Anxiety Disorders: An Introduction
Most people experience feelings of
anxiety before an important event such as a big exam, business presentation, or first date. Anxiety disorders, however, are illnesses that fill people's lives with overwhelming anxiety and fear that are chronic and unremitting, and that can grow progressively worse. Tormented by
panic attacks, obsessive thoughts, flashbacks of traumatic events, nightmares, or countless frightening physical symptoms, some people with anxiety disorders even become housebound.
Anxiety disorders, as a group, are the most common mental illness in America. More than 19 million adults in America are affected by these debilitating illnesses each year. Children and adolescents can also develop anxiety disorders
(see Anxiety in Children).
Different Types of Anxiety Disorders
There are several types of anxiety disorders. These anxiety disorders include:
Each of these anxiety disorders has its own distinct features, but they are all bound together by the common theme of excessive, irrational fear and dread.
Generalized Anxiety Disorder
Most people experience anxiety at some point in their lives and some nervousness in anticipation of a real situation.
However if a person cannot shake unwarranted worries, or if the feelings are jarring to the point of avoiding everyday activities, he or she most likely has an anxiety disorder.
Symptoms of Generalized Anxiety Disorder
Chronic, exaggerated worry; tension; and irritability that appear to have no cause or that are more intense than the situation warrants are possible indications of
generalized anxiety disorder. Physical signs often accompany these psychological symptoms, for example:
- Restlessness
- Trouble falling or staying asleep
- Headaches
- Trembling
- Twitching
- Muscle tension
- Unexplained sweating.
Formal Diagnosis for Generalized Anxiety Disorder
When someone spends at least six months excessively worring about everyday problems, he or she is said to have generalized
anxiety disorder. However, incapacitating or troublesome symptoms warranting treatment may exist for shorter periods of time.
Treatment for Generalized Anxiety Disorder
Anxiety is among the most common, most treatable mental disorders. Effective treatments include:
Medication, most commonly anti-anxiety drugs, such as benzodiazepine and its derivatives, may also be required in some cases. Some commonly prescribed anti-
anxiety medications are
diazepam,
alprazolam, and
lorazepam. The non-benzodiazepine anti-anxiety medication
buspirone can be helpful for some individuals.
People with
panic disorder experience white-knuckled, heart-pounding terror that strikes suddenly and without warning. Since they cannot predict when a
panic attack will seize them, many people live in persistent worry that another attack could overcome them at any moment.
Symptoms of Panic Disorder
Most
panic attacks last only a few minutes, but they occasionally go on for ten minutes, and, in rare cases, have been known to last for as long as an hour. They can occur at any time, even during sleep.
- Pounding heart
- Chest pains
- Lightheadedness or dizziness
- Nausea
- Shortness of breath
- Shaking or trembling
- Fear of dying
- Sweating
- Feelings of unreality
- Numbness or tingling
- A feeling of going out of control or going crazy.
Formal Diagnosis for Panic Disorder
To be diagnosed with
panic disorder, a person must experience either four attacks within four weeks, or one or more attacks followed by at least a month of persistent fear of having another attack. A minimum of four of the symptoms listed previously must occur during at least one of the attacks.
Treatment for Panic Disorder
Panic attacks are treated with
cognitive-behavioral therapy and medications such as high-potency anti-
anxiety drugs like
alprazolam. Several classes of
antidepressants (such as
paroxetine, one of the newer selective serotonin reuptake inhibitors or
SSRIs) and the older tricyclics and monoamine oxidase inhibitors (MAOIs) are considered "gold standards" for treating panic disorder. Sometimes, a combination of therapy and medication is the most effective approach to helping people manage their symptoms. Proper treatment helps 70 percent to 90 percent of people with panic disorder, usually within six to eight weeks.
Most of us steer clear of certain hazardous things.
Phobias, however, are irrational fears that lead people to completely avoid specific things or situations that trigger intense anxiety.
Phobias occur in several forms. For example,
agoraphobia is the fear of being in any situation that might trigger a panic attack and from which escape might be difficult.
Social phobia is a fear of being extremely embarrassed in front of other people. The most common social phobia is fear of public speaking.
Symptoms of Phobias
Many of the physical symptoms that accompany
panic attacks -- such as sweating, racing heart, and trembling -- also occur with
phobias.
Formal Diagnosis for Phobias
For a person to be diagnosed with a
phobia, he or she must:
- Experience extreme anxiety with exposure to the object or situation
- Recognize that his or her fear is excessive or unreasonable
- Find that normal routines, social activities, or relationships are significantly impaired as a result of these fears.
Treatment for Phobias
Cognitive-behavioral therapy has the best track record for helping people overcome most phobic disorders. The goals of this therapy are to desensitize a person to feared situations or to teach a person how to recognize, relax, and cope with anxious thoughts and feelings. Medications, such as anti-anxiety agents or
antidepressants, can also help relieve symptoms. Sometimes, therapy and medication are combined to treat phobias.
Post-Traumatic Stress Disorder
Researchers now know that anyone, even children, can develop
PTSD if they have experienced, witnessed, or participated in a traumatic event -- especially if the event was life threatening. PTSD can result from terrifying experiences such as rape, kidnapping, natural disasters, war, or serious accidents such as airplane crashes. The psychological damage such incidents cause can interfere with a person's ability to hold a job or to develop intimate relationships with others.
Symptoms of Post-Traumatic Stress Disorder
The symptoms of PTSD can range from constantly reliving the event to a general emotional numbing. Common symptoms include:
- Persistent anxiety
- Exaggerated startle reactions
- Difficulty concentrating
- Nightmares
- Insomnia.
People with PTSD typically avoid situations that remind them of the traumatic event because they provoke intense distress or even
panic attacks.
Formal Diagnosis for Post-Traumatic Stress Disorder
Although the symptoms of
PTSD may be an appropriate initial response to a traumatic event, they are considered part of a disorder when they persist beyond three months.
Treatment for Post-Traumatic Stress Disorder
Psychotherapy can help people who have PTSD regain a sense of control over their lives. They may also need cognitive-behavior therapy to change painful and intrusive patterns of behavior and thought and to learn relaxation techniques. Support from family and friends can help speed recovery and healing. Medications, such as
antidepressants and anti-
anxiety agents, can ease the
symptoms of depression and sleep problems. Treatment for PTSD often includes both psychotherapy and medication.
Anxiety Disorders and Other Conditions
It is common for an anxiety disorder to accompany
depression,
eating disorders, substance abuse, or another anxiety disorder. Anxiety disorders can also co-exist with illnesses such as cancer or
heart disease. In such instances, the accompanying disorders will also need to be treated. Before beginning any treatment, however, it is important to have a thorough medical examination to rule out other possible causes of symptoms.
Statistics on Anxiety Disorders
As mentioned previously, anxiety disorders include:
Each year, approximately 19.1 million American adults ages 18 to 54 (about 13.3 percent of people in this age group) have an anxiety disorder.
Anxiety disorders frequently co-occur with depressive disorders,
eating disorders, or substance abuse. Many people have more than one anxiety disorder.
Women are more likely than men to have an anxiety disorder. Approximately twice as many women as men suffer from panic disorder, post-traumatic stress disorder, generalized anxiety disorder, agoraphobia, and specific
phobia, though nearly equal numbers of women and men have obsessive-compulsive disorder and social phobia.
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