Understanding Anxiety Disorders

Everyone can experience occasional anxiety at various points in life, but excessive anxiety that interferes with everyday life may lead to diagnosis of an anxiety disorder. Anxiety disorders are some of the most common psychiatric disorders in the US, with 18.1% of the population (around 40 million people) diagnosed throughout their lifetime. There are various types of anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which are different than those listed in the DSM-3 and DSM-4, and many are treatable or manageable with talk therapy, medication, or a combination of the two. If you or a loved one has anxiety or you're looking to learn more about these mental health conditions, it can be helpful to distinguish between their symptoms and presentations. 

What are the different classifications in the DSM-5?

In the DSM-5, there are 12 anxiety disorders listed, including the following:

• Panic disorder
• Generalized anxiety disorder (GAD)
• Specific phobias
• Social anxiety disorder
• Separation anxiety disorder
• Selective mutism
• Agoraphobia
• Substance or medication-induced anxiety disorder
• Anxiety disorder due to another medical condition
• Other specified anxiety disorder

Understanding generalized anxiety disorder (GAD) 

Generalized anxiety disorder (GAD) is a mental illness marked by persistent feelings of anxiety lasting longer than six months. People experiencing GAD might not be concerned about specific stressful events but may experience pervasive worries about social relationships, work, financial matters, and health that interfere with daily life.

Symptoms of GAD

If you have three or more of the following symptoms for most days over six months or more, your doctor or mental health professional may arrive at a diagnosis of generalized anxiety disorder: 

• Dwelling on plans and solutions to worst-case scenarios
• Frequent worrying 
• Feeling threatened in situations where no threat exists
• Difficulty accepting uncertainty
• Indecisiveness 
• Difficulty letting go of worrying thoughts
• Feeling restless, on edge, and unable to relax
• Experiencing a "blank mind" 
• Fatigue
• Difficulty sleeping
• Muscle tension
• Trembling
• Nervousness
• Startling easily 
• Sweating
• Indigestion 
• Irritability

Treatment for GAD

Generalized anxiety disorder is often treatable. Treatment options include but aren't limited to, cognitive-behavioral therapy, supportive psychotherapy, mindfulness-based therapy, medications, and other forms of therapy. 

Panic disorder

Panic disorder is often characterized by a sense of losing control, fear, and panic. These feelings can emerge at any time, often without an apparent cause. 

Symptoms of panic disorder

Panic attacks often feel primarily physical. The following are the most common symptoms of anxiety attacks:

• Feeling sudden, intense fear
• Heart palpitations
• Sweating
• Trembling
• Shortness of breath
• Choking sensations
• Chest pain
• Nausea
• Dizziness
• Feelings of detachment
• A fear of dying
• Numbness or tingling
• Chills or hot flushes

Treatments for panic disorder

Social anxiety disorder is one of the most common anxiety disorders in the US. It might also be referred to as social phobia. 

Social anxiety disorder often appears early in life, with 80% of people having symptoms before age 20. If you have social anxiety disorder, you may experience any of the following symptoms:

• Severe anxiety in social situations 
• Difficulty talking to people
• Fear of being judged
• Worrying about a social event before it occurs 
• Feeling self-conscious in front of other people
• Fear of being humiliated or rejected
• Fear of offending others
• Avoiding places where other people might be
• Blushing, trembling, or sweating in social conversations 
• Feeling nauseous when you're with other people
• Difficulty making or keeping friends
• Performance anxiety in stressful situations 
• Difficulty working in groups at work or school 

The primary treatment for social anxiety may be cognitive-behavioral therapy or exposure and response prevention (ERP). Because social anxiety is also often considered a type of phobia, exposure therapy may help these individuals gradually expose themselves to social situations to reduce self-consciousness, gain social skills, and relieve anxiety symptoms. 

Separation anxiety disorder is marked by intense anxiety when away from home or someone you're attached to. Infants and toddlers go through stages of separation anxiety as a regular part of development. However, when older children, teenagers, and adults have persistent separation anxiety, it may indicate an underlying mental health concern. 

Symptoms of separation anxiety can include:

• Distress about being away from home or loved ones before or during the absence
• Constant worry about losing someone you love through illness or disaster
• The constant worry that something may happen to separate you from loved ones
• Avoiding fear by refusing to leave home
• Experiencing difficulty being alone at home 
• Refusing to sleep away from home unless loved ones are present
• Nightmares about being separated from loved ones
• Headaches or stomachaches when you expect to be away from loved ones
• Anxiety or panic attacks before or during separation

Cognitive-behavioral therapy may be an effective treatment for separation anxiety. In CBT, individuals learn to manage their fears around separation by looking at their thoughts and behavioral patterns. In some cases, medication might be recommended. 

The other anxiety disorders not discussed in detail above include the following: 

• Selective mutism
• Specific phobias 
• Agoraphobia
• Substance or medication-induced anxiety disorder
• Anxiety disorder due to another medical condition
• Other specified anxiety disorder

These mental health conditions can also cause severe feelings of anxiety, physical symptoms, and impaired functioning. You can discuss your symptoms with a mental health professional to learn more about the potential causes of your anxiety, including risk factors, which may include genetic and environmental factors. You might also ask them what things tend to make anxiety symptoms worse, which may help you to make some lifestyle changes that reduce your anxiety.

Counseling options 

If you are experiencing frequent, prolonged symptoms of any anxiety disorder and feel that these symptoms disrupt your daily life, consider seeking a diagnosis from a qualified mental health professional. Through tailored therapeutic approaches, healthcare professionals are able to provide care, treatment, and coping strategies for various anxiety disorders. If your therapist recommends medication, your primary doctor or a psychiatrist may prescribe anti-anxiety or antidepressant medications. However, consult this individual before starting a new medication. 

Therapy may help you make changes in how you cope with anxiety symptoms. However, some people can experience barriers to obtaining treatment. For instance, people with symptoms of social anxiety may feel anxious about speaking to a therapist in person or encountering others in an office setting. Online therapy provides a convenient solution to many barriers, and it's as effective as in-person therapy in treating anxiety and depression, as well as other mental health conditions.

If you're interested in trying online therapy, a platform like BetterHelp can connect you with a licensed professional who has experience treating people with anxiety disorders and other mental health disorders. A therapist can use cognitive behavior therapy and teach you evidence-based stress management techniques and ways to control fear. You can speak with a therapist online from any location with an internet connection and choose between phone, video, or chat sessions.