Anxiety Disorders

Anxiety Disorders

By Amanda Shaw (New York, NY)

Anxiety is a natural human instinct meant to protect you from perceived danger or threats of imminent danger. The body activates its fight-or-flight response when facing a stressful situation, often including sweaty palms, nausea, trembling, and accelerated breathing and heart rate.

While these physical sensations, caused by a release of adrenaline and other chemicals in the body, occur immediately, the mental response is delayed by a few seconds as the brain assesses the situation. For example, if the brain determines the perceived threat to be illegitimate, the fight-or-flight response is deactivated, and the nervous system relaxes. However, if the threat is recognized as real, both the physical and mental anxiety symptoms may persist.

Although everyone does experience anxiety at one time or another, intensity and duration vary from person to person, typically depending upon individual experiences and the situation at hand. Mild anxiety often incurs a sense of nervousness and restlessness, while more intense forms of anxiety can cause feelings of dread, pending danger, or panic.

Occasional anxiety and nervousness in unfamiliar or challenging situations, such as meeting new people or speaking in front of a large crowd, are normal. However, such circumstances present a perceived threat to one’s emotional well-being rather than physical safety.

Thus, anxiety and stress are fairly expected in the average person’s life, although it is important to distinguish between the two. Stress is a direct response to a perceived threat, whereas anxiety is a stress reaction. Both are natural reactions to an important presentation, an exam, a date, a job interview, etc. “Normal” anxiety may even lead to better performance, although in excessive amounts, it can lead to an overload of the senses, resulting in fumbled words or stage fright.

When anxiety becomes all-consuming, however, one might experience difficulty focusing on anything else. Excessive time spent worrying, difficulty sleeping, or other prolonged physical symptoms of anxiety may indicate an anxiety disorder.

Anxiety Disorders

Anxiety disorders are characterized by a prolonged and/or worsening state of worry, which may no longer be classified as temporary fear stemming from specific circumstances (an exam, a new job, a big decision, etc.). Anxiety disorders may arise suddenly or may develop gradually. Oftentimes, a person suffering from an anxiety disorder is unable to identify the cause of their stress.

Anxiety disorders affect individuals of all ages. In fact, 18% of adults and 8% of children and teenagers in the U.S. experienced an anxiety disorder in any given year.^[1] Globally, 1 in every 13 people suffers from an anxiety disorder, according to the World Health Organization.

While there are several different anxiety disorders, each is marked by intense and excessive fear, dread, nervousness, or worry. In many cases, an anxiety disorder may grow to overwhelming proportions and may interfere with a person’s daily quality of life.

In short, an anxiety disorder is defined as a somewhat debilitating state of fear or anxiety which occurs too often and too intensely.

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder is marked by exaggerated concern over work, school, money, health, family, etc. GAD affects 6.8 million adults, or three percent of the population, in the U.S; women are twice as likely to suffer from GAD.^[2] Some suffering from the disorder may avoid certain high-stress situations due to overwhelming worry, which can lead to difficulty completing everyday tasks.

GAD is diagnosed when an individual finds themself worrying for over 50% of the time for six months and exhibits three or more symptoms, which can include:

• • Nervousness and irritability
• • Feelings of imminent dread, doom, or panic
• • Increased heart rate
• • Hyperventilation, trembling, and/or sweating
• • Fatigue or weakness
• • Difficulty concentrating
• • Insomnia
• • Gastrointestinal problems (gas, constipation, diarrhea, etc.)

Obsessive-Compulsive Disorder (OCD)

OCD affects 1 in 40 adults and 1 in 100 children in the U.S.; 25% of cases emerge by age 14, and one-third of affected adults experienced symptoms of OCD as children.^[3] Obsessions are recurring and unwanted thoughts, urges, or mental images which lead to anxiety. Compulsions are repetitive behaviors or actions performed in hopes of ameliorating the stress caused by obsessions. For example, an individual with an obsessive fear of germs may wash their hands an excessive number of times as a result.

Many suffering from OCD do not recognize their compulsions and obsessions as irrational and, left untreated, may experience trouble maintaining normal daily routines.

Specific Phobias

A phobia is an intense irrational fear of a specific object, place, or situation. Common phobias include fear of flying, emetophobia (fear of vomiting), fear of heights, fear of insects, and fear of elevators. Most phobias may arise during any stage of life, often suddenly.

Social Anxiety

Characterized by a consuming fear of judgment or rejection in social situations, social anxiety disorder is not confused with mere shyness. Social anxiety disorder is the second most commonly diagnosed anxiety disorder after specific phobia and affects 15 million adults, or 6.8% of the population, in the U.S., typically emerging around age 13.^[4]

Individuals who suffer from social anxiety disorder may blush, fumble their words, experience increased heart rate, excessive sweat, etc., when dealing with others in a public situation. As a result, many tend to avoid social settings often altogether to circumvent any possibility of embarrassment.

Panic Attacks (PD)

These attacks may occur at any given time and often without any discernible reason. Panic disorder affects 6 million adults, or 2.7% of the population, in the U.S., and like GAD, women are twice as likely to be affected.^[5] Although PD and panic attacks typically appear in adulthood, children are also susceptible to PD and/or panic-like symptoms.

Symptoms can include:

• • Palpitations, pounding heart, or increased heart rate
• • Sweating
• • Trembling or shaking
• • Shortness of breath
• • Feeling of choking
• • Chest pain or tightness
• • Nausea or gastrointestinal problems
• • Dizziness, lightheadedness, or faintness
• • Chills or hot flashes
• • Numbness or tingling (paresthesia)
• • Derealization (feeling detached from reality) or depersonalization (feeling detached from oneself)
• • Fear of losing control
• • Fear of dying

Panic attacks or panic disorder may result in absences at work or school. In extreme cases, agoraphobia may develop, which is defined as a fear of being overcome by panic or anxiety with no way to escape or seek help. For those who have panic disorder and agoraphobia, leaving the house can seem an insurmountable task.

Post-Traumatic Stress Disorder (PTSD)

PTSD is typically caused by exposure to actual or near death, serious injury, or sexual violation. Exposure includes direct experience, witnessing, learning of the traumatic experiences of a loved one, or recurring exposure to the details of the traumatic event, as is the case for many first responders. PTSD affects 7.7 million adults, or 3.5% percent of the population, in the U.S.^[6]

Three main symptoms:

• Recurring memories of the traumatic event(s) through intrusive flashbacks and nightmares
• Emotional numbness and avoidance of places, people, and activities that serve as reminders of the trauma
• Heightened arousal, such as insomnia, reckless behavior, irritable or aggressive mood, startled responses, etc.

Causes

Although the exact causes of anxiety disorders are unclear to mental health professionals, they seem to originate from a combination of nature and nurture—genetics, brain chemistry, overactive fight-or-flight response, stressful home environment, etc.

For example, an individual with a family history of anxiety disorders may be more likely to develop an anxiety disorder. Another individual raised to view the world as dangerous may also be predisposed to suffer from anxiety. Similarly, someone accustomed to life in a legitimately dangerous environment—such as a violent household—may also develop an anxiety disorder. However, in all of these cases, anxiety is by no means guaranteed. In fact, many people who experience traumatic events never exhibit symptoms of anxiety.

Even though there is no set formula for the emergence of an anxiety disorder, treatment strategies are highly effective and tailored to individual experiences and backgrounds.

Treatment

In general, only about one-third of those experiencing an anxiety disorder receive treatment. For example, of the 6.8 million Americans suffering from GAD, only 43.2% are receiving treatment. In addition, of the 15 million Americans suffering from a social anxiety disorder, 36% reported experiencing symptoms for 10 or more years before seeking treatment.

Fortunately, anxiety disorders are highly treatable. Upon taking the first and most important step to seek treatment, a mental health professional will assess the individual’s symptoms, diagnose the disorder, and provide an effective treatment plan. Although the timeline varies from person to person, most experience significant improvement within 12 to 16 weeks.

As aforementioned, while anxiety in small doses can be healthy, serving as motivation to study extra hard for an exam, for example, excessive anxiety can inhibit an individual’s ability to concentrate, incurring long-term harm. In particular, adolescents exhibiting signs of anxiety—fatigue, irritability, insomnia, etc.—for weeks or months on end may be suffering from an anxiety disorder. In such cases where teenage anxiety begins to interfere with daily life and well-being, time spent at a residential treatment center in a structured, caring setting may be highly beneficial.

Early diagnosis and treatment of teenage anxiety are essential to prevent escalation of the disorder from including depression and self-medication via drugs, alcohol, or other destructive behaviors.

Troubled teens may be introduced to the trusted and highly effective cognitive-behavioral therapy (CBT) technique in a residential treatment center. In cognitive-behavioral therapy, the therapist will assist the patient in identifying, understanding, and changing negative thinking and behavioral habits. Cognitive-behavioral therapy is centered around learning and practicing coping skills, such as relaxation techniques or breathing exercises, to overcome anxiety with positive behaviors rather than medication.

Although medication is occasionally prescribed in tandem with cognitive-behavioral therapy when treatment alone proves ineffective, treatment is often preferred as the healthier and more lasting treatment method. As a parent, dealing with a teen suffering from an anxiety disorder can be overwhelming. Still, with early diagnosis and professional treatment, you can rest assured that your teen will be best equipped to heal and eventually thrive.