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Anxiety disorders

Published by Bupa's health information team, May 2009.

This factsheet is for people who have an anxiety disorder, or who would like information about them.

Anxiety disorders are conditions where severe or long-lasting feelings of anxiety interfere with every day life.

About anxiety disorders
Types of anxiety disorder
Symptoms of anxiety disorders
Complications of anxiety disorders
Causes of anxiety disorders
Diagnosis of anxiety disorders
Treatment of anxiety disorders
Questions and answers
Video
Related topics
Further information
Sources

About anxiety disorders

Anxiety is a feeling of unease. Everybody gets anxious when faced with a stressful situation, for example before an exam or an interview, or during a worrying time such as illness. It's normal to feel anxious when you face something difficult or dangerous, and mild anxiety can be a positive and useful experience.

However, for one in 10 people in the UK, anxiety interferes with normal life. Excessive anxiety is often associated with other mental health problems, such as depression. Anxiety is only considered to be a mental health problem when it's long lasting, severe and is interfering with every day activities.

Types of anxiety disorder

Below are some examples of anxiety disorders.

Phobias

A phobia is a fear that is out of proportion to any real danger. If a phobia interferes with your ability to lead a normal life then it may be considered an anxiety disorder. Common phobias are fears of heights, spiders, mice, blood, injections or enclosed space (claustrophobia).

Social phobia is also one of the more common, but complex, phobias. If you're affected by this, meeting people causes anxiety, because you're overly worried about what others think of you. One form of social phobia is severe anxiety about speaking or performing in public. It's common to feel nervous in these situations, but people with social phobia find these activities impossible.

Agoraphobia, another common phobia, is a fear of various places and situations, such as crowds or public places, and is often associated with panic disorder.

Obsessive-compulsive disorder (OCD)

OCD consists of recurring obsessions and/or compulsions. Obsessions are recurring thoughts or images about specific things that trigger feelings of disgust. Common obsessions include fears around germs, dirt or violence. Compulsions are thoughts or actions that people feel they must do or repeat. A compulsion is usually a response to ease the anxiety of an obsession, such as repeatedly washing your hands to deal with an obsession about dirt.

Panic disorder

If you have panic disorder, you live 'in fear of fear'. You experience panic attacks, which are sudden feelings of anxiety that occur without warning and for no apparent reason. The symptoms of the anxiety (see Symptoms of anxiety disorders) can be very severe and may feel like a wave of panic. Panic attacks usually last five to 10 minutes but they can last longer.

Post-traumatic stress disorder (PTSD)

PTSD can happen if you have or witness a traumatic event, such as a major accident or military combat. Anxiety, which may come and go, is one of the symptoms. Others include recurring thoughts, memories, images, dreams, or distressing 'flashbacks' of the trauma. It's common to react with anxiety to a frightening experience - it's only considered to be PTSD if the symptoms don't go away. It may develop years after the traumatic event.

Generalised anxiety disorder (GAD)

Anxiety can be a long-term disorder where you feel worried most of the time about things that might go wrong. This is called GAD.

Symptoms of anxiety disorders

When you're anxious, you may also have a range of physical symptoms. These happen because of your body's so-called 'fight or flight' response, which is caused by the release of the stress hormone adrenaline. The symptoms can include:

discomfort in your abdomen (tummy)
diarrhoea
dry mouth
rapid heartbeat or palpitations
tightness or pain in your chest
shortness of breath
dizziness
needing to urinate more often than usual
difficulty swallowing
shaking

You can also get psychological symptoms, which can include:

sleeping difficulties (insomnia)
feeling worried or uneasy all the time
feeling tired
being irritable or quick to get angry
being unable to concentrate
a fear that you're 'going mad'
feeling not in control of your actions, or detached from your surroundings (derealisation)

Complications of anxiety disorders

Sometimes when anxiety disorders occur with other conditions, such as depression, schizophrenia or bipolar disorder, they can be associated with self-harm or suicide.

Causes of anxiety disorders

Anxiety may be a symptom of other mental health problems, such as depression or alcohol dependence. It can also be caused by substances such as LSD, ecstasy or caffeine, or by withdrawal from medicines taken long-term, such as tranquillisers.

Sometimes anxiety can be associated with a physical illness, such as thyroid disorder. For this reason you should see your GP in order to rule out a physical cause.

Your anxiety could be caused by some sort of stressful life event such as a bereavement, or if you witness something traumatic. In many cases this sort of anxiety will lessen after a few weeks. It would only be considered to be an anxiety disorder if the feelings were severe or long-lasting and were interfering with your every day life.

Diagnosis of anxiety disorders

If you think your life is being affected by anxiety, visit your GP. He or she will want to identify any physical or psychiatric problems that may be causing the anxiety. Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history. You may have a blood test if your GP suspects a thyroid disorder or some other physical illness.

Your GP may refer you to a psychiatrist (a doctor who specialises in mental health) for further help.

Treatment of anxiety disorders

Self-help

You may be able to improve your symptoms by using relaxation techniques and exercise. Contacting other people who have anxiety disorders through charities and patient groups can be a good source of support and advice. Your GP may be able to advise you about self-help groups in your area.

Counselling

This involves talking through your problem with a counsellor who can help you focus on what you want to do and how you can achieve your goal.

Research shows that counselling can help with some kinds of anxiety disorder, including panic disorder, social phobia, and GAD, especially in the short term.

Cognitive behavioural therapy (CBT)

CBT is a type of talking therapy, or psychotherapy, carried out by a specially trained therapist. CBT is based on the idea that negative thinking results in negative reactions. It involves assessing the reasoning behind your thinking and then gradually exposing you to the situation that causes anxiety in order to change your behaviour.

CBT is often used to treat GAD and panic disorder.

Medicines

Your GP may prescribe the following medicines.

Tranquillisers, such as benzodiazepine tablets, may help to relieve some short-term stress-related anxieties. However, they shouldn't be taken for long periods because of the risk of addiction. For this reason they aren't usually prescribed.
Buspirone is another type of medicine that can help relieve anxiety. It has different side-effects to benzodiazepines and it isn't thought to be addictive.
Antidepressants can treat certain anxiety disorders such as GAD, social phobia, OCD and anxiety associated with depression.
Beta-blockers relieve many of the physical symptoms of anxiety such as palpitations and shaking, and may be helpful for some people. They don't affect psychological symptoms, but some people find they can relax more if their physical symptoms are relieved.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Relaxation

Relaxation training is a feature of some types of psychotherapy. Various types of relaxation therapy are available, which you might want to discuss with your doctor. You may find yoga, Tai Chi or other exercises helpful.

Complementary therapy

Although there are a wide variety of complementary therapies available for the treatment of anxiety, none have been conclusively shown to work and they may have side-effects. If you do choose to take a complementary medicine, you should always tell your GP or pharmacist, as it may interact with other medicines you're taking.