Anxiety Disorders: An Overview
Sanne van Rooij, PhD, and Anaïs Stenson, PhD
In an anxiety-related disorder, your fear or worry does not go away and can get worse over time. It can influence your life to the extent that it can interfere with daily activities like school, work and/or relationships. Fear, stress, and anxiety are “normal feelings and experiences” but they are completely different than suffering from any of the seven diagnosable disorders plus substance-induced anxiety, obsessive-compulsive disorders, and trauma- or stressor-related disorders.
Anxiety disorders keep people from sleeping, concentrating, talking to others, or even leaving their home. Anxiety that may need treatment is often irrational, overwhelming, and disproportionate to the situation. It makes sufferers feel as though they have no control over their feelings, and it can involve severe physical symptoms like headaches, nausea, or trembling. It becomes classified as a disorder when normal anxiety becomes irrational and begins to recur and interfere with daily life.
But, as an example, what if someone will not leave their home for extended periods of time because they are afraid of being in a crowd or being reminded of a past traumatic event. That is not a “normal feeling or experience.”
If you think you might be struggling with an anxiety disorder, you’re not alone:
How Does Social Anxiety Differ From Generalized Anxiety
Studies show that people with generalized anxiety disorder and those with social anxiety disorder share heightened sensitivity to negative feedback and learn more under such conditions. But the similarities may end there. Generalized anxiety disorder can encompass any worry in any of the major domains of lifehealth, finances, work.
Social anxiety disorder reflects a specific worrynegative judgment by othersand it is manifest only in social settings. Scientists now know that optimism and anxiety are related. Its long been known that most people are inherently biased toward an optimistic outlook in life. But recent studies show that this bias does not exist among those with generalized anxiety. In contrast, people with social anxiety do retain a general optimism.
Major Types Of Anxiety Disorders
Anxiety is a normal human emotion and is part of life. Anxiety is only considered a disorder if it causes significant distress and/or keeps a person from keeping up with at least one part their life, including school, work, relationships, responsibilities or enjoyable activities. Anxiety disorders often persist over time and generally do not go away on their own. When anxiety disorders are left untreated, many people develop depression because of the toll that the anxiety has taken on their life. Anxiety is treatable by a mental health professional with short-term therapy if there are no other challenges or concerns.
We spoke to several pediatric psychologists at CHOC for an overview on the six major types of anxiety disorders.
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Risk Factors For Anxiety Disorder
Some things also make you more likely to develop an anxiety disorder. These are called risk factors. Some risk factors you canât change, but others you can.
Risk factors for anxiety disorders include:
- History of mental health disorder. Having another mental health disorder, like depression, raises your risk for anxiety disorder.
- Childhood sexual abuse. Emotional, physical, and sexual abuse or neglect during childhood is linked to anxiety disorders later in life.
- Trauma. Living through a traumatic event increases the risk of posttraumatic stress disorder , which can cause panic attacks.
- Negative life events. Stressful or negative life events, like losing a parent in early childhood, increase your risk for anxiety disorder.
- Severe illness or chronic health condition. Constant worry about your health or the health of a loved one, or caring for someone who is sick, can cause you to feel overwhelmed and anxious.
- Substance abuse. The use of alcohol and illegal drugs makes you more likely to get an anxiety disorder. Some people also use these substances to hide or ease anxiety symptoms.
- Being shy as a child. Shyness and withdrawal from unfamiliar people and places during childhood is linked to social anxiety in teens and adults.
- Low self-esteem. Negative perceptions about yourself may lead to social anxiety disorder.
Prevention And Coping With Anxiety
All human beings experience anxiety. In many cases, anxiety can have some beneficial and adaptive qualities such as pushing one to study for an upcoming difficult exam or propelling a person to flee from danger. Although experiencing some anxiety with life stressors and worries is normal, sometimes it can be difficult to manage and can feel overwhelming. Below we provide a list of tips and strategies to help individuals prevent anxiety from reaching a diagnosable level. Even though not everyone will struggle with a diagnosable anxiety disorder, learning strategies to aid in relief from anxiety and to manage the “normal” anxiety experienced in everyday life can help you live the life you desire.
Learning Relaxation Strategies
Mindfulness, Meditation, and Yoga
Exercise, Healthy Diet, and Rest
Awareness and Identifying Triggers
- It could be helpful to have a journal that you use to track your stressors, mood, thoughts, and behaviors that are impacted by anxiety. This will further help you identify the cause of your anxiety and notice when you may be engaging in unhelpful thoughts that only increase your anxiety.
Supportive Friendships & Family/ Contact a Therapist
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How Do I Deal With Anxiety
There are many ways to deal with anxiety and combining a variety of approaches may help. For those with a diagnosed anxiety disorder, a combination of psychotherapy alongside a medication plan can be very effective. For those who experience anxiety from time to time, there are a variety of relaxation techniques to try that may qualm feelings of worry or fear: breathing techniques, meditation, and progressive muscle relaxation are just some examples of techniques to try. Finding a distraction, taking part in physical activity, and talking to someone you trust are also all great options for relieving everyday anxiety.
Types Of Anxiety: Identify The Type Of Anxiety You Are Experiencing
When experiencing signs and symptoms of an anxiety disorder, as listed below, it is important to provide your doctor with as many specifics as possible so that they can diagnose you accurately and then provide a treatment plan for the specific diagnosis.
Types of Anxiety Disorders
Panic Disorder – Unpredictable attacks of anxiety that are accompanied by physiological manifestations. People with this disorder often undergo medical evaluations for symptoms related to heart attacks or other medical conditions before the diagnosis of panic disorder is made. Attacks may last from minutes to hours. An affected person often lives in fear of another attack and may be reluctant to be alone or far from medical assistance. Panic attacks can occur at any time, even during sleep. An attack generally peaks within 10 minutes, but some symptoms may last much longer.
Agoraphobia – An abnormal fear of being helpless in an embarrassing or unescapable situation that is characterized especially by the avoidance of open or public places. It may occur alone or may accompany panic disorder. People with this disorder may become housebound for years, with resulting impairment of social and interpersonal relationships.
Specific Phobias – Persistent fear of objects or situations. When these situations or objects appear, they can produce immediate and severe symptoms of anxiety.
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Who Is At Risk For Anxiety Disorders
The risk factors for the different types of anxiety disorders can vary. For example, GAD and phobias are more common in women, but social anxiety affects men and women equally. There are some general risk factors for all types of anxiety disorders, including
- Certain personality traits, such as being shy or withdrawn when you are in new situations or meeting new people
- Traumatic events in early childhood or adulthood
- Family history of anxiety or other mental disorders
- Some physical health conditions, such as thyroid problems or arrhythmia
Finding Out About Your Anxiety
Only a trained professional can give you a true diagnosis. But the above explanations should give you a better understanding of the types of anxiety disorders that affect millions of people all over the world.
No matter what type of anxiety you feel you’re suffering from, the good news is that there are genuinely effective ways to help. Many people have cured their anxiety altogether, and others find ways to make it easily manageable.
All you need to do is understand your anxiety better, choose effective treatment techniques, and make sure that you’re ready to commit to what it takes to rid yourself of your anxiety forever. These techniques are out there and available to treat your anxiety and keep it from coming back.
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How Anxiety Disorders Affect People
For people dealing with anxiety disorders, symptoms can feel strange and confusing at first. For some, the physical sensations can be strong and upsetting. For others, feelings of doom or fear that can happen for no apparent reason can make them feel scared, unprotected, and on guard. Constant worries can make a person feel overwhelmed by every little thing. All this can affect someone’s concentration, confidence, sleep, appetite, and outlook.
People with anxiety disorders might avoid talking about their worries, thinking that others might not understand. They may fear being unfairly judged, or considered weak or scared. Although anxiety disorders are common, people who have them may feel misunderstood or alone.
Some people with anxiety disorders might blame themselves. They may feel embarrassed or ashamed, or mistakenly think that anxiety is a weakness or a personal failing. Anxiety can keep people from going places or doing things they enjoy.
The good news is, doctors today understand anxiety disorders better than ever before and, with treatment, a person can feel better.
Post Traumatic Stress Disorder
As a human being, there are always risks that put your life in danger. Most people are lucky enough to avoid these dangers and live a nice and safe life. But in some cases, you may experience a life trauma â either physically or emotionally â and this can cause an anxiety problem known as post-traumatic stress disorder.
As the name implies, PTSD is an anxiety disorder that comes after the traumatic event has occurred. Those living with PTSD often must get outside help, because PTSD can affect people for years after the event occurs â possibly even for the rest of their life.
PTSD affects people both psychologically and physically. In most cases, the person with PTSD is the one that experienced the traumatic event, but it’s possible to get PTSD by simply witnessing an event or injury, or even simply discovering that someone close to you dealt with a traumatic event.
Symptoms include:
You may also experience severe “what if” scenarios everywhere you go, including disaster thinking or feeling helpless/hopeless in public situations. Many of those with PTSD also experience avoidance behaviors of events, things, and even people that may remind them of the event â even if there is no link between these issues and the trauma.
Those with post-traumatic stress disorder may be at a greater baseline of stress on most days. They may be short-tempered or easy to anger. They may be startled/frightened easily or be unable to sleep. PTSD can be a difficult problem to live with.
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What Is An Anxiety Disorder
We all feel anxious from time to time, but anxiety disorders are more than a temporary bout of worry or fear. An anxiety disorder is characterized by persistent, overwhelming feelings of anxiety, worry, or fear that are intense enough to interfere with an individuals day-to-day life. People with an anxiety disorder experience stress that is out of proportion to the thing they are worrying about and are unable to put these negative thoughts aside. They may feel constantly tense and on-edge, even if they arent certain what exactly they are anxious about.
Causes And Risk Factors
- Behavioral Choices
- Demographics
It’s important to note that everyone feels anxiety to some degree regularly throughout their life. Fear and anxiety are helpful emotions that can function to help us notice danger or threats that keep us safe and help us adapt to our environment. Anxiety disorders occur when significant distress impairs your ability to function in important facets of life, such as work, school, or relationships. There are many potential risk factors for anxiety disorders, and most people likely experience multiple different combinations of risk factors, such as neurobiological factors, genetic markers, environmental factors, and life experiences. However, we do not yet fully understand what causes some people to have anxiety disorders.
Genetic risk factors have been documented for all anxiety disorders. Clinical genetic studies indicate that heritability estimates for anxiety disorders range from 30-67%. Many studies, past and present, have focused on identifying specific genetic factors that increase one’s risk for an anxiety disorder. To date, an array of single nucleotide polymorphisms or small variations in genetic code, that confer heightened risk for anxiety have been discovered. For the most part, the variants that have been associated with risk for anxiety are located within genes that are critical for the expression and regulation of neurotransmitter systems or stress hormones.
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Why Do I Have Anxiety
What causes anxiety and anxiety disorders is complex. It is likely that a combination of both genetics and environmental factors play a role in why some individuals are more prone to anxiety than others. Some events, emotions, or experiences may make it more likely for the symptoms of anxiety to begin or worsenthese are known as triggers. Anxiety triggers can cause panic attacks in some people and differ from person to person and so working with a mental health professional to identify what your triggers are and how you can react when faced with them can be incredibly helpful.
Learn About The 4 Different Types Of Social Anxiety
Did you know that there are four different types of social anxiety?
Psychologist David Moscovitch of the University of Waterloo in Ontario, Canada proposed this new understanding of social anxiety.
Moscovitch suggests that instead of trying to categorize your social anxiety based on the type of situation that you are afraid of , it makes more sense to divide fears into four different types of social anxiety.
What Moscovitch proposes is that you are afraid that some fatal flaw about yourself will be revealed to other people.
In this way, its not the situation that you fear as much as what will happen.
Author and psychologist Ellen Hendriksen agrees, writing in her book How to Be Yourself that social anxiety is inherently a fear of the Big Reveal.
That point at which someone figures out what is wrong with you.
The four areas of fatal flaws that you might fear will be revealed are the following:
- Flaws in your social skills
- Fear about your anxiety symptoms becoming obvious to others
- Flaws in your appearance
- Flaws in your personality/character
Lets consider each of these in a bit more detail as described by Moscovitch so that you can figure out which one apply to you.
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