Anxiety Disorders

We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.

Anxiety disorders are the most common mental health concern in the United States. An estimated 40 million adults in the U.S. (18%) have an anxiety disorder. Meanwhile, approximately 8% of children and teenagers experience an anxiety disorder. Most people develop symptoms before age 21.

Symptoms

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 or dread
  • Feeling tense or jumpy
  • Restlessness or irritability
  • Anticipating the worst and being watchful for signs of danger

Physical symptoms:

  • Pounding or racing heart and shortness of breath
  • Sweating, tremors and twitches
  • Headaches, fatigue and insomnia
  • Upset stomach, frequent urination or diarrhea

Types of Anxiety Disorders

There are many types of anxiety disorders, each with different symptoms. The most common types of anxiety disorders 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 or nausea.

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 stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.

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.

Other anxiety disorders include:

  • Agoraphobia
  • Selective mutism
  • Separation anxiety disorder
  • Substance/medication-induced anxiety disorder, involving intoxication or withdrawal or medication treatment

Causes

Scientists believe that many factors combine to cause anxiety disorders:

  • Genetics.  Studies support the evidence that anxiety disorders “run in families,” as some families have a higher-than-average amount of anxiety disorders among relatives.
  • Environment. A stressful or traumatic event such as abuse, death of a loved one, violence or prolonged illness is often linked to the development of an anxiety disorder.

Diagnosis

Physical symptoms of an 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 tests. 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 the specific type of anxiety disorder causing symptoms as well as any other possible disorders that may be involved. Tackling all disorders through comprehensive treatment is the best recovery strategy.

Treatment

Psychotherapy

Cognitive Behavioral Therapy (CBT) is the most researched psychotherapy for anxiety disorders. In general, CBT 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.

CBT has the largest research base to support its effectiveness, though it can be difficult to figure out which therapists are trained in CBT. There is no single national certification program for this skill. Ask your therapist how they approach treating anxiety and learn about their trainings in these approaches.

Exposure Response Prevention is a psychotherapy for specific anxiety disorders like phobias and social anxiety. Its aim is to help a person develop a more constructive response to a fear. The goal is for a person to “expose” themselves to that which they fear, in an attempt to experience less anxiety over time and develop effective coping tools.

Medication

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

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, such as allowing for 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 postures, 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.