Anxiety Disorders Explained: Causes, Symptoms, and Effective Treatments
Anxiety is a feeling of nervousness, worry, or unease that is part of the normal human experience. It is also present in many mental health conditions, including generalized anxiety disorder, panic disorder, and phobias. Although each of these disorders is different, they are all characterized by distress and dysfunction specifically related to anxiety and fear.
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When people experience anxiety, they often also experience physical symptoms, including shortness of breath, dizziness, sweating, rapid heart rate, and/or trembling.
Anxiety disorders often significantly impair the behavior of those affected in their daily lives, including forcing them to avoid certain activities and situations.
These disorders are diagnosed using standard medical criteria.
Medication and/or psychotherapy can significantly help most people with anxiety disorders.
⚠️ When Does Normal Anxiety Become a Disorder?
Anxiety is a normal response to psychological threat or stress. Normal anxiety is rooted in fear and is an important survival function. When a person faces a dangerous situation, anxiety triggers a fight-or-flight response.
A range of physiological changes are associated with this response, such as increased blood flow to the heart and muscles to provide the energy and strength the body needs to cope with the dangerous situation, such as fleeing from an aggressive animal or fighting off an attacker.
Anxiety can help a person adapt to more ordinary stressors by prompting them to prepare, practice, and rehearse. It can even prompt a person to approach potentially dangerous situations with appropriate caution. However, anxiety is considered a disorder when it:
✔️ Persists for six months or more;
✔️ Occurs without a real or proportional threat;
✔️ Interferes with daily life, work, or relationships;
✔️ Causes significant distress or emotional suffering;
✔️ Leads to avoidance of normal activities or situations;
✔️ Manifests with physical, emotional, behavioral, or cognitive symptoms;
✔️ Reduces overall quality of life;
Occurs at inappropriate times;
Occurs frequently.
🧠 Understanding Anxiety Disorders: Prevalence and Types
Anxiety disorders are more common than any other category of mental health disorder, affecting approximately one-third of adults in the United States at some point in their lives.
📊 Prevalence of Anxiety Disorders in the U.S.
Acute anxiety can persist for years and eventually seem normal to the anxious person. For this and other reasons, anxiety disorders often go undiagnosed or untreated. They can also be associated with suicidal thoughts and suicide attempts. There are many anxiety disorders:
✔️ Generalized Anxiety Disorder (GAD);
✔️ Panic Disorder;
✔️ Social Anxiety Disorder (Social Phobia);
✔️ Specific Phobias;.
✔️ Separation Anxiety Disorder;
✔️ Agoraphobia;.
✔️ Selective Mutism;
✔️ Substance/Medication-Induced Anxiety Disorder;
✔️ Anxiety due to another medical condition;
✔️ Other Specified or Unspecified Anxiety Disorders.
Most of these disorders develop in adulthood, but separation anxiety and selective mutism typically begin in childhood. Doctors also screen people with severe anxiety for substance-induced anxiety disorder and anxiety due to another medical condition.
Other disorders that often present with significant anxiety include acute stress disorder, adjustment disorders, and post-traumatic stress disorder (PTSD). These disorders are caused by traumatic or stressful experiences. Anxiety disorders tend to occur in conjunction with other medical and mental health conditions:
💡 Mental Health Conditions:
✔️ Depression;
✔️ Bipolar disorder;
✔️ Post-traumatic stress disorder (PTSD);
✔️ Obsessive-compulsive disorder (OCD).
🏥 Medical Conditions:
✔️ Heart disease;
✔️ Diabetes;
✔️ Chronic pain;
✔️ Respiratory disorders (e.g., asthma);
✔️ Thyroid problems;
⚠️ Substance-Related Issues:
✔️ Alcohol or drug abuse;
✔️ Medication side effects;
✔️ Caffeine or stimulant overuse;
📈 How Anxiety Affects Performance
The effects of anxiety on performance can be represented by a curve. As anxiety levels increase, performance increases proportionally, but only up to a certain point. If anxiety increases beyond this point, performance decreases.
Before the peak of the curve, anxiety is considered adaptive because it helps the person prepare for a crisis and improves their performance. After the peak of the curve, anxiety is considered maladaptive because it causes distress and impairs performance.
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🧠 Causes of Anxiety Disorders
The causes of anxiety disorders are not fully understood, but the following factors may be involved:
🧬 Genetics and family history
✔️ Having close relatives with anxiety or other mental health disorders increases risk;
⚡ Brain chemistry and neurotransmitter imbalances
✔️ Dysregulation of serotonin
Dopamine, or
GABA can contribute to anxiety;
🩹 Trauma or stressful life events
✔️ Childhood abuse
Accidents, or loss of a loved one can trigger anxiety disorders;
🌱 Personality traits
✔️ Traits like high neuroticism
Perfectionism
Low resilience make one more vulnerable;
💊 Chronic medical conditions
✔️ Heart disease
Thyroid problems
Or chronic pain can exacerbate anxiety;
🍷 Substance abuse or withdrawal
✔️ Alcohol
Caffeine
Nicotine
Or drugs may worsen symptoms;
🏙️ Environmental factors
✔️ Work pressure
Social stress
Or unstable living conditions can increase anxiety risk;
👶 Learned behaviors from childhood experiences
✔️ Modeling anxious behaviors from parents or caregivers may contribute to anxiety disorders.
An anxiety disorder can be triggered by environmental stresses such as the breakup of a significant relationship or exposure to a life-threatening disaster. However, many people develop an anxiety disorder in the absence of any identifiable trigger.
When a person reacts strongly to stressors or becomes overwhelmed by events, an anxiety disorder can develop. For example, some people find speaking in front of a group exhilarating. But others dread it, becoming anxious and experiencing symptoms such as sweating, fear, rapid heartbeat, or trembling. Some people may avoid speaking, even in front of a small group.
>>> Anxiety often runs in families. According to doctors, this tendency may be partly hereditary, but partly probably acquired by living with anxious people. So, did you know that anxiety disorder is the most common type of mental disorder? A person with an anxiety disorder has a greater risk of depression than another. <<<
🧬 Anxiety caused by a medical condition or medication
Anxiety can be caused by a medical condition, or taking or stopping (withdrawing) medication. Medical conditions that can cause anxiety include:
⚕️ Anxiety linked to medical conditions;
✔️ Heart disease;
✔️ Diabetes;
✔️ Thyroid problems (hyperthyroidism or hypothyroidism);
✔️ Respiratory disorders such as asthma or COPD;
✔️ Chronic pain conditions;
💊 Anxiety related to medication use or withdrawal;
✔️ Certain prescription drugs (steroids, stimulants, etc.);
✔️ Caffeine, nicotine, or alcohol withdrawal;
✔️ Recreational drug use or withdrawal.
It is normal for people to experience some degree of anxiety when they have a medical condition that they fear will impact their health or cause their death. There is no right answer to the question of how much anxiety is reasonable or excessive for a given person or condition.
However, if it causes distress or interferes with daily functioning, the person may have an anxiety disorder that requires treatment. Even fever can cause anxiety. Drugs, medications, and other substances that can trigger anxiety include:
✔️ Alcohol
✔️ Stimulants ( e.g. amphetamines )
✔️ Caffeine
✔️ Cannabis (marijuana) in some people
✔️ Cocaine
✔️ MDMA (ecstasy)
✔️ Many prescription medications, such as corticosteroids
✔️ Certain over-the-counter medications, such as antihistamines and decongestants
✔️ Some over-the-counter weight-loss products, such as those containing guarana (a herbal product), caffeine, or both.
Withdrawal from alcohol or sedatives, such as benzodiazepines (used to treat anxiety disorders), can cause anxiety as well as other symptoms, such as insomnia or agitation. Factors that have caused or worsened fear and anxiety include the risk of illness or death, symptoms such as shortness of breath, treatment with corticosteroids, illness or death of a loved one, the need for preventive measures, and many other personal or social factors.
Symptoms of Anxiety Disorders
Anxiety can occur suddenly, as in a panic attack, or gradually over minutes, hours, or days. The duration of anxiety can vary from a few seconds to years. The intensity of the disorder can range from a barely perceptible feeling of apprehension to a full-blown panic attack that can cause shortness of breath, dizziness, rapid heartbeat, and trembling. Anxiety disorders can cause many physical symptoms, including:
✔️ Rapid heartbeat or palpitations;
✔️ Shortness of breath or hyperventilation;
✔️ Muscle tension, trembling, or shaking;
✔️ Excessive sweating;
✔️ Nausea, dizziness, or stomach discomfort;
✔️ Fatigue or difficulty sleeping;
✔️ Chills, hot flashes, or tingling sensations;
It may be helpful for the individual to keep a detailed diary of their panic or worry episodes, recording descriptions of symptoms and associated factors (day, time, known causes of anxiety). It can be difficult to remember details to report to the doctor after the fact. The most effective treatment strategies often depend on the specific details.
An anxiety disorder can cause so much distress and disrupt a person's life that it can lead to depression. People with an anxiety disorder have at least twice the risk of depression as others. Sometimes people experience depression first and then develop an anxiety disorder later. People may try to treat their anxiety by using alcohol or drugs, and develop a substance use disorder.
Diagnosis of anxiety disorders
Deciding when anxiety is severe enough to be considered a disorder can be complicated. Individuals vary in their ability to tolerate anxiety, and it can be difficult to determine what constitutes abnormal anxiety. Doctors generally use the following established criteria:
✔️ Anxiety is a source of great suffering.
✔️ Anxiety interferes with a person's functioning.
✔️ Anxiety is long-lasting or recurring.
Doctors look for other conditions that may be causing anxiety, such as depression or sleep disturbances. Doctors also ask if any family members have had similar symptoms, as anxiety disorders tend to run in families. Doctors perform a physical examination. They may perform blood tests or other tests to check for other medical conditions that may be causing anxiety.
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Treatment of anxiety disorders
✔️ Psychotherapy, especially Cognitive Behavioral Therapy (CBT);
✔️ Medication, such as antidepressants or anxiolytics when needed;
✔️ Relaxation techniques, including breathing exercises and meditation;
✔️ Lifestyle changes like exercise, healthy diet, and quality sleep;
✔️ Stress management strategies and coping skills training;
✔️ Support groups or counseling for emotional support.
An accurate diagnosis is important because treatment varies depending on the anxiety disorder. It is also important to distinguish anxiety disorders from the anxiety seen in many other mental illnesses, which require different treatment approaches. If the cause of anxiety is another condition or a medication, doctors try to correct the cause.
Anxiety should improve after the physical condition is treated or when the offending medication has been stopped long enough for withdrawal symptoms to subside. If it persists, anti-anxiety medications or psychotherapy (such as behavioral therapy) are used.
Many people with anxiety disorders self-medicate with substances such as alcohol, marijuana, and benzodiazepines (anxiolytics). Not only may they be embarrassed to admit this to their doctor, but they may also be reluctant to give up these substances until their doctor offers a viable alternative. Self-medicating in this way is dangerous and can lead to a vicious cycle of recurring anxiety after use, followed by an urgent need to self-medicate again and again.
If an anxiety disorder is diagnosed, medication or psychotherapy (such as behavioral therapy), alone or in combination, can significantly alleviate the suffering and dysfunction of most people. Different types of psychotherapy can be used, such as cognitive behavioral therapy, mindfulness-based stress reduction, hypnosis, and supportive psychotherapy.
Benzodiazepines (such as diazepam) are frequently prescribed. For many, antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are as effective for anxiety disorders as they are for depression.
📝 Conclusion: Managing Anxiety with the Right Support
All anxiety disorders can co-occur with other mental health conditions. Physicians must treat all anxiety-related conditions. For example, anxiety disorders often co-occur with alcohol use disorder. Treating alcohol use disorder without treating anxiety is unlikely to be effective since the person may be using alcohol to reduce their anxiety.
On the other hand, treating anxiety without addressing the alcohol use disorder may be ineffective because daily changes in the amount of alcohol in the blood can cause anxiety levels to fluctuate.
👉 Take the first step toward peace of mind today. At Everts Psychiatry & Family Medicine in Duncanville, TX, we are here to help you manage anxiety with personalized treatment and compassionate care.
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