Anxiety Disorders: Symptoms, Causes, Treatment
Also known as: Anxiety, Generalized Anxiety Disorder, GAD
What are anxiety disorders?
Anxiety disorders are a group of psychiatric conditions marked by excessive, persistent anxiety that disrupts daily life. Occasional anxiety is an expected part of life, but for people with these disorders the anxiety does not go away, is felt in many situations, and can get worse over time. Quality of life is often poor as a result. They’re among the most common mental disorders, affecting roughly 19% of U.S. adults in a given year, according to the National Institute of Mental Health (NIMH). Both men and women can be affected, though women are diagnosed more often (23.4% of women versus 14.3% of men in a given year).
Causes and risk factors
The cause of anxiety is unknown. Factors such as genetics, brain biology and chemistry, stress, and your environment may all play a role.
Several things can raise your risk:
- Traumatic or stressful events, especially early in life
- A family history of mental disorders
- Certain personality traits, such as being shy or withdrawn in new situations
- Certain physical health conditions
Symptoms
Anxiety disorders show up both mentally and physically:
- Excessive worry about everyday things, and trouble controlling it
- Feeling irritable or “on edge,” restless, or unable to relax
- A hard time concentrating
- Sleep disturbances: trouble falling asleep or staying asleep, or feeling fatigued
- A pounding or rapid heartbeat, sweating a lot, trembling or twitching
- Feeling lightheaded or out of breath
- Pain such as headaches, muscle aches, stomachaches, or tension
These symptoms vary depending on the type of disorder: generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, or various phobia-related disorders.
Diagnosis
A doctor will ask about your symptoms and your medical history. You may also have a physical exam and lab tests: these are done to make sure a different health problem isn’t causing your symptoms, not to confirm the anxiety disorder itself. Tests used to exclude other causes can include thyroid and glucose testing, echocardiography, or toxicology screening. If no physical cause is found, you may be referred for a psychological evaluation.
Doctors assess symptoms against the criteria in the DSM-5, weighing their duration, intensity, and impact on daily life. To be diagnosed with generalized anxiety disorder, for example, a person must find it difficult to control worry on most days for at least 6 months, along with three or more associated symptoms.
Available treatments
Care for anxiety disorders relies on two complementary approaches:
- Psychotherapy: Cognitive behavioral therapy (CBT) is the gold standard. This research-supported talk therapy helps you identify inaccurate thought patterns, understand how thoughts affect emotions, and change unhelpful behaviors. Other approaches such as acceptance and commitment therapy (ACT) or mindfulness may also be offered.
- Medication: SSRI (selective serotonin reuptake inhibitor) and SNRI (serotonin-norepinephrine reuptake inhibitor) antidepressants are commonly used to treat depression, but they can also help treat the symptoms of GAD. They may take several weeks to start working. Benzodiazepines, which are anti-anxiety sedative medications, can also be used to manage severe forms. Some people build up a tolerance to them and need increasing doses to get the same effect, and some become dependent on them, so a doctor may prescribe them only for brief periods.
Prevention and practical tips
Several lifestyle habits help reduce anxiety day to day:
- Engage in regular physical activity: just 30 minutes of walking a day can boost your mood
- Stick to a schedule and make sure you’re getting enough sleep
- Pay attention to your caffeine and alcohol intake, since cutting back helps some people
- Learn relaxation techniques such as meditation, muscle relaxation, or breathing exercises
- Reach out to friends or family who can offer emotional support and practical help
- Keep an eye on how much news and social media you take in, since more exposure to the latest headlines is linked to emotional distress, and reduce blue light from screens before bedtime
When should you see a doctor?
Don’t wait for a symptom to hit a certain mark. If your anxiety, or the anxiety of someone you love, starts to cause problems in everyday life, such as at school, at work, or with friends and family, it’s time to seek professional help. Left untreated, anxiety disorders often lead to severe depression and to abuse of drugs and alcohol.
In a crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline. Conversations are free and confidential, and the Lifeline is available 24/7/365. If someone is in immediate danger, call 911.
Sources
- National Institute of Mental Health (NIMH), U.S. anxiety disorder prevalence: 19.1% of adults in the past year, 23.4% of females and 14.3% of males
- National Institute of Mental Health (NIMH), GAD symptoms, the 6-month criterion, CBT as the gold standard psychotherapy, SSRIs/SNRIs and benzodiazepines, when to seek help, and improving quality of life with treatment
- National Institute of Mental Health (NIMH), types of anxiety disorders and how they differ from occasional anxiety
- MedlinePlus, causes and risk factors, diagnosis, and treatment options
- National Institute of Mental Health (NIMH), day-to-day self-care: physical activity, sleep, caffeine and alcohol, relaxation, social support, blue light
- StatPearls, Generalized Anxiety Disorder (NIH National Library of Medicine), anxiety disorders among the most common mental disorders, DSM-5 criteria, tests to exclude organic causes, quality of life, and the course of untreated anxiety disorders
- American Psychological Association, news exposure and its link to emotional distress
- American Psychological Association, limiting social media use and anxiety levels
- 988 Suicide & Crisis Lifeline, call or text 988, free and confidential, 24/7/365