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Anxiety Disorders

Intense apprehension that may or may not have an obvious cause

  • Some types more common in females
  • Some types run in families
  • Stress is a risk factor
  • Age as a risk factor depends on the type

Temporary feelings of nervousness or worry in stressful situations are natural and appropriate. However, when anxiety becomes a general response to many ordinary situations and causes problems in coping with normal everyday life, it is considered a disorder.

Anxiety disorders occur in a number of different forms. The most common is generalized anxiety disorder, characterized by excessive, persistent anxiety that is difficult to control. Another type of anxiety disorder is panic disorder, in which there are recurrent panic attacks of intense anxiety and alarming physical symptoms. These attacks occur unpredictably, usually have no obvious cause, and generate fear of further attacks. Panic attacks may also feature in generalized anxiety disorder. In another type of anxiety disorder known as phobia, severe anxiety is provoked by an irrational fear of a situation, activity, creature, or object (see Phobias).

Generalized anxiety disorder affects about 2–4 per cent of people every year in the UK. The condition usually begins in early adulthood and affects more women than men. Sometimes, anxiety disorders exist alongside other mental health disorders, such as depression or schizophrenia.

What are the causes?

An increased susceptibility to anxiety disorders may be inherited or may be due to experiences in childhood. For example, poor bonding between a parent and child and abrupt separation of a child from a parent have been shown to play a part in some anxiety disorders. Generalized anxiety disorder may develop after a stressful life event, such as the death of a close relative. However, frequently the anxiety has no identifiable cause. Similarly, panic disorder often develops for no obvious reason.

What are the symptoms?

People with generalized anxiety disorder and panic disorder experience both physical and psychological symptoms. However, in generalized anxiety disorder, the psychological symptoms tend to be persistent while physical symptoms are intermittent. During panic attacks, psychological and physical symptoms develop together suddenly and unpredictably. The psychological symptoms of generalized anxiety disorder include:

  • A sense of foreboding with no obvious reason or cause.

  • Being on edge and unable to relax.

  • Impaired concentration.

  • Repetitive worrying thoughts.

  • Disturbed sleep (see Insomnia) and, sometimes, nightmares.

In addition, you may have symptoms of depression, such as early waking or a general sense of hopelessness. Physical symptoms of the disorder, which occur intermittently, include:

  • Headache.

  • Abdominal cramps, sometimes with diarrhoea, and vomiting.

  • Frequent passing of urine.

  • Sweating, flushing, and tremor.

  • A feeling of something being stuck in the throat.

Psychological and physical symptoms of panic attacks include the following:

  • Shortness of breath.

  • Sweating, trembling, and nausea.

  • Palpitations (awareness of an abnormally rapid heartbeat).

  • Dizziness and fainting.

  • Fear of choking or that death may be imminent.

  • A sense of unreality and fears about loss of sanity.

Many of these symptoms can be misinterpreted as signs of a serious physical illness, and this may increase your level of anxiety. Over time, fear of having a panic attack in public may lead you to avoid situations such as eating out in restaurants or being in crowds.

What might be done?

You may be able to reduce your anxiety levels yourself using methods such as relaxation exercises. If you are unable to deal with or identify a specific cause for your anxiety, you should consult your doctor. It is important to see a doctor as soon as possible after a first panic attack to prevent repeated attacks developing. There are several measures you can try to help to control a panic attack, such as breathing into a bag (see Coping with a panic attack). For any anxiety disorder, your doctor may suggest counselling to help you to manage stress. You may also be offered cognitive–behavioural therapy or behaviour therapy to help you to control anxiety. You may also be prescribed antidepressant drugs, some of which are useful in relieving the symptoms of anxiety and panic attacks whether or not depression is also present. A self-help group may be useful.

If you are under particular stress, your doctor may prescribe a benzodiazepine drug (see Antianxiety drugs), but these drugs are usually prescribed for only a short time because of the danger of dependence. You may be prescribed beta-blocker drugs to treat the physical symptoms of anxiety.

In most cases, the earlier anxiety disorders are treated, the quicker their effects can be reduced. Without treatment, an anxiety disorder may develop into a lifelong condition.

Self-help: Coping with a Panic Attack

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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