Anxiety Disorders

We often feel tense, nervous, worried, or fearful in certain situations. Occasional anxiety can be a normal response to the world around us and is not always a sign that there is an underlying mental health condition. However, when it becomes persistent and excessive worry as if there were the presence of actual danger, this may signal the onset of an anxiety disorder. 

Anxiety is one of the most common causes of mental illness: Approximately 31% of U.S. adults will live with an anxiety disorder at some point in their lives. There are several different anxiety disorders, which vary in terms of symptoms and basic characteristics. Below, we’re going to discuss the most common anxiety disorders, their symptoms, and how to manage them. 

Causes of anxiety disorders

While there are no unified theories as to why these mental disorders develop, anxiety is thought to primarily be caused by biological and environmental factors. From a biological standpoint, genetics are thought to play a significant part in the development of anxiety disorders. Specifically, researchers believe that the interplay of numerous different genes tends to lead to anxiety, as opposed to a single variation of a gene.

An individuals early upbringing is one of the environmental risk factors for developing anxiety disorders. Also, research shows that individuals who have a relative with anxiety are more likely to develop an anxiety disorder — a correlation that is likely based on both genetic and environmental factors. Behavior modeling, or the examples set by early caregivers, may influence how children cope with stress and anxiety in the future. 

Some anxiety disorders may arise out of a major life change (e.g., transitioning from high school to college). Because uncertainty is often a trigger for anxiety, upheaval in an individual’s life can lead to symptoms of an anxiety disorder. In the same vein, sometimes a stress disorder, or other physical illnesses and mental health conditions can lead to symptoms of an anxiety disorder. 

Common anxiety symptoms

Anxiety disorders exist on a spectrum, ranging from mild and manageable to severe and debilitating. Though the different anxiety disorders have unique characteristics that manifest uniquely in each individual, several common symptoms include:

• Nervousness
• Racing heartbeat
• Rapid breathing
• Sense of impending doom
• Shortness of breath.
• Tightness in the chest
• Muscle tension
• Trouble focusing
• Sweating

For a diagnosis of social anxiety disorder, for example, symptoms typically must be present for six months and primarily apply to social situations.

What are the different types of anxiety disorders

There are several common anxiety disorders, that affect the body, mind and life of each person differently. Below, we’re going to outline six of these conditions: generalized anxiety disorder, social anxiety disorder, panic disorder, phobias, separation anxiety disorder, and agoraphobia. 

Generalized anxiety disorder

Generalized anxiety disorder (GAD) is a condition that is not necessarily brought on by a specific scenario. People with GAD often have bouts of extreme worry or anxiety that are disproportionate to the situation. They typically have difficulty controlling their fear and may frequently expect the worst-case scenario.

Under the DSM-5, one must experience “excessive anxiety and worry” more days than not for at least six months to be diagnosed with GAD. These feelings of anxiety must be related to at least three of the below symptoms:

• Disruptions in sleep pattern
• Irritability
• Rapid heartbeat
• Trouble focusing
• Tense muscles
• Edginess or excitability
• Fatigue

For a diagnosis of GAD, symptoms typically need to have an impact on an individual’s ability to function regularly and not be related to a fear that may apply to other anxiety disorders, such as phobias or social situations.  

Generalized anxiety disorder can develop alongside other mental health disorders, including depression, substance use disorder, and other anxiety disorders. GAD is often diagnosed in childhood or adolescence but can develop at any point in an individual’s life. 

Social anxiety disorder

 is characterized by apprehension or nervousness in social situations. It often arises due to the fear of being judged or ridiculed by others. Symptoms of social anxiety can start in adolescence and, with inadequate treatment, can persist throughout an individual’s life. Sometimes children can struggle with selective mutism, where they find it difficult to speak in certain settings. For example a child may be talkative at home, but unable to speak at school.

Symptoms of social anxiety disorder, previously called social phobia, typically appear in situations where an individual has to interact with others or otherwise make themselves vulnerable to judgment, like attending a party or speaking in front of others. Symptoms of social anxiety disorder may include:

• Blushing in the presence of others
• Nausea
• Speaking with an overly soft voice
• Difficulty communicating in large groups
• Sweating
• Dizziness
• Headaches
• Extreme self-consciousness

Panic disorder

According to the DSM-5, individuals with panic disorder have “recurrent and unexpected panic attacks”, along with ongoing worry about experiencing another one. 

Panic attacks are episodes of intense anxiety and fear that usually last between a few minutes and half an hour. Since they often occur with little warning or without a discernable cause, many don't know when the next one will happen. This uncertainty can be the cause of the individual’s excessive worry and apprehension. Symptoms of panic disorder include:

• Heart palpitations
• Shaking
• Shortness of breath
• Nausea
• Dizziness
• Chills
• Numbness

Phobias

A phobia is an irrational fear of a scenario or entity that causes severe anxiety. To rise to the level of a phobia, the individual must actively avoid coming into contact with the object of the fear. Specific phobias that are relatively common include claustrophobia (fear of enclosed spaces), arachnophobia (fear of spiders), aviophobia (fear of flying), acrophobia (fear of heights).

Separation anxiety disorder

Someone who is living with separation anxiety will typically experience intense fear or anxiousness in relation to being separated from someone they have become attached to. This fear and anxiety are disproportionate to the individual’s age and persist for at least four weeks (for children) or six months (for adults), causing disruptions to the person’s daily functioning. 

Agoraphobia

Agoraphobia is the excessive fear of being in environments or situations where one may not be able to escape. Agoraphobia typically induces fear that is disproportionate to the circumstances and presents for at least six months. This type of anxiety disorder can cause extreme disruptions to the everyday life of the person who experiences it. Individuals who experience this type of phobia often live with panic disorder as well. In fact, agoraphobia can apply to a person’s fear of experiencing a panic attack and not being able to control it. 

Obsessive compulsive disorders

Also known as OCD, obsessive compulsive disorder is characterized by obsessions (unwanted, distressing thoughts that the person can’t get rid of) and compulsions (actions the person feels the need to take that interrupt their life). An example of an obsession may be “germaphobia” and a resulting obsession with cleanliness; a compulsion in this vein could include overusing hand sanitizer, or washing one’s hands so frequently that it damages the skin. These obsessions and/or compulsions interfere with one’s quality of life in areas such as work, school, and relationships.

Treatment for anxiety disorders

While there are numerous ways to treat anxiety disorders, psychotherapy and medication are typically the two main approaches. The exact treatment plan will depend on the individual, their specific mental health condition(s) or specific phobia, and their symptoms. While cognitive behavioral therapy is the most effective method for some, others will benefit from other forms of treatment.

Medication

Treatments for anxiety disorders might include anti-depressants, like selective serotonin reuptake inhibitors (SSRIs), and anti-anxiety medications, like benzodiazepines. These medications are frequently used to help manage physical and mental symptoms of anxiety. 

Therapy

Psychotherapy modalities, like cognitive behavioral therapy, can help people with anxiety disorders understand how their thoughts, behaviors, and emotions relate. A mental health professional can work with the individual to identify sources of apprehension and worry so that proper coping mechanisms may be developed. 

There are different therapeutic approaches based on each person’s unique needs. For example, exposure therapy focuses on gradually exposing individuals to feared situations or objects in a controlled environment, allowing them to confront things and situations that trigger anxiety. This is worthwhile for people who have specific phobias, and in time, they can learn stress-management techniques that promote healthier responses and relieve symptoms of anxiety. Meanwhile, individuals who are struggling with panic attacks may benefit from cognitive behavioral therapy.

While therapy is an effective treatment method that can reduce anxiety, it cannot necessarily cure anxiety disorders. The success of mental health treatment depends on multiple factors.

Lifestyle changes

There are several practices that people with anxiety disorders can incorporate into their everyday routines to alleviate symptoms and complement their treatment plans. These lifestyle changes include: 

• Exercising. Physical activity has been shown to improve stress management and boost mood. Consider creating an at-home workout routine, joining a gym, or taking frequent walks.
• Getting quality sleep. Because anxiety can disrupt sleep patterns, getting a good night’s rest can be important. It may help to develop a nighttime routine that prepares you for sleep. This can include reading, tending to hygiene, journaling, and avoiding electronics in the hour before bed. 
• Consuming a balanced diet. Research shows that a diet high in fruits, vegetables, omega-3 fatty acids, and other nutrient-rich foods can decrease symptoms of anxiety disorders.
• Limiting alcohol consumption. Alcohol can increase anxiety over time, so limiting it can help you avoid exacerbating symptoms. 
• Meditating. Meditation can help you slow down, relax, and quiet your mind. There are a variety of meditation techniques you can practice, including mindfulness, progressive muscle relaxation, and breath awareness meditation. 

Navigating anxiety disorders with online therapy

Studies show that online therapy is a convenient method of treating anxiety disorders. For example, a review of studies found that online therapy is as effective as in-person therapy when treating anxiety disorders, both for mental health professionals and those seeking treatment. Researchers noted that online therapy could overcome common barriers to treatment, including geographical limitations, time constraints, and cost. 

If you’re living with an anxiety disorder, online therapy can provide you with convenient mental health care. Using a platform like BetterHelp, you can participate in therapy remotely through video chats, voice calls, or in-app messaging.