Anxiety disorders are disorders where anxiety is a primary characteristic. Anxiety is an unpleasant emotional state where the person feels dread, uneasiness and apprehension. Anxiety also affects the body and a person may feel dizzy, tense, have a dry mouth and sweat more than normal.

We all experience anxiety, but if it becomes too severe, it can become problematic and be regarded as a disorder. One in ten people will experience an anxiety disorder.

There are different types of anxiety disorder, the most common being, generalised anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive compulsive disorder and phobias.

Generalised anxiety disorder

What is it?

Generalised anxiety disorder (GAD) is the most common anxiety disorder and is also known as anxiety reaction. With GAD, the person experiences anxiety symptoms which can occur at any time. The anxiety is not limited to a particular situation and as such are likely to be ongoing and about many different things. Sufferers worry excessively about things happening in their life or things they fear may happen. The experience can be overwhelming. A person is diagnosed with the disorder if they experience the anxiety for more than six months.

Symptoms

The person with GAD will experience trembling, sweating, light-headedness, irritability and feel jittery. They will feel overwhelmed and constantly worried and apprehensive. Sleep difficulties, headaches, muscle tension, nausea and rapid heart rate are likely. The sufferer is often pessimistic, assuming the worst has happened or will happen. People may also experience panic attacks.

What causes it?

A number of causes are likely:

• Life events can lead to anxiety - particularly those deemed threatening to the person.

• The person may have come to associate a situation as anxiety-provoking and so avoid the situation. However, by avoiding the situation, the anxiety is upheld.

• They may have concerns about the future.

• Sufferers may feel they are not in control.

• Stress and drug abuse can also lead to anxiety.

Who does it affect?

Generalised anxiety disorder can affect anyone, although it does tend to run in families. Approximately 3% of Australians will experience GAD.

How is it treated?

Different treatments are available and may include the following:

• Behaviour therapy: helps address the symptoms of anxiety.

• Cognitive therapy: helps deal with thought patterns and to overcome distortions.

• Psychotherapy / counselling: assists sufferer to build on strengths and personal qualities.

• Drug therapy: if the anxiety is extremely problematic,the sufferer is given medication. This can relieve symptoms and help the person function again.

• Relaxation techniques can help.

Panic disorder

What is it?

With panic disorder the sufferer experiences panic attacks. Panic attacks are episodes where the sufferer feels overwhelming fear and are convinced the worst is about to happen. They can occur at anytime and so are not associated with a particular object or situation. People diagnosed with the disorder will experience at least four panic attacks a month.

Symptoms

Symptoms of panic disorder include: nausea, sweating, palpitations, dizziness, feeling faint, muscle tremors, chest pains and shortness of breath. The person thinks they are going to die or lose control. An attack lasts between 10 and 20 minutes. The person may avoid places where they previously had a panic attack, fearing it will happen again. Agoraphobia may develop as a result. People with the disorder have also attempted suicide.

What causes it?

Different causes are likely and may include the following:

• The disorder may be due to a possible reaction to chemicals in the brain.

• Childhood: experiencing difficulties in the home or school.

• As a result of a particularly traumatic life experience.

• There may be a genetic link.

Who does it affect?

Statistics vary, although it is believed 10% of the population may have a panic attack at least once in their life. Approximately 1.3% of Australians are affected by panic disorder. A person is more likely to experience it if a family member also suffers from the disorder. It is more common in women than men. Panic disorder is found throughout the world, although symptoms may vary.

How is it treated?

Panic disorder is treatable and probably a combination of behaviour therapy (desensitization) or cognitive behaviour therapy (to help cope with faulty thinking) and medication (to reduce panic) will be most effective. Support groups are also available. Also, relaxation and stress reduction training sometimes helps.

Post-traumatic stress disorder

What is it?

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs after a person has experienced a traumatic event. Such an event may have caused a threat to the person's life. The traumatic event can include natural disasters such as fire or flood as well as accidents, assaults and torture. People who have experienced combat may develop PTSD.

Symptoms

After experiencing a traumatic event, a person may experience a number of symptoms. They are likely to relive the event as though it is really happening. Nightmares, recurring thoughts and images may be experienced. The person feels removed from the world. The sufferer may become hyper-vigilant and experience an exaggerated startle response. The person may also self-harm, to provide temporary relief from their symptoms. Furthermore, the person may avoid certain situations, so they are not reminded of the event.

What causes it?

PTSD is caused by a traumatic event deemed highly threatening to the person. It can continue for many years after the event, if the traumatic memories are not effectively dealt with.

Who does it affect?

Anyone who has experienced a traumatic incident in their lives can develop PTSD. It is estimated that 3.3% of Australians are affected by PTSD. It can be experienced at any age and by any gender or culture.

How is it treated?

• Antidepressants can help relieve symptoms.

• Stress management training can help.

• Relaxation techniques.

• Counselling can help  work through the traumatic memories to  make them more manageable and not so overwhelming.

Myths

PTSD may not be all negative, and good can come out of PTSD. This is known as post-traumatic growth. For some it is an opportunity to realise their strengths as a person, which can enhance confidence and self-esteem, to reappraise their values and develop a greater appreciation of their existence.

Obsessive compulsive disorder

What is it?

Obsessive compulsive disorder is where the person has recurring, obsessive thoughts and feelings (obsessions) which are usually accompanied by repetitive, ritualised behaviours (compulsions) brought about by their obsession. The person feels highly anxious if they do not give in to their compulsion. The action relieves tension, but the behaviour itself is not pleasurable. Relief is only temporary and the thoughts will start over again. The disorder will interfere with everyday life. It is also called OCD.

Symptoms

The person has obsessive thoughts that they cannot get out of their head. These may have sexual, blasphemous or aggressive undertones. Behaviour is ritualistic and is beyond an act of reassurance. Checking the door is locked may be a common bedtime ritual, but to do it repeatedly is when it becomes compulsive. Sufferers find the experience highly distressing. They are aware their actions make no sense but feel unable to control it. Common compulsive behaviours are checking and washing. The person with OCD may also suffer from depression.

What causes it?

As with many mental health disorders, there is no one obvious cause. However, the following are suggested:

• It is possible that brain damage can bring about obsessive compulsive disorder.

• There may be an interaction between the environment and neurobiological factors.

• It may be due to lower levels of serotonin in the brain.

• It could be a result of inappropriate suppression of angry feelings, which come to be expressed indirectly.

• As a consequences of stressful life events.

Who does it affect?

It is estimated to affect 1-3% of the population. It can affect men and women and usual emerges before the age of 40. For many sufferers it begins in childhood and in such cases it often runs in families.

How is it treated?

• Drug therapy has shown to be helpful in managing the symptoms.

• Behaviour therapy is also used, in the form of exposure therapy, where the sufferer is exposed to the thing that causes the obsessive thoughts and are then taught new responses.

• Cognitive therapy can help put a stop to obsessive thoughts.

• Support groups are also beneficial.

Phobias

What is it?

Phobias can be either simple or complex. A simple phobia is an intense, irrational fear towards a specific object or event. For example, a fear of heights or spiders. The person may know their fear makes no sense, but are unable to control it. Most people have fears, however to be regarded as a phobia, it will interfere with the person's daily life.

Agoraphobia and social phobia are both complex phobias.

Agoraphobia is the fear of being around public places. Sufferers may avoid crowds and travelling and may become afraid to leave their home. It is the most common phobia. For some, even when at home they need someone with them, which will affect the whole family. The person may also experience generalised anxiety.

Social phobia is the fear of social situations. The person fears being noticed or being evaluated badly. They believe everyone knows they are anxious. There may be a specific thing that the person has a problem doing, for example speaking in public or eating in front of other people. Going into such situations is out of the question for the sufferer. People with social phobia are twice as likely to have an alcohol problem than are those without the phobia.

Symptoms

The person experiences persistent fear of the object or event. They are highly anxious and can feel dizzy and nauseous and experience sweating, shaking and palpitations. The symptoms are alleviated once the person is removed from the feared object or situation. As a result, avoidance behaviours are common as it prevents the anxiety symptoms. Sufferers may also experience panic attacks (especially agoraphobics). The person feels great distress that they have the phobia.

What causes it?

Different explanations for the causes of phobias have been put forward and include the following:

• Learning: behaviour therapists suggest phobias are a result of conditioning and as such are learned.

• Thinking: irrational and false beliefs and thoughts may maintain and  even exacerbate the phobia.

• Evolution: we  instinctively fear that which was a real threat to our survival in our prehistoric past.

• Genetics: phobias tend to run in families.

• Social phobia may develop from childhood shyness.

• It does not necessarily require a traumatic episode to bring about a phobia.

Who does it affect?

Phobias can affect anyone, although different fears affect people more at different ages. For example, fear of the dark peaks during childhood, whereas fear of illness peaks during later life. Phobias are found throughout the world, across different cultures. Simple phobias may emerge in childhood and can last a lifetime. Agoraphobia often develops in the twenties. One in ten of the population are affected by phobias. Women suffer more from agoraphobia and simple phobias.

How is it treated?

Treatment can include the following:

• Behaviour therapy: the therapist may use exposure therapy or systematic desensitisation to help the client overcome the phobia. Since the phobia is learned, so it can be unlearned. Behaviour therapy may be used in combination with drug therapy or cognitive therapy.

• Cognitive therapy: thought patterns and irrational beliefs are challenged then replace with more realistic ones.

• Drug therapy to control the symptoms.

• Agoraphobia is the most difficult to treat due to its complexity.

Useful link

http://www.panicanxietydisorder.org.au