Anxiety disorders are among the most common mental health conditions. According to the National Institute of Mental Health, over 19% of U.S. adults experience anxiety each year. The good news is that anxiety is highly treatable. With the right treatment plan, most people can achieve significant relief from anxiety symptoms and regain control over their lives.
What are the most common types of anxiety disorders?
There are several different types of anxiety disorders. Some of the most common include:
- Generalized anxiety disorder (GAD): Excessive worry about everyday events and activities.
- Social anxiety disorder: Intense fear about social situations and interactions.
- Panic disorder: Sudden recurring panic attacks followed by ongoing worry about future attacks.
- Phobias: Extreme fear about specific objects or situations.
- Obsessive-compulsive disorder (OCD): Intrusive thoughts and compulsive behaviors.
- Post-traumatic stress disorder (PTSD): Anxiety stemming from a traumatic event.
While the specific symptoms vary, all anxiety disorders share features of excessive fear, anxiety, and related behavioral disturbances. Anxiety can also co-occur with other mental health conditions like depression.
What causes anxiety disorders?
Anxiety disorders have no single cause. Multiple factors contribute to their development, including:
- Genetics: Anxiety disorders run in families. You may inherit a predisposition from parents or other relatives.
- Brain chemistry: An imbalance in neurotransmitters like serotonin or dopamine could make anxiety more likely.
- Trauma: Stressful events, especially in childhood, can alter the brain’s stress response.
- Substance abuse: Chronic alcohol or drug abuse can increase anxiety symptoms.
- Medical conditions: Certain illnesses, like hyperthyroidism, may trigger anxiety.
- Environment: Factors like poverty, discrimination, or trauma can raise anxiety risk.
For any individual, it’s usually a combination of genetic, biological, environmental, and psychological factors that contribute to anxiety disorder development.
When does normal anxiety become a disorder?
It’s completely normal to feel anxious occasionally. Most people get nervous in situations like public speaking, first dates, job interviews, or important exams. This normal anxiety helps motivate us and focus our attention.
However, anxiety crosses the line and becomes a potential disorder when:
- It’s out of proportion to the situation or unrealistic.
- It’s excessive and uncontrollable.
- It interferes significantly with normal life and daily activities.
- It causes intense physical and emotional distress.
- It persists for six months or longer.
If anxiety is preventing you from doing things you’d normally do or want to do, it’s probably becoming problematic. Consider talking to your doctor or a mental health professional.
What are some common anxiety disorder symptoms?
Though each anxiety disorder has its own specific symptoms, many share similar manifestations. Common symptoms include:
- Excessive fear and worry: About everyday situations, events, problems, or even minor things.
- Restlessness: Feeling keyed up, on edge, or unable to relax and sit still.
- Fatigue: Feeling tired, weary, or lacking energy from chronic stress and worry.
- Irritability: Feeling impatient, having a “short fuse,” snapping at minor annoyances.
- Muscle tension: Stiff, tense muscles; headaches and body aches.
- Sleep problems: Difficulty falling or staying asleep; poor sleep quality.
- Concentration issues: Trouble focusing; mind going blank.
- Panic attacks: Sudden episodes of intense fear with physical symptoms like a racing heart, dizziness, nausea, sweating, shaking, etc.
Anxiety can also cause other mental and physical symptoms like stomachaches, vomiting, and depression. Symptoms vary between anxiety disorders.
How do doctors diagnose anxiety disorders?
If you suspect you may have an anxiety disorder, the first step is to talk to your primary care doctor or a mental health professional. They will ask about your symptoms and medical history. Tell them how long symptoms have lasted, their severity, and how much distress they cause.
There are no lab tests to diagnose anxiety disorders. Instead, doctors rely on:
- Physical exam: To check for illness causing anxiety.
- Psychiatric evaluation: Discussion of thoughts, feelings, symptoms.
- Questionnaires: Like generalized anxiety disorder (GAD-7) screening tools.
- Criteria in the DSM: The Diagnostic and Statistical Manual of Mental Disorders lists criteria for diagnosing different anxiety disorders.
Based on your symptoms, physical exam, psychiatric history, and screening scores, the doctor will determine if you meet the diagnostic criteria for an anxiety disorder.
What are some medical conditions that can mimic anxiety?
Several medical conditions can produce physical symptoms similar to anxiety. Always see a doctor for a full evaluation, because medications and treatments for these physical illnesses are very different from anxiety treatment.
Some examples of medical mimics of anxiety include:
- Hyperthyroidism
- Hypoglycemia
- Mitral valve prolapse
- Pheochromocytoma
- Seizure disorders
- Asthma
- Chronic obstructive pulmonary disease (COPD)
Testing like bloodwork, imaging scans, EEGs, etc. can help determine if your anxiety is due to an underlying medical issue requiring specific treatment.
What are some home remedies and lifestyle changes that help with anxiety?
While professional treatment is ideal for anxiety disorders, some lifestyle tweaks and home remedies can also help manage symptoms. These include:
- Cutting back on caffeine
- Quitting smoking and avoiding nicotine and tobacco
- Exercising regularly
- Getting enough good quality sleep
- Practicing relaxation techniques like yoga, deep breathing, and meditation
- Spending time outdoors and with supportive loved ones
- Following a healthy diet and staying hydrated
- Avoiding alcohol and recreational drugs
- Keeping a consistent daily routine
While not cures, these lifestyle measures can help reduce anxiety vulnerability and control symptoms.
What medications are used to treat anxiety?
Several types of medications may be used to treat anxiety disorders:
- SSRIs: Selective serotonin reuptake inhibitors like escitalopram (Lexapro) and sertraline (Zoloft) are commonly prescribed. They boost serotonin brain levels.
- SNRIs: Serotonin-norepinephrine reuptake inhibitors like duloxetine (Cymbalta) and venlafaxine (Effexor) target both serotonin and norepinephrine.
- Benzodiazepines: Drugs like alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) work fast but can cause dependence.
- Beta blockers: Beta blockers like propranolol help control physical anxiety symptoms.
- Tricyclic antidepressants: Older drugs like imipramine (Tofranil) may sometimes be used.
Medications can take 4-6 weeks to become fully effective. Doctors often have patients try SSRIs first since they tend to have fewer side effects than other drug classes. Some patients may need a combination of medications.
What are the side effects of anti-anxiety medications?
Common side effects of medications used for anxiety include:
- Drowsiness or fatigue
- Dizziness
- Headaches
- Nausea, diarrhea, or upset stomach
- Dry mouth
- Appetite changes and weight gain or loss
- Sexual side effects like reduced libido and erectile dysfunction
- Insomnia or vivid dreams
Side effects are usually worst when first starting a new medication. They often improve over time. Talk to your doctor about any intolerable side effects.
Are medications the only treatment option for anxiety?
No, medications are just one component of anxiety treatment. Effective treatment also utilizes psychotherapy techniques like:
- Cognitive behavioral therapy (CBT): Helps identify and change negative thought patterns that fuel anxiety.
- Exposure therapy: Gradually exposes you to feared situations or objects in a controlled, safe way to conquer phobias and fears.
- Acceptance and commitment therapy (ACT): Focuses on accepting emotions and committing to value-based actions.
- Interpersonal therapy: Improves interpersonal skills and relationships.
- Mindfulness-based therapies: Teach meditation, yoga, mindfulness to manage anxiety.
Therapy provides long-term coping skills. Medications treat symptoms short-term. Using both together is often the most effective strategy.
Can natural supplements and herbs help with anxiety?
Some supplements may modestly reduce anxiety, especially when combined with other treatments. Options to discuss with your doctor include:
- Omega-3 fatty acids: Found in fish oil, these healthy fats reduce inflammation.
- L-theanine: An amino acid found in green tea that promotes calmness.
- Valerian: An herb used for centuries as a sedative.
- Chamomile: A traditional herb that may reduce anxiety.
- Probiotics: May improve gut-brain connection and serotonin levels.
- Magnesium: Helps regulate the stress hormone cortisol.
While generally safe, always talk to your doctor before trying new supplements, especially if you take any medications.
How can you tell if your anxiety treatment is working?
Give any new anxiety treatment 6-12 weeks to take full effect. Along the way, you should notice:
- Decreased anxiety symptoms
- Less frequent worrying or panic attacks
- Improved sleep
- Feeling calmer overall
- More energy and concentration
- Better able to confront fears and handle triggers
- Less disruption to work, school, or relationships
Track your symptoms using a scale from 1-10. This allows you to monitor progress. If after 12 weeks there is no improvement, talk to your doctor about adjusting treatment.
How long does anxiety treatment last?
Treatment duration varies:
- Medications are usually continued for at least 12 months. They may be used longer-term in some cases.
- Therapy often lasts around 12-20 sessions over 3-6 months. More sessions may help ingrain new coping skills.
- Lifestyle changes should become lifelong habits.
Ideally, by the end of treatment you will have new tools to manage anxiety. But anxiety can return even after successful treatment. Ongoing self-care, therapy tune-ups, support groups, or medications may help prevent relapse.
Is anxiety curable?
There is no instant “cure” for anxiety disorders. They tend to be chronic conditions that require ongoing management. However, they are very treatable. With professional help, most people can reach remission from their anxiety disorder.
This means your anxiety symptoms are reduced to a manageable, minimal level. You can function normally and fully participate in life again. Periodic care may be needed to maintain remission and prevent relapse.
Can anxiety disorders get worse over time without treatment?
Generally, yes. Without treatment, anxiety disorders tend to worsen over time. This happens because:
- Symptoms can spiral as anxiety builds upon itself.
- Avoidance and unhealthy coping behaviors become entrenched.
- Panic attacks may increase in frequency or severity.
- Depression, substance abuse, and suicide risk increase.
- Relationships, school/work, and health decline.
Anxiety becomes more difficult to overcome the longer it persists. Early intervention with professional treatment provides the best results long-term.
Will I need anxiety treatment for the rest of my life?
Not necessarily. Again, there is no instant cure. But with consistent treatment and hard work, many people fully recover from anxiety disorders. For example, one study found that after 10 years:
- 74% of people with generalized anxiety disorder achieved full remission
- 70% with panic disorder achieved full remission
- 61% with social anxiety achieved full remission
Remission means anxiety is no longer significantly disrupting your life. Symptoms may occasionally recur but can be managed with self-care. Lifelong treatment is not always required.
Can anxiety ultimately be a good thing?
Ironically, properly managed anxiety can sometimes lead to positive outcomes. Handled constructively, anxiety can:
- Motivate you to make positive changes
- Inspire you to help others facing similar struggles
- Make you more compassionate and sensitive to suffering
- Prompt inner reflection about life’s purpose and meaning
- Help you prioritize health, family, and enjoyment
While painful in the moment, adversity sometimes allows room for personal growth. Your experience with anxiety may similarly open your eyes to what matters most.
Conclusion
Anxiety disorders are challenging, but far from hopeless. With professional treatment incorporating medications, therapy, lifestyle changes, and self-care, the vast majority of anxiety sufferers get significant symptom relief and regain quality of life. While not cured, they learn to successfully manage lingering anxiety. With time, dedication, and support, recovery is absolutely possible.