Anxiety Disorders

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Anxiety Disorders

Anxiety is an emotion that can signal just the right response to a

situation. It can spur you on, for example, to add the finishing

touches that elevate an essay, painting, or important work

document from good to excellent. But if you have an anxiety

disorder, exaggerated anxiety can stop you cold and disrupt your

life. Like many other illnesses, anxiety disorders often have an

underlying biological causes and frequently run in families. These

disorders can be treated by several methods.

Anxiety disorders range from feelings of uneasiness most of the

time to immobilizing bouts of terror. This fact sheet briefly

describes generalized anxiety disorder, panic disorder, phobias,

and post-traumatic stress disorder. It is intended only as a

starting point for gaining an understanding 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 other forms of support.


Most people experience anxiety-that knot in the stomach over a

backlog of bills or just before a job interview-at some point in

their lives. Such nervousness in anticipation of a real situation

is normal. But if a person cannot shake unwarranted worries, or

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. These psychological symptoms often are

accompanied by physical signs such as restlessness, trouble

falling or staying asleep, headaches, trembling, twitching, muscle

tension, or sweating.

Formal Diagnosis: When someone spends at least 6 months worried

excessively about everyday problems. However, incapacitating or

troublesome symptoms warranting treatment may exist for shorter

periods of time.

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 antianxiety drugs, such as

benzodiazepines and its derivatives, also may be required in some

cases. Some commonly prescribed antianxiety medications are

diazepam, alprazolam, and lorazepam. The nonbenzodiazepine

antianxiety medication buspirone can be helpful for some




People with panic disorder experience white-knuckled,

heart-pounding terror that strikes with the force of a lightning

bolt-suddenly and without warning. Some people feel like they are

being devoured by fear, going crazy, or that they are surely dying

of a heart attack. And because they can not predict when a panic

attack will seize them; many people live in persistent worry that

another one could overcome them at any minute.

Most panic attacks last only a few minutes, but they occasionally

go on for 10 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. The good news is that proper treatment helps 70 to 90

percent of people with panic disorder, usually within 6 to 8 weeks.

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 crazy.

Formal Diagnosis: Either four attacks within 4 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.

Treatment: Cognitive behavioral therapy and medications such as

high-potency antianxiety drugs, for example, alprazolam. Several

classes of antidepressants [such as paroxetine one of the newer

selective serotonin reuptake inhibitors (SSRIs)] and the older

tryicyclics 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.


Most of us steer clear of certain things-for instance, stinging

insects or hazardous situations. But phobias are irrational fears

that lead people to avoid altogether specific things or situations

that trigger intense anxiety.

Symptoms: Phobias occur in several forms. Specific phobia is an

unfounded fear of a particular object or situation-such as being

afraid of dogs yet loving to ride horses or avoiding highway

driving yet being able to drive on city and country roads.

Virtually an unlimited number of objects or situations-such as

being afraid of flying, heights, or spiders-can be the target of a

specific phobia. Agoraphobia is the fear of being in any situation

that might trigger a panic attack and from which escape might be

difficult. Many people who have agoraphobia become housebound.

Others avoid open spaces, standing in line, or being in a crowd.

Many of the physical symptoms that accompany panic attacks-such as


sweating, racing heart and trembling-also occur with phobias.

Social phobia is a fear of being extremely embarrassed in front of

other people. The most common social phobia is fear of public


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 these fears.

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 antianxiety agents or

Antidepressants, can also help relieve symptoms. Sometimes therapy

and medication are combined to treat phobias.


In the past, post-traumatic stress disorder (PTSD) was thought to

affect only war veterans with heavy combat experience. 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, 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 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. In addition, people with PTSD

typically avoid situations that remind them of the traumatic event

because they provoke intense distress or even panic attacks. A

rape victim with PTSD, for example, might avoid all contact with

men and refuse to go out alone at night. Many people with PTSD

also develop depression and may at times abuse alcohol or other

drugs as "self-medication" to dull their emotional pain and to

forget about the trauma.

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 3 months.

Treatment: Psychotherapy can help people who have PTSD regain a

sense of control over their lives. Many people who have this

disorder need to confront what has happened to them and, by

repeating this confrontation, learn to accept the trauma as part

of their past. They also may need cognitive behavior therapy to

change painful and intrusive patterns of behavior and thought and

to learn relaxation techniques. Another focus of psychotherapy is

to help people who have PTSD resolve any conflicts that may have

occurred as a result of the difference between their personal

values and how behavior and experience during the traumatic event

violated them. Support from family and friends can help speed

recovery and healing. Medications, such as antidepressants and

antianxiety agents to reduce anxiety, can ease the symptoms of

depression and sleep problems. Treatment for PTSD often includes

both psychotherapy and medication.

Information courtesy of National Institute of Mental Health
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