Understanding Anxiety Disorders

Getting sweaty palms and “butterflies” in the stomach right before an important job interview, a big speech, a first date or any challenging situation is normal. Anxiety disorders, however, are medical illnesses that differ dramatically from normal feelings of nervousness. The symptoms of these disorders often occur without any warning and can actually interfere with one’s life.

Anxiety is the most common medical illness in the U.S., afflicting upwards of 20 million Americans. If left untreated, anxiety disorders can propel people to take extreme measures to avoid situations that may trigger or worsen their fears, such as refusing to leave the house. These illnesses generally respond well to treatment, and the majority of patients receiving treatment experience significant relief from their symptoms. Unfortunately, many people with anxiety disorders do not seek treatment because they either do not recognize their symptoms as a sign of illness or they fear the reactions of co-workers, family and friends. Symptoms of anxiety disorders can include: overwhelming feelings of panic and fear; uncontrollable obsessive thoughts; painful, intrusive memories, recurring nightmares; and uncomfortable physical reactions such as nausea, sweating or a pounding heart.


Generalized Anxiety Disorder is excessive anxiety or worry that interferes with daily functioning. Individuals with GAD worry constantly even if there is no apparent reason for doing so. Common concerns can be health, family, work or money. People suffering from GAD are unable to relax, are easily tired and irritable, have difficulty concentrating and may experience muscle tension, fatigue and headaches. Individuals with GAD may have other mental health difficulties such as depression, substance abuse or another anxiety disorder.


Post Traumatic Stress Disorder occurs in individuals who have survived a severe or terrifying ordeal or emotional event. People who suffer from PTSD keep experiencing the ordeal through recurrent nightmares or memories of the event, flashbacks, and extreme emotional and physical distress when exposed to situations that remind them of the event. A good example of PTSD is the reaction many people have had to the tragedy of September 11th.


Panic Disorder is an overwhelming fear of being in danger, resulting in a “panic attack.” During a panic attack, an individual may experience symptoms such as pounding heart or chest pain; sweating, trembling or shaking; shortness of breath; abdominal pain; dizziness; feeling unreal; fear of losing control or dying; numbness; and chills or hot flashes. Many people experiencing their first panic attack believe they are having a heart attack because it comes on so unexpectedly.


Specific Phobias are uncontrollable, irrational and persistent fears of specific objects, situations or activities. Individuals suffering from phobias will do everything they can to avoid the object or situation they fear, and this avoidance in turn significantly interferes with normal daily activities. Just thinking of fearsome situations can trigger anxiety. Some typical phobias include fear of heights, snakes or blood.


Social Phobias are characterized by fears of being in social situations or situations in which one is expected to perform in some way. The individual is anxious because he or she fears acting in a way that is embarrassing or humiliating, or being embarrassed by showing anxiety symptoms. Adults may respond to the anxiety by having panic attacks, while children may cry, tantrums or shrink from a situation, such as a birthday party. This phobia may develop after a childhood in which the person is very inhibited or shy, but may also develop in adulthood with no prior symptoms. People who are socially phobic may avoid promotions that require them to interact with more people, or may isolate themselves in a way that severely narrows their social support system.


Obsessive-Compulsive Disorder is a preoccupation with specific thoughts, images or impulses often resulting in repetitive rituals or behaviors to reduce the anxiety. For example, a preoccupation with dirt or germs is a common obsession and could result in excessive hand washing. Since compulsive behaviors can take up a great deal of time, they can disrupt normal daily routines and social relationships.

So, what causes anxiety disorders? It is often unclear what triggers them, but it has been found they can run in families, which suggests that genetics – possibly in combination with life experiences – make some people more susceptible than others. Brain chemistry also appears to play a role in their onset, as symptoms are often relieved by medications that alter levels of chemicals there. People who have low self-esteem and poor coping skills may also be prone to anxiety disorders.

Anxiety disorders respond well to medication and psychotherapy, and these treatments can be used alone or together. They won’t necessarily provide a “cure”, but they will relieve the symptoms of anxiety and educate one about better coping skills, enabling individuals to live healthier lives.

Cognitive-behavioral therapy (CBT) is extremely successful in addressing the symptoms of anxiety disorders. The behavioral part of CBT may use relaxation techniques and exposure to the feared object or situation in a carefully planned, gradual manner so the patient can learn to control the anxious responses. The cognitive portion of CBT helps patients understand their patterns of thinking so they can respond differently to situations causing them anxiety.

If you are experiencing some of the symptoms mentioned above, don’t hesitate to get help. Stop in your public library or a bookstore and look through the many books on dealing with anxiety. Or contact a cognitive-behavioral psychologist who has expertise in dealing with these disorders. You might be surprised at how quickly you experience relief. Anxiety disorders often respond to specific short term therapy and the skills you learn during treatment can provide you with coping techniques that can benefit you throughout your life.