What is anxiety?
Anxiety is a term which describes a normal feeling people experience when faced with threat or danger, or when stressed.
When people become anxious, they typically feel upset, uncomfortable and tense.
Feelings of anxiety are caused by experiences of life, such as job loss, relationship breakdown, serious illness, major accident or the death of someone close. Feeling anxious is appropriate in these situations and usually we feel anxious for only a limited time. These feelings are not regarded as clinical anxiety, but are a part of everyday life.
What are the anxiety disorders?
The anxiety disorders are a group of illnesses, each characterised by persistent feelings of high anxiety. There are feelings of continual or extreme discomfort and tension, with the fear of panic attacks, usually without discernible cause.
People are likely to be diagnosed with an anxiety disorder when their level of anxiety and feelings of panic are so extreme that they significantly interfere with daily life and stop them doing what they want to do. This is what characterises an anxiety disorder as more than normal feelings of anxiety.
Anxiety disorders affect the way the person thinks, feels and behaves and, if not treated, cause considerable suffering and distress.
They often begin in early adulthood and are often triggered by a series of significant life events.
Anxiety disorders are common and affect one in 20 people at any given time.
What are the main types of anxiety disorders?
Most types of anxiety disorder are characterised by heightened anxiety and fear of panic. Obsessive compulsive disorder and post-traumatic stress disorder are considered types of anxiety disorder, as both feature high levels of anxiety, which people try to control.
Generalized anxiety disorder
People with this disorder worry constantly about harm affecting themselves or loved ones, for example, financial disaster, their health, work or personal relationships.
The irrational worry is accompanied by a feeling of constant apprehension.
Agoraphobia is a fear of being in places or situations from which it may be difficult or embarrassing to get away, or the fear that help might be unavailable if needed.
Agoraphobia is the most common anxiety disorder and constitutes about half those with anxiety disorders who seek professional help.
People with agoraphobia most commonly experience fear in a cluster of situations: in supermarkets and department stores, crowded places of all kinds, confined spaces, public transport, lifts, freeways and heights.
People experiencing agoraphobia may find comfort in the company of a safe person or object. This may be a spouse, friend, pet or medicine carried with them.
We do not understand why, but the onset of agoraphobia is common between the ages of 15 and 20, or between 30 and 40. Many more women than men seek treatment.
Panic disorder (with or without agoraphobia)
People with this disorder experience extreme panic attacks in situations where most people would not be afraid.
The attacks are accompanied by all the unpleasant physical symptoms of anxiety, with a fear that the attack will lead to death or a total loss of control.
It is because of this that some people start to experience a fear of going outside (agoraphobia) and being in places where help is not at hand.
Everyone has some irrational fears, but phobias are intense fears about particular objects or situations which interfere in our lives. These might include fear of heights, water, dogs, closed spaces, snakes or spiders.
Someone with a specific phobia is fine when the feared object is not present. However, when faced with the feared object or situation, the person can become highly anxious and experience a panic attack.
People affected by phobias can go to great lengths to avoid situations which would force them to confront the object or situation which they fear.
People with social phobia fear that others will judge everything they do in a negative way. They believe they are permanently flawed and worthless if any sign of poor performance is detected.
They cope by either trying to do everything perfectly, limiting what they do in front of others, especially eating, drinking, speaking or writing, or they withdraw gradually from contact with others.
Obsessive compulsive disorder
This disorder involves constant unwanted thoughts, and often results in the performance of elaborate rituals in an attempt to control or banish the persistent thoughts.
The rituals are usually time consuming and seriously interfere with everyday life. For example, people may be constantly driven to wash their hands or continually return home to check that the door is locked or the oven is turned off.
People with this disorder are often acutely embarrassed and keep it a secret, even from their families.
Post-traumatic stress disorder
Many people who have experienced major traumas such as war, torture, vehicle accidents, fires or personal violence continue to feel terror long after the event is over.
They may experience nightmares or flashbacks for years. The flashbacks are often brought about by triggers related to the experience, but not necessarily central to it.
What causes anxiety disorders?
The causes of each disorder may vary and it is not always easy to determine the causes in every case.
People with certain characteristics are more prone to anxiety disorders.
Those who are easily aroused and upset, and are very sensitive and emotional, are more likely to develop anxiety disorders.
People who, in childhood, were inhibited and shy may also be prone to develop certain anxiety disorders, such as social phobia.
Some people exposed to situations, people or objects that are upsetting or anxiety-arousing may develop an anxiety response when faced with the same situation, person, or object again, or become anxious when thinking about the situation, person, or object.
The tendency to develop anxiety disorders may run in families or a person may also ‘learn’ anxious responses from their family or parents.
Although there is no clear evidence, it is possible that some anxiety disorders result from chemical processes in the brain.
In all cases, there is a need for a thorough examination of the person to help determine the nature of the problem and how it may best be treated.
What treatment is available?
Anxiety disorders, if they are not managed, continue to interfere significantly with the person’s thinking and behaviour, causing considerable suffering and distress.
Many professionals such as your general practitioner, psychologists, social workers or counsellors can assist in the treatment of anxiety disorders.
Treatment will often include education and counselling, to help the person understand their thoughts, emotions and behaviour.
People develop new ways of thinking about their anxiety and how to deal more effectively with feelings of anxiety.
Medication is sometimes used to help the person control their high anxiety levels, panic attacks or depression.
The benzodiazepines (e.g. diazapam and valium), are used for the temporary relief of anxiety, but care has to be taken as these medications may cause dependence. Anti-depressants play an important role in the treatment of any associated or underlying depression. Contrary to common belief, anti-depressants are not addictive.
Where to go for help
- Your general practitioner.
- Your community health centre.
- Your community mental health centre.