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Information about Anxiety disorders

Treatments for Anxiety Disorders

A variety of treatments, including medications and therapy, are available for generalized anxiety, panic, social anxiety, obsessive-compulsive, and post-traumatic stress disorders.

Some individuals do well with treatment that includes both psychotherapy and medication. Medications commonly used to treat these disorders include antidepressants and anti-anxiety medications (including benzodiazepines and other “Valium-like” medications). Helpful information about specific medications can be found at www.medlineplus.gov (click on "Drugs and Supplements").

Psychotherapies such as Cognitive-Behavioral Therapy (CBT) are also used to treat anxiety disorders. CBT reduces symptoms through exposing a person to situations, sensations and thoughts that provoke anxiety, in a safe and structured therapeutic setting, and working to help the person change thinking and behavior patterns, and learn skills to manage difficult emotions and overcome difficulties in interpersonal relationships.

Click here to view a free online video on CBT: Step-by-Step Strategies for Enhancing Well-Being: An Introduction to Cognitive-Behavior Therapy for the Treatment of Anxiety and Mood Disorders.

Anxiety Disorders

While everyone may have occasional moments of feeling anxious or worried, an anxiety disorder is a treatable medical condition that causes people to feel persistently, uncontrollably anxious, fearful or worried over an extended period of time. The disorder may result in significant distress in a number of settings, such as work, social settings, and home life, and it may dramatically affect people's lives by limiting their ability to engage in a variety of activities. The tendency to develop an anxiety disorder involves complex genetic and environmental factors, and it is possible for a person to have more than one anxiety disorder.

These disorders include:

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) causes excessive anxiety and worry about a number of life issues or day-to-day concerns, on the majority of days, for at least six months. People with GAD find it difficult to control their worry. This inability to stop worrying, or to relax, even in the absence of major life stresses, is one of the cardinal features of the disorder.

People with GAD also often experience associated symptoms such as: restlessness, feeling keyed up or on edge, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance. The anxiety and worry is considered a disorder if it is severe enough to cause significant distress or interferes with social or occupational functioning.

Adults with GAD often worry excessively about everyday, routine life circumstances such as job responsibilities, finances, or the health of themselves or their family members. Children with generalized anxiety disorder are often preoccupied with worries about their success in school and social activities and their ability to obtain the approval of others. They may appear inflexible or excessively worried about conforming to rules and may not be able to enjoy hobbies or other recreational activities. Click here for information on Treatments.

Panic Disorder

Panic disorder is characterized by repeated panic attacks, at least some of which are “out of the blue.” Panic disorder differs from GAD in that the anxiety in panic disorder comes and goes and is of varying intensity, whereas the anxiety of GAD is continuous. In addition, a person with panic disorder experiences at least a month of: persistent concern about having more attacks, worry about the implications of having an attack (for example, “is there something wrong with my heart?”), or a change in behavior related to the attacks (for example, avoiding a place or situation).

Panic attacks are periods of intense fear or anxiety that tend to come on quickly and usually end within 10 minutes. These attacks are accompanied by at least four of the following symptoms of arousal: palpitations (heart racing); sweating; trembling or shaking; shortness of breath or choking; chest pain; feeling dizzy, lightheaded or “woozy”; nausea or upset stomach; face or skin flushing or hot or cold flushes; tingling in hands, feet or other parts of the body; “spaciness” or feeling unreal or cut off from one’s surroundings; or feeling as if one may be dying, going crazy, or losing control. Many people with panic disorder develop agoraphobia .

Panic disorder may look different in young people than in adults, because children may tend to focus to an even greater extent on the physical rather than psychological symptoms that accompany panic attacks. Children having a panic attack may appear to be suddenly frightened or upset with no easily identified explanation. Sometimes children having a panic attack incorrectly explain their symptoms as a response to an external trigger. Click here for information on treatments.

Agoraphobia

Agoraphobia is anxiety about, or avoidance of, places or situations where previous panic attacks have occurred, or where help or easy escape may not be available in the event of a future panic attack. Some people with agoraphobia avoid the feared situations or require a companion to accompany them, while others endure the feared situations with a great deal of distress. Panic disorder can cause significant difficulties, including marked distress, social and job-related dysfunction, repeated visits to doctors and emergency rooms, and increased rates of depression and alcohol abuse. Click here for information on treatments.

Social Anxiety Disorder

Social anxiety disorder (SAD), also known as social phobia, causes significant, often impairing, anxiety about being in situations where an individual perceives him or herself to be the center of attention, as well as fear of embarrassing oneself in social situations. It is characterized by marked and persistent anxiety about performance situations such as public speaking or may be generalized to a variety of social situations including interacting in small groups or with people in authority, where they may be exposed to unfamiliar people or to the possible scrutiny of others. People with SAD often recognize that their fear is excessive or unreasonable, but they avoid such situations or endure them with great difficulty. This avoidance or distress can significantly interfere with a person’s normal routine. SAD differs from panic disorder in that the anxiety is focused on social and/or performance situations.

Social phobia may look different in young people than in adults. While adults recognize the excessiveness of their discomfort in social situations, children may not have that understanding. Younger children with social phobia may protest when forced to leave a parent’s side, have a tantrum when facing a social encounter, refuse to play with friends, or complain about physical illness at the time of a social event. Adolescents may simply avoid group gatherings or describe little interest in friendships. Click here for information on treatments.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) produces uncontrollable, recurring thoughts and fears that are often accompanied by repetitive behaviors intended to prevent the fears from being realized. People with OCD typically experience the persistent thoughts, impulses, and images of the disorder as intrusive, unwanted, or inappropriate, and the symptoms may cause them marked anxiety.

Obsessions are preoccupations with certain thoughts or impulses that are not simply excessive worries about everyday problems. Individuals suffering from obsessions might count things out multiple times, worry about potential contamination, or constantly evaluate the symmetry of their surroundings. People with OCD often attempt to suppress, ignore or neutralize their obsessions with another thought or action, without success.

Compulsions are repetitive actions a person feels he or she must carry out. The repetitive actions are aimed at preventing or reducing distress or a dreaded event or situation. Compulsions may include cleaning (such as frequent hand washing) and checking behaviors (such as repeatedly checking whether the stove is off, or if the house is locked).

OCD is commonly diagnosed when a person’s obsessions or compulsions cause significant distress, take a substantial period of time each day, and are recognized by the person, at least some of the time, as being unreasonable. Click here for information on treatments.

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) may develop after a person experiences or witnesses a highly traumatic event. PTSD produces persistent re-experiencing of the event and intrusive psychological and physical symptoms. In general the traumatic event involves a significant threat of, or experience of, severe bodily harm or loss of life. Some examples of traumatic events that could lead to the development of PTSD are: car accidents; natural disasters such as hurricanes or earthquakes; physical or sexual assault; emotional, physical, or sexual abuse; combat exposure; or learning about the unexpected death or injury of a loved one.

Although not all individuals exposed to a trauma develop PTSD, some individuals experience a number of distressing psychological and physical symptoms including re-experiencing the event, avoidance or numbing, and hyperarousal (difficulty falling or staying sleep, irritability, angry outbursts, difficulty concentrating, being easily startled, or feeling always “on guard”).

PTSD is diagnosed when symptoms persist for at least one month and cause significant distress, interference, or impairment at work, school, or in social functioning. Symptoms may last for several months, or become even more chronic. For some people, PTSD symptoms emerge six months or more after the traumatic event. One way PTSD differs from OCD is that in PTSD intrusive thoughts pertain to the traumatic experience. Click here for information on treatments.