While experiencing feelings of anxiety from time to time is normal, these emotions, when they become extreme, can start interfering with everyday activities and lead to an anxiety disorder. People with anxiety disorders may experience persistent and disabling anxiety symptoms, including muscle tension, edginess, digestive issues, shortness of breath, and fatigue.
The Anxiety and Depression Association of America defines anxiety disorders as specific psychiatric disorders that involve extreme fear or worry, which include generalized anxiety disorder (GAD), panic disorder and panic attacks, agoraphobia (fear of places and situations that may cause panic, helplessness, and embarrassment), social anxiety disorder, selective mutism, separation anxiety, and certain phobias.
Anxiety disorders are the most common mental disorders in the United States. Anxiety symptoms vary across individuals, but include both psychological and physical reactions to anticipation of a threat. Only 36.9% of those suffering from an anxiety disorder receive treatment, even though the disorders are highly treatable.
How Do Anxiety Disorders Affect People?
Anxiety disorders are psychiatric disorders that can change the body’s stress response. Its impact may look different depending on the type of anxiety disorders.
Generalized Anxiety Disorder (GAD)
People with generalized anxiety disorder (GAD) experience excessive anxiety most days for at least six consecutive months. Anxious thinking can be focused on work, relationships, and personal health.
In people with GAD, these thoughts and associated anxiety symptoms are often so persistent and overwhelming that they cause serious disruptions to everyday life and social interactions.
Other symptoms of GAD include those commonly associated with anxiety: restlessness, irritability, fatigue, and trouble sleeping.
People who have panic disorder experience repeat unexpected or triggered panic attacks. The National Institute of Mental Health characterizes panic attacks as a fear of disaster or of losing control even when there is no real danger. Panic attacks may result in heart racing, sweating, dizziness, and the feeling of having a heart attack.
Experiencing panic attacks can lead to fearing panic attacks, which in turn can lead to social withdrawal and isolation. People with panic disorder may avoid places where they’ve previously experienced attacks.
Social Anxiety Disorder
Social anxiety disorder, or social phobia, is about much more than being shy. People with this anxiety disorder experience extreme fear of being judged by others and are self-conscious in social interactions to the point of avoiding them. These feelings must persist for six months to be considered to be caused by social anxiety disorder.
Separation Anxiety Disorder
People with this disorder may constantly worry about what will happen to their loved one in their absence, and they may play out distressing worst case scenarios in their heads. Both children and adults can be negatively affected by separation anxiety. When this fear of separation lasts for six or more months and impairs relationships with others, it becomes a problem. Nightmares involving worst-case scenarios and physical symptoms of stress and anxiety can occur in people with this disorder.
Everyone is afraid of certain people, places, and things, but when that fear turns into feelings of intense anxiety or dread that lasts six or more months, it may indicate a phobia. Specific phobia is an intense, irrational fear of something that poses little or no actual danger. While the specific source of fear can differ from person to person, phobias are a type of anxiety disorder that can severely impair someone’s ability to function in everyday situations. Phobias can include spiders (arachnophobia), the dark (nyctophobia), and clowns (coulrophobia).
People with agoraphobia have a disabling fear of any places or situations where escape may prove challenging. This fear goes beyond what may be rational and influences behavior. It involves avoidance of situations such as being alone outside of the home, traveling in a car, bus, or airplane, or being in a crowded area.
What is Selective Mutism?
The National Institute of Mental Health defines selective mutism as a somewhat rare disorder commonly associated with anxiety. It results in a failure to speak in specific social situations despite having normal language skills. This disorder usually presents before the age of 5. Other associated behaviours may include extreme shyness, fear of social embarrassment, compulsive traits, withdrawal, clinging behavior, and temper tantrums.
How Do I Know If I Have an Anxiety Disorder?
Everybody experiences anxiety, but only some will develop an ongoing anxiety disorder that requires diagnosis, treatment, and follow-up.
While each specific disorder comes with its own characteristic anxiety symptoms, there are tell-tale signs that anxiety is becoming unmanageable or is beginning to disrupt daily functioning.
Symptoms common to all anxiety disorders include:
- Difficulty sleeping
- Dry mouth
- Feelings of nervousness, panic, fear, and unease
- Muscle tightness
- Rapid or irregular heartbeat
- Sweaty or cold hands and/or feet
- Tingling or numbness in the hands or feet
- Unable to be calm or hold still
If you notice these symptoms and they last six or more months, you may have an anxiety disorder.
Getting diagnosed with an anxiety disorder can be the first step to getting treatment. While there is no definitive test for anxiety, if symptoms are present and persistent, your doctor may conduct a physical assessment and may run diagnostic tests to rule out underlying conditions.
If no physical illness is found to be causing your symptoms, you will be referred to a psychiatrist or psychologist to be evaluated for an anxiety disorder. They will use the standard reference manual for the diagnosis of recognized mental illnesses in the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to determine if you have an anxiety disorder. The diagnostic criteria for each anxiety disorder may be different.
You may be asked questions like whether or not you worry more days than not and if you’ve noticed any physical symptoms such as restlessness, feeling tired easily, trouble concentrating, irritability, muscle tension, or trouble sleeping.
Anxiety disorders are influenced by both genetic and environmental factors. For example, a family history of mental illness and adverse childhood experiences can increase someone’s risk of having an anxiety disorder.
While risk factors for each anxiety disorder may vary, there are some common factors associated with developing an anxiety disorder:
- Adverse childhood experiences, including neglect or abuse
- Temperamental traits of shyness or behavioral inhibition in childhood
- A history of anxiety or other mental illnesses in the family
Some physical health conditions, such as thyroid problems or heart arrhythmias, are also commonly associated with anxiety. For example, there is a high prevalence of psychiatric symptoms and disorders in thyroid disease. Heart arrhythmias or palpitations are also associated with anxiety and can be induced by stress.
Caffeine or other stimulants and some medications can also trigger or aggravate symptoms of anxiety disorders.
How Do I Know If I Have an Anxiety Disorder?
In understanding your own relationship to anxiety, Beyond Blue, a mental health charity, says it can be helpful to do a self-assessment based on anxiety checklist questions. This exercise gauges the severity of your anxiety.
You may wish to consider how often over the past two weeks you have been bothered by the following problems:
- Feeling nervous, anxious, or on edge
- Not being able to stop or control worrying
- Worrying too much about different things
- Trouble relaxing
- Being so restless that it’s hard to sit still
- Being easily annoyed or irritable
- Feeling afraid as if something awful might happen
Your answers will indicate whether your anxiety falls in low, moderate, or high categories and what kinds of treatments are appropriate for your level of anxiety.
How Can I Get Help if I Have Severe Anxiety?
Severe anxiety requires treatment. Your mental health professional may decide one or two of the following options or a combination of all three is ideal for treating and managing your disorder.
Cognitive behavioral therapy, or CBT, is a short term form of psychotherapy that has been proven to be the most effective form of treatment for anxiety disorders. If avoidance of feared situations is a relevant factor in phobic disorders, exposure techniques should be included in the treatment schedule, in which patients are confronted with their feared situations.
For specific phobias, behavioral therapy should be performed as exposure treatment. It has been shown that only a few sessions (eg, one to five) were necessary for effective treatment of specific phobias.
Pharmacological therapies most commonly prescribed for the treatment of anxiety disorders include selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, but people with anxiety disorders can also be treated with other medications such as pregabalin, tricyclic antidepressants, buspirone, moclobemide, and more.
Be mindful of the following when taking medications to manage anxiety disorder symptoms:
- Keep your provider informed about your symptoms. If a medicine isn’t controlling symptoms, its dosage may need to be changed, or you may need to try a new medicine
- Do not change the dosage or stop taking the medicine without talking to your provider
- Take medicine at set times. For example, take it every day at breakfast. Check with your provider about the best time to take your medicine
- Ask your provider about side effects and what to do if they occur
Antidepressant medications have been associated with increased risk of suicidality (suicidal thinking and behavior) in children and adolescents who were treated with these agents.
Self-care is an essential part of mental health care. The World Health Organization defines self-care as a broad concept that also encompasses hygiene (general and personal); nutrition (type and quality of food eaten); lifestyle (sporting activities, leisure, etc.); environmental factors (living conditions, social habits, etc.); socioeconomic factors (income level, cultural beliefs, etc.); and self-medication.
Some self-care tips for people with anxiety disorders include:
- Getting enough sleep
- Eating healthy foods
- Keeping a regular daily schedule
- Getting out of the house every day
- Exercising every day. Even a little bit of exercise, such as a 15-minute walk, can help
- Stay away from alcohol and street drugs
- Talk with family or friends when feeling nervous or frightened
- Find out about different types of group activities available
A Word From Verywell
Life is filled with different stressors, and we all experience some form of anxiety every day. When anxiety levels are high for a long period of time, however, you may have an anxiety disorder. These disorders can be persistent and disabling, but fortunately, there are several effective treatment options for you if you have an anxiety disorder.
Besides therapy and medications, you can also be proactive about managing your symptoms by taking good care of yourself. Maintaining a positive mindset and keeping yourself healthy will go a long way toward minimizing disruptions from your anxiety and a better quality of life.