Anxiety Disorders

Anxiety is a normal part of life. But there are times when you may experience anxiety that is persistent, overwhelming, and seemingly uncontrollable. This excessive, irrational dread of everyday situations can be disabling. But with treatment, many people can manage those feelings and get back to a fulfilling life.

Anxiety disorders are the most common mental disorder in the United States. Nearly 40 million people in the United States (18%) experience an anxiety disorder in any given year. Approximately 8% of children and teens experience an anxiety disorder with most people developing symptoms before age 21. Only about one-third of those suffering from an anxiety disorder receive treatment , even though the disorders are highly treatable. 

The term anxiety disorder refers to specific psychiatric disorders that involve extreme fear or worry, and includes generalized anxiety disorder (GAD), panic disorder and panic attacks, phobias, social anxiety disorder, selective mutism, separation anxiety, and specific phobias. Obsessive compulsive disorder (OCD) and post traumatic stress disorder (PTSD) are closely related to anxiety disorders, which some may experience at the same time of depression. 

  • Types of Anxiety Disorders
  • Symptoms
  • Risk Factors
  • Diagnosis
  • Treatment
  • Anxiety & Depression

There are may types of anxiety disorders, each with different symptoms. The most common types include:

Generalized Anxiety Disorder (GAD)

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension, and nausea.

Generalized anxiety disorder symptoms include:

  • Feeling restless, wound-up, or on-edge
  • Being easily fatigued
  • Having difficulty concentrating; mind going blank
  • Being irritable
  • Having muscle tension
  • Difficulty controlling feelings of worry
  • Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep
Social Anxiety Disorder

More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Panic Disorder

This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath, and an upset stomach. Many people will go to desperate measures to avoid an attack, including social isolation.

During a panic attack, people may experience:

  • Heart palpitations, a pounding heartbeat, or an accelerated heartrate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath, smothering, or choking
  • Feelings of impending doom
  • Feelings of being out of control
Phobias

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions. To avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

People with a phobia:

  • May have an irrational or excessive worry about encountering the feared object or situation
  • Take active steps to avoid the feared object or situation
  • Experience immediate intense anxiety upon encountering the feared object or situation
  • Endure unavoidable objects and situations with intense anxiety

There are several types of phobias and phobia-related disorders:

Specific Phobias (sometimes called simple phobias): As the name suggests, people who have a specific phobia have an intense fear of, or feel intense anxiety about, specific types of objects or situations. Some examples of specific phobias include the fear of:

  • Flying (aerophobia)
  • Heights (acrophobia)
  • Specific animals, such as spiders (arachnophobia), dogs (cynophobia), or snakes (ophidiophobia)
  • Receiving injections (trypanophobia)
  • Blood (hemophobia)

Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People typically experience one or more of the following symptoms.

Emotional symptoms:

  • Feelings of apprehension, uneasiness, and dread
  • Feeling tense or jumpy
  • Restlessness or irritability
  • Anticipating the worst and being watchful of signs of danger

Physical symptoms:

  • Pounding or racing heart and shortness of breath
  • Sweating, tremors, and twitches
  • Headaches, dizziness, fatigue, and insomnia
  • Tense muscles
  • Dry mouth
  • Cold, sweaty, numb or tingling hands or feet
  • Upset stomach, frequent urination, or diarrhea

Researchers are finding that both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Although the risk factors for each type of anxiety disorder can vary, some general risk factors for all types of anxiety disorders include:

  • Temperamental traits of shyness or behavioral inhibition in childhood
  • Exposure to stressful and negative life or environmental events in early childhood or adulthood
  • A history of anxiety or other mental illnesses in biological relatives
  • Some physical health conditions, such as thyroid problems or heart arrhythmias, or caffeine or other substances/medications, can produce or aggravate anxiety symptoms; a physical health examination is helpful in the evaluation of a possible anxiety disorder.

Physical symptoms of anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab test. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation. 

Using the Diagnostic and Statistical Manual of Mental Disorders (DSM), a mental health professional is able to identify a specific type of anxiety disorder causing symptoms as well as any other possible disorders that may be involved. Tackling all disorder through comprehensive treatment is the best recover strategy. 

Different anxiety disorders have their own set of symptoms. This means that each type of anxiety disorder also has its own treatment plan. But there are some common types of treatment.
 
Psychotherapy 
  • Cognitive Behavioral Therapy (CBT)  is the most researched psychotherapy for anxiety disorders. In general, CBT is a type of counseling that focuses on our reactions to events, not changing the events themselves. CBT offers many constructive strategies to reduce the beliefs and behaviors that lead to anxiety symptoms. Finding the counterproductive thinking patterns that contribute to anxiety is a cornerstone of CBT.
  • Exposure Response Prevention is a psychotherapy for specific anxiety disorders like phobias and social anxiety. It aims to help a person develop a more constructive response to a fear. The goal is for a person to “expose” themselves to that what they fear, in an attempt to experience less anxiety over time and develop effective coping tools.
Medications (anti-anxiety medications and antidepressants)

Some people find that medication is helpful in managing an anxiety disorder. Talk with your health care provider about the potential benefits, risks and side effects.

  • Anti-anxiety medications – Certain medications work solely to reduce the emotional and physical symptoms of anxiety. Benzodiazepines can be effective for short-term reduction of symptoms, but can create the risk of dependence when used for a long time. Be sure to review these potential risks if you select these medicines.
  • Antidepressants – Many antidepressants may also be useful for treating anxiety. These can also be useful if your anxiety has a co-occurring depression. 

Complementary health approaches (stress and relaxation techniques to manage symptoms)

More and more people have started using complementary and alternative treatments along with conventional treatment to help with their recovery. Some of the most common approaches for treating anxiety include:

  • Self-management strategies – this could include allowing specific periods of time for worrying. Someone who becomes an expert on their condition and its triggers gains more control over their day.
  • Stress and relaxation techniques – often combine breathing exercises and focused attention to calm the mind and body. These techniques can be an important component in treating phobias or panic disorder.
  • Yoga – the combination of physical posture, breathing exercises, and meditation found in yoga have helped many people improve the management of their anxiety disorder.
  • Exercise – Aerobic exercise can have a positive effect on your stress and anxiety. Check with your primary care doctor before beginning an exercise plan. 
  • Healthy habits – this includes cutting down on caffeine, eating healthy, getting enough sleep and physical activity. 

After a while, anxiety symptoms can take a huge emotional toll on a person, and depression often sets in. There’s no conclusive explanation as to why anxiety and depression so often co-exist, according to the Anxiety and Depression Association of America, but you can find relief from both with the right treatment.

Depression and anxiety disorders are different, but people with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms.

Many people who develop depression have a history of an anxiety disorder earlier in life. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

Source: National Institute of Mental Health

Resources

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