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Anxiety Disorders

What is mental illness?

Mental illness is a general term for a group of brain disorders that can affect the way a person thinks, feels and acts. They also can affect the way a person relates to others, or to his or her environment. Although the symptoms of mental illness can vary from mild to severe, a person with mental illness often is unable to cope with life’s daily routines and demands.

What is an anxiety disorder?

Anxiety is a normal human emotion. Many people feel anxious, or nervous, when faced with a problem at work, or before taking a test or making an important decision. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person's ability to lead a normal life.

An anxiety disorder is a serious mental illness. People with anxiety disorders respond to certain things or situations with fear and dread, as well as physical signs of anxiety such as a pounding heart and sweating. For people with anxiety disorders, worry and fear are constant and overwhelming, and can be crippling. An anxiety disorder is diagnosed if the person’s response is not appropriate for the situation, if the person cannot control the response or if the anxiety interferes with normal functioning. Anxiety disorders can get worse if not treated; however, effective treatments are available.

What are the types of anxiety disorders?

There are several recognized anxiety disorders, including the following:

Panic disorder

People with this disorder have feelings of terror that strike suddenly and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain, palpitations (unpleasant sensations of irregular heartbeats) and a feeling of choking, which might make the person feel like he or she is having a heart attack or "going crazy."

Obsessive-compulsive disorder (OCD)

People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.

Post-traumatic stress disorder (PTSD)

PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.

Social anxiety disorder

Also called social phobia, social anxiety disorder involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule.

Specific phobias

A specific phobia is an intense fear of a specific object or situation, such as snakes, heights or flying. The level of fear usually is inappropriate to the situation and might cause the person to avoid common, everyday situations.

Generalized anxiety disorder

This disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.

What are the symptoms of an anxiety disorder?

Symptoms vary depending on the type of anxiety disorder, but general symptoms of anxiety include:

  • Feelings of panic, fear and uneasiness
  • Uncontrollable, obsessive thoughts
  • Repeated thoughts or flashbacks of traumatic experiences
  • Nightmares
  • Ritualistic behaviors, such as repeated hand washing
  • Problems sleeping
  • Cold or sweaty hands
  • Shortness of breath
  • Palpitations
  • An inability to be still and calm
  • Dry mouth
  • Numbness or tingling in the hands or feet
  • Nausea
  • Muscle tension

What causes anxiety disorders?

The exact cause of anxiety disorders is not known; but anxiety disorders—like other forms of mental illness—are not the result of personal weakness, a character flaw or poor upbringing. As scientists continue their research on mental illness, it is becoming clear that many of these disorders are caused by a combination of factors, including biology and environmental stresses.

Like certain illnesses, such as diabetes, anxiety disorders might be caused by chemical imbalances in the body. Studies have shown that severe or long-lasting stress can change the balance of chemicals in the brain that control mood. Studies also have shown that anxiety disorders run in families, which means that they can be inherited from one or both parents, like hair or eye color. In addition, certain environmental factors—such as a trauma or significant event—might trigger an anxiety disorder in people who have an inherited susceptibility to developing the disorder.

How common are anxiety disorders?

Anxiety disorders affect about 19 million adult Americans. Most anxiety disorders begin in childhood, adolescence and early adulthood. They occur slightly more often in women than in men, and occur with equal frequency in Caucasians, African Americans and Hispanics.

How are anxiety disorders diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination.

Although there are no laboratory tests to specifically diagnose anxiety disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If no physical illness is found, the person might be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an anxiety disorder. The doctor bases his or her diagnosis on the patient’s report of the intensity and duration of symptoms—including any problems with daily functioning caused by the symptoms—and the doctor’s observation of the patient’s attitude and behavior. The doctor then determines if the patient’s symptoms and degree of dysfunction indicate a specific anxiety disorder. The standard reference manual used for the diagnosis of recognized mental illnesses in the United States is the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association.

How are anxiety disorders treated?

Anxiety disorders are real disorders that require treatment. Recovery is not simply a matter of will and self-discipline. Fortunately, much progress has been made in the last two decades in the treatment of people with mental illnesses. Although the exact treatment approach depends on the type of disorder, one or a combination of the following therapies might be used for most anxiety disorders:

Medication

Medicines used to reduce the symptoms of anxiety disorders include antidepressants and anxiety-reducing medications.

Psychotherapy

Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.

Cognitive-behavioral therapy

People suffering from anxiety disorders often participate in this type of therapy in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.

What is the outlook for people with anxiety disorders?

Early diagnosis and treatment can limit the problems caused by an anxiety disorder and improve the outlook. Unfortunately, many anxiety disorders are not recognized and, as a result, not treated.

Can anxiety disorders be prevented?

Anxiety disorders cannot be prevented; however, there are some things you can do to control or decrease symptoms:

  • Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola and chocolate.
  • Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
  • Exercise daily and eat a healthy, balanced diet.
  • Seek counseling and support after a traumatic or disturbing experience.

© Copyright 2013 Cleveland Clinic. All rights reserved.

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/1/2009…#9536