Anxiety Disorders

What Are Anxiety Disorders?

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 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.

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:

 

 

When someone spends at least six months excessively worrying 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.

 

Anxiety is among the most common, most treatable mental disorder. 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.

 

Panic Disorder

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.

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.

 

Common symptoms of a panic attack include:

 

 

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.

 

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 to 90 percent of people with panic disorder, usually within six to eight weeks.

 

Phobias

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.

Many of the physical symptoms that accompany panic attacks -- such as sweating, racing heart, and trembling -- also occur with phobias.

 

For a person to be diagnosed with a phobia, he or she must:

 

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.

 

The symptoms of PTSD can range from constantly reliving the event to a general emotional numbing. Common symptoms include:

 

 

People with PTSD typically avoid situations that remind them of the traumatic event because they provoke intense distress or even panic attacks.

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.

 

Psychotherapy can help people who have PTSD regain a sense of control over their lives. They may also need cognitive behavioral 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 anxiety disorders 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 conditions 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.