Anxiety disorders

Anxiety disorders are a group of mental health problems. They include generalised anxiety disorder, social phobias, specific phobias and panic disorders. Depression is often related to anxiety disorders.

Anxiety disorders are common and affect many people. About one in four people will have an anxiety disorder that warrants treatment at some point in their life, and a similar proportion experience less severe anxieties, such as a fear of spiders or snakes. Everyone feels anxious or fearful at times. These are normal and helpful emotions that prepare us to deal with danger.

When anxiety becomes a disorder#

Anxiety becomes a disorder when it is irrational and excessive, and when it interferes with a person’s ability to function in daily life. Often there appears to be no obvious or logical reason for the way the person feels, which can make the anxiety even more distressing.

The main features of an anxiety disorder are fears or thoughts that are constant and distressing and that interfere with daily living. Other symptoms may include:

• panic or anxiety attacks, or a fear of these attacks
• physical reactions such as trembling, sweating, faintness, rapid heartbeat, difficulty breathing or nausea
• avoidance behaviour, where a person goes to great lengths to avoid a situation they think could bring on anxiety or panic

Panic attacks#

A panic attack does not necessarily mean a person has an anxiety disorder, but it is a common feature of each type. Symptoms of a panic attack may include nausea, shortness of breath, dizziness, rapid heartbeat and a feeling of choking.

The cause of panic attacks is unknown, but they may be related to a chemical response in the brain triggered by threatening or stressful events, or even by thinking about stressful events. This brain response leads to physical changes in the body, such as shallow breathing and a rapid heartbeat.

Panic attacks can be frightening. Some people say they feel as though they are going to die or lose control. People affected by panic attacks may avoid situations where they think an attack might occur. In some cases this can lead to other anxiety disorders, including agoraphobia.

Types of anxiety disorders#

Generalised anxiety disorder#

Generalised anxiety is excessive anxiety and constant worry about many things. The focus might be family or friends, health, work, money or forgetting important appointments. A person may be diagnosed with generalised anxiety disorder when the worry has been present most days over a six-month period and they find it difficult to control their anxiety.

Social phobias#

People with social phobia are afraid of being negatively judged or evaluated by others. This leads to a fear of doing something that may humiliate them in public, such as public speaking, using public toilets, eating or drinking in public, writing in public, or social situations such as parties or workplaces. Some people fear only one type of situation, while others are concerned about several. Avoiding these situations can lead to severe isolation and to giving up people and activities they usually enjoy.

Specific phobias#

A person with a specific phobia has a persistent and irrational fear of a particular object or situation. They may fear animals, places or people, such as dogs, blood, storms or spiders. The fear can be so severe that the person experiences physical symptoms or panic attacks. In all cases the anxiety is both excessive and interfering. Adults with a phobia usually know that their fear is unreasonable, yet the need to avoid the object, place or person can significantly restrict their life.

Panic disorders#

Panic disorders are less common, affecting about 2% of the population. To be diagnosed with a panic disorder, a person would usually have had at least four panic attacks each month over an extended period. Panic attacks often come on spontaneously rather than in response to a specific situation. A panic disorder may be diagnosed when attacks are frequent and there is a strong, persistent fear of another attack occurring.

The effects of anxiety disorders#

An anxiety disorder may lead to social isolation and clinical depression, and can impair a person’s ability to work, study and carry out routine activities. It can also strain relationships with friends, family and colleagues.

It is common for depression and anxiety to occur at the same time. Depression can be a serious illness with a high risk of self-harm and suicide. Recovery from an anxiety disorder is possible with the right treatment and support.

Treatment#

Effective treatments for anxiety disorders may include:

• cognitive behavioural therapy, which aims to change patterns of thinking and behaviour that trigger anxiety
• exposure therapy, which gradually exposes a person to anxiety-provoking situations using a fear hierarchy (also called systematic desensitisation)
• anxiety management and relaxation techniques, such as deep muscle relaxation, meditation and breathing exercises
• medication, which may include antidepressants and benzodiazepines

Key points#

• Anxiety disorders are common mental health problems that affect many people.
• Not all anxiety is a disorder; anxiety becomes a disorder when it is excessive, irrational and interferes with daily life.
• Panic attacks are a common symptom across the different types of anxiety disorder.
• The main types include generalised anxiety disorder, social phobias, specific phobias and panic disorders.
• Recovery is possible with treatment, which may include therapy, relaxation techniques and medication.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).