It is normal to experience occasional anxiety, especially in stressful situations. However, continuing to experience extreme and persistent anxiety, can be a sign of an anxiety disorder presence. This is referring to those who feel their feelings becoming difficult to control and begin to cause psychological distress and interfere with daily functioning. There are several different types of anxiety disorders, including:
Social Anxiety Disorder
Separation Anxiety Disorder
While it is difficult to determine the exact causes of anxiety disorders, there are several risk factors 3 for developing one, including:
Brain Structure and Chemistry
Stressful or Traumatic Characteristics
Familty History of Depression
Certain Medical Conditions
Substance abuse problems
People with generalized anxiety disorder (GAD) experience overwhelmingly high amounts of anxiety and worry about numerous situations, activities, and events. They typically worry about daily life circumstances, including matters related to their family, relationships, finances, or health. They often also worry about minor issues.
The amount of anxiety they feel is disproportionate to the object or situation itself, or they may not even have a specific reason for their worries.
People with GAD may also experience the following:
• Feelings of restlessness or being “on edge” and difficulty relaxing
• Being easily fatigued
• Difficulty concentrating / mind going blank
• Irritability Muscle tension
• Trouble falling or staying asleep
• Trembling, twitching, or feeling shaky
• Physical symptoms such as increased heart rate, sweating, headaches, nausea, or diarrhea
While the median age of onset for GAD is 30 years, it can also occur during childhood or adolescence. Individuals with GAD often describe that they have felt anxious for their entire lives.
People with social anxiety disorder experience extreme fear or anxiety in social situations. Situations that may include interacting with others, performing in front of others, or being observed by others. The anxiety experienced in social cases is developed from a fear of being judged, rejected, or embarrassed by others. Some people may also fear that they will offend others by accident.
To be diagnosed with social anxiety disorder, the social situation fears must almost always trigger anxiety in the individual. This triggered anxiety must be deemed excessive.
People with social anxiety disorder may also:
• Spend many days worrying about an upcoming social event
• Excessively prepare for anticipated social interactions
• Show overly rigid body posture
• Have inadequate eye contact
• Speak in an overly quiet voice
• Seek jobs where social connection is not required
• Experience physical symptoms of anxiety in social situations, such as trembling, sweating, rapid heartbeat, or blushing
The typical age at onset for social anxiety disorder is between 8 and 15 years. It may develop slowly, or it may onset after experiencing a particularly humiliating or stressful event.
Any friends or family members that you know struggling with panic disorders are known to repeatedly have unexpected panic attacks. According to professionals, panic attacks are sudden episodes of intense fear or discomfort that reach a peak within minutes.
During a panic attack, at least four of the following symptoms occur:
• Palpitations, pounding heart
• Accelerated heart rate
• Trembling or shaking
• Sensations of shortness of breath
• Feelings of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, light-headed, faint
• Chills or heat sensations
• Numbness or tingling sensations
• Feelings of unreality (derealization)
• Feeling detached from oneself
• Fear of losing control or “going crazy.”
• Fear of dying
To be diagnosed with panic disorder or other mental illnesses, panic attacks must be unexpected. This means that they are not triggered by anything. Instead, the panic attacks seemingly occur from out of the blue. Individuals with panic disorder continuously worry about having additional panic attacks.
The age at onset for panic disorder typically begins in early adulthood, between the ages of 20-24. Although it is less common, panic disorder can also occur in childhood or adolescence.
Clinical trials have shown anxiety disorders can be treated with psychotherapy, medication, or a combination of both 5. Research has shown that psychotherapy and medication are both effective treatments for anxiety disorders. Talking with your doctor to find a suitable treatment option would be extremely beneficial.
Psychotherapy, or “talk therapy,” involves working with a licensed mental health professional to identify, understand, and treat the psychological symptoms and difficulties you are having.
Research shows that individuals who receive psychotherapy, experience an improvement in their functioning. About 75% 6 of people receiving psychotherapy experience some benefit from it.
Studies show that cognitive-behavioral therapy (CBT) is the most effective 7 types of therapy for treating anxiety disorders. CBT helps people understand the relationship between their thoughts, feelings, and behaviors. Also, to focus on teaching people practical coping skills and problem-solving skills. Therapists often give their patients “homework” assignments so that they can practice the new skills they learn in their daily lives.
Two methods of CBT 8 are commonly used to treat anxiety disorders: cognitive therapy and exposure therapy. When using cognitive therapy techniques, your therapist will help you learn how your thoughts and beliefs are contributing to your anxiety symptoms.
Also, exposure therapy is especially beneficial for people who tend to avoid the things they fear, as it allows them to learn to confront their fears. In exposure therapy, your therapist will slowly “expose” you to the situation or object that provokes anxiety in a safe environment.
Over time, you will become less and less sensitive to the feared situation or object, until, eventually, it no longer evokes fear. When treating panic disorder 9, interoceptive exposure may be used.
Three standard classes of medications 10 used to treat anxiety disorders include antidepressants, benzodiazepines, and beta-blockers.
Some medications help with anxiety symptoms immediately, while others may take several weeks until improvement is felt. Certain medications may work better for specific anxiety disorders, and, sometimes, medications may be combined to best treat symptoms.
It may take some trial and error to find the right drug and dosage for you, but your doctor will work with you until you find the right one.
Antidepressants are frequently used to treat most anxiety disorders. Two newer types of antidepressants 11 are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Both are considered first-line drug treatments for anxiety disorders.
Tricyclic antidepressants (TCAs) may also be used to treat anxiety disorders, but is used less often because it is capable of producing more side-effects than others. As antidepressants have a low risk of dependency, it can take 2 to 6 weeks before symptoms may begin to improve.
Benzodiazepines are effective in rapidly relieving anxiety symptoms soon after they are taken. However, taking benzodiazepines for extended periods can lead to problems related to dependence and tolerance. Instead, benzodiazepines are commonly used 15 for short-term symptom relief.
When someone suddenly stops taking their benzo medication, withdrawal symptoms are likely to develop. Because of this, your doctor can help you gradually reduce your usage to help make these effects minimal.
Although beta-blockers are typically used to treat high blood pressure or heart conditions, they may also be used to treat certain anxiety disorders.
While they do not relieve feelings of anxiety, they can help reduce the various physical symptoms of anxiety, such as rapid heart rate, trembling, and sweating.
Other ways to manage anxiety symptoms are listed below.
It is recommended that you use these methods along with psychotherapy, medication, or both.
• Deep breathing exercises 18
• Progressive muscle relaxation 19
• Binaural beats 20
• Regular exercise, especially 30 min/cardio
• Limiting alcohol, nicotine & caffeine intake