What Is an Anxiety Disorder?

While experiencing feelings of anxiety from time to time is normal, these emotions, when they become extreme and start interfering with everyday activities can be symptoms of an anxiety disorder. The Anxiety and Depression Association of America defines anxiety disorders as specific psychiatric disorders that involve extreme fear or worry, including generalized anxiety disorder (GAD), agoraphobia, social anxiety disorder, selective mutism, separation anxiety disorder, and 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. It is estimated that only about 40% of those suffering from an anxiety disorder receive treatment, even though the disorders are highly treatable.

Types of Anxiety Disorders

Anxiety disorders are psychiatric disorders that involve a dysregulation of the body’s stress response. They differ from one another in terms of what exactly provokes the fear, anxiety, avoidance, and associated cognitive symptoms, and what type of impact they have.

Generalized Anxiety Disorder (GAD)

People with generalized anxiety disorder (GAD) experience excessive anxiety and worry most days for at least six consecutive months. Anxious thinking can be focused on a number of circumstances, including 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.

Panic Disorder

People who have panic disorder experience repeated, unexpected panic attacks. The National Institute of Mental Health characterizes panic attacks as an abrupt surge of intense fear or discomfort that often involves 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 a fear of panic attacks, which in turn can lead to social withdrawal and isolation. People with panic disorder may avoid places where they’ve previously experienced panic 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 or themselves when they are separated. Both children and adults can experience separation anxiety. When this fear of separation lasts for six or more months in adults 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.

Specific Phobias

Everyone is afraid of certain objects and situations, but when that fear turns into feelings of intense anxiety or dread that lasts six or more months, and interferes with your life, 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 be of spiders (arachnophobia), the dark (nyctophobia), clowns (coulrophobia), repetitive patterns of holes (trypophobia), and many others.

Agoraphobia

People with agoraphobia have a disabling fear of any places or situations where escape seems challenging if they panic or feel embarrassed. 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.

How Do I Know If I Have an Anxiety Disorder?

Everybody experiences anxiety, but only some will develop an anxiety disorder that requires diagnosis, treatment, and follow-up.

Symptoms

While each specific disorder comes with its own 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
• Dizziness
• Dry mouth
• Feelings of nervousness, panic, fear, and unease
• Muscle tightness
• Nausea
• 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 months or longer, you may have an anxiety disorder.

Diagnosis

Getting a diagnosis can be the first step to getting treatment. While there is no definitive test for anxiety, if symptoms are present and persistent, your healthcare provider may conduct a physical assessment and may run diagnostic tests to rule out potential medical causes. 

If no physical illness is found to be causing your symptoms, you will be referred to a psychiatrist or another mental health professional to be evaluated for an anxiety disorder. They will use the standard reference manual for diagnosing recognized mental illnesses in the United States, the Diagnostic and Statistical Manual of Mental Disorders 5^th Edition (DSM-5), to determine if you have an anxiety disorder. The diagnostic criteria for each anxiety disorder are different.

You may be asked questions like whether 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.

Risk Factors

Anxiety disorders are influenced by both genetic and environmental factors. While risk factors for each anxiety disorder vary, some factors associated with developing an anxiety disorder are common across different types:

• 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 Can I Get Help if I Have Severe Anxiety?

Severe anxiety requires treatment. Your mental health professional may decide that one or two of the following options or a combination of all three is ideal for treating and managing your anxiety disorder.

Psychotherapy

Cognitive behavioral therapy, or CBT, is a short-term form of psychotherapy that has been proven to be an 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. It has been shown that only a few sessions (e.g., one to five) may be necessary for effective treatment of specific phobias.

Medication

Pharmacological therapies are commonly prescribed to alleviate the symptoms of anxiety disorders, including anti-anxiety medications. The most common one used for anxiety disorders is benzodiazepine, which are effective in relieving anxiety and take effect quickly, but people can build up a resistance to it. Buspirone is a non-benzodiazepine medication specifically used to treat chronic anxiety, although it does not help everyone.

Antidepressants like selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are also prescribed to treat anxiety disorders. People with anxiety disorders can also be treated with other medications such as pregabalin, tricyclic antidepressants, 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.

Self-Care

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.

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 improving your quality of life.