Anxiety Disorders: Types, Symptoms, and Treatment

Introduction: Anxiety Disorders: Types, Symptoms, and Treatment

Feeling anxious is a normal emotional reaction toward stress in life. At times, feeling anxious can be beneficial. Worrying about a deadline, an exam, or a big presentation spurs us into action. It can also alert us to danger. Anxiety can be healthy and help us achieve personal goals or protect us from harm. 

Anxiety disorders are more than everyday fears and worries. Instead, people experience intense panic, terror, and extreme anxiety. Symptoms can cause people to avoid situations that trigger or worsen their symptoms. It becomes difficult to function. Job performance, school, work, and personal relationships are often affected.

Anxiety disorders are the most common mental health condition. The American Psychiatric Association reports nearly 30% of all adults will experience an anxiety disorder. And women are more likely than men to be diagnosed with anxiety. 

Symptoms of an Anxiety Disorder

The American Psychiatric Association defines clinical anxiety as excessive worry or apprehension, occurring more days than not for at least 6 months. The symptoms must impact several events or activities, such as work or school performance.

Anxiety disorders can range from mild to severe. Not all symptoms must be present for an anxiety disorder diagnosis, and they may vary based on the type of disorder. Symptoms might include:

• Anxiety or excessive worry
• Feeling restlessness or on edge
• Having a sense of impending danger, panic, or doom
• Easily tired
• Irritability
• Muscle tension
• Trouble concentrating
• Having trouble sleeping
• Experiencing stomach problems
• Unable to control the worry
• Having the urge to avoid things that trigger anxiety
• Distress or difficulty in social, occupational, or other areas of life

These constitute broad symptoms consistent with clinical anxiety. However, several types of anxiety disorders exist that may have additional symptoms. 

Types of Anxiety Disorders

There are many different types of anxiety. Anxiety disorders can be inherited, meaning a family member has a history of experiencing a related mental health condition. Some of these may be caused by things that happen to us, such as trauma or stress related to a severe illness. Others can be induced by substance use. Often anxiety develops due to a combination of these. Research suggests that between 40 and 60% of all anxiety disorders develop because of environmental factors, in other words, the things that happen in our lives. 

Types of anxiety disorders include:

• Generalized Anxiety Disorder (GAD)
• Obsessive-Compulsive Disorder (OCD)
• Panic Disorder
• Agoraphobia
• Specific Phobias
• Social Anxiety Disorder
• Separation Anxiety Disorder

Talking with your doctor or a mental health professional is the best first step if you recognize signs of anxiety. Sometimes medical conditions can have similar symptoms to these types of disorders. Helping professionals assist you in understanding your symptoms and identifying the best course of treatment for you. 

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder, often referred to as GAD, is characterized by chronic and constant worry that is usually unsupported. It’s not uncommon, with about 2% of the population experiencing GAD. This anxiety is difficult to control. These worries often concern work, money, family, or health, including many of the symptoms listed above. This anxiety usually continues throughout the day, often every day, causing disruption to everyday life. These symptoms persist most days for at least six months. 

Research identifies that the brains of people with GAD process emotions and stress differently. Often GAD runs in families. This means a person may be genetically predisposed to develop anxiety in response to life stressors, whereas another person may not. It’s also not uncommon for a person with GAD to develop additional serious mental health symptoms, such as depression. 

Effective treatment options for GAD include talk therapy. Most experts recommend Cognitive Behavioral Therapy or CBT. This therapy helps you develop different ways of thinking about things you worry about. You gradually begin to participate in the activities you’ve been avoiding. CBT offers tools that are easy to use daily. Your therapist also guides you through building on your successes, increasing confidence and independence in managing these symptoms.

Sometimes, your provider might recommend medications to lessen your anxiety. There are many different medication options, so talking with your doctor will help you choose the best one. 

Obsessive-Compulsive Disorder (OCD) 

Obsessive-Compulsive Disorder is most commonly known as OCD. With OCD, the symptoms are related to specific obsessive worries and compulsive behaviors. Typically, a person with OCD will act out compulsive behaviors to alleviate some of the anxiety caused by the obsessions. 

Obsessions are unwanted, intrusive mental images or thoughts that cause intense anxiety. Common examples include:

• Fear of coming into contact with dirt and germs
• Intense focus on neatness and perfection
• A constant fear of harm to self or others
• Religious preoccupation
• Persistent sexual thoughts

Often, these fears are exaggerated or not based on reality. These thoughts are persistent and difficult to control. They create intense anxiety, making it difficult to work, attend school, and sometimes even leave home. 

Compulsive behaviors are actions that are repeatedly done. People with OCD engage in these behaviors to eliminate the anxiety from the obsessive thoughts. People with OCD do not want to engage in these behaviors, which usually causes them more distress than relief. Compulsive behaviors might include:

• Excessive handwashing
• Repeatedly checking locks and doors
• Ritualistic behavior, such as counting
• Constantly checking that you haven’t caused someone harm
• Engaging in sexual acts

Treatment for OCD has become much more effective in recent years, making a previous chronic and debilitating disorder much more manageable. The “gold standard” treatment combines a CBT technique called exposure and response prevention (ERP) and medications. ERP helps face fears and let obsessive thoughts occur without engaging in compulsions to manage them. Anti-anxiety drugs can help to support these therapeutic interventions. 

Panic Disorder

The DSM-5 describes a panic attack as an abrupt surge of intense fear or discomfort that peaks within ten minutes. Common symptoms include:

• Pounding heart
• Chest pain 
• Sweating 
• Trembling 
• Shortness of breath 
• Choking sensation 
• Nausea 
• Dizziness or light-headedness 
• Numbness 
• Chills or heat 
• A feeling of being detached from oneself 
• Fear of dying 

Often, panic may feel like a heart attack. It’s one of the most costly anxiety disorders, as people frequently go to the emergency room due to the severity of the symptoms. 

Panic can become disabling. You become so afraid of when the next panic attack may happen that you can’t cope with regular tasks. People with panic disorder relate an attack to what they did when it happened. They may think an elevator, movie theater, or classroom caused the attack, then avoid those settings. Thus, symptoms worsen over time. Research suggests that this anxiety disorder develops due to our family history of panic disorder and stressful life events, especially as a young child.

The most effective treatment for panic disorder is a combination of therapy and medications. Again CBT is the therapeutic intervention of choice. More specifically, clinical studies have supported using Mindfulness-Based Cognitive Behavioral Therapy (MBCT). MBCT introduces skills such as meditation, visualizations, and yoga to help consciously pay attention to thoughts and feelings without placing any judgments on them.

Agoraphobia

It’s not uncommon for people with panic disorder to also experience agoraphobia. Agoraphobia is anxiety in a public or crowded place where it is hard to escape or get help, accompanied by the fear that a panic attack will happen. People with agoraphobia experience intense fear and avoidance of at least two of the following:

• Using public transportation
• Being in open spaces
• Being in enclosed spaces 
• Being in a crowd
• Being outside the home alone

They avoid these, experience severe distress or anxiety about having a panic attack, or require the presence of a companion. The fear of the situation is out of proportion to the actual danger. 

Again, research supports that the most effective treatment for agoraphobia is a combination of CBT and medications. A class of drugs often prescribed to reduce the severity of panic is Benzodiazepines. While effective short-term, the FDA warns that this drug class has abuse, addiction, and withdrawal risks. Your doctor can recommend the best treatment for you.

Specific Phobias

A specific phobia is defined by the National Institute of Mental Health as an intense and irrational fear of something that is likely, not dangerous. People with a phobia may realize that these fears don’t make sense, yet they cannot control their anxiety about it. People with specific phobias are highly distressed about the fear and often go to great lengths to avoid it. Exposure usually results in an intense emotional reaction, such as a panic attack. Specific phobias are common, with about 12% of people experiencing a phobia.

Specific phobias fall into five different types:

• Animals: Fear of dogs, snakes, spiders, etc.
• Natural Environments: Heights, storms, water, etc. 
• Blood-Injection-Injury: Like fear of seeing blood or receiving a shot
• Situational: Flying, riding in elevators, enclosed places, etc.
• Other Types: Such as fear of choking or contracting an illness 

The most effective treatments for a specific phobia include CBT and Exposure Therapy. This approach has been proven to help people confront their fears by creating a safe environment and “exposing” individuals to the phobia. The mental health professional helps reduce anxiety and decrease avoidance in this safe space. This occurs by gradually increasing exposure to the fear while supporting the person to develop skills to tolerate the anxiety. This puts the brakes on, not allowing the phobia to worsen through increased avoidance over time. This also helps build confidence.

Social Anxiety Disorder

Social anxiety disorder isn’t just shyness. It’s an intense and persistent fear of being watched and judged by others. It can affect friendships, work, school, and other day-to-day activities. It makes it hard to function. People who suffer from this may avoid the following:

• Meeting new people
• Making phone calls
• Using public bathrooms
• Paying for items at a store
• Eating in front of people
• Going on job interviews

Studies have shown that the brains of people with social anxiety respond differently to stress, causing a hyperactive stress response. 

Like other phobia-based anxiety disorders, a combination of therapy like CBT or Exposure Therapy and medication is the first line of treatment.

Separation Anxiety Disorder (SAD)

Separation Anxiety Disorder (SAD) is most commonly a childhood anxiety disorder characterized by excessive anxiety when separated from parents. This is typical behavior for infants and very young toddlers. However, children with SAD display these behaviors in a way that is not developmentally appropriate. Children with the disorder can’t think about anything but the present fear of separation and may:

• Refuse to sleep alone
• Have nightmares about being separated
• Worry when away from home and family
• Extreme anxiety about the safety of a family member
• Excessive worry about getting lost from family.
• Refusal to go to school
• Fear of being alone

Like most anxiety disorders, genetic and environmental predispositions are risk factors for developing SAD. These may include life events that trigger the anxiety, such as losing a parent from death or divorce, moving, being in foster care, being adopted, or parenting that discourages independence. Other environmental factors might include low birth weight and maternal smoking or alcohol consumption during pregnancy. 

SAD is best treated by CBT and is most effective when the family learns the skills the child is learning. This helps the family to support the child in practicing at home. Medications can also be helpful in extreme cases to help overcome the symptoms. This allows a child to be ready to learn the skills needed. Developing the skills to manage symptoms enables the child to maintain long-term control over their anxiety. 

Help is available…

If you or someone you know is struggling with anxiety symptoms, the most important thing to know is that anxiety is treatable. Anxiety disorders are chronic conditions that do not usually get better without treatment. But people do recover. Getting help makes it easier. 

The right treatment can help you overcome anxiety and get back to living life. There is no correct answer. The best treatment approach is the one that works for you. Seek help from your doctor or a mental health professional if experiencing symptoms of an anxiety disorder.  

Featured Image Credit: Photo by Andrea Piacquadio (Pexels)