Anxiety

What are anxiety disorders?

Anxiety disorders are a group of mental illnesses that cause people to feel excessively frightened, distressed, or uneasy during situations in which most other people would not experience these same feelings. When they are not treated, anxiety disorders can be severely impairing and can negatively affect a person’s personal relationships or ability to work or study and can make even regular and daily activities such as shopping, cooking or going outside incredibly difficult.

Anxiety disorders are the most common mental illnesses in America: they affect around 20 percent of the population at any given time. Fortunately there are many good treatments for anxiety disorders. Unfortunately, some people do not seek treatment for their illness because they do not realize how severe their symptoms are or are too ashamed to seek help.

What are the most common anxiety disorders?

• Panic Disorder – Characterized by “panic attacks,” panic disorder results in sudden feelings of terror that can strike repeatedly and sometimes without warning. Physical symptoms of a panic attack include chest pain, heart palpitations, upset stomach, feelings of being disconnected, and fear of dying.

• Obsessive-compulsive Disorder (OCD) – OCD is characterized by repetitive, intrusive, irrational and unwanted thoughts (obsessions) and/or rituals that seem impossible to control (compulsions). Some people with OCD have specific compulsions (e.g., counting, arranging, cleaning) that they “must perform” multiple times each day in order to momentarily release their anxiety that something bad might happen to themselves or to someone they love.

• Posttraumatic Stress Disorder (PTSD) – When people experience or witness a traumatic event such as abuse, a natural disaster, or extreme violence, it is normal to be distressed and to feel “on edge” for some time after this experience. Some people who experience traumatic events have severe symptoms such as nightmares, flashbacks, being very easily startled or scared, or feeling numb/angry/irritable, that last for weeks or even months after the event and are so severe that they make it difficult for a person to work, have loving relationships, or “return to normal.”

• Phobias – A phobia is a disabling and irrational fear of something that really poses little or no actual danger for most people. This fear can be very disabling when it leads to avoidance of objects or situations that may cause extreme feelings of terror, dread and panic.

• Generalized Anxiety Disorder (GAD) – A severe, chronic, exaggerated worrying about everyday events is the most common symptom in people with GAD. This is a worrying that lasts for at least six months, makes it difficult to concentrate and to carry out routine activities, and happens for many hours each day in some people. • Social Anxiety Disorder – An intense fear of social situations that leads to difficulties with personal relationships and at the workplace or in school is most common in people with social anxiety disorder. Individuals with social anxiety disorder often have an irrational fear of being humiliated in public for “saying something stupid,” or “not knowing what to say.”

People with anxiety disorders are more likely to use or abuse alcohol and other drugs including benzodiazepines, opiates (e.g., pain-killers, heroin) or cigarettes. This is known as self-medication. Some people use drugs and alcohol to try and reduce their anxiety. This is very dangerous because even though some drugs make people feel less anxious when they are high, anxiety becomes even worse when the drugs wear off.

Are there any known causes of anxiety disorders?

Although studies suggest that people are more likely to have an anxiety disorder if their parents have anxiety disorders, it has not been shown whether biology or environment plays the greater role in the development of these disorders. Some anxiety disorders have a very clear genetic link (e.g., OCD) that is being studied by scientists to help discover new treatments to target specific parts of the brain. Some anxiety disorders can also be caused by medical illnesses. Other anxiety disorders can be caused by brain injury.

What treatments are available for anxiety disorders?

Effective treatments for anxiety disorders include medications and psychotherapy. Psychotherapy techniques such as cognitive behavioral therapies are most useful in the treatment of anxiety disorders and are referred to as “first-line treatments.”

In most cases, a combination of psychotherapy and medications is most beneficial for people with severe anxiety disorders. Some commonly used medications for anxiety disorders are antidepressant medications called selective serotonin reuptake inhibitors (SSRIs).

The importance of having a good diet and getting enough sleep are known to decrease symptoms in people with anxiety disorders. Regular exercise has also been scientifically proven to be effective.

Reviewed by Ken Duckworth M.D., and Jacob L. Freedman M.D., April 2012

*Information sheet available from the National Alliance on Mental Illness at http://www.nami.org

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