UTHealth Harris County Psychiatric Center

Anxiety Disorders

Anxiety DisorderGeneralized Anxiety DisorderGeneralized Anxiety Disorder TestSocial Anxiety DisorderSeparation Anxiety DisorderPanic Anxiety DisorderCommon Medications for Anxiety Disorder and DepressionTreatments

Everyone experiences anxiety - the butterflies in your stomach before a job interview, the tension you feel in a confrontation, the way your heart pounds when you are in danger. Anxiety is a perfectly normal and often helpful feeling. It prepares you for action and readies you to respond to a threatening situation.

But when you are unable to cope with your fears to the extent that they disrupt your daily life, you probably suffer from an anxiety disorder. Anxiety disorders can cause overwhelming fear or the complete inability to deal with a given situation, for no apparent reason. Sometimes anxiety disorders can cause fear so intense it totally disables its victims.

Anxiety disorders are the most common of all mental illnesses, and they are also the most treatable. Unfortunately, only about one quarter of the victims ever seek treatment.

Anxiety Disorder

Anxiety disorder is the most common of all mental illnesses. The combined prevalence of the group of anxiety disorders is higher than that of all other mental disorders in childhood and adolescence. Anxiety disorder leaves you unable to cope with daily life due to abnormal fears of life. Anxiety in moderation is a perfectly normal response – it is a healthy response preparing you for any action that may even be threatening. Anxiety disorders cause overwhelming fear and an inability to cope with any daily chore. Anxiety disorders can completely paralyze and disable the victim.

Anxiety disorder is the most treatable of all mental illnesses. Anxiety disorder produces unrealistic fears, excessive worry, flashbacks from past trauma leading to easy startling, changes in sleep patterns, intense tension and ritualistic behavior. Anxiety disorder also results in a slew of related physical symptoms such as shaking, sweating, racing heart, dizziness, nausea, vomiting etc.

A wide range of effective therapies and treatments of anxiety disorder are available. Usually anxiety disorder requires medication and cognitive-behavioral therapies in combination. Most patients of anxiety disorder respond well to treatment and there is a high success rate of treating anxiety disorder resulting in the return to productive and fulfilling daily lives. Unfortunately, most victims of anxiety disorder do not seek treatment.

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) refers to constant yet unrealistic worry about many areas of one’s daily life. Examples of generalized anxiety disorder are the safety about family members or persistent worries about financial security in spite of repeated assurances to the contrary. People with generalized anxiety disorder feel anxious, irritable, sleep deprived and physically stressed. In generalized anxiety disorder these symptoms are at a level that interferes with daily functions of life. Children with generalized anxiety disorder have excessive worries about all upcoming events and worry unduly about academic performance, sports activities, punctuality and even natural disasters. Generalized anxiety disorder persists even though they are not being judged and the performance has attained good results. Generalized anxiety disorder creates children who are perfectionistic, overly conforming and insecure and who need constant reassurance on all levels. Most adults seeking generalized anxiety disorder treatment report the onset in childhood or adolescence.

According to the NIMH (National Institute for Mental Health) generalized anxiety disorder is characterized by extended symptoms of unfounded chronic, exaggerated worry and tension, much more intense than normal anxiety experiences. People with generalized anxiety disorder expect the worst and worry incessantly about money, health, family and the workplace even though there are no visible signs to suggest a need to worry.

Generalized anxiety disorder sufferers are unable to relax and suffer insomnia and have many physical symptoms such as fatigue; trembling; muscle tension; headaches, irritability and hot flashes. Fortunately effective treatments for GAD have been developed and funded through industry and research supported through the NIMH.

Generalized anxiety disorder happens more in women. In half of the cases general anxiety disorder begins in childhood or adolescence. Generalized anxiety disorder has a fluctuating nature and symptoms exacerbate according to life’s stresses and difficulties.

In generalized anxiety disorder excessive worry and anxiety as well as apprehensive expectation occurs more often than not for more than a 6 month period. Controlling worry is difficult with general anxiety disorder. The worry of generalized anxiety disorder is not confined to specialized areas as in having panic attacks; the embarrassment of social phobia or being away from home in separation anxiety disorder. Rather in generalized anxiety disorder the worry, anxiety and physical symptoms cause impairment of social, occupational or other functional areas of life.

Generalized anxiety disorder usually strikes in childhood and adolescence but can also begin in adulthood, and seems to affect more women than men. NIMH research indicates that generalized anxiety disorder is genetic and grows worse during stressful times. Symptoms of generalized anxiety disorder manifest more slowly than in other anxiety disorders. The generalized anxiety disorder treatment includes simultaneous medication and cognitive-behavioral therapy. NIMH also reports that generalized anxiety disorder coexists with depression, substance abuse and/or other anxiety disorders. Irritable bowel syndrome, another stress related condition, can also accompany generalized anxiety disorder.

Generalized Anxiety Disorder Test

Once in a while everyone feels stressed and anxious, if these feelings persist, however, and interfere with daily tasks, generalized anxiety disorder may be the culprit. In order to diagnose the problem a generalized anxiety disorder test can be taken and can help in the diagnosis of this disorder that affects the lives of many Americans. The generalized anxiety disorder test is used in diagnosing the many men and women of all ages and races and socio-economic groups that are struck by this mental disorder. There are about 9 different symptoms that are available in a pre-screening test that does not replace the generalized anxiety disorder test that is used in the medical and psychiatric diagnosis of this common mental affliction. If you answer “yes” to some of the questions posed, a generalized anxiety disorder test may be indicated for further evaluation by a physician or mental health professional. Another indication for undergoing the generalized anxiety disorder test is the duration of some or all of the symptoms outlined in the preliminary anxiety screening. Besides the generalized anxiety disorder test that is measured at Research Institutes other related clinical research studies and investigational medications are available at Institutes such as Feighner Research.

Social Anxiety Disorder

Social anxiety disorder causes people to feel dread at the possibility of being humiliated during any social exposure. Social anxiety disorder involves a preoccupation of embarrassment and ridicule with tasks as diverse as eating a meal to delivering a speech. The social anxiety disorder emanates from the expectation of negative evaluation by others. A severe form of social anxiety disorder causes fear that even precludes contact with others. Social anxiety disorder is generally associated with significant anticipatory anxiety for a long time before the event in question. Social anxiety disorder produces symptoms that create even more tension for the sufferer in case others detect these symptoms. Social anxiety disorder symptoms tend to be found more in females.

Society anxiety disorder includes symptoms such as trembling, sweating/blushing, stuttering, fainting, losing bladder control or having a mind that goes blank. The severity of social anxiety disorder symptoms and impairments fluctuates normally in relation to vocational demands and social stability within the circle of family and friends.

Children with social anxiety disorder suffer consistent embarrassment during public performance or class presentations. These anxious feelings in social anxiety disorder produce physical reactions such as palpitations, tremors, sweating, diarrhea, blushing, muscle tension etc. Social anxiety disorder can result in full-blown panic attacks. Adults with social anxiety disorder are able to recognize the behavior as excessive, but are not able to prevent or control the fear. Children with social anxiety disorder are not able to recognize their excessive reactions but notice others' reactions to their anxiety. Children with social anxiety disorder do not function well in age appropriate social situations, fall behind and in more severe cases, avoid school completely. Social anxiety disorder is long lasting and interferes with daily routine, social situations and job and school venues.

Separation Anxiety Disorder

Separation anxiety disorder in children or adolescents should not be confused with the normal separation anxiety experienced in children and toddlers in daily situations. If an older child continues to react to potential separations with unreasonable fear, separation anxiety disorder may be diagnosed. Without professional help this disorder can damage a child’s self image and ultimately lead to adult emotional problems.

To reach the diagnostic level of separation anxiety disorder, the anxiety or fear must last at least a month and cause distress and affect social, academic and job functioning. Fear of separation in separation anxiety disorder can lead to symptoms of dizziness, nausea or palpitations and is also associated with the symptoms of depression, sadness, withdrawal, apathy and concentration challenges. Young children even suffer from fear and experience nightmares with separation anxiety disorder.

Separation anxiety disorder may run in families and is likely to affect shy, nervous children. Separation anxiety disorder is triggered by major changes in the child’s life such as death, hospitalization, divorce or a move to a new school. The symptoms of separation anxiety disorder are displayed in a number of ways as diverse as temper tantrums, nightmares, fear of the dark, physical symptoms, lack of concentration etc.

Although children or adolescents seeking treatment for separation anxiety disorder are equally distributed between the sexes, the separation anxiety disorder according to surveys is higher in girls. The remission rate is high with separation anxiety disorder. The cause of separation anxiety disorder is not clearly known although some risk factors have been identified. Separation anxiety disorder might develop after a significant family stress such as death or illness. Trauma, especially physical or sexual assault can trigger separation anxiety disorder. Children affected with separation anxiety disorder tend to emerge from close-knit families and although separation anxiety disorder tends to run in families, the exact role of environmental and genetic factors is yet to be established.

Panic Anxiety Disorder

Panic anxiety disorder involves sudden and unexpected attacks of extreme terror. The terror of panic anxiety disorder is intense. The symptoms of panic anxiety disorder can include shortness of breath, palpitations of the heart, chest pain, choking, trembling and faintness. Any or all of these symptoms of panic anxiety disorder can occur at any time. The distinguishing features of panic anxiety disorder are different from natural reactions to real danger. Anxiety panic disorder is potentially disabling but can be treatable although the symptoms of anxiety panic disorder were once dismissed as nerves or stress. Your predisposition to anxiety panic disorder increases if a close family member suffers from the disorder. Anxiety panic disorder can be destructive and debilitating.

Panic anxiety disorder is diagnosed when two unexpected panic attacks have been experienced. Additionally, panic anxiety disorder is marked by the development of persistent concern regarding further attacks and the change to behavior to avoid or minimize these attacks. Panic anxiety disorder is often complicated by a major depressive disorder. Panic anxiety disorder is also exacerbated by alcoholism and substance abuse disorders. Panic anxiety disorder co-occurs with other specific anxiety disorders such as social phobia, generalized anxiety disorder, specific phobia and obsessive-compulsive disorder.

Women are about twice as susceptible to panic anxiety disorder than men, and the disorder appears more commonly between late adolescence and mid-adult life. Panic anxiety disorder is genetic and is distinguishable form depressive conditions.

Anxiety panic disorder interferes with a child’s normal development and disrupts the school situation and social life. In extreme forms of anxiety panic disorder children may not leave the house and even avoid going to school to prevent fearful situations. Anxiety panic disorder increases the risk of depression, suicide and alcohol and drug abuse.

Treatment for anxiety panic disorder is effective and involves antidepressant or anxiety-relieving medications. Cognitive behavior therapy is another form of treatment anxiety panic disorder. The best treatment results for anxiety panic disorder are a combination of both treatments. Coping strategies in the form of relaxation techniques, leisure and recreation activities help to reduce the factors that exacerbate the condition of anxiety panic disorder.

Common Medications For Anxiety and Depression

New meds for anxiety disorder and depression results from research that indicates the engagement of a wide range of neural-circuits. Two key regulatory centers, called hippocampus and amygdala govern memory storage and emotions amongst others. Benzodiazepines, antidepressants and buspirone are typically used to treat anxiety disorder and depression.

  • Benzodiazepines are medications with anti-anxiety and sedative- hypnotic effects.
  • Antidepressant medications have substantial anti-anxiety and anti-panic effects. Monoamine oxidate inhibitors (MAOIs) are new meds for anxiety disorder and depression that have significant antiobsessional, antipanic and anxiolytic effects, however they are seldom used unless simpler medication strategies have failed. The five drugs within the SSRI class, are new meds for anxiety disorder and depression and are the preferred type of antidepressant for treatment of anxiety disorders.
  • Buspirone, one of the new meds for anxiety disorder and depression is not habit forming and has no abuse potential. It is comparable to the SSRIs and is better tolerated than the TCAs. It is more useful in the treatment of generalized anxiety disorder.

Anxiety and depression frequently coexist, so that patients that exhibit both conditions are the rule rather than the exception. Many of the new meds for anxiety disorder and depression medications can be used in isolation or concurrently for both disorders.

New meds for anxiety disorder and depression involves medications such as Paxil, Toffranil or Norpramin and are effective in preventing future attacks. Other new meds for anxiety disorder and depression such as Ativan or Xanax may be given alone or in combination with other medications.

Cognitive behavior therapy enables the understanding of the condition, how to deal with the problem and finally the coping techniques for the disorder. A combination of medicine and cognitive behavior techniques work best to manage the condition.

Treatments

Mental health professionals offer a wide range of effective therapies and treatments for anxiety disorders, drawing on significant advances in procedures and technologies. Anxiety disorders usually require a combination of medication and cognitive-behavioral therapies.

Today, a variety of medications are available for anxiety disorders. If one is ineffective, there are usually others to try. Patients generally start with low doses and gradually increase as needed. Like others, medications for anxiety disorders have side effects, but they usually become tolerable or diminish with time.

Behavioral therapies are also effective in treating anxiety disorders. They focus on changing specific actions and use several techniques to stop negative behavior. One technique - exposure therapy - involves exposing the patient to the feared object or situation on a gradual basis until the fear is reduced or eliminated. In cognitive-behavioral therapy, a related therapy, patients learn to react differently to the triggers of anxiety attacks. They also learn to understand how their thinking patterns contribute to their symptoms and how to change their thoughts to reduce or prevent the symptoms.

Most patients respond well to treatment, and the success rates among those who receive treatment are usually very high, allowing patients to return to productive, fulfilling lives.