One in three adults in America will struggle with an anxiety disorder at some point in their lives, making it the most common type of mental illness. Anxiety disorders describe a category of disorders with several subtypes. While each type has different symptoms, they share a core defining symptom of excessive anxiety that impacts a person’s daily life and functioning.
Most people experience occasional feelings of nervousness, worry, or fear. These feelings are often triggered by a particular situation and subside afterward, which is considered normal. When these feelings occur too frequently (like almost daily for 6 months) and impact one’s ability to enjoy themselves, engage in activities, and meet the demands of daily life, they might be a sign of an underlying anxiety disorder. Left untreated, anxiety disorders often worsen but with treatment, symptoms can be improved and hopefully resolved.
Types of Anxiety Disorders
Anxiety disorders include a number of distinct mental health conditions that can be diagnosed by a licensed mental health professional. Each disorder features different patterns of onset, duration, and symptoms. Some anxiety disorders, like Generalized Anxiety Disorder, can result in spontaneous anxiety while others like Specific Phobias and Posttraumatic Stress Disorder tend to be triggered by specific circumstances.
Here are some of the most common types of anxiety disorders:
Generalized Anxiety Disorder
While many people with anxiety can identify specific situations or triggers for their symptoms, people suffering from Generalized Anxiety Disorder (GAD) might have more trouble doing so. People with GAD regularly experience excessive anxiety in response to a variety of triggers.1
Their symptoms can include restlessness, fatigue, trouble concentrating, irritability, muscle tension, and sleep disturbance. These symptoms occur more days than not for a period of at least six months and cause problems or impairments in the person’s life. It’s estimated that GAD will affect 5.7% of adults in the US at some point in their lives.
Social Anxiety Disorder
Social Anxiety Disorder is a disorder where symptoms of anxiety are limited to social settings. People affected by Social Anxiety Disorder fear specific situations where they feel they may be judged or scrutinized by others. They often go to great lengths to avoid these situations and this avoidance can result in significant disruptions to their routine, occupational functioning, and personal relationships.
When a person with Social Anxiety Disorder is in social situations, they tend to experience high levels of self-consciousness and discomfort which can escalate into panic attacks. It is estimated that 12.1% of American adults will experience Social Anxiety Disorder at some point in their lives.2
Social Anxiety Disorder can escalate into Agoraphobia, which is a disorder characterized by an intense fear of being in public places. People with Agoraphobia can be triggered by specific types of public places like crowded places, large open spaces, or by any public place. When they are in these spaces or even anticipate being in them, they experience intense anxiety and panic attacks.
Over time, their avoidance of these public spaces tends to lead to a worsening of their symptoms and a significant disruption to their lives, routines and relationships. At the extreme, people with Agoraphobia may not leave their homes at all, relying heavily on others to function. Only 1.3% of adults will develop Agoraphobia in their lifetimes, and females and older adults are at higher risk for the disorder.
Panic attacks are intense symptoms of anxiety that usually manifest in physiological changes like rapid heart rate and breathing, sweating, dizziness, or pain in the chest or stomach. These symptoms tend to come on suddenly and can last for several minutes.
Panic attacks can affect people with any kind of anxiety disorder, but when these attacks become regular they may signal the development of Panic Disorder. Panic Disorder develops when a person becomes intensely anxious about having a panic attack, resulting in disruptions to their routine and functioning. Panic disorder will affect an estimated 4.7% of American adults at some point in their lives.
When a person’s anxiety is limited to a specific trigger or situation, they may be suffering from a phobic disorder. Phobias are specific fears that people might have including a fear of flying, needles, speaking in public, or a fear of snakes. While most people have one or more specific fear, few would meet the criteria for a Specific Phobia.
In order to be diagnosed with a Specific Phobia (or any mental health disorder), the person’s symptoms must cause significant distress or impairment to the person on a regular basis. In the course of their lives, an estimated 12.5% of American adults will experience a specific phobia.1
Obsessive Compulsive Disorder
Obsessive Compulsive Disorder (OCD) is an anxiety disorder that is characterized by intrusive thoughts (obsessions) and repetitive behavior patterns (compulsions). People with OCD often are significantly distressed by the nature of their intrusive thoughts, which may include themes of violence, sexual content, disease or danger.
In order to relieve anxiety generated by these thoughts, people with OCD will often engage in specific repetitive behaviors like handwashing, checking, or mental tasks like counting, repeating words or researching. In some instances, these repetitive behaviors may be self-destructive like skin picking or hair pulling. Over time, people with OCD may find that their lives become significantly disrupted by these routines. An estimated 2.3% of American adults will experience OCD in their lives.2
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a disorder where symptoms of anxiety begin after a person hears about, witnesses, or directly experiences a traumatic event. The traumatic event could be an assault, accident, or any other incident involving a threat of death or serious harm.
Symptoms of PTSD can mimic those of other anxiety or mood disorders but a core defining symptom is the experience of flashbacks, nightmares, or uncontrolled memories of the event. When these occur, the person re-experiences the traumatic event and feels unable to stop these upsetting memories, sometimes even dissociating (losing touch with where they are). They often will go to great lengths to avoid thinking about or triggering a memory of the trauma. 6.8% of adults in the US will experience PTSD in their lifetime.
Other Types of Anxiety Disorders
Less frequently, people will suffer from other types of anxiety disorders not mentioned in the list above. These might include:
- Anxiety disorders related to an underlying health issue or are related to the effects of a prescribed or illicit substance
- Separation Anxiety which primarily affects children and is characterized by extreme anxiety when separated from loved ones (usually caregivers)
- Selective Mutism which also primarily impacts children and is characterized by a fear of speaking and a refusal to do so in certain settings.
- Unspecified Anxiety Disorders which includes some symptoms of anxiety that do not match other known anxiety disorders but do cause significant distress or impairment.
Symptoms of Anxiety
Symptoms of anxiety vary depending on the type of disorder and also on individual differences of people experiencing them. Even for people who experience many of the following symptoms, typically a diagnosis would only be made if there was also evidence of impairment or distress. This means that people who experience some of these symptoms and find that they get in the way of their ability to enjoy, engage or function in their daily lives are more likely to be suffering from an anxiety disorder.2
While a formal diagnosis can only be made by a licensed professional, some of the warning signs and symptoms of an anxiety disorder include frequent experiences of:
- Nervousness, worry or fear that is excessive and disproportionate to the situation
- Restlessness or feelings of being tense or on-edge
- Frequent irritability or a tendency to lash out at others
- Panic symptoms which can include shortness of breath, a racing heart, dizziness, shaking, sweating, or loss of consciousness
- Intrusive fear-based thoughts that are difficult to control and cause distress
- Disturbing nightmares, flashbacks or memories of something bad that happened
- Anxiety that causes a temporary loss of awareness of where a person is or what they are doing
- Anxiety that gets in the way of being able to focus or perform daily tasks
- Anxiety that leads to avoiding tasks or situations that are important to the person
- Anxiety that leads to a strong uncontrollable impulse to engage in certain rituals or repetitive actions
- Anxiety that leads to frequent physical ailments like migraines, nausea, or GI upset
- Anxiety that disrupts normal sleep or eating routines
What Anxiety Looks Like
People of all ages can, and do, experience anxiety, but the signs of anxiety can vary. In children, anxiety can sometimes present differently than in older teens and adults. Children commonly describe more physical symptoms of anxiety which can include complaints of stomach and headaches or chest pains. Anxious children may also act out, throwing tantrums or displaying a lot of defiant behavior. These different presentations may be partially due to the fact that children often lack the language or abstract thinking skills needed to describe their emotions.
In teens, anxiety can also show up behaviorally. Anxious teens may seem more moody and get into more confrontations with teachers and parents or they may begin socially isolating themselves. Parents of anxious children and teens may notice that their grades are dropping or hear from teachers that their child is less focused in class. Changes in sleep and eating patterns may also indicate an underlying anxiety disorder.
Even adults may miss signs and symptoms of an anxiety disorder. They might chalk their symptoms up to stress or deny the extent to which they are getting in the way of their ability to function. Not all adults will experience anxiety in the same way. Some may experience more physical symptoms like a racing heart, GI upset, muscle tension, and migraines. Others may experience anxiety more cognitively, struggling with worried thoughts about bad things that might or could happen. Some might even lack the ability to recognize changes in their thoughts and feelings but just notice behavior changes like that they are not sleeping or eating well, are lashing out more, or are performing worse at work.
Understanding Anxiety: What It Is and Why It Happens
Understanding what is happening in the body and brain when people are experiencing anxiety can help improve their ability to cope and respond effectively. The discomfort that people feel when they are anxious is largely a result of physiological and neurological changes occurring.4 These changes begin in the brain when the amygdala, one part of the brain that helps detect danger, becomes aware of a potential threat. The amygdala then activates the nervous system, resulting in the release of stress hormones and chemicals like cortisol and adrenaline.
When the nervous system is activated and hormones and chemicals are released, people experience a range of physical changes. These changes can vary but usually include an increase in heart rate and respiration and a surge of nervous energy. These responses have an adaptive function, providing energy that could help us fight, ward off or outrun a predator. This response is called the “fight or flight response” and is wired into humans for survival purposes.
The problem is that the amygdala hasn’t evolved to match the modern world. Since most people aren’t regularly being attacked by bears or a neighboring tribe, fight or flight responses aren’t as useful as they once were. Still, many people continue to experience these responses on a regular basis and people with anxiety disorders experience them too frequently. The constant activation of fight or flight is largely a problem related to “false alarms”, or the amygdala’s inability to discern what is safe from what is dangerous.
Treatment for Anxiety Disorders
Anxiety disorders can cause people a great deal of distress, and can get in the way of living a full and productive life. Luckily, anxiety disorders are highly treatable.3 Treatment for anxiety disorders can include therapy, medication, and even lifestyle changes that can help reduce symptoms.
Therapy for Anxiety Disorders
Therapy is a front-line treatment for anxiety, and can be highly effective at helping people learn skills and strategies to manage and reduce symptoms. Usually, therapy is offered by a licensed counselor or social worker for about an hour a week, although that can vary based on a person’s needs. Over time and as people’s symptoms improve, they often come less frequently and eventually complete treatment.
Therapists vary in their style, approach, and training, and while many approaches can be effective, some people will respond better to one approach than another. Some of the more common types of therapy for anxiety disorders include:
- Cognitive Behavioral Therapy (CBT): A therapy approach that helps people adjust their thoughts and behaviors to manage symptoms of anxiety
- Exposure Therapy: A type of Cognitive Behavioral Therapy that helps people become desensitized to specific anxiety triggers
- Trauma Focused Cognitive Behavioral Therapy (TFCBT): A combined individual and family therapy effective in treating children and teens with PTSD
- Eye Movement Desensitization and Reprocessing (EMDR): A therapy that helps people process through traumatic memories using bilateral stimulation via eye movements or tapping
- Acceptance and Commitment Therapy (ACT): A therapy approach that focuses on helping people decrease unhelpful responses to symptoms and engage in activities that align with their personal values
- Mindfulness Based Approaches: A broad therapy approach that teaches people to use mindfulness techniques to promote relaxation, engagement, and awareness
- Person-Centeredness: Most therapists use aspects of this approach but those who use it exclusively tend to be less directive, using reflection to help clients build self awareness
Medication Options for Anxiety Disorders
At times, medication may be recommended as a part of treatment for an anxiety disorder. Medications can be prescribed by a medical doctor, psychiatrist, nurse practitioner, or physician’s assistant, but usually not by a therapist or social worker. The three most commonly prescribed types of medication for anxiety disorders are Antidepressants, Beta blockers and Benzodiazepines, but other medications are also sometimes prescribed.
The medications commonly used to treat anxiety disorders include:
- Certain antidepressants that work on neurotransmitters thought to be involved in anxiety disorders. These medications might be prescribed to those struggling with both anxiety and depression, but are also sometimes prescribed as a stand-alone treatment for anxiety.
- Beta blockers are medications that block certain chemicals (mainly norepinephrine and adrenaline) that are released during times of stress or anxiety. While these medications are usually prescribed to control blood pressure or heart problems, they are increasingly being prescribed to people with anxiety because they are safer than other anti-anxiety drugs.
- Benzodiazepines are a class of drugs that have sedative effects. They work in the central nervous system on specific neurotransmitters known to affect anxiety (primarily the neurotransmitter GABA). While these drugs are often prescribed to treat occasional anxiety, they carry serious risks, particularly that of dependence, especially when used long-term.
- Buspirone is a medication that has a unique mechanism of action unlike other medications in these classes and boasts a higher safety profile with less side effects and no known risk of dependence.
- Antipsychotic medications are sometimes prescribed to people with anxiety disorders. While normally used to treat people with psychotic disorders like Schizophrenia, these medications can be helpful to people who experience a lot of intrusive thoughts with their anxiety, like those struggling with OCD.
Lifestyle Changes to Help with Anxiety Disorders
In addition to formal treatment options like therapy and medication, there are also certain lifestyle changes that people can make to help their anxiety. Certain activities and routine adjustments can help to reduce stress and control symptoms. Because anxiety has a neurochemical basis, many of the suggested lifestyle changes are ones that work to rebalance these chemicals.
Some lifestyle changes that can help manage anxiety include:
- Mindfulness and meditation practices can help promote relaxation, decrease stress, and distance people from anxious thoughts
- An active lifestyle that includes regular exercise helps to balance neurochemicals and stress hormones linked to anxiety
- A consistent sleep routine that includes 7-8 hours per night helps reduce stress, improve focus and performance, and prevent health and mental health issues
- Cutting back on caffeine can also make a difference for those suffering with anxiety disorders, as caffeine’s stimulating properties can induce anxiety
- Regularly spending time with friends or family is an essential part of wellness, decreasing risk and severity for both physical and mental health issues
- Enjoying offline time is another lifestyle change that can help reduce anxiety, as some people might find that work emails, social media, or other notifications cause stress and anxiety
- Introducing positive thoughts can help to build new thinking habits that counteract stress and anxiety
- Practicing self-compassion through kind self-talk and consistent self-care activities has shown to be helpful in reducing a range of mental health issues, including anxiety
- Learning more about anxiety online or from a professional can be helpful in understanding signs and symptoms, helping people feel more in control of their symptoms
- Finding supportive people to talk to about anxiety (friends, a therapist, or a support group) can also help people have an outlet and feel less alone in their experience
How to Get Treatment for Anxiety
If you know or suspect that you or someone you care about is struggling with an anxiety disorder, it’s important to get treatment. Left untreated, anxiety disorders often worsen but with treatment, symptom relief and even symptom resolution is possible. If you have health insurance, the best place to start finding treatment options is often to go through your insurance plan to find an in-network provider.
You can usually do so by calling the number on the back of your insurance card or by using the insurance company’s website to locate local in-network providers. Going through your insurance company is also helpful because you can get answers about what your out-of-pocket costs will be. Typically, searching for “behavioral outpatient” or “mental health outpatient” will provide you with a list of options for therapists near you. If you are looking for medication in addition to therapy, you would search for in-network psychiatrists.
For those without insurance or who prefer to pay out-of-pocket, it might make more sense to use a therapist directory where you can browse profiles of local therapists. Online therapist directories usually have advanced search filters that allow you to narrow down to providers who are within a certain mile radius of you, who have afterhours availability or those who have specialized experience in anxiety.
If you are a parent looking for help for your child, you can use these filters to find a provider who specializes in working with children. Increasingly, there are more options accommodating those with scheduling restrictions or who live in underserved areas through online and video therapy (also known as telemental health or teletherapy).
Aside from professional help, people with anxiety disorders often benefit from having a strong personal support system. This may consist of friends, family, or a significant other. For those without strong natural supports in place, it may be important to begin building these relationships. Most communities offer self-help groups like those sponsored by NAMI (The National Alliance on Mental Illness), which can provide support and connection to those struggling with mental illness.
Key statistics on anxiety from the National Institute of Mental Health
- Anxiety disorders impact 40 million adults in America each year
- 31.9% of teens between the ages of 13-18 are affected by an anxiety disorder
- Within their lifetime, 31.1% of adults in America will struggle with an anxiety disorder
- Only 36.9% of people struggling with an anxiety disorder will get treatment
Living with Anxiety: Coping & Managing Symptoms
It is possible for people with anxiety disorders to live full and productive lives. Like managing any other chronic health issue, this is often achieved through a combination of formal treatment and healthy lifestyle choices. Over time, people may find that their treatment needs change as their anxiety worsens or improves. Working closely with a health or mental health professional can help people assess their treatment needs over time, making adjustments as needed.
Anxiety vs Stress vs Depression
Much overlap exists between anxiety, stress, and depression, but they are distinctly different experiences that can occur independently or together. Anxiety is the frequent experience of excessive nervousness or worry. People can experience high levels of anxiety in response to small triggers and even during times when there is no identifiable trigger. Stress, on the other hand, occurs in response to specific triggers that are typically identifiable. During times of high stress, people with any mental health disorder, including anxiety, are at higher risk of developing symptoms.
Depression is the second most common mental health condition affecting American adults and is characterized by persistent feelings of sadness and a loss of energy, motivation or interest. People who experience depression often have depressive episodes lasting weeks or longer. Many people who experience depression also experience anxiety, and there is a high rate of comorbidity between the two disorders. While symptoms of anxiety and depression can happen at the same time, they can also occur independently, even in those diagnosed with both disorders.
Anxiety Tests & Quizzes
While people cannot self-diagnose an anxiety disorder, doing some additional research can be helpful to some in identifying signs or symptoms. This should not be a substitute for professional help or a clinical diagnosis, but may be useful for those looking for more information. Here are some resources where you can learn more about symptoms of anxiety:
- The Anxiety and Depression Association of America’s website provides some useful information about anxiety disorders.
- The National Institute on Mental Health conducts widespread research into mental health disorders and is a reputable source of information.
- The Anxiety and Depression Association of America also has a screening tool that people can use to identify signs of an anxiety disorder.
- The GAD-7 is a tool that professionals sometimes use to help determine a diagnosis of an anxiety disorder, but should not be used as a standalone tool for diagnosis.
While these tools can be helpful resources in identifying warning signs, they are not reliable tools for diagnosing an anxiety disorder.
If you or someone you care about is concerned about a potential anxiety disorder, seeking professional treatment is highly recommended. Licensed professional counselors, social workers, psychologists, or psychiatric medication prescribers are able to determine whether a person is experiencing an anxiety disorder and also help the person understand this disorder and their options for treatment.