Anxiety disorders are mental health conditions that cause persistent or recurring feelings of nervousness and worry. They can cause a range of physical symptoms, such as fast or shallow breathing, sweating, or difficulty sleeping.
Anxiety disorders are the most common type of mental health condition in the United States, affecting roughly 40 million adults. However, they are also treatable.
This article will discuss anxiety disorder symptoms, some treatment options to consider, and when to seek support.
The primary symptom of any anxiety disorder is a persistent, intense feeling of worry that affects one or more aspects of the person’s life.
It is normal to feel worried occasionally, particularly when experiencing something stressful. However, people with anxiety disorders often feel worried or panicked in a way that interferes with their daily life.
This can result in behavioral changes. For example, a person may begin to avoid situations that trigger their anxiety or adopt coping mechanisms to distract themselves from anxious thoughts.
Anxiety can also cause physical symptoms, such as:
- sweating
- shaking
- a rapid heartbeat
- fast or shallow breathing
- dizziness
- muscle tension
- digestive symptoms, such as nausea or diarrhea
- tiredness
During moments of severe anxiety, a person may also experience anxiety attacks, or panic attacks. These are periods of intense anxiety that can last for several minutes.
The objects or situations that cause the anxiety and the impact they have on a person are typically what distinguish anxiety disorders from one another.
However, it is not uncommon for these disorders to overlap or for people to have more than one.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists the following conditions as anxiety disorders:
- specific phobias
- agoraphobia
- generalized anxiety disorder (GAD)
- panic disorder
- social anxiety disorder
- separation anxiety disorder
- selective mutism
- substance- or medication-induced anxiety disorder
- anxiety disorder due to another medical condition
- other specified or unspecified anxiety disorder
Previous editions of the DSM listed obsessive-compulsive disorder and post-traumatic stress disorder as anxiety disorders, as both can cause considerable anxiety. However, the DSM-5 now lists these conditions separately.
Specific phobias are fears of certain objects or situations. Some common examples include a fear of flying, certain animals, or needles.
To an extent, it is normal to be afraid of things that carry some risk. However, people with phobias experience fear that is disproportionate to the threat the trigger really poses. They may try to avoid the trigger, sometimes at risk to themselves.
When a person does encounter a trigger, they may feel extreme fear or panic, a feeling of imminent danger or doom, the need to escape, or a fear of dying.
They may acknowledge that their reaction is out of proportion to the potential danger but remain unable to control their feelings of anxiety.
Agoraphobia is an excessive or irrational fear of two or more of the following:
- using public transport
- being in open spaces
- standing in line or in a crowd
- being outside of the home alone
- being in enclosed spaces
People often confuse agoraphobia with a fear of going outside, but it is more complex than this.
People with agoraphobia can fear leaving the home, being in crowds, or being in open or enclosed spaces because they feel that it would be difficult for them to escape if they felt panicked.
GAD involves persistent and excessive worry about a range of nonspecific events and situations. For example, people with GAD may worry about their money, health, family, work, and many other things.
Often, the cause of this worry is that the individual anticipates the worst outcome in a given situation, even if there is no evidence to suggest that this will happen. This can result in difficulty concentrating, feeling on edge, irritability, fatigue, and difficulty sleeping.
To meet the criteria for diagnosis, this worry must last for over 6 months and be difficult for a person to control. It must also be accompanied by at least three of the following symptoms:
- restlessness
- being easily fatigued
- difficulty concentrating
- muscle tension
- sleep disturbances
A person may have panic disorder if they:
- experience frequent panic attacks
- are afraid of having panic attacks
- change their behavior in unhelpful ways to avoid having panic attacks
- have panic attacks that occur abruptly and peak within minutes
- have panic attacks that arise from either a calm or anxious state
“Expected” panic attacks occur in response to a specific stressor. For example, a person with a phobia may experience a panic attack if they encounter a trigger.
However, people with panic disorder experience unexpected panic attacks that occur for no obvious reason.
The symptoms may include:
- heart palpitations or a pounding heartbeat
- trembling
- sweating
- feeling short of breath
- a choking sensation
- a feeling of being out of control or impending doom
- feeling detached or disconnected from reality (disassociation)
- having a fear of dying
- nausea or other symptoms of digestive distress
Panic attacks can also occur in people with other types of mental health condition.
Social anxiety disorder, or social phobia, is a persistent fear of negative judgment from others, embarrassment, rejection, or offending others. This may cause a person to worry about or avoid:
- meeting strangers
- eating or drinking in public
- starting conversations
- making eye contact
- talking on the phone
- attending social events
- public speaking or performing
Someone with social anxiety may also find it difficult to do tasks if someone is watching them, and they may have low self-esteem.
The impact of social anxiety on a person’s life can vary. Some people may be unable to work, attend school, or form relationships, while others can still do these things even though they are experiencing symptoms.
People with separation anxiety are afraid of leaving people they are attached to in a way that is developmentally inappropriate for their age. Separation anxiety among infants and children is expected and typical. It most often develops in children, but it can also occur in adults.
People with separation anxiety may experience:
- excessive fears about their loved ones coming to harm
- reluctance to leave them or be away from them
- overprotectiveness
- nightmares
- rumination on thoughts of being removed from them by kidnapping, death, or illness
- physical complaints, such as stomach aches or headaches
Children with this disorder may refuse to attend school or feel anxious about sleeping at someone else’s house, away from their parent or caregiver.
Adults with this disorder may feel anxious at the thought of letting their children leave home.
If the subject of the anxiety is a romantic partner, the person may become highly dependent on them. They may also be prone to jealousy and codependency.
Selective mutism is a disorder that causes an inability to speak in situations that involve performance, such as at school or work. Symptoms persist for at least 1 month.
Unlike a developmental disorder or disability that affects speech, people with selective mutism may be very capable of speaking in familiar situations, such as at home. However, they become unable to speak in social or unfamiliar situations due to anxiety.
According to the Selective Mutism Association, this disorder may be a manifestation or result of social anxiety.
- Substance- or medication-induced anxiety disorder: This condition occurs when symptoms of anxiety arise as the direct result of using a substance or medication or during withdrawal. Potential causes may include alcohol, caffeine, and cannabis use.
- Anxiety disorder due to another medical condition: This describes anxiety that is the direct result of a health condition. This may occur with endocrine disease, cardiovascular disorders, respiratory illnesses, metabolic disturbances, and neurological conditions.
- Other specified or unspecified anxiety disorder: This applies to people who experience clinical anxiety but do not meet the criteria for any specific disorder.
Treatment options for anxiety disorders may include the following:
Psychotherapy
Psychotherapy is an umbrella term for a range of talk therapies. Typically, they involve confidential sessions with a therapist, who helps the person understand where their anxiety comes from and how to move forward.
There are many types of psychotherapy to choose from, including:
It takes time for therapy to work. Sometimes, people find that they have to try different types to find a method that suits them.
Learn more about the types of therapy here.
Medication
Medication does not cure anxiety disorders, but it can reduce the symptoms. Examples of medications that may help include antidepressants, such as selective serotonin reuptake inhibitors, and beta-blockers.
Some people may find it helpful to take medication in order to begin therapy. However, these drugs can have side effects. It is important to discuss this with a doctor to find the right fit.
If anxiety occurs frequently or has a significant impact on a person’s well-being, support and treatment are available.
People can speak with a healthcare professional about their symptoms, or they can contact a therapist.
It is also important to speak with a doctor if anxiety is affecting a person’s physical health.
Stress and anxiety trigger the “fight, flight, freeze, or fawn” response, which is the body’s way of preparing for danger. During this response, the body produces stress hormones such as cortisol and noradrenaline.
If a person is frequently anxious, they may have chronically elevated stress hormone levels, which can affect sleep, digestion, hormone health, blood pressure, and more.
With treatment, a person can lower their anxiety levels, improve their quality of life, and alleviate symptoms or health conditions that may worsen due to stress.
Anxiety disorder symptoms typically include intense feelings of worry or dread that persist or recur over a long period of time. People may also notice physical symptoms of anxiety, such as an elevated heart rate or sweating.
These feelings and symptoms may manifest in different ways depending on the type of anxiety disorder a person has. However, anxiety disorders are treatable with support from a doctor or therapist.