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Anxiety disorder: Types, Causes, Symptoms, Treatments Methods, Prognosis & Daily Life

Anxiety disorder: Types, Causes, Symptoms, Treatments Methods, Prognosis & Daily Life

Medically reviewed by Jeevika Yu, written by Carl Lee. Reading Time: 12 minutes

Anxiety, also known as anxiety neurosis, is the most common of the broad category of neurological disorders and is characterized by the experience of anxious emotions. In the United States, nearly 18% of the population has anxiety disorders. This article will provide a third-party perspective, so let's explore it together!

Also, there are many ways to help you relieve anxiety or stress. Meanwhile, If you want to learn more information about anxiety disorder, we also provide some videos resources.

Maybe some touching stories can make you relate more. If you need professional help, please find professional people on page "Urgent Help". Anyway, we are always with you!

 

Overview

  • Intense, excessive, and persistent worries and fears.
  • Nervousness is accompanied by symptoms such as increased heart rhythm and difficulty sleeping.
  • The incidence rate is higher in women than in men.
  • The treatment is based on medication and psychotherapy.

Definition of anxiety disorder

 Anxiety disorders are defined as intense, excessive, and persistent worry and fear in everyday situations that can reach a peak within a few minutes. The symptoms can interfere with daily activities and are difficult to control. Common anxiety disorders include generalized anxiety disorder, panic disorder, social phobia, specific phobia, and separation anxiety disorder.


Epidemiology

The prevalence of anxiety disorders is higher in women than in men and varies by different anxiety disorders.

  • The lifetime prevalence of generalized anxiety disorder is 4.1% to 6.6%.
  • The lifetime prevalence of social phobia is 13.3%.
  • The prevalence of separation anxiety disorder in children before puberty is 3.5% to 4.1%.

Types of anxiety disorder

Panic disorder

Repeated unpredictable and intense feelings of fear or discomfort that peak within minutes.


Agoraphobia

Patients feel anxious when they are away from home, in a crowd, or in an environment where it is not easy to leave.


Social phobia

Significant fear or anxiety results from being confronted with one or more social situations in which others may scrutinize them.


Specific phobia

A significant fear or anxiety about a specific thing or situation: it is not the thing itself that the patient fears, but rather the dire consequences that the patient perceives may result from being exposed to the item or being in a situation.


Generalized anxiety disorder

Excessive anxiety and worry about many events or activities for at least six months.


Separation anxiety disorder

Excessive fear or anxiety, asymmetrical to their developmental stage when parting from an attachment partner.


Cause of anxiety disorder

To date, the etiology of anxiety disorders is complex. Its pathogenesis is not clear. And there are pathological processes of both mind and body, which result from a combination of bio-psycho-social factors. 


Underlying causes of disease


Biological factors

Genetic factors

Studies have shown that people with a family history of the disease are more likely to develop anxiety disorders than the general population.


Neurobiochemical factors

It has been found that gamma-aminobutyric acid (GABA) is one of the bases of pathogenesis. In addition, it may be associated with hyperfunction of the noradrenergic system and abnormalities of the 5-hydroxytryptamine system.


Neuroimaging factors

Emotion control loops in the brain are composed of the prefrontal lobe, amygdala, hippocampus, hypothalamus, and anterior cingulate gyrus. Abnormalities in these regions’ structure, function, or connections can cause emotion control disorders and constitute the structural basis of the pathology of anxiety disorders.


Psychological factors

Anxiety disorders may occur when external and self-induced reasons make patients depressed, worried, and fearful if effective defense mechanisms are not applied.


For example, generalized anxiety disorder is caused by unresolved subconscious conflicts and persistent distortions in information processing. Social anxiety disorder is caused by the patient's excessive concern and attention to the evaluation of others. It may also be related to some negative experiences in pre-adulthood. Specific phobias may be related to feared objects and traumatic experiences.


Predisposing factors

The following conditions may increase the risk of disease.

  • Traumatic injuries and serious diseases
  • Poor health
  • Accumulation of stress
  • Other mental illnesses (for example, depression)
  • Usage or misusage of drugs or alcohol
  • Addictive substances such as caffeine and nicotine
  • The patient's personality

Symptoms of anxiety disorder

The psychological experience and feelings of excessive worry are the core symptoms of people with anxiety disorders. In addition, the following symptoms are included.

  • Nervousness and restlessness
  • Uncontrollable worries and imminent danger
  • Panic or doom
  • rapid heart rhythm and fast breathing
  • Sweating, trembling, weakness, and tiredness
  • Difficulty sleeping and intestinal problems

Typical symptoms

Psychological symptoms

The primary manifestation is the psychological experience and feeling of excessive worry. Patients experience persistent or episodic symptoms of inexplicable anxiety, fear, nervousness, and restlessness. They are distracted throughout the day as if misfortune is about to befall them or their loved ones, and they are in a state of heightened alertness.


The symptoms vary by disorder type. For example, generalized anxiety disorder is characterized by persistent, excessive worry about a dangerous or unfortunate event that may occur and is difficult to predict. 


Social anxiety disorder is characterized by inappropriate anxiety in situations where one is noticed and may be judged. 


Panic disorder mainly manifests as a sudden onset of irresistible fear, fear, worry, and a feeling of doom and near death in daily activities.


Somatic symptoms

Reactive sympathetic excitation causes somatic symptoms involving the respiratory, neurological, genitourinary, and cardiovascular systems.


Nervous System

Patients experience skin flushing, pallor, sweating, palpitations, panic, chest tightness, shortness of breath, and dry mouth.


Genitourinary system

Sexual dysfunction such as impotence, premature ejaculation, irregular menstruation, and other abnormalities of the reproductive system and the urinary system such as frequent or urgent urination.


Respiratory System

Some patients show signs of breath-holding, choking sensation, hyperventilation and may develop symptoms of respiratory alkalosis, such as numbness of the limbs and twitching of the hands and feet.


Cardiovascular System

Patients often go to the emergency room with the suspicion of a heart attack, except for some patients whose electrocardiogram shows sinus tachycardia and premature ventricular beats. Very few patients may present with symptoms such as paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation, and conduction block, but other tests are not abnormal.


Gastrointestinal System

Patients have symptoms such as gastric neurosis, neurogenic diarrhea, or constipation. The main symptoms are loss of appetite, abdominal distention, and burning sensation, etc.


Behavioral symptoms

Except for external behavioral manifestations in psychological and physical symptoms, such as restlessness, unnatural facial expressions, slight tremors in the limbs, tense muscle twitching, the rigidity of movement, shortness of breath, choking sensation, palpitations, and increased heart rate, chest discomfort, or pain, sweating, nausea, abdominal discomfort or pain, and other symptoms.


Seek medical treatment

Compared with the past, when a patient has the following "unreasonable" manifestations in cognition, emotion, behavior, etc., he is deemed a potential patient with "anxiety disorder.” He should go to the psychiatric department of the hospital in time.

  • Something terrible will happen and interfere with work or life.
  • Anxiety makes you distracted.
  • You think that anxiety may be related to physical health problems.
  • Suicidal thoughts or behaviors.

Medical Department

Department of Psychiatry


Diagnostic basis

The diagnosis of anxiety disorders is determined primarily by psychometric testing. People may need to complete the forms below, such as the Hamilton Anxiety Rating Scale (HAMA), the State-Trait Anxiety Inventory (STAI), the Social Disability Screening Schedule (SDSS), or the Life Events Scale (LES).


Related checks

Psychometric testing

The diagnosis of anxiety disorders is determined primarily by psychological testing, which helps the physician confirm the diagnosis and determine the severity of the disease to assist in developing a treatment plan.


People may need to complete the forms below, such as the Hamilton Anxiety Rating Scale (HAMA), the State-Trait Anxiety Inventory (STAI), the Social Disability Screening Schedule (SDSS), or the Life Events Scale (LES).


Auxiliary examinations

Changes in physiological and motor indicators generally accompany anxious emotional responses. Physiological indicators can indirectly reflect the level of anxiety. The commonly used indicators include electrical skin response, skin conductivity, skin temperature, skin blood flow volume, electromyography, heart rate, blood pressure, respiratory rate, etc.


Treatment methods

Patients with anxiety disorders are often associated with significant functional deficits and reduced quality of life. They are primarily treated with psychotherapy and medication for symptom relief or a combination of both for better results. Still, repeated trials are needed to find the most appropriate treatment.


Psychotherapy

cognitive behavioral therapy

CBT is the most effective form of psychotherapy for people with anxiety disorders. People with anxiety disorders are prone to two types of faulty logic: one is to overestimate the likelihood of bad things happening. The other is to dramatize or catastrophize the outcome of the event overly.


Distorted perceptions of people with anxiety disorders are why the disease does not heal in the long run. Therefore, they need to be helped to change the wrong perceptions and carry out cognitive reconstruction to achieve treatment.


Supportive Psychotherapy

Explain to patients about the disease through psychoeducation to reduce secondary anxiety about the condition. Convey positive emotions to patients through listening, encouragement, and support techniques to enhance treatment compliance.


Other Treatments

In addition, biofeedback therapy, relaxation training, and breathing control training are available for some patients to help relieve anxiety symptoms.


Drug treatment

Due to significant individual differences, there is no absolute best, fastest, or most effective medication. In addition to commonly used over-the-counter drugs, the most appropriate medicines should be selected under the guidance of a physician with full consideration of individual circumstances.


Benzodiazepines

Benzodiazepines, which have a robust anxiolytic effect, have a faster onset of action and improve sleep. These drugs have fewer adverse effects and are generally treated for no more than 2 to 3 weeks. Patients with mild cases can use such drugs intermittently.


If these drugs are used in large quantities over a long time, people are prone to drug dependence and withdrawal symptoms when the drugs are suddenly stopped. In addition, benzodiazepines have a muscle-relaxing effect, leading to falls and fractures in elderly patients.


Non-benzodiazepine anxiolytic drugs

Non-benzodiazepine anxiolytics, indicated for outpatient treatment, will gradually become an alternative to benzodiazepines. These drugs have no significant adverse effects of sedation, drowsiness, or weight gain. However, the results of these drugs are weaker.


Antidepressants

Antidepressants are currently the primary choice for the clinical treatment of anxiety. Selective serotonin reuptake inhibitors (SSRIs) have become the drug of choice for treating anxiety disorders because of their safety and efficacy.

In addition, Serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic drugs also have good efficacy in treating anxiety disorders. However, the clinical application of tricyclic drugs is limited due to their toxic side effects on the heart.


Prognosis

People with anxiety disorders generally have a better prognosis with regular psychological and pharmacological treatment. Special attention needs to be paid to poor treatment outcomes, which may develop secondary to depressive disorders.


Curability

People with anxiety disorders generally have a good prognosis, and some people can have recurrent episodes. However, they can well control symptoms through psychotherapy and medication.


Side effects

  • People with anxiety disorders can develop negative feelings such as fear, which affects their ability to work and live in varying degrees.

  • Anxiety disorders can affect the nervous system. For example, it excites the sympathetic nerves, causing vasoconstriction, increased blood pressure, and increased heart rate. These symptoms can induce chronic cardiovascular diseases such as hypertension, coronary artery disease, stroke, and heart failure.

  • Anxiety disorders may even induce depression, eventually leading to self-injury or even suicide with severe consequences.

Complications

Prolonged physical stress and anxiety will lead to the following complications for people with anxiety disorder.


Sleep disorders

Difficulty in falling asleep, decreased sleep quality, and reduced sleep time, memory, and concentration due to excessive excitement, anxiety, mental tension, etc.


Irritable bowel syndrome (IBS)

Anxiety disorders have a more significant impact on the digestive system of patients. A higher number of patients will have unexplained frequent diarrhea with tiny bowel movements and a feeling of incomplete defecation.


Unstable blood pressure and blood sugar

Anxiety can lead to irregular vasoconstriction and diastole and abnormal blood sugar regulation.


Depression

Some patients have depression symptoms such as low emotion, slowed thinking, reduced and delayed speech and movement due to excessive anxiety, which seriously disturbs the life and work of people with anxiety disorder.


Daily Life

Because of the complex etiology of anxiety disorders, the course of the disease is prolonged and prone to recurrence. Therefore, in daily life, in addition to controlling anxiety symptoms through medication, we should also strengthen the management of patients' psychological and life aspects to improve their quality of life.


Home care

  • Family members should instruct patients to have a correct understanding of anxiety disorders and reduce their mental burden.
  • Family members should provide the patient with a quiet and good sleep environment and supervise the patient to ensure adequate sleep time daily.
  • Family members should supervise patients to take medication according to medical prescriptions and make regular review appointments to encourage patients to adhere to medication and psychotherapy.

Daily monitoring of disease

Foods

Avoid fried food and junk food, and eat more fruits, vegetables, coarse grains, and fish. Avoid substances such as alcohol, caffeine, and tobacco, which may cause or exacerbate anxiety.


Lifestyle

When the patient has an anxiety attack, the family should fully distract the patient's attention and get rid of them from the source of stimulation in time. Family members should control possible suicidal and self-injurious behaviors on time, observe them closely, and accompany the patient exclusively when necessary.


Sports

Exercise can improve the patient's mood and keep them happy, developing an appropriate exercise routine. The amount of training should be low at first. And then gradually increase exercise intensity.


Special Notes

  • The treatment of anxiety disorders takes time. Some patients have recurring conditions and should give feedback to their doctor to find the cause and treat it as early as possible.
  • Patients should not dwell too much on past worries. They should develop hobbies to divert their attention and reduce the psychological symptoms of anxiety.
  • Patients can practice yoga and meditation to relieve anxiety.
  • Patients can keep a personal record of their lives by keeping a diary. This method can help to identify the cause of the disease to find a more appropriate treatment.

Prevention

  • Good sleep, diet, and exercise habits play an essential role in strengthening physical resistance, reducing mental stress, and preventing anxiety attacks.
  • Pay attention to adverse factors that may trigger anxiety, such as reducing negative psychological stimuli in childhood or adolescence.
  • When taking over-the-counter medications, identify whether they contain chemicals that increase anxiety symptoms.
  • Prevention of anxiety disorders caused by trauma through timely psychological consultation and treatment with a psychologist after experiencing mental or physical trauma.
  • Learning techniques to deal with stress to prevent anxiety disorders caused by stress, such as yoga or meditation.

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