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Anxiety Disorders

Overview

Sometimes, experiencing anxiety is a normal part of life. However, people who suffer from anxiety disorders often have excessive and persistent fears and worries about everyday situations. Often, anxiety disorders include recurring episodes of sudden feelings of intense anxiety, fear, or terror, reaching their peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, and are disproportionate to the actual danger. Some individuals may avoid certain places or situations to prevent these feelings. Symptoms may start in childhood, adolescence, or even adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias, and separation anxiety disorder. You may have more than one anxiety disorder. Sometimes anxiety may result from another medical condition or substance use that requires treatment.

Whatever form your anxiety takes, treatment can help you overcome it.

Symptoms

  • Common signs and symptoms of anxiety include:
  • Feeling nervous, anxious, or tense
  • Feeling impending danger, panic, or pessimism
  • Experiencing an increased heart rate
  • Increased breathing rate (hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Difficulty concentrating or thinking about anything other than the current anxiety.
  • Experiencing difficulty sleeping
  • Having gastrointestinal (GI) problems
  • Having difficulty controlling anxiety
  • Avoiding things that cause anxiety
  • The symptoms vary depending on the type of anxiety disorder you have. The anxiety may sometimes result from another medical condition or substance use.

Types of anxiety disorders include

  • Agoraphobia is a type of anxiety disorder where you fear and often avoid places or situations that might cause you to panic and feel trapped, helpless, or embarrassed.
  • Anxiety disorder due to a medical condition involves having excessive anxiety or panic caused directly by a medical condition.
  • Generalized anxiety disorder involves constant, excessive, and unrealistic worry about activities or events, including ordinary and routine matters. It is difficult to control the excessive anxiety that does not correlate with the actual situation and affects your physical well-being. This often occurs concurrently with depression or other anxiety disorders.
  • Panic disorder involves recurrent episodes of sudden feelings of intense anxiety and fear or terror that reach their peak within minutes (panic attacks). You may feel impending doom, shortness of breath, chest pain, rapid heartbeat, or palpitations (heart palpitations). Panic attacks may lead to anxiety about the recurrence of these events or avoidance of situations in which they occurred.
  • Selective mutism is an inability of children to consistently speak in certain situations, such as during school, even though they are able to speak in other situations, such as at home with close family members. This may conflict with your ability to perform school tasks, work, and social interaction.
  • Separation anxiety disorder is a childhood disorder characterized by excessive anxiety related to your child’s level of development and associated with separation from parents or others who have parental roles.
  • Social anxiety disorder (social phobia) includes high levels of anxiety, fear, and avoidance of social situations due to feeling embarrassed, self-conscious, and concerned that others will judge you negatively.
  • Specific phobia is characterized by severe anxiety when you are exposed to a specific object or situation and the desire to avoid it. Irrational fear may cause some people to have panic attacks.

When to see a doctor

Please seek medical attention if you experience the following:

  • Excessive anxiety that negatively affects your work, relationships, or other aspects of your life
  • Distress from feelings of fear, tension, or anxiety that are difficult to control
  • Feeling depressed or having problems due to Qat use, smoking, drug use, or other mental health problems associated with anxiety
  • Believing that anxiety is associated with another physical condition.
  • Having thoughts or behaviors of self-harm – if so, emergency treatment should be sought immediately
  • Your fears do not go away on their own, and they may worsen if you do not seek help. Visit a doctor or mental health care provider before your anxiety worsens. Treatment is easy if you seek help early.

Causes

The causes of anxiety disorders are not fully understood. Life experiences seem to trigger anxiety disorders in individuals who are already prone to anxiety. Inherited traits also play a role.

Medical causes

For some people, anxiety may be linked to another health issue. In some cases, anxiety symptoms are the first indicators of an illness. If your doctor suspects that your anxiety may have another medical cause, he or she may request tests to search for signs of a problem.

Other medical conditions that may be connected to anxiety include:

  • Heart disease
  • Diabetes
  • Thyroid problems, such as an overactive thyroid gland
  • Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
  • Substance use disorders, such as substance abuse or withdrawal
  • Withdrawal from alcohol, benzodiazepines, or other medications
  • Chronic pain or irritable bowel syndrome
  • Rare tumors that produce certain fight-or-flight hormones
  • Anxiety may also occasionally be a side effect of certain medications.

Your anxiety may be due to underlying medical conditions if:

  • You don’t have any relatives (such as a parent or sibling) with anxiety disorder
  • You didn’t have anxiety as a child
  • You don’t avoid certain things or situations due to anxiety
  • You have sudden-onset anxiety that doesn’t seem related to life events, and you have no history of anxiety

Risk factors

The following factors may increase your risk of developing an anxiety disorder:

  • Trauma. Children who have experienced abuse, trauma, or witnessed traumatic events are more likely to develop anxiety disorders at some point in their lives. Anxiety disorders can also affect adults who have experienced another traumatic event.
  • Stress due to illness. Developing a serious health condition can cause intense anxiety about things such as treatment and the future.
  • Accumulated stress. Experiencing a major event or a buildup of smaller life events that cause stress can increase your risk of anxiety. This may include the death of a family member, feeling work-related stress, or chronic financial worries.
  • Personality. Certain personality types are more prone to anxiety disorders than others.
    Other mental health disorders. People with other mental health disorders, such as depression, often have anxiety disorders as well.
  • Family history. Anxiety disorders can be hereditary.
  • Substance abuse. Drug use can cause or worsen anxiety. If you have a substance use disorder, quitting may cause anxiety. If you can’t quit on your own, see your doctor or find a support group to help you.

Complications

Having an anxiety disorder leads to more than just anxiety. It can also lead to or worsen other mental and physical conditions, such as:

  • Depression (which often occurs with anxiety) or other related mental health disorders
  • Substance abuse
  • Sleep difficulties (insomnia)
  • Gastrointestinal or gastrointestinal problems
  • Headaches and chronic pain
  • Social isolation
  • Difficulty functioning at school or work
  • Decreased quality of life
  • Suicide

Prevention

There is no surefire way to predict who will develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you feel anxious:

  • Seek help early. Like with many other mental health conditions, the longer you wait to treat anxiety, the harder it is to treat.
  • Stay active. Engage in activities that you enjoy and that make you feel good about yourself; enjoy social interaction and relationships with caregivers, which can reduce your anxiety.
  • Avoid using Qat or drugs. These substances can cause or worsen anxiety. If you are addicted to any of these substances, quitting can cause anxiety. If you cannot quit on your own, see your doctor or find a support group to help you.

Treatment

The main treatments for anxiety disorder are psychotherapy and medications. A combination of both may be more beneficial. Trial and error may be necessary to find the best treatment for you.

Psychotherapy

Psychotherapy involves working with a therapist to reduce your anxiety symptoms. This can be an effective treatment for anxiety.

Cognitive-behavioral therapy (CBT) is one of the most effective forms of psychotherapy for anxiety disorders. Generally, short-term CBT focuses on teaching specific skills to improve symptoms and gradually return to the activities that the patient avoids due to anxiety.

CBT includes exposure therapy, where you gradually face the thing or situation that triggers your anxiety, thereby building confidence to cope with the situation and anxiety symptoms.

Medications

Different types of medications are used for treatment depending on the type of anxiety disorder you have and whether you also have other mental or physical health problems.

Talk to your doctor about the benefits, risks, and potential side effects of medications. Follow the treatment plan and have regular follow-ups with your doctor during the treatment period.

Lifestyle and Home Remedies

While most people with anxiety disorders need psychotherapy or medications to control their anxiety, lifestyle changes can also make a difference. Here’s what you can do:

  • Maintain physical activity. Develop habits that make you physically active most days of the week. Exercise contributes to reducing anxiety strongly. It may improve your mood and help you stay in good health. Start slow and gradually increase the amount and intensity of activities.
  • Avoid Qat use and reduce caffeine drinks. These substances can worsen anxiety symptoms. Nicotine and caffeine both increase anxiety symptoms.
  • Use stress management and relaxation techniques. Visualization, meditation, and yoga are examples of relaxation techniques that can alleviate anxiety.
  • Make sleep a priority. Do what you can to ensure you get enough sleep to feel rested. If you’re not sleeping well, talk to your doctor.
  • Eat a healthy diet. Healthy eating may be associated with decreased anxiety. Focus on including vegetables, fruits, whole grains, and fish. However, more research is needed.

Adaptation and Support

To cope with anxiety disorder, here’s what you can do:

  • Learn about your specific disorder. Talk to your doctor or mental health care providers. Learn about what may be causing your specific condition and the best treatment options for you. Involve your family and friends and ask for their support.
  • Adhere to your treatment plan. Take medications as directed. Keep your appointment schedule and complete any tasks your therapist gives you. Consistency in treatment can make a big difference, especially in terms of medication adherence.
  • Be positive. Identify what triggers your anxiety symptoms or causes stress. Practice the strategies you developed with your health care provider so that you are prepared to deal with feelings of anxiety in these situations.
  • Keep a journal. Tracking your personal life can help you and your health care provider identify stressors and issues that seem to improve your condition.
  • Join an anxiety support group. Remember that you are not alone. Support groups provide empathy, understanding, and shared experiences.
  • Learn time management techniques. You can reduce anxiety by learning how to manage your time and energy carefully.
  • Engage in social activities. Do not let fears isolate you from loved ones or activities.
  • Break the routine. When you feel anxious, take a brisk walk or immerse yourself in a hobby to divert your mind from worries.

Preparing for your appointment

You may start by seeing your primary care provider to determine if your anxiety may be related to your physical health. They may search for signs of a hidden medical condition that may need treatment.

However, you may need to see a mental health care specialist if you have severe anxiety. A psychiatrist is a specialized doctor in diagnosing and treating mental health conditions. Psychiatrists and other specific mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose your anxiety disorder, the mental health professional will:
Give you a psychological assessment. This includes discussing your thoughts, feelings, and behaviors to help identify, diagnose, and explore any associated complications.

Anxiety disorders often occur concurrently with other mental health problems, such as depression, which can make diagnosis more challenging.