People often mistake anxiety disorders simply as having temporary fears about something, worrying, feeling distressed and tense, overthinking, having panic attacks or being extremely nervous especially when they are about to do something or when they anticipate something to happen. Basically mistaking anxiety disorders for being mentally weak or instable, which is why many people experiencing the disorders don’t reach out for help. But there’s a lot more to anxiety disorders than that.
People experiencing anxiety disorder usually experience these feelings for much longer while the disorder gets stronger, perhaps more complex, but strong enough to affect their thoughts, feelings, emotions, moods, behaviours, and physical health. They feel uneasy and afraid to do things such as chores, get out of the house to go to school, work or to see other people, therefore interfering greatly with their personal and professional lives, and crippling them.
There are several types of anxiety disorders, such as generalised anxiety disorder, panic disorder, and different phobia-related disorders, and people often experience more than one at a time. In addition, they might suffer from depression, substance abuse and eating disorders, which can all become stronger and more complex if left untreated.
Types of anxiety disorders
Anxiety disorders are the most common group of mental health conditions in Australia. In 2020-21, 3.3 million Australians experienced a 12-month anxiety disorder. It is estimated that anxiety disorders will affect 1 in 4 Australians at some stage of their life.
The common types of anxiety disorders are:
- Generalised anxiety disorder: Usually lasts for more than six months. The person is experiencing an unusually high level of anxiety due to being excessively worried about different ordinary aspects of their life, such as their health, well-being, safety, finances, relationships, school or work.
- Panic disorder: People with panic disorder regularly experience unexpected and repeated panic attacks and are terrified that they might experience even more panic attacks and that the panic attacks could cause something bad to happen (such as they worry that they will faint, lose control over themselves or even die). A panic attack can last a few seconds or several minutes but can take longer for the symptoms to subside. During a panic attack, the person experiences a sudden rush of intense fear, plus other symptoms such as chest pain, shortness of beath and can ‘hear’ their heart pounding. It’s important to note that panic attacks are fairly common and that not everyone who has panic attacks has panic disorder. For example, if the person is afraid of snakes, they might have a panic attack whenever they are near a snake, and they expect to have a panic attack whenever they see a snake. They are not thinking about what the panic attack could do to them, they are afraid of what the snake and what it could do. In panic disorder, the panic attacks are unexpected, unpredictable, and the person is afraid of what could happen due to the panic attack.
- Agoraphobia (often goes with panic disorder): The person fears they might have a panic attack in a certain place or situation, such as going out alone, being on public transport, being in an enclosed space, an open space (where they feel vulnerable) or being in busy areas, crowds or queues. They might feel anxious and experience panic attacks in these situations because feel it would be difficult to escape if they needed to and fear they would have a panic attack. In severe agoraphobia cases, the person becomes housebound.
- Specific phobias (sometimes called simple phobias): The person experiences extreme fears of a certain thing, object or situation, and so do their best to avoid it. In some cases, they may develop an inability to function normally when put in that situation. Common specific phobias include fear of dogs (cynophobia), fear of snakes (ophidiophobia), fear of spiders (arachnophobia), fear of blood (hemophobia, AKA blood phobia), fear of water (aquaphobia), fear of heights (acrophobia), fear of flying (aerophobia), and fear of being in small or enclosed spaces (claustrophobia).
- Post-traumatic stress disorder(PTSD): The person was part of or witnessed one or more traumatic life events that negatively impacted their mental health. Perhaps they experienced war, an assault, other crime, an accident or natural disaster and are reliving these events through memories, flashbacks and nightmares, and these original memories, flashbacks and nightmares may also be triggered if the person goes through similar experiences or hears about other people’s experiences.
- Social anxiety disorder (also known as social phobia): The person is very self-conscious and has a chronic fear of being in social settings, even if it’s not a large crowd. This can happen at work, school, parties, anywhere. And it can happen before and during the social experience. They believe other people will pay attention to them and will judge what they wear, say or do, and so they become anxious on how they would be perceived and fear they could say or do something to humiliate or embarrass themself. So while not wanting to go out into social settings may come across as being an introvert, it could be the person is experiencing social anxiety disorder.
- Separation anxiety disorder: While many people think separation anxiety only to only occur in young children, it is common for older youths and adults to experience the condition. A person can become extremely anxious, afraid, worried and distressed before and during separation from someone, a place or their pet, and this fear can affect how they function in life, including socially, and in their relationships, jobs and education.
- Obsessive-compulsive disorder (OCD): The person is experiencing intrusive obsessive thoughts (such as “my home is always dirty”) that make them do repetitive, compulsive mental and/or physical acts (compulsions, such as look for flaws in their home and clean their home several times a day). These behaviours are their coping mechanism to try and reduce anxiety or distress, but often significantly affect their well-being and their quality of life.
Signs and symptoms
The signs and symptoms of anxiety disorders often include:
- Frequently experiences panic attacks and worries about having more panic attacks and what might happen if they do
- Goes out of their way to avoid people, things or situations that scare them or make them feel self-conscious
- Frequently unable to concentrate or sleep because they are worrying about their health, relationships, school, work, home or other people
- Constantly feels stuck and unable to move on with their life following a trauma, and finds themself reliving the trauma day after day
- Deeply worries about being embarrassed in public
- Seems to repeat a behaviour like always re-organising their home, washing their hands, checking and re-checking that they have done something, or repeating words or counting in their head or out loud
- Has been complaining about feeling nauseous
- Often has trouble catching their breath
- Appears to break out into a sweat when nervous or anxious
- Sounds like they are feeling ‘foggy’ and disconnected from reality
- Often feeling like their heart is pounding
- Complains about feeling lightheaded, faint or dizzy
- Often experiences shaky hands or body
- Often says they have goosebumps or a tingly feeling in their hands and feet
- Always feeling worried that something terrible will happen
- Feels like your hair follicles are on fire
- Constant dry mouth, nothing can quench your thirst
- Constantly going to the toilet, thinking you have a full bladder and it’s not, chronic diarrhoea
- Complete loss of appetite.
Talk to a doctor or a mental health professional to get the right treatment and support to help reduce or eliminate these symptoms.
What causes anxiety disorder?
There are a number of common factors that could put anyone at greater risk of developing an anxiety disorder:
- Gender: In Australia, females reportedly experience higher rates than males (21.0% compared with 12.4%), whereas 44.7% of people who identified as Gay, Lesbian, Bisexual, Asexual, Pansexual or Queer had experienced a 12-month anxiety disorder.
- Personality types: People who are shy, worried, perfectionists, have low self-esteem or always mental needing to have control over others, things and situations.
- Family history: Anxiety disorders tend to run in families who have a history of anxiety disorder or related mental health conditions.
- Occupational risks: People working in jobs where they are exposed to trauma (such as police officers, firefighters, paramedics, nurses, doctors and soldiers.
- Lack of support for PTSD: People who lack of support after traumatic life events, including abuse.
- Lack of support in general: Such as people who are always between jobs, losing accommodation, experiencing family breakdowns, or losing people through deaths.
- Substance abuse: People who have developed addictions to alcohol and other drugs.
- Illnesses and medical conditions: People with chronic mental or physical illnesses worry about their future, wellbeing and treatments, and worry about how their illness and treatment may be affecting other people around them.
As we are all different, the combination of factors causing anxiety in one person will differ to the factor for others.
How are anxiety disorders diagnosed?
A general practitioner (GP) will use a detailed questionnaire to ask about any symptoms the person has been experiencing and to what extent these symptoms have been affecting their life and their ability to function, such as at home, at work and in social settings. The more information the better. The questions will also help determine the severity of the condition and whether they may be experiencing other conditions such as depression.
The GP will then base their diagnosis on the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the manual that health professionals must use when attempting to diagnose mental illness. Their diagnosis will be for a specific type of anxiety disorder.
Treatments for anxiety disorders
Anxiety disorders are treatable, and there are different treatments that work best for each person and the type of anxiety disorder that they are experiencing. The person may find it beneficial to change their lifestyle, seek psychological treatments, supportive counselling or therapy, or even medication. They might have a combination of different experts on their ‘recovery team’, including their GP, mental health nurse, psychiatrist or psychologist, maybe a counsellor or a peer worker with lived experience of anxiety disorders.
Common treatments for anxiety disorders include:
Designed to directly address the person’s specific needs and anxieties. For example, a mental health professional trained in cognitive behaviour therapy (CBT) can help them work through the many thoughts, fears, emotions, behaviours and triggers that cause their anxiety disorder. The professional can also educate them and give them new coping skills and slowly and safely introduce them to the things or situations they have been avoiding or have been extremely afraid of, and the goal here is to make the person feel comfortable in the future (desensitised) when put in these situations.
Other effective talk therapies for anxiety disorders include:
- interpersonal therapy: the person works on the anxiety issues that are affecting their relationships
- acceptance and commitment therapy: they accept that they can’t control everything, so they can focus on the present and what they can do to improve themself
- narrative therapy: identifying their values, experiences, skills and worth, and to develop greater compassion for themself and therefore grow
Antidepressants may be used in combination with therapy to relieve some of the symptoms or when the person needs to manage how their body responds to anxiety, although medications may not completely treat anxiety disorders. Medications for anxiety disorders may take time to be effective, and a GP will prescribe any antidepressants needed and this will be based on the symptoms or type of anxiety disorder.
Experiencing anxiety can feel isolating and lonely. There are anxiety disorder support groups where people can share their experiences, ask questions and learn from others.
May be best for people experiencing mild-to-moderate anxiety disorders. There is a wide range of different programs through which people can seek support from mental health organisations and specialists. Particularly helpful for anyone living in remote Australia where in-person support may be hard to access.
Take a look at the following resources:
- Beyond Blue
- Black Dog Institute
- Head to Health website
- MindSpot Clinic
- ReachOut NextStep
- The brave program
There are many ways people help themselves recover from anxiety disorders. The following things are what people have shared were helpful in reducing anxiety or keeping their anxiety from getting worse:
- exercising more often
- taking up yoga
- eating healthier
- managing their stress
- spending time with people who make them happy
- limiting or no longer using alcohol and other drugs
- defusing essential oils. in particular, citrus base oils
- Reading. getting involved with a story plotline can reduce symptoms as you have paused some of the thoughts you may be having
Most importantly people need to be able to explore what works for them. Each person is unique and therefore so are the things that work for each person.
Simply talking to others, asking for tips and taking charge of their own health can help someone along their recovery journey and give them a sense of accountability and achievement. Plus, it’s always safer if the person checks with the professional before making decisions when attempting to do anything considered ‘self-help’.
Help & Support
Seeking support and treatment for an anxiety disorder can help manage the condition and its symptoms. With effective anxiety disorder treatment, it may be possible to enjoy a better life without fear, and with less stress and fewer or no panic attacks at all.
The right treatment options and recovery pace will be unique to each person, their specific anxiety disorder and how soon they seek treatment. And perhaps they work better one on one with the professional whereas others may prefer working in a group setting or through online support. Regardless, the best step forward is to seek treatment to help overcome the anxiety they are experiencing.
Talk to a GP about the suspected anxiety disorder and work together to figure out ways to treat and prevent the symptoms and prevent any attacks that may be making life difficult.
A GP is the best place to start the discussion about anxiety disorders even if the symptoms appear mild. They have the training and experience to help and can also refer to the appropriate supports, services and therapies for recovery.