An overview of Anxiety disorders

Anxiety disorder is a A mental health disorder characterised by feelings of worry, anxiety or fear that are strong enough to interfere with one's daily activities.

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

Generalized anxiety disorder : includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.

Panic disorder : You feel sudden, intense fear that brings on a panic attack. During a panic attack you may break out in a sweat, have chest pain, and have a pounding heartbeat (palpitations). Sometimes you may feel like you’re choking or having a heart attack.

Agoraphobia : is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.

Medication-induced anxiety disorder : Use of certain medications or illegal drugs, or withdrawal from certain drugs, can trigger some symptoms of anxiety disorder.

Panic disorder : involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.

Selective mutism : is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.

Separation anxiety disorder : is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.

Social anxiety disorder : Also called social phobia, this is when you feel overwhelming worry and self-consciousness about everyday social situations. You obsessively worry about others judging you or being embarrassed or ridiculed.

Specific phobias : are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.

Substance-induced anxiety disorder : is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.

Other specified anxiety disorder and unspecified anxiety disorder : are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

Anxiety disorders are like other forms of mental illness. They don’t come from personal weakness, character flaws or problems with upbringing. But researchers don’t know exactly what causes anxiety disorders. They suspect a combination of factors plays a role:

Heredity: Anxiety disorders tend to run in families. You may inherit them from one or both parents.

Environmental stress : This refers to stressful events you have seen or lived through. Life events often linked to anxiety disorders include childhood abuse and neglect, a death of a loved one, or being attacked or seeing violence.

Chemical imbalance : Severe or long-lasting stress can change the chemical balance that controls your mood. Experiencing a lot of stress over a long period can lead to an anxiety disorder.

Medical conditions :Some heart, lung, and thyroid conditions can cause symptoms similar to anxiety disorders or make anxiety symptoms worse. It’s important to get a full physical exam to rule out other medical conditions when talking to your doctor about anxiety.

Drug withdrawal or misuse : Certain drugs may be used to hide or decrease certain anxiety symptoms. Anxiety disorder often goes hand in hand with alcohol and substance use.

1. Having the urge to avoid things that trigger anxiety.

2. Having difficulty controlling worry.

3. Experiencing gastrointestinal (GI) problems.

4. Having trouble sleeping.

5. Trouble concentrating or thinking about anything other than the present worry.

6. Feeling weak or tired.

7. Trembling.

8. Feeling nervous, restless or tense.

9. Having a sense of impending danger, panic or doom.

10. Having an increased heart rate

11. Breathing rapidly (hyperventilation).

12. Sweating

If you have symptoms of an anxiety disorder, talk to your healthcare provider. They’ll start with a complete medical history and physical examination.

There are no lab tests or scans that can diagnose anxiety disorders. But your provider may run some of these tests to rule out physical conditions that may be causing symptoms.

An anxiety disorder is like any other health problem that requires treatment. You can’t will it away. It’s not a matter of self-discipline or attitude. Researchers have made a lot of progress in the last few decades in treating mental health conditions. Your healthcare provider will tailor a treatment plan that works for you. Your plan may combine medication and psychotherapy.

How does medication treat anxiety disorders?

Medications can’t cure an anxiety disorder. But they can improve symptoms and help you function better. Medications for anxiety disorders often include:

Anti-anxiety medications, such as benzodiazepines, may decrease your anxiety, panic and worry. They work quickly, but you can build up a tolerance to them. That makes them less effective over time. Your healthcare provider may prescribe an anti-anxiety medication for the short-term, then taper you off or the provider may add an antidepressant to the mix.

Antidepressants can also help with anxiety disorders. They tweak how your brain uses certain chemicals to improve mood and reduce stress. Antidepressants may take some time to work, so be patient. If you feel like you’re ready to stop taking antidepressants, talk to your provider first.

Beta-blockers, usually used for high blood pressure, can help reduce some of the physical symptoms of anxiety disorders. They can relieve rapid heartbeat, shaking and trembling.

Your healthcare provider will work with you to find the right medication combination and dosage. Don’t change the dose without consulting your provider. They’ll monitor you to make sure the medicines are working without causing negative side effects.

How does psychotherapy treat anxiety disorders?

Psychotherapy, or counseling, helps you deal with your emotional response to the illness. A mental health provider talks through strategies to help you better understand and manage the disorder. Approaches include:

Cognitive behavioral therapy (CBT) is the most common type of psychotherapy used with anxiety disorders. CBT for anxiety teaches you to recognize thought patterns and behaviors that lead to troublesome feelings. You then work on changing them.

Exposure therapy focuses on dealing with the fears behind the anxiety disorder. It helps you engage with activities or situations you may have been avoiding. Your provider may also use relaxation exercises and imagery with exposure therapy.

These factors may increase your risk of developing an anxiety disorder:

1. Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.

2. Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.

3. Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances

4. Personality. People with certain personality types are more prone to anxiety disorders than others are.

5. Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.

6. Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.

7. Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

1. Depression (which often occurs with an anxiety disorder) or other mental health disorders

2. Substance misuse

3. Trouble sleeping (insomnia)

4. Digestive or bowel problems

5. Headaches and chronic pain

6. Social isolation

7. Problems functioning at school or work

8. Poor quality of life

9. Suicide