Anxiety Disorders

Anxiety disorders are mental health conditions that cause an individual to experience intense anxiety, fear, and worry, out of proportion to his or her situation. The feelings persist and are difficult to manage or to stop. There are several types of anxiety disorders, including generalized and social anxiety disorders, all of which cause excessive worry, but often with different triggers. Anxiety disorders can be successfully treated with therapy, medication, lifestyle changes, relaxation techniques, and other strategies.

What Are Anxiety Disorders?


Anxiety disorders are mental illnesses that cause excessive worry, fear, stress, and anxiety. The severity and extent of these negative emotions are outsized compared to an individual’s situation, and they persist and are difficult, or at times impossible, to control. The anxiety causes impairment in a person’s life. It may cause poor performance at work or school, an inability to meet responsibilities, or social isolation.

Experiencing anxiety or worry is normal at times, such as when anticipating giving a speech, taking an important exam, or meeting someone new. However, the worry and fear that someone with an anxiety disorder experiences is much more extreme, and it often occurs even in situations in which there are no logical reasons to be anxious. The feelings persist and are difficult to control or lessen without professional assistance.

Types of Anxiety Disorders


The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the official guide for diagnosing and categorizing mental illnesses. Professionals use the criteria in the DSM-5 to make diagnoses for patients. The manual lists several types of anxiety disorder:

  • Generalized anxiety disorder. This type of anxiety disorder causes worry about anything, often all the things associated with daily life. This can make getting through each day, and ordinary tasks, very challenging. It often causes physical symptoms like headaches, upset stomach, and tense muscles.
  • Social anxiety disorder. Social anxiety goes well beyond being shy. It causes extreme stress and worry about being in social situations and being embarrassed in front of other people. It can cause a person to avoid any situations in which socializing is necessary and can lead to isolation. Panic attacks ahead of social events are not uncommon.
  • Panic disorders. This is characterized by panic attacks, episodes of extreme fear and impending doom that are not rational. They can happen with little or no warning and are distressing because they cause physical symptom similar to a heart attack: chest pains, dizziness, shortness of breath, and heart palpitations.
  • Specific phobias. A phobia is an extreme and irrational fear. A person may have any type of phobia, but examples include a fear of heights or a fear of germs. A phobia may cause someone to avoid any situation involving the object of fear, which can cause significant impairment.
  • Agoraphobia. Agoraphobia is a fear and excessive worry about being in a situation that could cause a panic attack, extreme embarrassment, or a feeling of being trapped or helpless with no escape. It often leads to isolation, because a person with agoraphobia will often avoid public places and anywhere there are crowds.
  • Separation anxiety disorder and selective mutism. These are both conditions that affect children. Separation anxiety is an excessive resistance to being separated from a parent or other primary caregiver. Mutism causes a child to be unable to speak in certain situations or around specific people, such as at school or with adults other than parents.

Obsessive-compulsive disorder, or OCD, used to be classified as a type of anxiety disorder, but now it heads its own category of mental illness. OCD is characterized by persistent, troubling thoughts that cause serious anxiety and compulsive behaviors designed to relieve that anxiety or to stop the thoughts.

Facts and Statistics


Anxiety disorders are the most common types of mental illness that Americans experience. Every year, approximately 40 million adults—18 percent of the population—struggle with an anxiety disorder.

  • More women than men have anxiety disorders. About 23 percent of women are affected by anxiety disorders, while just 14 percent of men are affected.
  • Of adults with anxiety disorder, 22 percent are seriously impaired, while 43 percent are mildly impaired.
  • About 32 percent of teens between the ages of 13 and 17 struggle with anxiety disorders.
  • Only 37 percent of people with anxiety disorder get adequate treatment.
  • Social anxiety disorder is the most common type of anxiety disorder in the U.S., followed by phobias and generalized anxiety disorder.

Symptoms and Diagnosis of Anxiety Disorders


To diagnose an anxiety disorder, a mental health professional may want to rule out physical health conditions, medications, or substance abuse as potential causes. Then, a diagnosis may be made by using the DSM-5 criteria and through interviews, psychiatric questionnaires, observations, and a review of medical history. There are specific symptoms that must be present for each type of anxiety disorder for a diagnosis to be made.

While some of the specific symptoms vary by type of anxiety disorder, to be diagnosed with any type a patient must have excessive worry that is difficult or impossible to control. The level of anxiety must be extensive to the point that it causes distress or impairment in other areas of a person’s life, such as difficulties at work or poor performance at school. To be diagnosed, the symptoms must also persist for a significant amount of time.

It is possible to have the symptoms of an anxiety disorder without being diagnosed because of the requirement that those symptoms cause significant impairment. High-functioning anxiety means that a person experiences excessive anxiety and worry but can still function normally. Other diagnoses that may be made include unspecified or other specified anxiety disorder, if a patient does not meet all the criteria for one of the other types of anxiety disorder.

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Causes and Risk Factors


The cause of an anxiety disorder is likely to be a complicated mix of genetics, environment, brain chemistry and structure, and personality traits. It is not possible to pin down any one cause for any type of anxiety disorder, but there are risk factors that are known to make it more likely that an individual will have one of these conditions:

  • A timid or cynical personality
  • Inhibited behavior or shyness
  • Family history of anxiety disorders
  • Experiencing stressful situations, such as divorce
  • Childhood trauma, like abuse or neglect

Co-Occurring Disorders


Anxiety commonly occurs with other mental health conditions and with substance use disorders. More than 10 million adults in the U.S. have a substance use disorder and some type of mental illness, often anxiety. Why anxiety disorders and substance use disorders co-occur often is not fully understood, but there may be several influences involved: they have common risk factors; substance use can trigger or worsen anxiety symptoms; and someone may use substances as a way to self-medicate anxiety symptoms.

Anxiety disorders also may co-occur with other mental illnesses or behavioral conditions. Some people may have one or more anxiety disorder, while others may have anxiety along with post-traumatic stress disorder or obsessive compulsive disorder, which are both related to and similar to anxiety disorders. Anxiety also commonly co-occurs with depression and suicidal thoughts, eating disorders, and attention deficit hyperactivity disorder, or ADHD.

Treatment and Prognosis of Anxiety Disorders


Anxiety disorders of all types are highly treatable, and the prognosis is good for anyone who gets comprehensive, long-term care. Most people can learn to manage and reduce anxiety and restore function in their lives. The most important component of treatment for anxiety is therapy. Cognitive behavioral therapy is commonly used as a way to teach patients how to be more aware of their negative feelings and reactions, how to manage triggers, and how to change unhealthy thought and behavioral patterns. Exposure therapy can also be useful and involves confronting one’s fears and triggers and learning how to control anxiety.

Patients being treated for anxiety disorders can also benefit from medications. Anti-anxiety medications, like benzodiazepines, can be used in the short-term to manage anxiety quickly. For long-term care, though, antidepressants are more useful and less risky. It can take some time to try different medications, to find one that works, and to minimize side effects.

In addition to therapy and medications, anxiety patients can learn to use lifestyle changes, relaxation techniques, stress coping strategies, health and wellness, diet, fitness, and alternative therapies to manage and lessen anxiety. Treatment may be done on an outpatient basis, but patients with severe anxiety disorders benefit from spending time in a residential facility where there is constant supervision, a safe environment, and the opportunity for intensive treatment.

Regardless of the setting, getting treatment for anxiety disorders is crucial. This is a treatable and manageable mental illness. With dedication to treatment and making positive changes, it is possible for nearly anyone struggling to anxiety to live normally again and with less worry and fear.