Anxiety Disorders: Types, Symptoms, & Treatments

Written by Dr. Paul Kelly, PhD, C.Psych.              February 25, 2024

This article is for people who want to learn about anxiety disorders.

• What is Anxiety?
• How is Normal Anxiety Helpful?
• When is Anxiety a Mental Health Problem?
• 5 Anxiety Signs Your Friends Might Notice
• 7 Signs and Symptoms of Anxiety
• Anxiety Attack, Panic Attack, or Heart Attack?
• Types of Anxiety Disorders
• Medical and Physical Causes of Anxiety Symptoms
• 7 Self-Help Tips for Anxiety
• 4 Lifestyle Changes to Manage Anxiety and Anxiety Disorders
• Medication Treatment for Anxiety
• Psychotherapy Treatment for Anxiety
• A Personal Note

 

What is Anxiety?

Why This Matters: You can understand and manage anxiety.

Anxiety is a normal emotional reaction when you are nervous or scared. Anxiety is like your body’s alarm system. The alarm is a good thing because it keeps you safe. That’s how anxiety works. It’s your brain’s way of telling you to be careful because it thinks there’s a problem.

You might feel anxious if you hear a noise at night. Did someone break in? But when you see that your cat knocked a lamp over, your anxiety stops. Normal anxiety goes away after you realize there is nothing to fear.

Anxiety can become an Anxiety Disorder if the alarm does not shut off. This can happen if your brain predicts trouble when there is none. Your brain could make this mistake for several reasons. You had a bad scare.,Your childhood was traumatic. Or anxiety runs in your family. You have a genetic sensitivity to danger.

Anxiety Disorders can interfere with your life and cause you unnecessary suffering. The alarm goes off too often, is too loud, and stays on too long.

Anxiety can be a tough problem. I know. I had to deal with it myself. Here is the good news: You can learn to overcome anxiety – so it stops interfering with your life. This article will tell you how to get started. You can do a lot to retrain your brain.

 

How is Normal Anxiety Helpful?

Why This Matters: Some anxiety is good. Learn how.

How does anxiety help? You are too chill to do your best when you are very relaxed. Some anxiety increases arousal levels. This can help you focus and be ready to face challenges.

Normal anxiety alerts you so you can prepare for a challenge or threat. It changes your brain and body. You are mentally sharper and stronger. You have more energy and can focus better.

Here are some of the benefits of normal anxiety:

1. Keeps You Safe: Anxiety can make you more aware of dangers around you. This can help you stay safe.
2. Improves Performance: Anxiety can push you to work harder and do better. This can pay off during exams, sports, or learning something new.
3. Helps You Solve Problems:When you’re anxious, your brain starts looking for solutions. You can be a better problem-solver.
4. Motivates You: Anxietycan nudge you to get things done.
5. Enhances Learning: Anxiety can make your brain more alert. It helps your attention and memory.

Some anxiety can be helpful. And too much can cause problems in your life. Learn more in the next section.

 

When is Anxiety a Mental Health Problem?

Why This Matters: Do you need to tame your anxiety?

Anxiety can cause mental health problems if it is too intense or lasts too long. It is like a smoke detector that keeps beeping when there is no smoke. Do you have excessive anxiety? Here are some warning signs that your anxiety might be a mental health problem:

1. Feeling constantly worried:It’s like having a worrying thought stuck in your head. You worry obsessively even when things are okay.
2. Trouble sleeping:Worries stop you from going to sleep. They wake you up in the night. Racing thoughts keep you awake.
3. Feeling scared for no reason:Everything is actually okay. But you feel scared as if something awful is going to happen,
4. Avoiding places or activities:You stop doing things because you worry that something bad will happen.
5. Feeling nervous or shaky:You are very anxious when meeting new people or talking at a meeting.
6. Trouble concentrating:Worries make it hard to focus on homework or using your phone.
7. Feeling tired a lot:Being anxious can make you feel worn out.

 

5 Anxiety Signs Your Friends Might Notice

Why This Matters:  Your friends might identify your anxiety before you do.

When someone has been anxious for a long time, it seems normal for them. They get used to it. They don’t realize that they could feel much better. The constant worry and nervousness feel normal.

It’s a bit like wearing a heavy backpack all the time. If you never take it off, you stop noticing it. You carry the weight even though you don’t need to. You don’t realize that you could lighten your load.

Perhaps you ‘don’t know’ you have an anxiety disorder. You might mistake anxiety for tiredness or stress. This is where a friend or loved one can help. They can point out that you may have an anxiety disorder. When you know the real problem, then you can start to get help.

Here are some signs your friends might notice:

1. You’re not hanging out as much:You always say “no” to hangouts or activities you used to love.
2. You seem too quiet: You seem more tired or less chatty than usual.
3. You get upset :Little things make you upset or frustrated.
4. You’re always asking for reassurance:You keep repeating questions. You double-checking plans a lot or asking if everything’s okay.
5. You can’t sit still: You keep fidgeting, like tapping your foot or playing with your phone.

 

7 Signs and Symptoms of Anxiety

Why This Matters: If you know what’s wrong, then you can learn to deal with it.

Feeling anxious once in a while is normal. It can happen before a big test or a work presentation. Clinical anxiety is more intense, and it lasts longer. It makes everyday things feel hard to do. It’s like having an alarm inside you that goes off too often. You feel on edge even when there’s no real danger.

Do you have clinical anxiety? Here are 7 signs and symptoms to check out:

1. Pervasive worry or unease:It’s like having butterflies in your stomach. You can’t relax or feel calm.
2. Sleep disturbance, insomnia:You toss and turn. Your mind won’t quiet down during the night.
3. Chronic fatigue:Mental strain and worry keep you tired all the time.
4. Concentration issues:You can’t focus. Worries distract you. Or your mind freezes and goes blank.
5. Heightened startle response:When the phone rings, you jump. You startle easily.
6. Unexplained Physical symptoms: You get frequent headaches, stomach aches, or back pain. Your doctor can’t find anything wrong.
7. Avoidance behavior:You avoid places or situations because you fear being anxious.

 

Anxiety Attack, Panic Attack, or Heart Attack?

Why This Matters: Learn the difference. It could save your life.

A heart attack can kill you. An anxiety or panic attack can’t. Many of the symptoms are similar. Learn how to spot a heart attack. The knowledge could save your life. Learn what to do. I tell you here:

Anxiety Attack:  It usually comes on when someone feels stressed or worried. Their heart might beat faster. They might start to sweat and feel nervous or restless. They feel on edge, and the feeling builds over time.

Panic Attack: A panic attack is like a surprise alarm that goes off in your body. It comes on fast. It can be very scary. Someone having a panic attack might have a pounding heart. They might sweat a lot and feel shaky. They might think they’re having a heart attack. It’s like getting startled by a loud noise, but much more intense.

Heart Attack: A heart attack is when something is physically wrong with your heart. A heart attack damages your heart muscle. Someone having a heart attack might feel pain in their chest. They could also feel pain in their jaw, neck, back, or arms. They might also feel exhausted. Other symptoms include trouble breathing, feel sick to their stomach, or feel dizzy.

 

What To Do

If you have any heart attack symptoms or think that you might be having a heart attack – don’t hesitate. Tell someone. Then call 911 or your local emergency helpline. A paramedic or other health professional can tell you on what to do next.

If you are not sure whether you are having an anxiety attack or a heart attack, call 911. They will not be upset with you if it turns out to be an anxiety or panic attack.

What if you have many hospital visits that turn out to be because of anxiety or panic and not a heart attack? The ER doctor or your family doctor will recommend that you get mental health treatment. Follow their advice so you can start to feel better.

I had a heart attack about 12 years ago. It took me about half an hour to realize what was happening. I told my wife. We called 911. Paramedics came and took me to a hospital. I had good treatment. I changed my diet and started exercising. Today, my health is better than it was before the heart attack.

Types of Anxiety Disorders

Why This Matters: You can make better decisions with this information.

All anxiety disorders are about fear and worry. The anxiety is out of step with your actual situation. Anxiety disorders interfere with your enjoyment of life. They can impair your ability to function at school, work, or in social situations. There are several major types of anxiety disorders.

1. Generalized Anxiety Disorder (GAD)

GAD means feeling anxious almost all the time. It’s like your brain is stuck on “worry mode” nonstop.

• Ongoing and excessive anxiety and worry about many things.
• Even when there is no big reason to worry.
• The worry is difficult to control.
• Symptoms can include restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

2. Social Anxiety Disorder (Social Phobia)

It is feeling nervous in social situations. It’s like your brain sees every social event as a huge challenge.

• Feeling nervous or scared in social situations.
• Worry about people judging you,  or feeling embarrassed.
• Avoid meeting new people, having face-to-face talks, giving presentations.

3. Specific Phobia

It is an intense fear of a particular thing or situation. It’s like your brain sets off an alarm for that one specific fear.

• Strong fear or anxiety about one thing, like spiders, elevators, or heights.
• Fear comes all at once in the situation, or even when thinking about it.
• Avoidance of the situation or object. Will run if you see a spider, and can’t get into an elevator alone.
• Fear of flying, animals, getting an injection, or seeing blood are also common phobias.

4. Panic Disorder: 

During a panic attack sudden, intense fear attacks come out of nowhere. It’s like your brain hits the panic button. Lots of unexpected panic attacks indicates Panic Disorder.

• Intense fear and discomfort starts quick.
• Symptoms include a racing heart, sweating, shaking, and shortness of breath.
• A feeling of dread that something terrible is going to happen.

5. Nocturnal Panic Disorder: 

When panic attacks wake you up from sleep you have Nocturnal Panic Disorder. It’s like your brain hits the panic button even in your dreams.

• Waking up suddenly, feeling very scared.
• Heart beating very fast.
• Sweating a lot during sleep.
• Feeling shaky or trembling when you wake up.
• Feeling like you can’t breathe or are choking.

6. Obsessive-Compulsive Disorder (OCD): 

Obsessive-Compulsive Disorder involves unwanted thoughts and repetitive actions. It’s like your brain gets stuck on a loop of worry and rituals.

• Unwanted thoughts that are hard to shake off.
• Repeated actions like checking the stove or washing your hands.
• Fear of contamination, with lots of cleaning or avoiding things.
• Doubting and checking even when you ‘know’ you already did it.

7. Posttraumatic Stress Disorder (PTSD)

PTSD is experiencing anxiety from past trauma. It’s like your brain keeps replaying a scary event over and over.

• Reliving a traumatic event with flashbacks or nightmares. Your brain keeps hitting the replay button.
• Avoid situations that remind you of the traumatic event.
• Hypersensitivity: Feeling on edge, easily startled, expecting  something bad to happen.
• Mood change: You might feel sad, angry, or numb. Emotions are strong and hard to control.
• Dissociation: You feel detached like you are in a bubble separate from your life and family.

8. Agoraphobia: 

Agoraphobia is the fear of places where escape feels hard. It’s like your brain sees certain spaces as off-limits due to fear.

• Fear in places or situations where you might feel trapped, embarrassed, or helpless.
• You feel panic and have other anxiety symptoms.
• Where? bus or subway, any enclosed space, standing in line, being in a crowd, being outside alone.

9. Separation Anxiety Disorder: 

Separation Anxiety Disorder is extreme fear of being apart from loved ones. It’s like your brain can’t handle the thought of separation.

• Feeling scared or worried when away from family or close friends.
• Worry that something bad will happen to your loved one when you are away.
• Separation can also cause nightmares, headaches or stomachaches.

10. Substance/Medication-Induced Anxiety Disorder: 

This is anxiety caused by drugs or medicine.

• Some medications, street drugs, and substances like energy drinks can cause anxiety.
• Sometimes, drug withdrawal can cause anxiety.
• See the next section for more details.

11. Anxiety Disorder Due to Another Medical Condition: 

This is anxiety caused by medical conditions or diseases.

• Some medical conditions can cause feelings of intense anxiety or panic.
• Check with your physician if you feel anxious ‘for no reason.’
• See the next section for more details.

 

Medical and Physical Causes of Anxiety Symptoms

Why This Matters: If your anxiety is not ‘psychological,’ psychotherapy won’t fix it.

Do you have anxiety symptoms even though your life is pretty good? Perhaps your symptoms are not psychological. Something physical or medical could be the cause. If so, psychotherapy won’t fix it. You might need medical treatment or a lifestyle change. Here are some common medical and physical causes of anxiety. Check with your physician if you wonder about any of these causes.

• Too Much Caffeine: Coffee, energy drinks, and certain teas have caffeine. This can increase alertness. Too much can make you jittery and anxious.
• Sleep Disorders: Chronic sleep deprivation or disturbed sleep can trigger or worsen anxiety. Ask about sleep apnea.
• Medication Side Effects: Medications for asthma, hypertension, and cold symptoms can cause anxiety. Medication withdrawl can also cause anxiety.
• Endocrine Imbalances: Hyperthyroidism, where the thyroid gland is overactive, can cause anxiety symptoms.

 

7 Self-Help Tips for Anxiety

Why This Matters: You don’t have to be a victim of anxiety. You can teach your brain to overcome anxiety.

Anxiety can hold you back from life. It often tricks you into avoiding things that might trigger anxious feelings. You might avoid situations, thoughts, or body feelings. This avoidance pattern keeps you locked in anxiety.

Avoidance prevents your brain from learning that you can handle things. So, your alarm system stays on ‘high alert.’  Then you feel anxious even in situations that are actually be safe and manageable

You can challenge your avoidance patterns. You can retrain your brain to recognize that many situations are, in fact, safe. How to make this change?

The key is this: Understand that your brain is always learning from experience. What happens when you avoid something? Your brain sees the avoidance as confirmation. It concludes that the thing is actually dangerous – even though it isn’t.

You can retrain your brain if you face your fears. As you stop avoiding, your brain learns an important lesson. It learns that you are safer and can handle more than you think. Here are some proven self-help tips.

1. Educate Yourself About Anxiety:

Anxiety is not solid. You can change it. To learn how start with these videos from Dr. Lisa Feldman Barrett. She explains how emotions are made. She gives some great advice for managing emotions. Her book is listed below in the Sources. I have given away lots of copies to friends and therapists.

2. Mindfulness and Awareness: 

Mindfulness can help you overcome anxiety. Listen to this podcast where Dan Harris interviews Dr. Judson Brewer. He gives some great advice. His book Unwinding Anxiety is listed below in the Sources.

3. Gradual Exposure:

We know that avoidance keeps you stuck in anxiety. The antidote is to start to expose yourself to things that make you anxious. Then, stay with the situation until your anxiety decreases. It will decrease eventually. Dr. David Barlow’s Unified Protocol is an excellent self-help program. Check his workbook in the Sources below. Many of my therapists offer coaching for this approach.

4. Identify and Challenge Negative Thoughts: 

Your brain gives you predictions. These are thought that things are worse than they really are. Mindfulness can help you to catch these automatic thoughts and then not act on them. Listen to Dr. Brewer’s advice mentioned above. He will tell you what to do.

5. Practice Self-Compassion: 

Be kind to yourself during this process. Here are some free Self-Compassion meditations from Dr. Kristen Neff.

6. Seek Social Support: 

Share your experiences with friends, family, or support groups. Social support can provide encouragement and make you feel less isolated on your journey.

7. Celebrate Your Progress: 

Here is a rating form you can use to measure and track your anxiety. Use this once a week to see how you are improving.

 

4 Lifestyle Changes to Manage Anxiety and Anxiety Disorders

Why This Matters: Simple lifestyle changes can help you manage anxiety.

You can help prevent or overcome anxiety by maintaining a healthy lifestyle. Start with some small changes and trust yourself. Here are 4 things to try.

1. Regular Exercise: 

Regular physical activity can significantly reduce your anxiety. Try a brisk walking, yoga, or strength training. I do high-intensity strength training twice a week and it is worth the time and effort.

2. Limit Screen Time: 

Too much phone or screen time can make you tense and anxious. Set some limits for yourself. I know how addictive smartphones can be. Can you start with a 20-minute phone vacation? For a deeper dive,

3. Connect with Others: 

Smartphone use stops us from getting together. And, if your phone is on when you are visiting, your attention is distracted. Try visiting with friends or family. Cook a meal together. Play a board game. Give someone a hug.

4. Do Things You Enjoy: 

Mindfully engage in activities you enjoy. It will calm your mind and help you to feel better. Do something to help you notice sensations. This is a great antidote to worrying or ruminating.

 

Medication Treatment for Anxiety

The National Institute of Mental Health (NIMH) mentions several types of anti-anxiety medication. These include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), benzodiazepines, and beta-blockers. For medication advice consult with a physician, psychiatrist, or nurse practitioner.

Most people prefer to try psychotherapy rather than medication. Psychotherapy is not addictive. It does not have any side effects. Psychotherapy also continues to help after you stop treatment. You get to keep using your new skills and insights to live better. Symptom relapse is very common after people discontinue anti-anxiety medication.

 

Psychotherapy Treatment for Anxiety

Why This Matters: This advice will help you make a good choice for yourself.

There is no shame in asking for professional help. I worked with a therapist when I hit a tough patch in my life. It was a good choice.

Read on and learn more, so you can make the a good choice for yourself. Consider working with a therapist if self-help is not getting you where you want to go.

Here is the Good News: Psychotherapy is a very effective treatment for anxiety disorders. Have a look at the list below. Which type of therapy feels right for you? They are all safe choices. All these types of therap can help you overcome anxiety. They all work by helping your brain to recalibrate. Then your emotional reaction to situations will be appropriate to the situation – not an anxious overreaction.

Here is a Tip: Your anxiety reaction start to be normal as you give your brain new experiences to learn from. Your therapist can help guide you – what to start with, and how to build on success. When you experiment and try something new, then your brain changes. This change is possible because of neuroplasticity. You are never too old to learn something new.

Here is Second Tip: Make sure you find a therapist who feels right for you. Who your therapist is matters more than the type of therapy. If your therapist is rigid, passive, cold and distant, or disorganized, then you need a new therapist. Check my article about this for more advice.

 

Some helpful types of psychotherapy for anxiety problems

1. Cognitive Behavioral Therapy (CBT): This talk therapy helps you challenge negative thoughts. Then you can make better choices and try new things. Your mental wellbeing will improve.
2. Interpersonal Therapy (IPT): IPT is helpful if you are anxious because of relationship problems. Common problems include unresolved grief, role conflicts, major life transitions, and problems with starting or supporting healthy relationships. Your brain learns to change out of date or unhelpful behavior so your relationship can be more satisfying.
3. Dialectical Behavior Therapy (DBT): DBT teaches you how to regulate emotions, improve interpersonal skills, and tolerate distress. A comprehensive DBT program is very helpful for people at risk of suicide or self-harm. It combines CBT with mindfulness practices.
4. Behavioral Activation (BA): BA helps you get moving and doing. It can help you to break the cycle of anxiety and avoidance. BA was developed for depression but research show that it can also be very helpful for anxiety. Here is how to get started.
5. Mindfulness-Based Cognitive Therapy (MBCT): MBCT combines cognitive therapy with mindfulness. You learn coping skills to get unstuck from the cycle of anxiety and avoidance. You learn to notice your anxious thoughts without getting overwhelmed by them.
6. Acceptance and Commitment Therapy (ACT): ACT uses acceptance and mindfulness strategies. You learn to live according to your personal values, with kindness for yourself. ACT can be very helpful for anxiety problems.
7. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: (I wish this treatment had a shorter name!) It combines mindfulness with CBT, behavioral activation, and acceptance. It is a structured therapy and can be very helpful for anxiety problems.

 

A Personal Note

When I was 9 years old, I developed phobic anxiety. A car hit me while I was riding my bicycle. I was almost killed. After I got out of the hospital, I could not cross a road if I saw any cars. My brain was hypersensitive to danger. It predicted that any moving car would hurt me. My parents were not therapists, but they gave me some practical advice. They told me to try crossing when a car was far away. I was anxious, but I still start to try something new. Little by little, my fear decreased. My brain learned how to recognize a safe car distance. I was doing exposure therapy, and I didn’t even know it. Eventually, the phobic anxiety went away, and I could buy ice cream without having it melt before I got home.

You have my sympathy if you have an anxiety disorder. Remember, anxiety can be tamed so it doesn’t control your life. Your anxiety may not go away completely. But you can learn to control. Improvement is possible. You have a right to enjoy your life. I wish you well.

 

Sources

It is important to me that you find practical and trustworthy information. That is why I personally selected and reviewed all the sources for this article. My advice is also based on my own experience with anxiety, and my decades of experience. I have treated thousands of clients. I have also trained and mentored hundreds of therapists and psychologists. The therapy approaches I recommend are used at my Clinic. We track progress, so I know that the techniques can help.

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (fifth edition.). Arlington, VA.
• Barlow, D.H. et al. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders, Workbook. Oxford University Press, 2018.
• Barlow, D.H. (Editor). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, (sixth edition). The Guilford Press, 2021.
• National Institute of Mental Health. Anxiety Disorders (April, 2023). Retrieved from: https://www.nimh.nih.gov/health/topics/anxiety-disorders.
• Barrett, L.F. How Emotions Are Made. Pan Books, 2018.
• Brewer, J. Unwinding Anxiety: New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind. Avery, Penguin Random House, 2021.