Anxiety Disorders: An Overview

    Anxiety disorders, such as generalized anxiety disorder (GAD) are a group of mental disorders that can affect the way you think, feel and behave.

    It’s normal to experience anxiety in stressful situations, such as before a job interview or while giving a speech or presentation in public. People with anxiety disorders, however, experience persistent, often severe anxiety that can occur outside of normally stressful situations.

    Anxiety disorders are very common, affecting approximately 40 million American adults every year — around 18 percent of the total adult population. Although they’re highly treatable, only about 36.9 percent of people with anxiety disorders receive treatment.

    If you believe that you may have an anxiety disorder, it’s important that you talk to a healthcare professional.

    Below, we’ve listed the types of anxiety disorder that can develop, as well as the symptoms you may experience if you have an anxiety disorder. We’ve also explained how anxiety disorders are diagnosed and the treatments that are available, from medication to psychotherapy and others.

    Types of Anxiety Disorders

    Although many people think of anxiety as a specific feeling, there are several different types of anxiety disorders. The five major types of anxiety disorders are:

    • Generalized anxiety disorder (GAD). Generalized anxiety disorder (GAD) can cause excessive or persistent feelings of anxiety or worry. It’s a common anxiety disorder that affects approximately 6.8 million adults in the United States.

      People with GAD may have excessive anxiety about things such as their health, work, social interactions and daily life. This anxiety may negatively affect their life and cause problems in education, work and maintaining relationships.

    • Panic disorder. Panic disorder can cause people to experience sudden, recurrent panic attacks, either randomly or after being exposed to a trigger. Panic attacks come on quickly and reach their peak within minutes. Panic attacks may involve a pounding or accelerated heartbeat, trembling, sweating, feelings of being out of control and other symptoms.

      Panic disorder is common, affecting approximately six million American adults, or around 2.7 percent of the US adult population. Women are approximately twice as likely to have panic disorder as men.

    • Obsessive-compulsive disorder (OCD). OCD can cause recurrent, unwanted thoughts and behaviors. People with OCD may check certain things, wash their hands, clean their home or perform other “rituals” repetitively to provide relief from obsessive thoughts.

      OCD affects approximately 2.2 million American adults, or about one percent of the US adult population. Like other anxiety disorders, OCD can interfere with a person’s social or professional life and affect their relationships.

    • Post-traumatic stress disorder (PTSD). PTSD can cause nightmares, flashbacks and feelings of stress related to a traumatic experience, such as a violent situation, sudden death of a loved one or personal assault.

      PTSD is a common anxiety disorder that affects 7.7 million adults, or approximately 3.5 percent of the US adult population. Like with many other anxiety disorders, women are more likely to be affected by PTSD than men.

    • Social anxiety disorder (social phobia). Social anxiety disorder can cause an intense fear or anxiety regarding being judged, rejected or viewed negatively in a social setting or while performing in front of others.

      As with other anxiety disorders, social anxiety disorder is a common issue that affects 15 million American adults, or approximately 6.8 percent of the US adult population.

    In addition to the five major types of anxiety disorders, people may experience anxiety regarding certain situations or objects. These are referred to as specific phobias, or simple phobias.

    Examples of specific phobias include anxiety or fear of traveling by airplane, swimming in deep water, being exposed to heights, receiving injections or being close to insects or animals, such as dogs or spiders.

    Finally, children and adults may experience a form of anxiety called separation anxiety disorder (SAD). People with separation anxiety disorder experience anxiety or fear of being separated from people to whom they’re attached, such as a parent, caregiver or loved one.

    Symptoms of Anxiety

    The symptoms of anxiety may vary based on the type of anxiety disorder you have. However, there are several symptoms that are common to many anxiety disorders and typically occur in most people affected by anxiety.

    Common symptoms of anxiety include:

    • Difficulty concentrating on anything other than current worries or concerns
    • Difficulty sleeping
    • Feelings of nervousness and restlessness
    • Feelings of physical weakness and/or tiredness
    • Gastrointestinal issues, such as stomachaches, cramps, diarrhea and/or constipation
    • Increased heart rate
    • Rapid breathing (hyperventilation)
    • Sweating
    • Trembling
    • Urges to avoid people, objects or situations that may cause anxiety

    Common symptoms of generalized anxiety disorder (GAD) include feelings of restlessness and irritability, difficulty concentrating, physical muscle tension, difficulty concentrating, a blank mind, as well as feelings of fatigue and sleep issues such as insomnia or unsatisfying sleep.

    Common symptoms of panic disorder can include sudden, recurrent panic attacks. During these attacks, people may experience heart palpitations, an accelerated heartbeat, sweating, feelings of impending doom, trembling, shortness of breath and a feeling of being out of control.

    People with specific phobias may feel intense anxiety and fear when in certain situations. They may take steps to avoid certain objects or situations in order to reduce their risk of experiencing anxiety.

    When Should You Talk to a Healthcare Professional? 

    It’s quite common and very normal to experience stress, fear and anxiety, especially in certain situations. 

    If you feel anxious before giving a speech, performing in front of a crowd, taking a major exam or making an important decision, this may not be a sign that you have an anxiety disorder and need treatment.

    However, if you regularly experience significant anxiety, or have recurring anxiety that occurs in certain situations, or around certain objects or people, it’s a good idea to talk to your healthcare provider. You should especially consider seeking help if:

    • You find it difficult to control your anxiety and/or fear, especially if you experience panic symptoms.
    • You frequently experience anxiety and think it’s interfering with your ability to maintain professional and/or personal relationships.
    • You believe that your feelings of stress or anxiety could be related to a physical health factor.
    • You have difficulties with drug and/or alcohol use, feel depressed or have other mental health issues.

    In some cases, such as during periods of significant stress or anxiety, it’s possible to experience suicidal thoughts and/or behavior. If you feel suicidal, seek emergency medical help immediately. 

    What Causes Anxiety?

    Experts aren’t yet aware of precisely what causes anxiety. However, research shows that some genetic and environmental factors, such as certain childhood behavioral traits or a family history of anxiety, may contribute to your risk of developing an anxiety disorder.

    We’ve listed these risk factors, as well as more information on how each may contribute to the development of anxiety, below. 

    Who Is Most at Risk?

    Anxiety disorders can develop in people of all ages and backgrounds, although certain factors may give you a higher risk of developing an anxiety disorder than other people. You may have an elevated risk of developing an anxiety disorder if:

    • You’re female. Many anxiety disorders are significantly more common in women than in men. Approximately one in every five women in the United States are affected by anxiety disorders, with women as a whole twice as likely as men to have an anxiety disorder.

    • You have a family history of anxiety or other mental illnesses. Genetic factors, such as a family history of anxiety and/or other mental illnesses, may contribute to your risk of developing an anxiety disorder.

    • You had shyness or behavioral inhibition as a child. Childhood shyness or inhibition is a risk factor for anxiety disorders. Studies show that children with behavioral inhibition (BI) have a sevenfold increase in risk for developing social anxiety disorder (SAD).

    • You have previously been exposed to stressful or negative life events. People who have been exposed to stressful or negative events, whether in childhood or as an adult, may be more likely to develop an anxiety disorder.

    • You suffer from other mental illnesses. People with other mental illnesses are more likely to develop anxiety disorders.

    • You drink coffee or other beverages with caffeine. Use of caffeine has been found to increase anxiety and exacerbate anxiety and sleep disorders. Caffeine withdrawal may also cause an increase in anxiety, restlessness, tremor and other symptoms.

    • You have physical health issues. Some physical health conditions, such as heart arrhythmias and thyroid conditions, may cause or aggravate anxiety.

    • You use illicit drugs and/or alcohol. Use of illicit drugs and/or alcohol, as well as use of certain medications, may increase your risk of developing anxiety or cause existing anxiety to worsen.

    Diagnosis of Anxiety

    If you’re worried that you may have an anxiety disorder, it’s important to talk to your healthcare provider as soon as you can.

    To test for anxiety, your healthcare provider may ask you about your symptoms. They may look for physical factors that could contribute to anxiety, such as a chronic disease, nutritional issue or hormonal imbalance.

    If your healthcare provider believes that a physical factor is causing your anxiety, they may ask you to complete a urine or blood test.

    To accurately diagnose and treat an anxiety disorder, you may need to speak to a mental health specialist. They may request that you complete a psychological evaluation in order to give them more information and allow for an accurate diagnosis.

    Anxiety Treatments

    Most anxiety disorders improve over time with treatment, when properly identified and treated. Treating anxiety disorders typically involves the use of medication, psychotherapy and changes to your lifestyle, such as stress management techniques and the use of anxiety prevention habits.

    Medications for Anxiety

    Anxiety is often treated using medication. Although medication doesn’t cure anxiety, it can help you to manage your anxiety and relieve your symptoms. Using medication, many people are able to keep their anxiety symptoms under control. 

    If you have been diagnosed with an anxiety disorder, your healthcare provider may recommend using one or several medications. Medications used to treat anxiety disorders include:

    • Antidepressants. Certain antidepressants, including some selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are used to treat anxiety disorders.

      Antidepressants used to treat anxiety disorders include Zoloft® (sertraline), Lexapro® (escitalopram), Paxil® (paroxetine), Cymbalta® (duloxetine) and others.

      Antidepressants can take several weeks to start working and often cause side effects, meaning you may need to try several medications of this type before finding one that’s right for you.

    • Benzodiazepines. Benzodiazepines, which reduce anxiety and promote sedation, are commonly used to treat anxiety disorders. These medications start to work quickly and can often provide immediate relief from anxiety symptoms.

      Benzodiazepines used to treat anxiety disorders include Xanax® (alprazolam), Valium® (diazepam), Ativan® (lorazepam) and Klonopin® (clonazepam).

      Most of the time, benzodiazepines are prescribed for short-term use, as long-term use of these medications can lead to dependence.

    • Beta-blockers. Beta-blockers, which block the effects of stress hormones on your heart, are occasionally used off-label to treat the physical symptoms of performance anxiety — a type of anxiety that occurs before speeches, presentations and performances.

      Although beta-blockers can prevent the physical symptoms of anxiety, they do not treat the psychological symptoms of anxiety. Because of this, they’re most commonly used to treat short-term, event-based anxiety.

    • Buspirone. Buspirone is a medication that’s prescribed for generalized anxiety disorder (GAD). It’s often used as a second-line treatment for people who don’t respond to other medications, such as antidepressants.

      Unlike some other medications used to treat anxiety, buspirone doesn’t have any risk of physical dependence or withdrawal.

    • Anticonvulsants. Some anticonvulsants, which are prescribed to prevent seizures, are prescribed off-label as treatments for some anxiety disorders. For example, Neurontin® (gabapentin) may be prescribed off-label to treat generalized anxiety disorder (GAD).

    • Antihistamines. Some antihistamines are used to treat anxiety. These medications can have calming and sedative effects, with research indicating that some antihistamines are helpful for treating dream anxiety and improving sleep.

    There’s no one-size-fits-all medication for every anxiety disorder. Your healthcare provider will prescribe the most effective and suitable medication for you based on your anxiety symptoms, general health and other factors.

    Some anxiety medications, such as antidepressants, can interact with other commonly used medications. To ensure that you’re safe, you’ll need to tell your healthcare provider about any other medications you currently use before you begin treatment. 

    Psychotherapy for Anxiety

    Many anxiety disorders can be treated through psychotherapy, or “talk therapy.” Two common forms of psychotherapy that are used to treat anxiety disorders are cognitive behavioral therapy (CBT) and exposure therapy. 

    Cognitive behavioral therapy (CBT) involves learning different methods of thinking and reacting to sources of anxiety. CBT can be carried out in a one-to-one setting, or in a group of people overcoming similar issues together.

    Exposure therapy involves being exposed to situations or objects which may trigger or worsen anxiety in a safe environment. It’s often combined with relaxation techniques to reduce stress and allow people to overcome their underlying fears.

    Like with medication, there’s no one-size-fits-all approach to psychotherapy for every anxiety disorder. Your therapist will work with you to provide the most suitable and effective option for your symptoms and needs.

    Home Remedies and Lifestyle Changes

    If you’ve been diagnosed with an anxiety disorder, you’ll likely need treatment with medication or psychotherapy. However, making certain changes to your lifestyle and habits may make it easier for you to to control your anxiety and improve your quality of life:

    • Be consistent. If your healthcare provider has prescribed you medication or booked you in for psychotherapy, be consistent and follow your treatment plan as advised. Anxiety is treatment, but it requires time, commitment and consistency.

    • Need to relax? Try yoga, meditation or visualization techniques. These can make it easier to relax, especially when you’re feeling overly stressed, anxious or worried about something.

    • Sleep. Lack of sleep can affect your mental health, with insomnia one of several factors that can contribute to anxiety disorders. For optimal mental and physical health, aim to get seven to eight hours of high quality sleep per night.

    • If you drink coffee or energy drinks, try to reduce your consumption. The caffeine in coffee and energy drinks can be helpful for gaining a little extra energy, but it can also worsen anxiety. Try to limit your caffeine intake to avoid developing anxiety symptoms.

    • Quit smoking. As a stimulant, nicotine can also contribute to anxiety. Although you may feel relaxed right after smoking a cigarette, smoking can cause anxiety symptoms to get worse over the long term. As such, it’s best to try to smoke less or quit smoking.

    • Avoid alcohol and illicit drugs. Alcohol and illicit drugs can worsen anxiety, causing you to experience worse symptoms over the long term.

      If you suffer from anxiety, avoid using alcohol or illicit drugs. Not only can these worsen anxiety — in some cases, alcohol and drugs may interact with the medications used to control anxiety and cause potentially serious side effects.

    • Try to eat anxiety-easing foods. Some foods, such as fish rich in omega-3 fatty acids and foods that contain B-vitamins, probiotics and zinc, may reduce feelings of anxiety naturally and could be worth adding to your diet.

      However, these foods should not be viewed as replacements for anxiety medications or psychotherapy.

    • Keep an anxiety journal. To keep track of your treatment, try keeping a journal of your day-to-day life. Make a note of when you experience anxiety symptoms, as well as any factors that you think might have contributed to them.

    • Learn your anxiety triggers. If your anxiety is triggered by certain situations, objects or people, make a note of them. Being aware of your anxiety triggers can help you to work with your healthcare provider and make real progress.

    • Join a support group. Joining a support group can allow you to share your experiences with other people who suffer from anxiety. Organizations such as NAMI and the Anxiety and Depression Association of America both host peer-led local support groups.

    • Find ways to manage and avoid feelings of anxiety. Walking, listening to music and enjoying your hobbies can all help to clear your mind and refocus on what’s important when you’re feeling stressed or anxious.

    • Spend time with friends, family and loved ones. People often isolate themselves if they feel anxious, stressed or unhappy. Make sure to spend time with your friends and loved ones, as they may be able to help you to make progress.

    • Try natural, relaxation-promoting products. Although the scientific evidence is mixed, some natural products may help to promote relaxation and ease anxiety.

      For example, some research has shown that chamomile tea may help to reduce feelings of anxiety in people with mild to moderate generalized anxiety disorder (GAD). There are also several studies linking passionflower to improvements in some types of anxiety.

    Talk to a Healthcare Provider About Anxiety

    Anxiety disorders are extremely common, affecting tens of millions of American adults each and every year. 

    They’re also very treatable, with medications, techniques and therapies available to help you get in control of anxiety and make improvements to your life. 

    If you think that you may have an anxiety disorder, talking to a licensed health provider can help you learn more about the type of anxiety disorder you could have and the treatment options that are available.

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.