Saludos Psychology Group

Dr. Kimberly Fitzgerald González

Florida Licensed Clinical Psychologist · License #PY10967 · Clinical and Forensic Psychology · Telehealth across Florida

Anxiety Disorders | SaludosPsych

Mental Health Education

When Worry Takes Over

When the brain turns on to perceived threat: anxiety is one of the most human experiences there is — a signal that something matters, that danger might be near. But the brain does not always get it right. Anxiety activates not only in the presence of real danger but in response to perception — and perception, at times, misfires. When anxiety becomes persistent, overwhelming, or disconnected from any real threat, it stops being a signal and starts being the problem.

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Anxiety Disorders

Conditions characterized by excessive fear, worry, and avoidance

Anxiety Disorders

Generalized Anxiety Disorder

Commonly known as: GAD

Most people worry. But people with Generalized Anxiety Disorder worry about everything — and they worry constantly. It's not the kind of worry that appears when something actually goes wrong. It's a background hum of dread that follows them everywhere, latching onto whatever is available: work, health, family, finances, the future, small everyday decisions.

What makes GAD different from ordinary stress is that the worry feels uncontrollable. People with GAD often know their anxiety is out of proportion to the situation. They tell themselves to relax, to stop catastrophizing, to think rationally. And they can't. The worry keeps coming, shifting from one concern to the next like a restless current.

"I was always waiting for the other shoe to drop. Even on good days, I couldn't enjoy them — I was too busy bracing for what came next."

GAD also lives in the body. Muscle tension, headaches, fatigue, stomach problems, and difficulty sleeping are all common. Many people with GAD are diagnosed with a physical condition first — only later connecting the dots to anxiety. With therapy, particularly cognitive-behavioral approaches, and sometimes medication, GAD is very treatable.

Common experiences people describe

  • Persistent, excessive worry about multiple areas of life
  • Difficulty controlling the worry even when you want to stop
  • Feeling restless, keyed up, or on edge
  • Fatigue that doesn't improve with rest
  • Muscle tension, headaches, or stomach upset
  • Difficulty concentrating — mind going blank
  • Sleep problems — difficulty falling or staying asleep
  • Irritability

Anxiety Disorders

Panic Disorder

Characterized by: unexpected panic attacks

A panic attack is one of the most frightening experiences a person can have — a sudden surge of intense fear that peaks within minutes, accompanied by physical symptoms so severe that many people believe they are having a heart attack or dying. Racing heart, chest pain, shortness of breath, dizziness, numbness, a feeling of unreality — it arrives without warning and feels completely out of control.

Panic attacks themselves can happen to anyone under extreme stress. What makes Panic Disorder distinct is what comes after. The person becomes terrified of having another panic attack. They begin to change their behavior — avoiding situations where an attack might occur, always scanning for early warning signs, organizing their life around the fear of the next one.

"The first attack came out of nowhere. After that, I was afraid to leave the house. I was afraid of my own body."

This anticipatory anxiety — dreading the panic itself — can become more disabling than the attacks. It can shrink a person's world dramatically. The good news is that Panic Disorder responds very well to treatment. Therapy that helps people understand and tolerate their physical sensations can be life-changing.

Common experiences people describe

  • Sudden, unexpected episodes of intense fear or discomfort
  • Racing or pounding heart, chest pain or tightness
  • Shortness of breath or feeling of choking
  • Dizziness, lightheadedness, or feeling faint
  • Numbness or tingling sensations
  • Feeling detached from yourself or your surroundings
  • Fear of losing control, "going crazy," or dying
  • Persistent worry about future attacks
  • Changing behavior to avoid triggering another attack

Anxiety Disorders

Social Anxiety Disorder

Formerly known as: social phobia

Social anxiety is far more than shyness or introversion. People with Social Anxiety Disorder experience intense, persistent fear of social situations — specifically, fear of being watched, judged, embarrassed, or humiliated. The fear is not just about big public speaking moments. It can attach to everyday interactions: eating in front of others, making a phone call, walking into a room, asking a question in class.

What makes this condition so isolating is that people with social anxiety are often acutely aware that their fear is excessive — and they feel ashamed of it. They may spend hours replaying a social interaction, convinced they said something wrong or embarrassing. They may decline invitations, avoid advancement at work, or build their lives around minimizing social exposure.

"I'd rehearse what I was going to say before every phone call. And then afterward, I'd replay it for hours, convinced I'd said something stupid."

Social Anxiety Disorder is one of the most common anxiety disorders, and one of the most undertreated — partly because avoidance makes it easier to hide. Therapy, particularly approaches that involve gradually facing feared situations, can produce profound and lasting change.

Common experiences people describe

  • Intense fear of social or performance situations
  • Fear of being humiliated, embarrassed, or judged negatively
  • Physical symptoms in social situations — blushing, sweating, trembling, nausea
  • Avoiding social situations or enduring them with significant distress
  • Replaying social interactions afterward with self-criticism
  • Difficulty making eye contact or speaking up in groups
  • Fear that others will notice your anxiety

Anxiety Disorders

Specific Phobias

Intense, focused fear of a specific object or situation

A specific phobia is a marked, persistent fear of a particular object or situation that is out of proportion to the actual danger it poses. Common phobias include fears of animals (spiders, dogs, insects), natural environments (heights, storms, water), blood or injections, and specific situations (flying, enclosed spaces, driving).

Most people have things they find unpleasant or a little scary. A phobia is different — the fear is immediate, intense, and often triggers a panic-like response. People go to great lengths to avoid the feared object or situation, and that avoidance can significantly affect their daily life and opportunities.

"I turned down a promotion because it required flying. I knew it was irrational. I did it anyway."

Specific phobias are among the most treatable of all anxiety disorders. Exposure-based therapy — gradually and safely approaching the feared situation — has an exceptionally strong track record. Many people experience significant relief in a relatively short period of time.

Common experiences people describe

  • Immediate, intense fear when confronted with the specific object or situation
  • Physical anxiety response — heart racing, sweating, trembling
  • Actively avoiding the feared thing, sometimes at significant personal cost
  • Recognizing the fear is excessive but being unable to control it
  • Fear that has persisted for six months or more

Anxiety Disorders

Agoraphobia

Fear of situations that feel impossible to escape

Agoraphobia is commonly described as a fear of open spaces or crowded places — but that's an oversimplification. At its core, agoraphobia is a fear of situations where escape might be difficult or help unavailable if something goes wrong. This typically includes public transportation, open spaces, enclosed spaces, crowds, and being outside the home alone.

For many people, agoraphobia develops in the wake of panic attacks. After experiencing panic in a particular setting, the person begins to avoid that setting — and then others, in an expanding circle of avoidance that can eventually leave them housebound. The world shrinks to wherever they feel safe.

"At first I just avoided the subway. Then buses. Then driving. Then stores. Eventually I couldn't leave my apartment at all."

Agoraphobia can be one of the more severe anxiety presentations because of how much it limits a person's life. But it is treatable. With the right support, people can gradually reclaim the spaces and experiences that anxiety took from them.

Common experiences people describe

  • Fear of using public transportation, being in open or enclosed spaces, or standing in crowds
  • Fear of being outside the home alone
  • Anxiety about situations where escape feels difficult or help unavailable
  • Avoiding feared situations or requiring a companion to manage them
  • In severe cases, inability to leave home without extreme distress

Anxiety Disorders

Separation Anxiety Disorder

Not just a childhood condition

Most people associate separation anxiety with young children clinging to a parent at the school gate. And while it is common in early childhood, separation anxiety disorder can persist into adulthood — or first appear in adulthood — in ways that are often missed or misidentified.

People with separation anxiety disorder experience excessive fear about being separated from attachment figures — people they are deeply bonded to, usually a parent, partner, or child. The fear goes well beyond normal concern. It involves persistent worry that something terrible will happen to the attachment figure, or that separation will lead to loss.

"Every time my husband traveled for work, I was convinced he wasn't coming back. I'd call him ten times a day just to hear his voice."

In adults, separation anxiety can look like clinginess, excessive checking-in, or difficulty functioning when a loved one is away. It is frequently missed because clinicians don't always think to ask about it in adults. With the right therapy, people can develop the security to tolerate separations without distress.

Common experiences people describe

  • Excessive distress when separated from home or attachment figures
  • Persistent worry that something bad will happen to a loved one
  • Reluctance or refusal to be away from attachment figures
  • Nightmares involving separation themes
  • Physical symptoms when separation occurs or is anticipated
  • Difficulty being alone even at home

Anxiety Disorders

Selective Mutism

When anxiety silences the voice

Selective mutism is a condition in which a person who is fully capable of speech consistently fails to speak in specific social situations — most commonly at school or in public — despite speaking normally in other settings, such as at home. It is most often seen in children, typically becoming apparent when they start school.

Selective mutism is not defiance, stubbornness, or a communication disorder. It is an anxiety disorder. The child wants to speak but is paralyzed by anxiety. Forcing or pressuring them to talk almost always makes things worse. The silence is not a choice — it is the body's anxiety response overriding the ability to speak in that moment.

"She talked nonstop at home. At school, not a single word for two years. Her teacher thought she couldn't speak English."

With patient, gradual, anxiety-focused intervention — never pressure or punishment — most children with selective mutism can learn to speak in the settings that previously silenced them. Early intervention produces the best outcomes.

Common experiences families and teachers describe

  • Child speaks freely at home but not at school or in public
  • Consistent pattern across situations, not just occasional shyness
  • Child appears frozen, stiff, or expressionless when expected to speak
  • May communicate through gestures, nods, or whispering to a safe person
  • Often accompanied by social anxiety or extreme shyness
  • No underlying speech or language disorder

Clinical Expertise

Why Dr. Fitzgerald González's expertise matters

51,000 hours of clinical and research experience across anxiety presentations

Dr. Fitzgerald González has assessed and treated anxiety disorders across the full range of clinical severity and complexity — from high-functioning outpatient presentations to anxiety embedded in the most acute and complex psychiatric presentations encountered in correctional and forensic settings. Anxiety rarely presents in isolation. It co-occurs with depression, personality pathology, trauma, and substance use in ways that require careful differential diagnosis and clinical precision to address effectively.

The anxiety disorders are among the most treatable conditions in all of psychiatry — but only when accurately identified and matched to the right evidence-based intervention. A misidentified anxiety presentation leads to a mismatched treatment. Diagnostic precision is the foundation of treatment that actually works.

That clinical foundation — built across 51,000 hours in the most demanding clinical environments that psychology offers — is what every patient at Saludos brings into their care.

Clinical Relevance

Why it matters for you

The right diagnosis changes everything that follows

If anxiety has been shaping your life — limiting where you go, what you do, how you relate, what you reach for — an accurate understanding of what you are experiencing is the first step toward changing it. Not all anxiety is the same. GAD, panic disorder, social anxiety, and specific phobias each have their own clinical profile and their own evidence-based treatment approach. What works for one does not necessarily work for another.

Accurate assessment maps the specific anxiety you are carrying — its triggers, its patterns, its relationship to other aspects of your clinical picture — and points directly toward the treatment most likely to produce real and lasting change.

An accurate diagnosis and evidence-based treatment changes everything.

Saludos Psychology Group provides services via telehealth. Schedule directly with Dr. Fitzgerald González — no referral required.

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This page is for educational purposes only. It is not a substitute for professional mental health assessment, diagnosis, or treatment. If you are in crisis, please immediately call or text 988 or go to the nearest emergency room.