Anxiety Disorders: Types, Risk Factors, And Treatment

Everyone experiences anxiety from time to time. Occasional anxiety is a normal stress reaction and can even be beneficial in some situations. There is a purpose to it - anxiety is meant to protect a person from danger by alerting them and helping them react to emergencies fast, so this emotion can actually benefit people.

However, excessive and persistent anxiety, nervousness, or fear can transform into something more than temporary worry and unease. It can become a serious mental condition - an anxiety disorder. In this case, the anxiety does not go away and may worsen over time. The symptoms can interfere with school or job performance, social life, activities, and relationships. These conditions are very common - they affect approximately 30% of adults at some point in their lives. There are several types of anxiety disorders. In this article, we will describe each of them in detail.

If you want to assess your level of anxiety, this free and valid Spielgerber’s Anxiety Test can help you. Remember that its results cannot replace the help of a medical professional. If you or someone you know need an official diagnosis, you should reach out to a mental health specialist.

Generalized anxiety disorder (GAD) is a long-term mental health condition. People with this disorder constantly feel anxious. GAD may last months or, in some cases, years.

Unlike individuals with a phobia, in which the fear is connected to a specific issue, people with GAD experience anxiety in a wide range of situations, rather than just one specific stressful event. Individuals suffering from this disorder feel worried and anxious most of the time and tend to always expect the worst. They go about their daily activities filled with magnified tension, even when there is nothing to worry about. People with this disorder have a hard time remembering when they last felt relaxed. This persistent dread, unease, and anxiety can significantly disrupt their daily life.

GAD symptoms can be mental, emotional, behavioral, and physical - or a combination of all of the above. In some people, symptoms fluctuate, becoming worse at times of extreme stress. They may include the following:

• Having intrusive negative thoughts, feeling excessively worried, wound-up, “on edge”, jumpy, restless;
• Feeling like anxiety is uncontrollable;
• Being irritable;
• Having headaches, stomachaches, diarrhea, or various unexplained pains;
• Having difficulty concentrating;
• Having trouble sleeping;
• Experiencing dizziness or palpitations.

Generalized anxiety disorder affects approximately 2% of the US population in any given year.

The core symptom of this condition is repeated and sometimes unexpected panic attacks. Panic disorder causes episodes of overwhelming and intense fear when there is no apparent cause for it, happening at unpredictable times.

When an individual is experiencing a panic attack, some of the following symptoms may occur:

• Sense of impending danger;
• Fear of losing control;
• Fear of death;
• Pounding heart or rapid heart rate;
• Sweating;
• Trembling or shaking;
• Teeth chattering;
• Headache;
• Chills;
• Hot flashes;
• Dry mouth;
• Throat tension;
• Shortness of breath;
• Feeling of choking;
• Chest pain;
• Nausea;
• Stomach cramps;
• Dizziness or faintness;
• Stiff muscles;
• Numbness;
• Tingling sensation;
• Feeling of unreality.

Even just one panic attack may provoke an intense and overwhelming fear of experiencing another attack. Someone who has had a panic attack once may constantly fear these attacks will happen to them again and again, to the point of avoiding specific situations where these attacks may occur. They can be expected (triggered by a feared object),or unexpected (occurring seemingly for no reason). According to some studies, individuals suffering from panic disorder are extremely sensitive to various smells, sunlight, or changes in the weather, but there is not enough scientific evidence for it yet. Strangers, friends, or family members might think the person experiencing a panic attack is having a heart attack or stroke. In fact, panic attack symptoms are dangerous also because they may mimic those of some other conditions.

The panic disorder itself is not life-threatening. However, because recurrent panic attacks are so frightening, they may significantly affect the quality of life of the individual suffering from them. Symptoms of the condition usually start between ages 20-24, but may also occur in the mid-30s. Children and adolescents can also experience panic disorder, but it often stays undiagnosed until they grow up.

The disorder is not very common in children and teenagers though - it happens in 1 to 3 percent of children and teenagers. It also affects 2% to 3% of adults in the US. Bear in mind that not everyone who experiences one or even several panic attacks has panic disorder. Most primary care physicians can diagnose individuals with panic disorder; so can mental health professionals.

Anyone may feel nervous or overwhelmed in some social situations sometimes. Giving an important presentation at work, starting a conversation with a stranger, or even going on a date with someone you really like may cause an individual a healthy amount of anxiety. But social anxiety disorder, previously referred to as social phobia, is not just shyness, nervousness, or being an introvert - it is a long-term condition in which a person experiences significant and constant discomfort and fear of social interactions. This persistent anxiety and fear of being humiliated, judged negatively, rejected, or looked down upon by others leads to avoidance that can result in severe distress that negatively impacts their daily routines, relationships, school, work, and/or other activities.

Social anxiety disorder symptoms may include the following:

• A great fear of talking to strangers, difficulty making eye contact;
• Persistent fear of situations in which others may judge the individual negatively;
• Constant worry about embarrassing or humiliating oneself;
• Intense fear of being watched;
• Anxiety about other people noticing the individual's anxious look;
• Fear of physical symptoms that may cause the person embarrassment, such as a quavering voice, blushing, trembling, or sweating;
• Avoidance of situations where the person could be the center of attention;
• Overwhelming anxiety due to anticipation of a feared event or activity;
• A rigid body posture;
• Constant worst-case expectations from social experiences;
• Intense anxiety during social situations, sometimes combined with an increased heart rate, blushing, sweating, strong nausea, feeling absent-minded, or trembling;
• A repeated thorough analysis of the individual's performance during a social situation and rigorous identification of their flaws after a social interaction episode.

This condition affects approximately 7% of the US population.

This disorder commonly occurs in infants between 8 and 12 months old. Usually, children outgrow it by age 3. However, some of them display symptoms of a separation anxiety disorder (SAD) until their adolescence. This condition can be also seen in some adults. Its symptoms in children and adults are similar. Because one of the core symptoms of SAD is an individual's intense fear that they may lose their loved ones, in children, it manifests as anxiety around being away from parents or guardians. Adults are anxious about being away from their romantic partners, children, or other family members.

Other common symptoms of SAD may include:

• Irrational fears that a loved one will experience a car accident, be abducted, or some other bad things will happen to them;
• Persistent unwillingness or refusal to separate from them;
• Trouble sleeping away from a loved one for fear that something bad will happen to them;
• Headache, other various aches and pains, and/or diarrhea associated with periods of anxiety.

This disorder can lead to significant impairment of school, work function, or other person's responsibilities. Individuals with SAD often experience high levels of anxiety, in some cases, even panic attacks, when their spouses or kids are out of reach.

SAD often occurs in combination with other anxiety-related disorders, such as generalized anxiety disorder and panic disorder.

Various phobias are a type of anxiety disorder provoking persistent, intense, overwhelming, and highly disabling fear. Specific phobia is a condition in which an individual has an excessive and unreasonable fear of a specific object, activity, or situation that generally poses no actual danger. Even though some adults with a specific phobia may realize that the fear they experience is unfounded, even the thought of facing the feared situation or object triggers severe anxiety symptoms. According to recent data, 8% to 12.5% of people in the US experience specific phobias, which makes them one of the most common types of anxiety disorders.

It is not unusual for a significant number of people to experience a specific phobia about several situations, activities, or objects.

The most common types of specific phobias involve a fear of the following:

• Situations or places, such as taking planes (aerophobia),enclosed spaces (claustrophobia),open spaces or situations where escape might be nearly impossible if something goes wrong (agoraphobia);
• Natural phenomenons, such as thunders/lightning (astraphobia) or tornadoes/hurricanes (lilapsophobia);
• Animals or insects, such as dogs (cynophobia),bees (melissophobia),or spiders (arachnophobia);
• Blood, medical procedures, or injuries, such as injections (trypanophobia) or accidents (dystychiphobia);
• Others, such as germs (mysophobia),vomiting (emetophobia),water (aquaphobia),loud noises (phonophobia),or clowns (coulrophobia).

According to numerous studies, family history of depression or other mental disorders, low self-esteem, female gender, sexual abuse at a young age, white race, number of experienced traumatic experiences, education level, unhealthy family environment, stress buildup, alcohol/drugs misuse, and having other mental health conditions are the main risk factors for developing anxiety disorders.

A primary care provider can usually determine what disorder a person has and provide a correct diagnosis. A psychologist, psychiatrist, or licensed clinical social worker can also diagnose an anxiety disorder. For an accurate diagnosis, a complete physical examination is crucial. A blood test can also help the doctor rule out other conditions, such as hypothyroidism, that might be causing the patient's symptoms. If the health professional does not find an underlying cause of the symptoms, they perform a psychological evaluation which includes asking the patient if they have a family history of depression or anxiety disorders. After the diagnosis, the doctor prescribes the most appropriate treatment options.

Correct treatment can help reduce the intensity of symptoms. That can significantly improve the patient's functioning in everyday life. Psychotherapy is considered a highly effective first-choice treatment for anxiety disorders. Several medications, such as selective serotonin reuptake inhibitors (SSRIs),serotonin and norepinephrine reuptake inhibitors (SNRIs),and benzodiazepines, have also been shown to be very effective in managing symptoms of anxiety disorders.

Here below are some related conditions:

• Acute stress disorder (ASD)
• Posttraumatic stress disorder (PTSD)
• Adjustment disorder
• Obsessive-compulsive disorder (OCD)
• Selective mutism.

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