About

Anxiety disorders fall into several broad categories:

• Generalized Anxiety Disorder (GAD). People with GAD are worried about something — money, health, their boss or their children — almost every waking moment. They know the situation isn’t as bad as they fear it is, but they can’t shake the feelings of impending doom. They often have trouble falling or staying asleep and may suffer from a host of problems such as sweating, twitching, inability to concentrate and/or irritability.
• Obsessive Compulsive Disorder (OCD). If you’re suffering from OCD, your day is marked by unwanted thoughts and behaviors that you can’t seem to control. For example, you might be so worried about germs that you’ll spend hours and hours washing your hands over and over and over and you might avoid touching anything or anyone for fear that you’ll get contaminated. Or you might become consumed with worry that you’ve left your front door unlocked and you’ll come back home dozens of times every day to check. Or you might get extremely upset if everything in your home or office isn’t arranged perfectly symmetrical. In the short run these rituals help ease the anxiety but eventually they take over and make things worse.
• Panic Attacks and Panic Disorder. A panic attack is a sudden onset of overwhelming terror, which seems to come out of nowhere and for no particular reason. These attacks usually last less than 15 minutes and are often accompanied by sweating, nausea, rapid heartbeat, chest pain, the sensation of being smothered and an intense fear that you’re going to lose control or die. Many people who have panic attacks have only one. For others, they happen repeatedly but are completely unpredictable, which makes the situation worse. If you had a panic attack in a grocery store or in your car once, you might do everything you can to avoid shopping or driving. About a third of those who have frequent panic attacks collect so many fears that they develop a condition called agoraphobia, leaving them terrified of leaving their own home. Fortunately panic disorder is easily treatable and symptoms can be controlled with medication or certain types of psychotherapy.
• Social Anxiety or Social Phobia. A phobia is an exaggerated fear of specific objects or situations such as spiders, flying or swimming. Many of us have experienced stage fright or worried about failing in front of others. That’s normal. But sometimes those fears can last for weeks and can become so severe that they it’s almost impossible to work,  go to school or have almost any encounters with other people. Besides the feelings of dread, people with social anxiety or phobias may have almost uncontrollable blushing, sweat profusely, have a rapid heartbeat and hardly be able to speak. People with severe, untreated social phobias also have an especially difficult time forming relationships with others are less likely to get married and are more likely to drop out of school.

FYI

WHAT CAUSES ANXIETY DISORDERS?

As with depression, no one is completely sure what causes anxiety disorders. Most experts agree, however, that it’s probably a combination of factors, including:

• Genetics. Anxiety often runs in families.
• Your environment. Where you live, how much money you make, whether or not you’re happy at work and in your personal relationships.
• Your personality. If, for example, you see yourself as a victim or as powerless to influence your own life, you’re likely to see the world as a very dangerous place.
• A trauma or significant stress.
• A major physical problem or illness.
• The build-up over time of many small, negative, life events.

Symptoms

DO YOU HAVE AN ANXIETY DISORDER?

The key to telling the difference between normal behavior and something that might require professional help is the impact it has on your life. If you’re doing well at work or school, have good friends, get over your nervousness and tension pretty quickly and feel that you’re functioning well; chances are you’ve got nothing to worry about. But if your worries or anxieties are interfering with your work or school life, make it hard for you to have friends or maintain relationships and affect your ability to enjoy life, you may have an anxiety disorder.

The following is a list of symptoms you may experience if you have one or more of the anxiety disorders we discussed above. If you have more than three or four on a regular basis, schedule an appointment with your healthcare provider as soon as possible.

• Intense feelings of worry, fear, confusion or nervousness that have lasted more than two months
• Frequent spells of apprehension, uneasiness or dread
• Frequent feelings of self-consciousness or insecurity
• Fear that you are about to die or that you are losing control or going crazy
• Fear that something terrible is going to happen
• Fear that you’ll have a panic attack
• A frequent — and very strong — desire to escape
• Avoiding social situations or fear of being embarrassed or humiliated in public
• Difficulty concentrating, either generally or only in specific situations
• Shortness of breath
• Palpitations or pounding heart
• Chest pain or discomfort
• Frequent headaches, muscle tension, pain, or upset stomach that doesn’t respond to ordinary treatment
• Trembling, shaking, restlessness, jumpiness, twitches, or feeling on edge
• Dizziness, nausea, or queasiness
• Hot flashes or chills
• Irritability
• Cold and clammy hands
• Profuse sweating
• Fatigue
• Trouble falling or staying asleep

Prevention

There are a number of steps you can take to reduce your anxiety.

• Get plenty of exercise. Yoga, jogging, cycling, racquetball, basketball, or anything that gets your heart rate up is good.
• Take a class in meditation or relaxation techniques. Spend time doing activities you really enjoy.
• Try to spend time with people you feel comfortable around.
• Join a support group. Knowing you’re not alone is extremely helpful and reassuring. There are general groups for people with a variety of anxiety issues. In addition, there are many groups that focus on specific types of anxiety. For example, if you get petrified at the thought of having to speak in front of a group, you might consider joining Toastmasters.
• Get plenty of sleep
• Eat well

Diagnosis

Men are less likely than women to be diagnosed with anxiety disorders but that’s in part because men are less likely to report them. Unfortunately, this could be because it’s more acceptable in our society for a man to see a healthcare provider for a physical problem such as chest pain, than it is to admit being nervous or anxious. And we have a tendency to believe that those traits affect women, not men. For that reason, if after reviewing the symptoms listed above, and you think you have an anxiety disorder; it’s essential that you contact your healthcare provider. One important reason for this is that anxiety symptoms can sometimes be caused by a physical condition such as heart problems, migraines or epilepsy.

Symptoms can also be caused by food (caffeine), medication (some decongestants, drugs for blood pressure and ADD or weight-loss pills) or illegal drugs (cocaine and others).

If able to rule out physical conditions, your healthcare provider may do some extensive screening to determine the type and severity of your anxiety. Although a team of researchers recently developed a blood test that may help diagnose anxiety disorders, it’s years away from being widely available. So healthcare providers have to do their diagnosing the old fashioned way: by asking you a series of questions and/or having you take a number of written tests.

Questions to Ask Your Health Care Provider

It’s important that you become proactive in your healthcare in order to get the best treatment. Here are some questions you can ask your healthcare provider about anxiety.

• What’s the cause of my anxiety?
• What are the symptoms associated with this disorder?
• Are there other health conditions that could be causing or worsening my anxiety?
• What medical tests do I need?
• What type of treatment options do you recommend and why?
• What are the side effects and benefits of the available treatment options?
• What can I do to help myself feel better during treatment for depression?
• Should I see a psychiatrist, psychologist or other mental health provider?
• Would cognitive behavioral therapy help me?
• Would medication help? If so, is there a generic alternative to the medicine you’re prescribing?
• Do you have any printed material that I can take home?
• What local support groups do you recommend?

Treatments

Once the correct diagnosis is made, anxiety disorders generally respond very well to treatment and you should start that treatment as soon as possible. At the very least, it will improve your quality of life. In addition, long-term, untreated anxiety increases your risk of hardening of the arteries (atherosclerosis), headaches, asthma, irritable bowel syndrome, ulcers, high blood pressure, and suicide. The specifics of your treatment will be based on your symptoms — how severe they are, how long they’ve lasted, what (if anything) triggered them and any other conditions you may have such as depression, diabetes, or alcoholism.

Nevertheless, those treatments will fall into 3 categories:

• Medication. The most common are specific anti-anxiety drugs, but antidepressants and some types of beta blockers (which help reduce performance jitters and anxiety) can also be helpful. Antidepressants often take a few weeks before they fully kick in and can be taken on a long-term basis. Anti-anxiety drugs are usually given only for a limited time because it’s possible to build up a tolerance, meaning you would need more and more to get the same effect over time. Remember that sharing another person’s medication is not a good idea. You may be taking the wrong thing for the wrong period of time.
• Psychotherapy, in particular cognitive behavioral therapy (CBT). Unlike traditional talk therapy, CBT is far more action-oriented and focuses on changing your thinking patterns by changing your behavior. You’ll learn what’s keeping you from functioning the way you’d like and you’ll learn new ways of dealing and coping by confronting your fears in a safe environment.
• A combination of medication and psychotherapy.

Resources

To find out more about anxiety visit the following:

Anxiety and Depression Society of America
Medline Plus
National Institute of Mental Health
Men’s Health Network