudden intense burst of anxiety, in which a number of symptoms occur within a short time interval and with a high intensity, such as dizziness, dyspnoea or heart palpitations. If you suffer from frequent panic attacks that occur without a specific apparent reason, you may be suffering from a clinical anxiety disorder. The subject may avoid certain situations out of fear of suffering another panic attack, which may cause the sufferer to also develop agoraphobia.
  • Specific phobias
    (warning; your health care insurer will not reimburse the costs of this diagnosis, see explanation at the end of this page)
    People suffering from a specific phobia experience an extreme anxiety when exposed to a specific situation, animal or object or the avoidance of any of these. Examples are: fear of spiders, fear of flying, fear of heights, claustrophobia, fear of blood or needles.
  • Social phobia
    A social phobia involves the fear of social rejection or of being judged negatively by others. This causes social events such as birthdays, meetings, presentations, phone calls or doing the groceries to cause the subject significant distress. The subject will undergo these activities with extreme tenseness or will avoid them altogether.
  • Generalised anxiety disorder (GAD)
    If you experience a lot of anxiety in different everyday situations, you may be suffering from a generalised anxiety disorder. This often involves situations over which the subject has little control, such as work or safety, whereas there is no actual reason to worry. The subject will be prone to excessive worrying, symptoms of depression and bad premonitions.

Obsessive-compulsive disorder and related complaints

Obsessive-compulsive and related disorders
An obsessive-compulsive disorder is characterised by obsessive thoughts (intrusive thoughts) and/or compulsive behaviours (so-called “rituals”). The client experiences a fear that disastrous consequences will follow as a result of their failure to perform a certain action or when they do something that “doesn’t feel good”. Examples of obsessive thoughts: doubts about whether or not the subject forgot to do something, the urge to do something over new or in a symmetric way, or intrusive, shameful sexual/aggressive thoughts. Compulsive behaviours are being performed to take away feelings of anxiety. Although the subject realises that the actions are exaggerated or pointless, he or she cannot refrain from carrying them out. Examples are repeatedly counting, checking, cleaning or arranging things symmetrically or doing things over new until they “feel” right.

Trauma and stress related complaints

Trauma and stress related disorders
People suffering from a post-traumatic stress-syndrome (PTSS) have experienced a very traumatic situation, often involving impeding death, injuries or (sexual) violence. A characteristic of PTSS is that the subject involuntarily relives the traumatic experience in the form of flashbacks, triggered by certain events. This involves severe feelings of anxiety and leads to the avoidance of specific feelings, thoughts and situations that may remind the subject of the trauma. Nightmares, insomnia, raised alertness, problems concentrating, irritability and outbursts of anger may occur as additional symptoms.

Mood disorders

Mood disorders

  • Depression
    The major symptoms of depression are: a state of low mood and a significant decline of interest in activities. In addition to these symptoms, subjects may experience excessive or diminished appetite, insomnia (trouble sleeping, or too much sleep), restlessness or feeling impaired, fatigue and loss of energy, feelings of guilt or feelings of worthlessness, problems concentrating, slow cognitive functions and having trouble making decisions, regular thoughts of death or suicide. The symptoms have to be present for a period of over two subsequent weeks. People who are depressed often do not recognise their own symptoms. Almost 20% of the people in The Netherlands encounter episodes of depression during their lives. A depression may vary in severity. There are different variants, such as a minor depressive disorder, a dysthymic disorder (chronic depression) and post/peri partum depression (which occurs during the pregnancy or after labour).
  • Bipolar disorders
    People suffering from a bipolar disorder experience prolonged disruptions of their moods. Subjects experience altering episodes of depression (see description of depressive disorders) and mania or hypomania. A manic episode is a period that lasts at least one week, in which the subject experiences a very cheerful mood, has plenty of energy and needs only little sleep. During this period, the subject often overestimates his or her own abilities and engages in uninhibited behaviour with regard to future plans, money and sex. Hypomania is similar to an episode of mania, but it is less severe.

Personality disorders
People suffering from personality disorders encounter problems in various aspects of life (work, education, relationships, friendships etc.) on account of how they treat others. This causes discomfort for themselves and their loved ones. Sufferers may suffer from personality disorders to different degrees. Some subjects only display a few symptoms that impair daily functioning and others suffer from a full-fledged personality disorder. Personality disorders are usually the result of a mix of various factors, such as biologically inherited factors, childhood experiences and other life events. Today, most personality disorders can be properly treated. In the last few decades various effective psychotherapeutic treatments were developed. Personality diagnosis is a means to determine which psychotherapy might be beneficial.

There are various kinds of personality disorders that PEP Psychologen offers treatments for:

  • Borderline personality disorder
    The borderline personality disorder is often identified as an emotional dysregulation, because emotional instability and problems handling emotions are central. Borderline personality disorders may manifest (among others) in: severe anxiety in intimate relationships, feelings of being permanently misunderstood by others as well as failure to understand the self, feelings of worthlessness and/or inferiority, tantrums, impulsivity and difficulties setting boundaries and recognising and respecting those of others. Sometimes the subject also engages in self-damaging behaviour, shows suicidal tendencies or dissociation. Dissociation is a temporary state of lessened consciousness, which may serve to control emotions. 1-2% of the population suffers from a borderline personality disorder.
  • Histrionic personality disorder
    The histrionic personality disorder is characterised by exaggerated emotionality and an elevated need for attention, which may involve inappropriate (sexual) behaviour. Insecurity, anger and sombreness may follow if others pay the subject insufficient attention. Emotions are often being experienced very intensely but also very swiftly and the subject often experiences relationships more intensely than they really are. About 1.3 to 3% of the population suffers from this personality disorder.
  • Narcissistic personality disorder
    A person suffering from a narcissistic personality disorder has a strong need for admiration. He/she has a tendency to take on a superior attitude, while being very insecure in reality. In addition people suffering from a narcissistic personality disorder are often very sensitive to critique and problems often arise in intimate relationships or professional relationships. About 0.1 to 3.9% of the population is estimated to suffer from this disorder.
  • Avoidant personality disorder
    eople with an avoidant personality disorder do have a need for personal contact, but will avoid this contact out of a fear for rejection. People suffering from this disorder feel inhibited, feel ashamed for their shortcomings and fear critique. 2.4% of the population suffers from this disorder.
  • Dependent personality disorder
    The dependent personality disorder is characterised by dependent and submissive behaviour in order to receive the help of others. The subject feels helpless and has a low self-esteem and is prone to self-sacrifice. This causes a lot of anxiety and stress. There is little sense of self-worth and little trust in one’s own capabilities and the subject needs the help of others. Conflicts are often avoided out of fear for abandonment. 0.49 to 1.7% of the population is estimated to suffer from a dependent personality disorder, patients are predominantly female.
  • Obsessive-compulsive personality disorder
    In case of an obsessive-compulsive personality disorder, the subject suffers from excessive perfectionism, orderliness and interpersonal control. The patient often is very inflexible and his/her thinking is characterised by things either being ‘good or bad’. The subject has very high expectations from him or herself, often making it impossible to successfully complete his or her tasks. 2.1% of the population suffers from an obsessive-compulsive disorder.

Physical complaints

Somatic symptom disorder
A person is said to suffer from a somatic symptom disorder if one or more physical symptoms that cause a discomfort to the patient coincide with abnormal thoughts, feelings and behaviour as a reaction to these symptoms. These ‘related disorders’ include among others the illness anxiety disorder (also known as hypochondria). People suffering from an illness anxiety disorder are preoccupied with the idea of having or contracting a serious disease. There often are no, or merely slight physical complaints. This worrying about the person’s own health may manifest in the excessive search for medical help or the far-stretching avoidance of medical help.

In addition to the disorders described above, PEP Psychologen also offers treatment for complaints that are not usually compensated by the health insurer, such as insomnia, relationship problems and bereavement. These treatments will be for your own account.


References

  • Multidisciplinaire Richtlijn Angststoornissen, Trimbos Instituut 2013
  • Zorgpad Angststoornissen, Trimbos Instituut 2014
  • Van Balkom, A.J.L.M., Gabriels, L., Van den Heuvel, O.A. Angst, obsessieve-compulsieve stoornis en trauma in de DSM-5. Tijdschrift voor Psychiatrie, 2014; 56: 177-181
  • Multidisciplinaire Richtlijn Depressie Trimbos Instituut 2013
  • www.volksgezondheidenzorg.info
  • Diagnostical and Statistical Manual of Mental Disorders (DSM-5)
  • Kenniscentrum persoonlijkheidsstoornissen www.kenniscentrumps.nl
  • Diagnostical and Statistical Manual of Mental Disorders (DSM-5)