Anxiety disorders are among the most common mental health conditions in the United States. They can affect people of any age, but anxiety is particularly prevalent among children and adolescents. In fact, anxiety disorders often first appear during childhood or adolescence, though many adults develop them later in life as well.
Anxiety disorders fall into a set of distinct diagnoses, depending upon the symptoms and severity of the anxiety the person experiences. Anxiety disorders share the anticipation of a future threat, but differ in the types of situations or objects that induce fear or avoidance behavior. Different anxiety disorders also have different types of unhealthy thoughts associated with them.
Types of Anxiety Disorders
Specific phobias: are characterized by a severe reaction to a specific object or situation, such as fear of heights (acrophobia), fear of insects (arachnophobia), fear of snakes (ophidiophobia), and fear of blood (hemophobia).
Social anxiety disorder : also known as social phobia, is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Self-esteem is unusually stable in persons with this anxiety disorder.
- Generalized anxiety disorder: or GAD, is a condition in which anxiety occurs on most days of the week for at least six months and includes a number of anxiety symptoms. This disorder may begin with one specific object or situation but then generalizes to others. Generalized anxiety disorder is often associated with physical symptoms such as tension headaches, irritable bowel syndrome, and sore muscles. Generalized anxiety disorder also often co-occurs with other anxiety disorders, depression, or substance abuse.
- Obsessive compulsive disorder : or OCD, is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions) that the person feels driven to perform.
Post-traumatic stress disorder : or PTSD, is anxiety and emotional distress after a psychologically traumatic event. Symptoms include re-experiencing of the trauma in nightmares and intrusive thoughts, avoidance of stimuli associated with the trauma, and increased anxiety and irritability.
- Panic attacks: are sudden periods of intense anxiety that may include physical sensations such as palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen. Panic attacks typically last for a short amount of time, anywhere from minutes to hours depending upon the person and the severity of their symptoms. This is probably one of the reasons panic attacks can be so devastating. People who experience regular panic attacks often go to great lengths to avoid situations where they might have one.
Anxiety Disorder Symptoms
The symptoms can differ depending on a person’s age and which anxiety disorder they have. Symptoms may include:
- Physical symptoms such as chest pain, heart palpitations, trouble breathing, stomach aches and headaches.
- Behavioral symptoms that could be mistaken for other illnesses such as school refusal or withdrawal from social activities.
- Cognitive symptoms such as worry about things before they happen; trouble focusing; fearfulness; irritability; and difficulties sleeping (insomnia).
What Causes Anxiety?
Anxiety can be caused by many factors. Sometimes anxiety is related to a physical illness such as thyroid problems or asthma, or other medical conditions such as breathing disorders and anxiety disorders themselves. Furthermore, anxiety can also be caused by overwhelming life events, abuse or neglect, psychological issues in childhood related to anxiety, chemical imbalances in the brain, genetics and anxiety-prone personalities. Sometimes anxiety is triggered by a specific event or situation that may seem harmless enough when it first occurs but an anxiety disorder develops later as the sufferers begins anticipating the anxiety-producing situation.
When does anxiety turn into an anxiety disorder?
Some anxiety is normal and beneficial — it’s a response to stress and can help us cope. But anxiety becomes a disorder when anxiety starts to interfere with daily life. An anxiety disorder may also be accompanied by other emotional disorders such as depression, substance abuse, eating disorders or obsessive-compulsive behaviors. It’s important for anxiety sufferers to remember that anxiety disorders are real, treatable medical conditions. A combination of medication and therapy may be the most effective solution for anxiety disorders.
Diagnoses of Anxiety Disorder
To get diagnosed as having an anxiety disorder, a person must have anxiety symptoms more days than not, for longer than six months. In children, anxiety symptoms often last only a few months before disappearing. In adults, anxiety disorders can be diagnosed alongside other physical or mental health conditions such as depression and bipolar disorder.
Treatment and Therapies For Anxiety
As we discussed above, anxiety is a feeling of nervousness or panic that can be caused by many different factors and triggered by any number of events. Whether anxiety is just a temporary phase in your life or something more serious, there are many ways to cope with both anxiety and panic attacks, let's explore a few of them.
EducationOne of the premiere resources on anxiety attacks and panic attacks is the Irish doctor and author Harry Barry who has written a number of books including “Anxiety And Panic” and "Toxic Stress: A step-by-step guide to managing stress" which provide a wealth of information about anxiety disorders.
Dr Barry believes anxiety disorders are caused by a mixture of anxiety-prone personalities and anxiety triggers brought on by anxiety’s physical symptoms. It's important to note that Dr Barry does not believe anxiety disorders are rooted in childhood traumas. What Dr Barry does believe it that anxiety disorders is an evolutionary response to danger that has left many people with anxiety-prone personalities unable to cope with anxiety triggers.
'We all have anxiety, but it's how we deal with it,' Dr Barry said. 'There are some things you can do very quickly.'
MedicationAlthough it should be seen as a last resort, and only for a very small subset of anxiety sufferers, medication can be effective for anxiety and panic attack that has proven resistant to other methods. The 3 main medications used to treat anxiety disorders are:
1. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) or paroxetine (Paxil)
2. Benzodiazepines, such as alprazolam (Xanax) or clonazepam (Klonopin). These anxiety-reducing medications are often used on a short-term basis while SSRI’s and other anxiety treatments take effect. When taking Benzodiazepines there is the danger of addiction, which is why they should be prescribed sparingly and taken for as little amount of time as necessary.
3. Beta blockers like propranolol (Inderal) and atenolol (Tenormin) are sometimes used to treat specific types of anxiety disorders.
Although anxiety medications are generally safe, anxiety drugs can in fact exacerbate anxiety, as well as create a whole host of side-effects such as dry mouth, drowsiness, nausea, and even psychotic breaks.
There are many therapies that can be used alone or in conjunction with medications for anxiety disorders. For example, cognitive behavioral therapy (CBT) helps anxiety sufferers change anxiety-producing thoughts and behavior patterns. CBT can be used alone or with medications such as antidepressants. Similarly, Exposure Therapy can be used to treat anxiety disorders by allowing people to gradually overcome their fears by exposing them to the triggers in a safe and supervised space.
PhilosophyIn ancient philosophy, anxiety was discussed by both the Epicureans and the Stoics. In “The Art Of Happiness”, Epicurus wrote that anxiety was a negative and destructive emotion and that it came from the fear of death. The Epicureans believed that we should not fear death because when we are dead, there is no suffering or pain.
The Stoics took a different view on the subject of anxiety. They believed that acknowledging fears were an important step to overcoming them. As the Stoic philosopher-king Marcus Aurelius wrote in Meditations:
“Rehearse death. To say this is to tell a person to rehearse his freedom. A person who has learned how to die has unlearned how to be a slave."
To the Stoics, panic and anxiety were not the same thing. Panic was a sudden rush of fear over what might happen, while anxiety is one’s constant contemplation or worrying about those things that might happen. It’s during this process of worry when panic sets in because panic is a response to thoughts about something negative happening. Aurelius was not suggesting to disregard one's fear but to use it as a way to appreciate one's life and reflect on what is truly important to each one of us. As Aurelius instructed himself:
“Think of yourself as dead. You have lived your life. Now take what's left and live it properly. What doesn't transmit light creates its own darkness.”
Exercise has been shown to be effective in reducing anxious thoughts. A 2013 study in Psychiatry Research found that when individuals engaged in exercise they experienced a decrease in physiological symptoms of panic. This is because exercise causes the release of endorphins which are chemicals in our bodies that reduce anxiety and panic.
Physical activity can distract an individual from panic attacks by creating other physiological responses that are not panic-driven. This can be incredibly beneficial for panic sufferers who deal with panic attacks at work or school where distraction is not always possible.There are many types of exercises to choose from so it may take some trial and error to find the one that works best for you. For example, aerobic exercise such as swimming or running while listening to fast-paced music can often be beneficial because panic attacks are usually brought about by a surge of adrenaline.
Additionally, panic sufferers may want to consider yoga as yoga focuses primarily on breathing and creating awareness, which can often help reduce panic attacks.
Meditation and mindfulness exercises can help panic sufferers prevent panic attacks by bringing awareness to the often-subconscious processes of their mind, as well as helping them remain in the present moment. Moreover, panic attacks can often be triggered by runaway thoughts that spiral into panic cycle, and meditation can help panic sufferers identify those moments and end panic cycles before they get out of hand.
Vipassana meditation is the most common form of Buddhist meditation, as it teaches one to see things for what they really are with an objective and non-judgmental awareness. This form of meditation can be incredibly helpful to panic sufferers who learn to recognize panic attack triggers and how to overcome them while seeing panic attacks for what they are, an uncomfortable but not dangerous physical reaction to perceived threat