Anxiety can be normal in stressful situations such as public speaking or taking a test. Anxiety is only an indicator of underlying disease when feelings become excessive, all-consuming and interfere with daily living.
According to the Nation Institute of Mental Health, about 20 percent of American adults report having had an anxiety disorder in the past year, and about 30 percent of Americans will have an anxiety disorder in their lifetime. These disorders include generalized anxiety disorder, agoraphobia, specific phobia, social anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and separation anxiety disorder. While it’s normal to get nervous sometimes, especially before important events, an anxiety disorder is a completely different matter. People with anxiety disorders may feel anxious most of the time for no good reason or they may become acutely anxious about particular things. For example, while it’s normal to be nervous about a job interview, if you panic and have trouble breathing, you might have an anxiety disorder. If left untreated, an anxiety disorder can negatively affect your life in many ways, including the following. Health , Digestive problem , Nurological Problems , Cardiovascular Problems , More Illness , Quality Of Life , Relationship , Addiction And So On.
There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, specific phobias, agoraphobia, social anxiety disorder and separation anxiety disorder.
Generalized Anxiety
Causes
As with many mental health conditions, the cause of generalized anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include:
- Differences in brain chemistry and function
- Genetics
- Differences in the way threats are perceived
- Development and personality
Risk factors
Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder:
- Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are.
- Genetics. Generalized anxiety disorder may run in families.
- Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk.
Complications
Having generalized anxiety disorder can be disabling. It can:
- Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating
- Take your time and focus from other activities
- Sap your energy
- Increase your risk of depression
Generalized anxiety disorder can also lead to or worsen other physical health conditions, such as:
- Digestive or bowel problems, such as irritable bowel syndrome or ulcers
- Headaches and migraines
- Chronic pain and illness
- Sleep problems and insomnia
- Heart-health issues
Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some mental health disorders that commonly occur with generalized anxiety disorder include:
- Phobias
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Depression
- Suicidal thoughts or suicide
- Substance abuse
Prevention
There's no way to predict for certain what will cause someone to develop generalized anxiety disorder, but you can take steps to reduce the impact of symptoms if you experience anxiety:
- Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
- Keep a journal. Keeping track of your personal life can help you and your mental health professional identify what's causing you stress and what seems to help you feel better.
- Prioritize issues in your life. You can reduce anxiety by carefully managing your time and energy.
- Avoid unhealthy substance use. Alcohol and drug use and even nicotine or caffeine use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a treatment program or support group to help you.
Panic Disorder
Do you sometimes have sudden attacks of anxiety and overwhelming fear that last for several minutes? Maybe your heart pounds, you sweat, and you feel like you can’t breathe or think clearly. Do these attacks occur at unpredictable times with no apparent trigger, causing you to worry about the possibility of having another one at any time?
An untreated panic disorder can affect your quality of life and lead to difficulties at work or school. The good news is panic disorder is treatable. Learn more about the symptoms of panic disorder and how to find help.
What is panic disorder?
People with panic disorder have frequent and unexpected panic attacks. These attacks are characterized by a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger. Not everyone who experiences a panic attack will develop panic disorder.
Panic attacks often include physical symptoms that might feel like a heart attack, such as trembling, tingling, or rapid heart rate. Panic attacks can occur at any time. Many people with panic disorder worry about the possibility of having another attack and may significantly change their life to avoid having another attack. Panic attacks can occur as frequently as several times a day or as rarely as a few times a year.
Panic disorder often begins in the late teens or early adulthood. Women are more likely than men to develop panic disorder.
What are the signs and symptoms of panic disorder?
People with panic disorder may have:
- Sudden and repeated panic attacks of overwhelming anxiety and fear
- A feeling of being out of control, or a fear of death or impending doom during a panic attack
- An intense worry about when the next panic attack will happen
- A fear or avoidance of places where panic attacks have occurred in the past
- Physical symptoms during a panic attack, such as:
- Pounding or racing heart
- Sweating
- Chills
- Trembling
- Difficulty breathing
- Weakness or dizziness
- Tingly or numb hands
- Chest pain
- Stomach pain or nausea
What causes panic disorder?
Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain and certain biological processes may play a crucial role in fear and anxiety. Some researchers think panic attacks are like “false alarms” where our body’s typical survival instincts are active either too often, too strongly, or some combination of the two. For example, someone with panic disorder might feel their heart pounding and assume they’re having a heart attack. This may lead to a vicious cycle, causing a person to experience panic attacks seemingly out of the blue, the central feature of panic disorder. Researchers are studying how the brain and body interact in people with panic disorder to create more specialized treatments. In addition, researchers are looking at the ways stress and environmental factors play a role in the disorder.
How is panic disorder treated?
If you’re experiencing symptoms of panic disorder, talk to a health care provider. After discussing your history, a health care provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.
Panic disorder is generally treated with psychotherapy (sometimes called “talk therapy”), medication, or both. Speak with a health care provider about the best treatment for you.
Psychotherapy
Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that happen during or before a panic attack. The attacks can become less frequent once you learn to react differently to the physical sensations of anxiety and fear during a panic attack.
Exposure therapy is a common CBT method that focuses on confronting the fears and beliefs associated with panic disorder to help you engage in activities you have been avoiding. Exposure therapy is sometimes used along with relaxation exercises.
For more information on psychotherapy, visit the National Institute of Mental Health (NIMH) psychotherapies webpage.
Medication
Health care providers may prescribe medication to treat panic disorder. Different types of medication can be effective, including:
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Beta-blockers
- Anti-anxiety medications, such as benzodiazepines
SSRI and SNRI antidepressants are commonly used to treat depression, but they also can help treat the symptoms of panic disorder. They may take several weeks to start working. These medications also may cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe, especially if the dose starts off low and is increased slowly over time. Talk to your health care provider about any side effects that you may experience.
Beta-blockers can help control some of the physical symptoms of panic disorder, such as rapid heart rate, sweating, and tremors. Although health care providers do not commonly prescribe beta-blockers for panic disorder, the medication may be helpful in certain situations that precede a panic attack.
Benzodiazepines, which are anti-anxiety sedative medications, can be very effective in rapidly decreasing panic attack symptoms. However, some people build up a tolerance to these medications and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time if you need them.
Both psychotherapy and medication can take some time to work. Many people try more than one medication before finding the best one for them. A health care provider can work with you to find the best medication, dose, and duration of treatment for you. A healthy lifestyle also can help combat panic disorder. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust for support. To learn more ways to take care of your mental health, visit NIMH’s Caring for Your Mental Health webpage.
For more information about medications used to treat panic disorder, visit NIMH’s Mental Health Medications webpage. Visit the U.S. Food and Drug Administration (FDA) website for the latest warnings, patient medication guides, and information on newly approved medications.
How can I support myself and others with panic disorder?
Educate Yourself
A good way to help yourself or a loved one who may be struggling with panic attacks or panic disorder is to seek information. Research the warning signs, learn about treatment options, and keep up to date with current research.
Communicate
If you are experiencing panic disorder symptoms, have an honest conversation about how you’re feeling with someone you trust. If you think that a friend or family member may be struggling with panic disorder, set aside a time to talk with them to express your concern and reassure them of your support.
Know When to Seek Help
If your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as at school, at work, or with friends and family—it’s time to seek professional help. Talk to a health care provider about your mental health.
Are there clinical trials studying panic disorder?
NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions—including panic disorder. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit NIMH's clinical trials webpage.
Finding Help
Behavioral Health Treatment Services Locator
This online resource, provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), helps you locate mental health treatment facilities and programs. Find a facility in your state by searching SAMHSA’s online Behavioral Health Treatment Services Locator. For additional resources, visit NIMH's Help for Mental Illnesses webpage.
Talking to a Health Care Provider About Your Mental Health
Communicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider. For additional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website.
Reprints
This publication is in the public domain and may be reproduced or copied without permission from NIMH. We encourage you to reproduce and use NIMH publications in your efforts to improve public health. If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more about using NIMH publications, please contact the NIMH Information Resource Center at 1-866‑615‑6464, email nimhinfo@nih.gov, or refer to NIMH’s reprint guidelines.
Specific Phobia
A specific phobia, formerly called a simple phobia, is a lasting and unreasonable fear caused by the presence or thought of a specific object or situation that usually poses little or no actual danger. Exposure to the object or situation brings about an immediate reaction, causing the person to endure intense anxiety (nervousness) or to avoid the object or situation entirely. The distress associated with the phobia and/or the need to avoid the object or situation can significantly interfere with the person's ability to function. Adults with a specific phobia recognize that the fear is excessive or unreasonable, yet are unable to overcome it.
There are different types of specific phobias, based on the object or situation feared, including:
- Animal phobias: Examples include the fear of dogs, snakes, insects, or mice. Animal phobias are the most common specific phobias.
- Situational phobias: These involve a fear of specific situations, such as flying, riding in a car or on public transportation, driving, going over bridges or in tunnels, or of being in a closed-in place, like an elevator.
- Natural environment phobias: Examples include the fear of storms, heights, or water.
- Blood-injection-injury phobias: These involve a fear of being injured, of seeing blood or of invasive medical procedures, such as blood tests or injections
- Other phobias: These include a fear of falling down, a fear of loud sounds, and a fear of costumed characters, such as clowns.
A person can have more than one specific phobia.
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