What are anxiety disorders?
Anxiety disorders range from feelings of uneasiness to immobilizing
bouts of terror. This fact sheet briefly describes the different types
of anxiety disorders. This fact sheet is not exhaustive, nor does it
include the full range of symptoms and treatments. Keep in mind that
new research can yield rapid and dramatic changes in our understanding
of and approaches to mental disorders. If you believe you or a loved
one has an anxiety disorder, seek competent, professional advice or another
form of support.
Generalized Anxiety Disorder
Most people experience anxiety at some point in their lives
and some nervousness in anticipation of a real situation. However if
a person cannot shake unwarranted worries, or if the feelings are jarring
to the point of avoiding everyday activities, he or she most likely
has an anxiety disorder.
Symptoms: Chronic, exaggerated worry, tension, and
irritability that appear to have no cause or are more intense than the
situation warrants. Physical signs, such as restlessness, trouble falling
or staying asleep, headaches, trembling, twitching, muscle tension, or
sweating, often accompany these psychological symptoms.
Formal diagnosis: When someone spends at least six
months worried excessively about everyday problems. However, incapacitating
or troublesome symptoms warranting treatment may exist for shorter periods
Treatment: Anxiety is among the most common, most treatable
mental disorders. Effective treatments include cognitive behavioral therapy,
relaxation techniques, and biofeedback to control muscle tension. Medication,
most commonly anti-anxiety drugs, such as benzodiazepine and its derivatives,
also may be required in some cases. Some commonly prescribed anti-anxiety
medications are diazepam, alprazolam, and lorazepam. The non-benzodiazepine
anti-anxiety medication buspirone can be helpful for some individuals.
People with panic disorder experience white-knuckled, heart-pounding
terror that strikes suddenly and without warning. Since they cannot
predict when a panic attack will seize them, many people live in persistent
worry that another one could overcome them at any moment.
Symptoms: Pounding heart, chest pains, lightheadedness
or dizziness, nausea, shortness of breath, shaking or trembling, choking,
fear of dying, sweating, feelings of unreality, numbness or tingling,
hot flashes or chills, and a feeling of going out of control or going
Formal Diagnosis: Either four attacks within four weeks
or one or more attacks followed by at least a month of persistent fear
of having another attack. A minimum of four of the symptoms listed above
developed during at least one of the attacks. Most panic attacks last
only a few minutes, but they occasionally go on for ten minutes, and,
in rare cases, have been known to last for as long as an hour. They
can occur at any time, even during sleep.
behavioral therapy and medications such as high-potency anti-anxiety
drugs like alprazolam. Several classes of antidepressants (such as
paroxetine, one of the newer selective serotonin reuptake inhibitors)
and the older tricyclics and monoamine oxidase inhibitors (MAO inhibitors)
are considered "gold standards" for treating
panic disorder. Sometimes a combination of therapy and medication
is the most effective approach to helping people manage their symptoms.
Proper treatment helps 70 to 90 percent of people with panic
disorder, usually within six to eight weeks.
Most of us steer clear of certain, hazardous things. Phobias
however, are irrational fears that lead people to altogether avoid
specific things or situations that trigger intense anxiety. Phobias
occur in several forms, for example, agoraphobia is the fear of being
in any situation that might trigger a panic attack and from which escape
might be difficult. Social phobia is a fear of being extremely embarrassed
in front of other people. The most common social phobia is fear of
Symptoms: Many of the physical symptoms that accompany
panic attacks - such as sweating, racing heart, and trembling - also
occur with phobias.
Formal Diagnosis: The person experiences extreme anxiety
with exposure to the object or situation; recognizes that his or her
fear is excessive or unreasonable; and finds that normal routines, social
activities, or relationships are significantly impaired as a result of
Treatment: Cognitive behavioral therapy has the best
track record for helping people overcome most phobic disorders. The goals
of this therapy are to desensitize a person to feared situations or to
teach a person how to recognize, relax, and cope with anxious thoughts
and feelings. Medications, such as anti-anxiety agents or antidepressants,
can also help relieve symptoms. Sometimes therapy and medication are
combined to treat phobias.
Post-traumatic Stress Disorder:
Researchers now know that anyone, even children, can develop
PTSD if they have experienced, witnessed, or participated in a traumatic
occurrence-especially if the event was life threatening. PTSD can result
from terrifying experiences such as rape, kidnapping, natural disasters,
or war or serious accidents such as airplane crashes. The psychological
damage such incidents cause can interfere with a person's ability to
hold a job or to develop intimate relationships with others.
Symptoms: The symptoms of PTSD can range from constantly
reliving the event to a general emotional numbing. Persistent anxiety,
exaggerated startle reactions, difficulty concentrating, nightmares,
and insomnia are common. People with PTSD typically avoid situations
that remind them of the traumatic event, because they provoke intense
distress or even panic attacks.
Formal Diagnosis: Although the symptoms of PTSD may
be an appropriate initial response to a traumatic event, they are considered
part of a disorder when they persist beyond three months.
Treatment: Psychotherapy can help people who have PTSD
regain a sense of control over their lives. They also may need cognitive
behavior therapy to change painful and intrusive patterns of behavior
and thought and to learn relaxation techniques. Support from family and
friends can help speed recovery and healing. Medications, such as antidepressants
and anti-anxiety agents to reduce anxiety, can ease the symptoms of depression
and sleep problems. Treatment for PTSD often includes both psychotherapy
For more information, as well
as referrals to specialists and self-help groups in your state, contact:
Anxiety Disorders Association of America
8730 Georgia Avenue - Suite 600
Silver Spring, MD 20910
Mental Help Net
570 Metro Place
Dublin, OH 43017
National Mental Health Association
2001 Beauregard Street, 12th Floor
Alexandria, VA 22311
The National Institute of Mental Health's toll-free information
1-866-615-6464; their web address is www.nimh.nih.gov/healthinformation/anxietymenu.cfm.