Anxiety Disorder: Symptoms, Causes and Treatment

Anxiety disorder involves experiencing excessive worry, fear, or panic that interferes with daily activities and is not proportionate to the actual threat or situation. Some people feel anxious all the time, which is called generalized anxiety disorder (GAD). Others have sudden, intense bursts of fear, known as panic attacks, which are part of panic disorder. Social anxiety makes people very nervous in social situations, while PTSD (post-traumatic stress disorder) happens after a scary or traumatic event. 

A person with anxiety disorder has a combination of psychological and physical symptoms. On the psychological side, individuals experience excessive worry or fear that feels difficult or impossible to control and anger. There is constant restlessness, tension, or being on edge as if something terrible could happen.  Physical symptoms include rapid heartbeat, sweating, trembling, and muscle tension. Dr. Craig Sawchuk, a psychologist at Mayo Clinic, explains that “people with anxiety disorders frequently have irritability, difficulty concentrating, and sleep disturbances.

This disorder occurs due to genetic factors, environmental influences, and life experiences. Dr. Rajita Sinha, director of Yale Medicine’s Interdisciplinary Stress Center, suggests that stressful life events, trauma, and chronic stress contribute to the development of anxiety disorders.

Treatment methods for individuals with such mental disorders often include cognitive-behavioral therapy (CBT) and medication. CBT is a widely recognized and effective form of psychotherapy for anxiety disorders, focusing on altering maladaptive emotional responses through skills-focused treatment. Dr. Fallon from The American Journal of Psychiatry suggests that while CBT and medication are effective, CBT often has longer-lasting effects, reducing the likelihood of symptom recurrence after treatment discontinuation.

What is Anxiety Disorder?

Anxiety Disorder is a mental health condition characterized by persistent and excessive worry or fear, according to the Cleveland Clinic article on “Anxiety Disorders” (March 2024). It is an umbrella term that encompasses various types of disorders, including panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobias.

In 2019, the WHO estimated that 301 million people were living with an anxiety disorder, including 58 million children and adolescents. However, in the same year, the WHO estimated that 280 million people had depression, making it the most common type of mental disorder globally.

Anxiety disorder occurs at any age and ranges from mild to severe, significantly impacting an individual’s daily life.

The very common symptoms of anxiety disorder are uneasiness, fears (phobias), and stress.  One also gets intense episodes of panic attacks and discomfort that lasts for several minutes. Physical signs and symptoms such as chest pain, heart palpitations, and shortness of breath accompany these signs.

Obsessive-compulsive disorder is another type of anxiety disorder characterized by uncontrollable thoughts (obsessions) and repetitive behaviors (compulsions). This condition interferes with an individual’s daily activities and requires professional treatment.

Post-traumatic stress disorder develops after experiencing a traumatic or life-threatening event. People with PTSD have flashbacks, nightmares, and severe anxiety related to the traumatic experience.

Specific phobias refer to an irrational fear of a particular object or situation, such as heights, spiders, or flying. This fear causes significant distress and avoidance behaviors in individuals with this disorder.

Anxiety disorder is a mental health condition that manifests in various forms and affects people from all walks of life. Seeking professional help and support from loved ones improves the well-being of those experiencing anxiety disorder. 

What are the Symptoms of Anxiety Disorder?

Anxiety disorders cause a wide range of physical and psychological symptoms that significantly impact daily life. The symptoms affect relationships, work, and leisure activities. The most common symptoms of anxiety disorders are restlessness, fatigue, irritability, muscle tension, racing thoughts, sleep disturbances, and increased heart rate, as suggested by the WHO article “Anxiety Disorders” (September 2023).

The common symptoms of anxiety disorders are explained below:

• Restlessness: Restlessness is a state of inability to relax or remain still, often accompanied by feelings of agitation. This manifests as constant fidgeting, pacing, or feeling like you can’t sit still. A sense of inner tension makes settling down or feeling at ease difficult.
• Fatigue: Fatigue is an overwhelming sense of tiredness or lack of energy. Individuals with anxiety feel tired quickly, even without engaging in strenuous activities. This persistent fatigue is not relieved by rest, leading to decreased productivity and difficulty concentrating.
• Irritability: Irritability is a heightened state of sensitivity or responsiveness to stimuli, often resulting in easily provoked frustration or anger. Anxiety makes people more prone to irritation and frustration. Minor annoyances feel magnified, and they tend to be impatient. 
• Muscle tension: Muscle tension is the state in which muscles remain contracted or partially contracted for an extended period. Physical manifestations of anxiety often include tense muscles. This leads to aches and pains, particularly in the neck, shoulders, and back. Some people experience jaw clenching or teeth grinding as well.
• Racing thoughts: Racing thoughts are rapid thought patterns often occurring in manic, hypomanic, or mixed episodes. Anxiety disorders frequently involve excessive worry and difficulty controlling these thoughts. The mind feels constantly in overdrive, jumping from one concern to another, making it hard to focus or make decisions.
• Sleep disturbances: Sleep disturbances affect sleep quality, timing, or duration. Some people tend to have nightmares or wake up feeling anxious.
• Increased heart rate: This is when the heart rate exceeds the standard resting rate, typically over 100 beats per minute in adults. Physical symptoms of anxiety include a rapid or pounding heartbeat accompanied by sweating, trembling, and impending doom or panic.

Living with anxiety feels like a constant, invisible weight, making even the simplest tasks feel overwhelming. Its appearance is often sudden and strikes without warning, making it difficult to function daily. These symptoms lead to difficulties concentrating, social interactions, and overall well-being. 

What are the symptoms of Anxiety Disorder in females?

The most common symptoms of anxiety disorder in females include feeling nervous, restless, or tense; having a sense of impending danger or doom; having an increased heart rate, breathing rapidly, sweating, trembling, feeling weak or tired, having trouble concentrating, and having trouble sleeping, according to the FDA article “Women and Anxiety” (October 2023).

Physical symptoms include a fast heartbeat, nausea, upset stomach, hot flashes, and dizziness. Anxiety disorders occur along with other mental health conditions like depression, according to the Cleveland Clinic article called “Anxiety Disorders” (March 2023).

What are the symptoms of Anxiety Disorder in children?

The common Symptoms of anxiety disorder in children are excessive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. Children experience physical symptoms like headaches and stomachaches, as suggested in a study published in the Journal of the American Academy of Child & Adolescent Psychiatry, “DSM-IV–Defined Anxiety Disorder Symptoms in South African Children” by researchers Peter Muris, PH.D, Henk Schmidt, PH.D and colleagues (Nov 2002).

What are the symptoms of Anxiety Disorder in dogs?

The symptoms of anxiety in dogs include panting, pacing, whining, trembling, drooling, and destructive behavior, especially when left alone or in new situations. Anxiety in dogs manifests as house soiling, refusal to eat, and excessive barking or howling, according to the Vet Cornel post, “Anxious behavior: How to help your dog cope with unsettling situations.”

What are the Causes of Anxiety Disorder?

The causes of an anxiety disorder include genetic factors, childhood experiences, mental health conditions, stressful life events, neurological factors, and physiological factors, according to a WebMD article on “Anxiety Disorders,” authored by Kristin Mitchell (May 2024). 

A person with this disorder has symptoms like chest pain, insomnia, and panic attacks, often leading to conditions like depression. Trauma and stress are significant contributors to the development of anxiety disorders, which worsen the symptoms and impact overall mental health.

• Genetics: Genetics refers to the hereditary factors that contribute to an individual’s predisposition to developing anxiety disorders, involving multiple genes that interact with environmental influences. Individuals with a close family member who has an anxiety disorder are more likely to create one themselves. A 2014 study by Katie A. McLaughlin and Evelyn Behar showed that anxiety disorders are seven times more common in children whose parents have them than in children whose parents have not been diagnosed with the disorder. 
• Childhood Experiences: Childhood experiences involve the various events, interactions, and environments that shape a child’s development during their formative years, typically defined as ages 0 to 17. Traumatic or stressful experiences during childhood, such as physical, emotional, or sexual abuse, increase the risk of developing an anxiety disorder later in life. A particular 2014 study by Stephanie S. Covington, Ph.D and Margaret Cramer, Ph.D involved 196 patients receiving alcoholism treatment.  A history of emotional abuse during childhood was linked to a markedly higher risk of mood disorders, particularly major depression and PTSD. Physical abuse during childhood was linked to a markedly higher risk of suicidal thoughts and attempts, and sexual abuse during childhood was linked to a markedly higher risk of anxiety disorders.
• Mental Health Conditions: Mental health conditions refer to a wide range of disorders that affect a person’s thinking, emotions, behavior, and overall mental well-being. The presence of another mental disorder contributes to the development or worsening of anxiety symptoms.
• Stressful Life Events: These are life changes, conflicts, or traumatic experiences, such as losing a loved one, a significant illness, or a natural disaster. Prolonged exposure to stress takes a toll on the body and mind, leading to the development of anxiety.
• Neurological Factors: Neurological factors refer to various elements that affect the brain, spinal cord, and nervous system, potentially leading to neurological disorders. Anxiety disorders are associated with imbalances in the brain’s neurotransmitters, such as serotonin and norepinephrine, which play a crucial role in regulating mood and emotions. These chemical imbalances contribute to the physiological symptoms of anxiety, such as chest pain, insomnia, and panic attacks.
• Physical Health Conditions: Physical health conditions refer to the well-being and proper functioning of the body’s organs and systems. Certain physical health conditions, such as thyroid disorders, respiratory problems, or chronic pain, also trigger or exacerbate anxiety symptoms. The physical symptoms associated with these conditions increase worry, fear, and apprehension.

The causes of anxiety disorder vary from individual to individual and often involve a complex interplay of multiple factors. Seeking professional help from a mental health provider is crucial in understanding the specific causes and developing an effective treatment plan.

What are the treatments for Anxiety disorder?

The treatments for anxiety disorder include counseling, medications, and self-care strategies, according to Dr. Andrew’s “Pharmacotherapy for Anxiety Disorders: From First-Line Options to Treatment Resistance” on Psychiatry Online (2021).

Self-Care

Self-care strategies help to alleviate anxiety and manage symptoms. These include avoiding alcohol, quitting smoking, reducing caffeine intake, stress management, practicing relaxation techniques and physical exercise, and maintaining a healthy diet.

• Avoid alcohol: Reducing or avoiding alcohol consumption can help manage anxiety symptoms, as alcohol worsens anxiety in the long run.
• Quit smoking: Smoking increases anxiety and makes it harder to manage. Quitting smoking can have a positive impact on anxiety levels.
• Reduce caffeine intake: Caffeine exacerbates anxiety symptoms, so reducing or eliminating caffeine from the diet can be beneficial.
• Implement Stress Management: Stress management techniques, such as mindfulness, meditation, or deep breathing, can help alleviate anxiety.
• Practice relaxation techniques: Engaging in relaxation activities, like yoga, tai chi, or progressive muscle relaxation, helps manage anxiety.
• Engage in physical exercise: Regular physical activity helps to reduce anxiety by releasing endorphins and improving overall well-being.
• Maintain a healthy diet: Eating a balanced, nutritious diet supports mental health and helps manage anxiety.

Incorporating self-care strategies into your daily routine alleviates anxiety and enhances overall well-being. By avoiding alcohol and smoking, reducing caffeine intake, and implementing effective stress management techniques, you create a healthier mental environment. 

Therapies

Counseling or therapy involves talking to a trained therapist, psychologist, or psychiatrist to understand and manage the root cause of anxiety. Different types of therapy used here include cognitive-behavioral therapy (CBT), meditation, and psychotherapy.

• Cognitive Behavioral Therapy (CBT): CBT is a highly effective form of psychotherapy that helps individuals identify and change negative thought patterns and behaviors that contribute to anxiety.
• Meditation: Mindfulness-based practices, such as meditation, help individuals become more aware of their thoughts and feelings and learn to manage anxiety more effectively.
• Psychotherapy: Various forms of psychotherapy, such as individual or group therapy, help individuals understand the root causes of their anxiety and develop coping strategies.

Engaging in therapy is a decisive step towards understanding and managing anxiety. Whether through Cognitive Behavioral Therapy, psychotherapy, or meditation, each therapeutic approach offers unique benefits.

Medications

Medications help manage anxiety disorder, but it’s essential to work closely with a doctor to find the right drug and dosage for your specific needs. The medications used include SSRIs (Selective Serotonin Reuptake Inhibitors), anxiolytics, antidepressants, benzodiazepines, nerve pain medications, and sedatives.

• SSRIs (Selective Serotonin Reuptake Inhibitors): These antidepressant medications can help regulate serotonin levels in the brain, which can alleviate anxiety symptoms.
• Anxiolytics: These medications, such as benzodiazepines, can provide short-term relief for anxiety by reducing physical symptoms and promoting relaxation.
• Antidepressants: Certain antidepressant medications, including SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors), can be effective in treating anxiety disorders.
• Benzodiazepines: These sedative medications can provide rapid relief for anxiety but have the potential for dependence and should be used with caution.
• Sedatives: Some sedative medications, such as certain antihistamines or sleep aids, can be used to manage anxiety-related insomnia or restlessness.
• Nerve pain medication: In some cases, medications typically used for nerve pain, such as gabapentin or pregabalin, may be prescribed to help manage anxiety symptoms.

It’s essential to work closely with a healthcare professional to determine the most appropriate treatment plan, which may involve a combination of self-care, therapy, and medication, depending on the individual’s needs and the severity of their anxiety disorder.

What are the critical risk factors for anxiety disorders?

The common risk factors of anxiety disorder include biological factors, environmental triggers, and past traumatic experiences, according to a study titled ” Risk Factors For Anxiety Disorders” by Dr Carlos Blanco and Dr Jose Rubio (February 2024).

The research highlights that a combination of genetic predispositions and environmental stressors influences anxiety disorders. Specific findings indicate that individuals with a history of trauma or adverse experiences are at a heightened risk, as are those exposed to adverse environmental influences, such as socioeconomic challenges. 

Biological factors include genetic predisposition, hormonal imbalances, and structural differences in the brain. Individuals with a family history of anxiety disorders are more likely to develop the disorder themselves due to inherited genes. Michael G. Gottschalk’s 2017 population-based family study reported an odds ratio ranging from 2.1 to 2.6 for children of parents with GAD, indicating a higher likelihood of developing the disorder themselves, even after adjusting for other factors like major depressive disorder (MDD) and non-GAD anxiety disorders.

Environmental triggers refer to external factors that trigger or worsen symptoms of anxiety disorder. This includes stressful life events such as a traumatic experience, major life changes, or ongoing stressors like financial problems or work-related stress. Additionally, exposure to certain substances or medications can also contribute to the development of anxiety disorder.

People who have experienced traumatic events in the past, such as physical or emotional abuse, neglect, or loss of a loved one, are at a higher risk for developing anxiety disorders. These experiences can lead to disruptions in brain functioning and lasting psychological effects that may manifest as symptoms of an anxiety disorder later in life.

While these are key risk factors for anxiety disorders, it is essential to note that everyone experiences anxiety differently. Some individuals develop an anxiety disorder despite having no known risk factors, while others may not build one even if they have multiple risk factors.

How common are anxiety disorders?

Anxiety disorders are pervasive and have affected around 19% of U.S. adults between 2001 and 2003 and 31% over a lifetime, according to the National Institute of Mental Health article titled “Any Anxiety Disorder.” This study suggests that approximately 19% of U.S. adults experience an anxiety disorder each year, while 31% will experience one at some point in their lifetime.

McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G.’s 2011 study. “Gender Differences in Anxiety Disorders”. Journal of Psychiatric Research suggests that prevalence is higher in women compared to men across most specific anxiety disorders. The study examined gender differences in anxiety disorders among a large sample of U.S. adults, revealing that women had significantly higher lifetime prevalence rates of anxiety disorders compared to men, with a male: female ratio of 1:1.7.The average age of onset for anxiety disorders is 11 years old, and they can develop at any time during the lifespan. This means that anyone, regardless of age, gender, or background, experiences an anxiety disorder.

What are the types of anxiety disorders?

The types of anxiety disorders are generalized anxiety disorder, social anxiety disorder, panic disorder, specific phobia, agoraphobia, separation anxiety disorder, medical illness-induced anxiety disorder, and substance-induced anxiety disorder. According to the National Institute of Mental Health article “Anxiety Disorders” (April 2024).

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about various aspects of life, such as work, school, health, finances, or everyday tasks. People with GAD often experience restlessness, difficulty concentrating, irritability, and sleep disturbances.

Panic Disorder

Panic Disorder is marked by recurring, unexpected panic attacks – sudden episodes of intense fear accompanied by physical symptoms such as rapid heartbeat, chest pain, shortness of breath, and dizziness. People with panic disorder often worry about future attacks and may change their behavior to avoid situations that might trigger them.

Social Anxiety Disorder (Social Phobia)

Social Anxiety Disorder, also known as social phobia, involves intense fear and anxiety in social situations. Individuals with this disorder feel overwhelmingly self-conscious, worry about being judged or embarrassed, and often avoid social interactions.

Specific Phobias

Specific Phobias are intense, irrational fears of particular objects or situations, such as heights, flying, or certain animals. These fears are disproportionate to the danger posed and can significantly interfere with daily life.

Agoraphobia

Agoraphobia is characterized by fear and avoidance of places or situations where escape is difficult, or help is not available in case of panic-like symptoms. This includes fear of open spaces, crowded areas, or being outside one’s home.

Separation Anxiety Disorder

Separation Anxiety Disorder involves excessive fear or anxiety about separating from attachment figures, typically seen in children but also occurring in adults. Individuals with this disorder experience distress when anticipating or experiencing separation from home or loved ones.

Medication-Induced Anxiety Disorder

Substance/Medication-Induced Anxiety Disorder occurs when anxiety symptoms are directly related to the use of substances or medications, including during withdrawal. This highlights the importance of considering the role of substances and medications in anxiety symptoms.

Can anxiety disorder cause depression?

Yes, an anxiety disorder causes depression. Hopwood, M.’s  (2023) study “Anxiety Symptoms in Patients with Major Depressive Disorder.” in Neurology and Therapy Journal suggests that anxiety and depression often occur together, with about 60% of people with anxiety also experiencing symptoms of depression and vice versa. The two conditions share some common symptoms, like agitation and restlessness. Anxiety disorders also trigger depressive episodes, and having both disorders simultaneously can worsen the symptoms of each or make them last longer.

How do neurotransmitters affect anxiety?

Neurotransmitters like serotonin, norepinephrine, and dopamine regulate mood and affect anxiety. Gregor Hasler of Psychiatric University Hospital’s 2010 post “Pathophysiology of Depression” suggests that an imbalance in these brain chemicals contributes to both anxiety and depression. Medications that target neurotransmitters, like selective serotonin reuptake inhibitors (SSRIs), are commonly used to treat both conditions.

Can you get rid of anxiety disorder?

Yes, you can get rid of anxiety disorder by treating and managing it. Professor Antonia N. Kaczkurkin of the University of Pennsylvania, Department of Psychiatry points out that the two main treatments are psychotherapy, especially cognitive behavioral therapy (CBT), and medications such as antidepressants and anti-anxiety drugs.

Who are the specialists of Anxiety Disorder?

Specialists who treat anxiety disorders include clinical psychologists, psychiatrists, and primary care providers (PCPs). Clinical psychologists specialize in diagnosing and treating mental health conditions through psychotherapy, also known as talk therapy or counseling. They help patients understand the root causes of their anxiety and develop coping strategies to manage symptoms. 

Cognitive Behavioral Therapy (CBT) is a common and effective form of psychotherapy used by psychologists to treat anxiety disorders. In some states, psychologists can also prescribe medications for anxiety if they have the appropriate training and licensure. Tori DeAngelis’s 2023 post “Prescriptive authority gains new momentum” in the American Psychological Association Journal points out that as of 2023, the states that allowed psychologists to prescribe under certain circumstances were New Mexico, Louisiana, Illinois, Iowa, and Idaho.

Psychiatrists are medical doctors with specialized training in mental health. They diagnose anxiety disorders, prescribe medications, and provide psychotherapy. Psychiatrists are particularly beneficial for patients who need a combination of medication and therapy to manage their anxiety. 

Primary care providers (PCPs) play a crucial role in the initial assessment and management of anxiety disorders. They conduct physical exams to rule out other medical conditions that might cause anxiety symptoms and refer patients to mental health specialists if necessary. PCPs often work in conjunction with psychologists and psychiatrists to provide comprehensive care for anxiety disorders.