Anxiety disorders constitute a category of mental health diagnoses that cause excessive nervousness, fear, dread, and worry.
These disorders change how a person processes emotions and behaves, which can also cause physical symptoms. Mild anxiety can be confusing and distracting, while severe anxiety can seriously affect daily life.
Anxiety disorders affect 40 million people in the United States. It is the most common group of mental illnesses in the country. However, only 36.9 percent of people with anxiety disorders receive treatment.
What is Anxiety?
The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings of stress, anxious thoughts and physiological changes such as increased blood pressure”.
Knowing the difference between normal feelings of anxiety and an anxiety disorder that requires medical attention can help a person identify and treat the condition.
In this article, we look at the differences between anxiety and anxiety disorders, the different types of anxiety and the treatment options available.
When Does Anxiety Need Treatment?
While anxiety can cause distress, it is not always a medical condition.
Anxiety
When an individual is exposed to potentially harmful or distressing stimuli, feelings of distress are not only normal but necessary for survival.
Since the earliest days of humanity, the sight of predators and impending danger have set off alarm bells in the body and allowed for stealthy action. These alarms become prominent in the form of increased heart rate, sweating and increased sensitivity to surroundings.
Threats cause a rush of adrenaline, a hormone and chemical messenger, in the brain, which triggers the anxiety response in a process known as the “fight or flight” response. It prepares humans physically to fight or run away from any potential threats for safety.
For many, running from large animals and imminent danger is a less pressing concern than for early humans. Worries now revolve around work, money, family life, health, and other pressing issues that demand a person’s attention without requiring a ‘fight or flight’ response.
The nervous feeling before a major life event or during a difficult situation is a natural echo of the original ‘fight or flight’ reaction. It may still be necessary for survival – the worry of being hit by a car while crossing the street, for example, means that a person will instinctively look both ways to avoid danger.
Anxiety Disorders
The duration or intensity of the anxious feeling can sometimes be out of proportion to the original stimulus, or stressor. Physical symptoms, such as increased blood pressure and nausea, may also occur. These reactions progress beyond anxiety to anxiety disorders.
The APA defines a person with an anxiety disorder as having “recurrent intrusive thoughts or worries.” Once anxiety reaches the stage of a disorder, it can interfere with daily functioning.
Symptoms
Although several different diagnoses make up an anxiety disorder, symptoms of generalized anxiety disorder (GAD) will often include the following:
- restlessness, and a feeling of being “on-edge”
- sleep difficulties, such as problems in falling or staying asleep
- increased irritability
- uncontrollable feelings of worry
- concentration difficulties
While these symptoms may be normal to experience in everyday life, people with GAD will experience them constantly or to an extreme level. GAD can present as vague, nagging anxiety or more severe anxiety that interferes with daily life.
For information on other diagnostic symptoms under the umbrella of anxiety disorders, follow the links in the “Types” section below.
Types
The Diagnostic and Statistical Manual of Mental Health Disorders: Fifth Edition (DSM-V) classifies anxiety disorders into manyl main types.
In previous editions of DSM, anxiety disorders included obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), as well as acute stress disorder. However, the manual now no longer groupsTrusted Source these mental health difficulties under anxiety.
Anxiety disorders now include the following diagnoses.
Generalized Anxiety Disorder: This is a chronic disorder that involves excessive, long-lasting anxiety and worry about non-specific life events, objects and situations. GAD is the most common anxiety disorder, and people with this disorder are not always able to identify the cause of their anxiety.
Panic Disorder: Short or sudden attacks of intense terror and fear are symptoms of panic disorder. These attacks can cause shaking, confusion, dizziness, nausea and difficulty breathing. Panic attacks occur and develop rapidly, peaking after 10 minutes. However, a panic attack can last for hours.
Panic disorders usually occur after frightening experiences or prolonged stress, but can also occur without any trigger. A person experiencing a panic attack may mistake it for a life-threatening illness, and make drastic changes in behavior to avoid future attacks.
Specific Phobia: This is an irrational fear and avoidance of a particular object or situation. Phobias are not like other anxiety disorders, because they are linked to a specific cause.
A person with a phobia may recognize the fear as illogical or extreme but be unable to control the anxiety surrounding the stimulus. Phobia triggers range from situations and animals to everyday objects.
Agoraphobia: This is a fear and avoidance of places, events, or situations from which escape is difficult or in which help is not available if one becomes trapped. People often mistake this condition for a phobia of open spaces and the outdoors, but it’s not that simple. A person with agoraphobia may fear leaving the house or using elevators and public transportation.
Selective Mutism: This is a form of anxiety that some children experience, in which they are unable to speak in certain places or contexts, such as school, even though they have verbal abilities around familiar people. Has excellent communication skills. This can be an extreme form of social phobia.
Social Anxiety Disorder, or Social Phobia: This is the fear of negative judgment from others or public embarrassment in social situations. Social anxiety disorder involves a range of feelings, such as stage fright, intimacy fear, and anxiety about disrespect and rejection.
The disorder can cause people to avoid public situations and human contact to the extent that daily life becomes extremely difficult.
Separation Anxiety Disorder: High levels of anxiety after separation from a person or place that provides feelings of safety or security is characteristic of separation anxiety disorder. Separation can sometimes result in panic attacks.
Causes
The causes of anxiety disorders are complex. Many may occur at the same time, some may lead to others, and some may not cause an anxiety disorder unless another is present.
Possible causes include:
- Environmental stressors, such as difficulties at work, relationship problems, or family problems
- Withdrawal from illicit substances, the effects of which can exacerbate the effects of other potential causes.
- Genetics, as people who have family members with an anxiety disorder are more likely to experience it themselves.
- Brain chemistry, as psychologists describe many anxiety disorders, is a misalignment of hormones and electrical signals in the brain.
- Medical factors, such as symptoms of a different disease, the effects of medication, or the stress of major surgery or a long recovery
Prevention
There are ways to reduce the risk of anxiety disorders. Remember that distressing feelings are a natural part of everyday life, and experiencing them does not always indicate the presence of a mental health disorder.
Take the following steps to moderate distressing emotions:
- Reduce the intake of caffeine, tea, cola and chocolate.
- Maintain a healthy diet.
- Before using over-the-counter (OTC) or herbal remedies, check with a doctor or pharmacist for any chemicals that may worsen anxiety symptoms.
- Avoid alcohol, cannabis and other recreational drugs.
- Maintain a sleep routine.
Treatment
Treatment will consist of a combination of psychotherapy, behavioral therapy, and medication.
Alcohol dependence, depression, or other conditions sometimes have such a profound impact on mental health that treatment for an anxiety disorder must wait until an underlying condition is under control.
Stress Management: Learning to manage stress can help limit potential triggers. Manage any incoming pressures and deadlines, create lists to make difficult tasks more manageable, and commit to taking time off from studying or work.
Relaxation techniques: Simple activities can help relieve mental and physical symptoms of anxiety. These techniques include meditation, deep breathing exercises, long baths, resting in the dark, and yoga.
Exercises to replace negative thoughts with positive thinking: Make a list of the negative thoughts that are cycling as a result of anxiety, and next to it write another list of positive, reliable thoughts to replace them. Creating a mental image of successfully facing and overcoming a specific fear can also provide benefits if anxiety symptoms are linked to a specific cause, such as in a phobia.
CBT: This type of psychotherapy aims to identify and change harmful thought patterns that form the basis of anxious and distressed feelings. In the process, CBT practitioners hope to limit distorted thinking and change the way people react to anxiety-provoking things or situations.
Summary
Anxiety is not a medical condition in itself, but a natural emotion that is necessary for survival when an individual finds themselves in danger.
An anxiety disorder occurs when the response is exaggerated or out of proportion to the stimulus that caused it. There are several types of anxiety disorders, including panic disorders, phobias, and social anxiety.
