Most people experience feelings of anxiety before an important event such as a big exam,
business presentation or first date. Anxiety disorders, however, are illnesses that cause
people to feel frightened, distressed and uneasy for no apparent reason. Left untreated,
these disorders can dramatically reduce productivity and significantly diminish an
individual's quality of life. Fortunately, through research conducted by the National
Institute of Mental Health (NIMH), there are effective treatments that can help. NIMH is
conducting a national education campaign to increase awareness of these disorders and
their treatments.
How Common Are Anxiety Disorders?
Anxiety disorders are the most common mental illnesses in America: more than 19 million
are affected by these debilitating illnesses each year. Anxiety disorders cost the
U.S. $46.6 billion in 1990 in direct and indirect costs, nearly one-third of the nation's
total mental health bill of $148 billion.
What Are the Different Kinds of Anxiety Disorders?
Panic DisorderRepeated episodes of
intense fear that strike often and without warning. Physical symptoms include chest pain,
heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of
unreality, and fear of dying.
Obsessive-Compulsive DisorderRepeated,
unwanted thoughts or compulsive behaviors that seem impossible to stop or control.
Post-Traumatic Stress DisorderPersistent
symptoms that occur after experiencing a traumatic event such as rape or other criminal
assault, war, child abuse, natural disasters or crashes. Nightmares, flashbacks, numbing
of emotions, depression and feeling angry, irritable, distracted and being easily startled
are common.
PhobiasTwo major types of phobias are
specific phobia and social phobia.
- People with specific phobia experience extreme,
disabling, and irrational fear of something that poses little or no actual danger; the
fear leads to avoidance of objects or situations and can cause people to limit their lives
unnecessarily.
- People with social phobia have an overwhelming and disabling fear of
scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of
many potentially pleasurable and meaningful activities.
Generalized Anxiety
DisorderConstant, exaggerated worrisome thoughts and tension about
everyday routine life events and activities, lasting at least six months. Almost always
anticipating the worst even though there is little reason to expect it; accompanied by
physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.
What Are the Treatments for Anxiety Disorders?
- Medications: Although they are not cures, medications can be very
effective at relieving anxiety symptoms. These include antidepressants or benzodiazepines.
Today's treatments are extremely effective and often involve the combination of medication
with specific types of psychotherapy. There are more medications available than ever
before to treat anxiety disorders, so if one drug is not successful, there are usually
others to try. In addition, new medications to treat anxiety symptoms are under
development. For most of the medications that are prescribed to treat anxiety
disorders, the doctor usually starts the patient on a low dose and gradually increases it
to the full dose.
Every medication has side effects, but they usually become tolerated or diminish with
time. If side effects become a problem, the doctor may advise the patient to stop taking
the medication and to wait a weekor longer for certain drugsbefore trying
another one.
When treatment is near an end, the doctor will taper the dosage gradually.
- Psychotherapy: Research has also shown that behavioral therapy and
cognitive-behavioral therapy can be effective for treating several of the anxiety
disorders.
- Behavioral therapy: This type of therapy focuses on changing specific
actions and uses several techniques to decreases or stop unwanted behavior. For example,
one technique trains patients in diaphragmatic breathing, a special breathing exercise
involving slow, deep breaths to reduce anxiety. This is necessary because people who are
anxious often hyperventilate, taking rapid shallow breaths that can trigger rapid
heartbeat, lightheadedness, and other symptoms. Another techniqueexposure
therapygradually exposes patients to what frightens them and helps them cope with
their fears.
- Cognitive-behavioral therapy: Like behavioral therapy,
cognitive-behavioral therapy teaches patients to react differently to the situations and
bodily sensations that trigger panic attacks and other anxiety symptoms. However, patients
also learn to understand how their thinking patterns contribute to their symptoms and how
to change their thoughts so that symptoms are less likely to occur. This awareness of
thinking patterns is combined with exposure and other behavioral techniques to help people
confront their feared situations.
For example, someone who becomes lightheaded during a panic attack and fears he is
going to die can be helped with the following approach used in cognitive-behavioral
therapy. The therapist asks him to spin in a circle until he becomes dizzy. When he
becomes alarmed and starts thinking, "I'm going to die," he learns to replace
that thought with a more appropriate one, such as "It's just a little
dizzinessI can handle it."
Is it Possible for Anxiety Disorders to Coexist with Other
Physical or Mental Disorders?
It is common for an anxiety disorder to accompany another anxiety disorder, or in some
cases depression, eating disorders or substance abuse.
Anxiety disorders can also coexist with physical disorders. In such instances, these
disorders will also need to be treated. Before undergoing any treatment, it is important
to have a thorough medical exam to rule out other possible causes.
Many people with anxiety disorders can be helped with the type of
treatments mentioned here. The best therapy is that which has been developed together with
your personal physician and tailored to your specific needs, goals, and objectives.
modified from
information provided by the National Institute of Mental Health |