Facts About Anxiety Disorders

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 fill people's lives with overwhelming anxiety and fear that are chronic, unremitting, and can grow progressively worse. Tormented by panic attacks, obsessive thoughts, flashbacks, nightmares, or countless frightening physical symptoms, some people with anxiety disorders even become housebound. Fortunately, through research supported 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 illness in America: more than 19 million Americans are affected by these debilitating illnesses each year.
• Anxiety disorders cost the U.S. $46.6 billion in 1990, nearly one-third of the nation's total mental health bill of $148 billion.

What Are the Different Kinds of Anxiety Disorders?

• Panic Disorder—Repeated 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 Disorder—Repeated, unwanted thoughts or compulsive behaviors that seem impossible to stop or control.
• Post-Traumatic Stress Disorder—Persistent 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 or distracted and being easily startled are common.
• Phobias—Two major types of phobias are social phobia and specific phobia. 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. 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.
• Generalized Anxiety Disorder—Constant, 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 Effective Treatments for Anxiety Disorders?

Treatments have been largely developed through research conducted by NIMH and other research institutions. They help many people with anxiety disorders and often combine medication and specific types of psychotherapy.

More medications are available than ever before to effectively treat anxiety disorders. These include groups of drugs called antidepressants and benzodiazepines. If one medication is not effective, others can be tried. New medications are currently under development to treat anxiety symptoms.

Two clinically-proven effective forms of psychotherapy used to treat anxiety disorders are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy focuses on changing specific actions and uses several techniques to stop unwanted behaviors. In addition to the behavioral therapy techniques, cognitive-behavioral therapy teaches patients to understand and change their thinking patterns so they can react differently to the situations that cause them anxiety.

Do Anxiety Disorders Co-Exist with Other Physical or Mental Disorders?

It is common for an anxiety disorder to accompany depression, eating disorders, substance abuse, or another anxiety disorder. Anxiety disorders can also co-exist with physical disorders. In such instances, the accompanying disorders will also need to be treated. Before beginning any treatment, however, it is important to have a thorough medical examination to rule out other possible causes of symptoms.

QUIZ

How Much Do You Know About Anxiety Disorders?

Fear and anxiety are a necessary part of life. Whether it's a feeling of anxiety before taking a test or a feeling of fear as you walk down a dark street, normal anxiety can be protective and stimulating. Unfortunately, more than 19 million Americans with anxiety disorders face much more than just "normal" anxiety. Instead, their lives are filled with overwhelming anxiety and fear that can be intense and crippling. Although anxiety disorders can be disabling, research supported and conducted by the National Institute of Mental Health (NIMH) has provided insight into their causes and has resulted in many effective treatments.

1. Which of the following are disorders of the brain?
   a. Stroke, epilepsy, multiple sclerosis
   b. Anxiety disorders, schizophrenia, depression, alcohol addiction
   c. Autism, anorexia, learning disabilities, dyslexia, migraines
   d. Alzheimer's, Tourette syndrome, Parkinson's, brain tumor
   e. All of the above
2. True or False?
   Post-Traumatic stress disorder, once referred to as shell shock or battle fatigue, is a condition that only affects war veterans.
3. True or False?
   Someone who feels compelled to spend a great deal of time doing things over and over again such as washing their hands, checking things, or counting things has an anxiety disorder.
4. What is the most common mental health problem in the United States?
   a. Depression
   b. Schizophrenia
   c. Anxiety disorders
5. Which of the following diseases/disorders are real medical illnesses?
   a. Anxiety disorders
   b. Diabetes
   c. High blood pressure
   d. All of the above
6. Which of the following are symptoms of an anxiety disorder known as panic disorder?
   a. Chest pains
   b. Dizziness
   c. Nausea or stomach problems
   d. Fear of dying
   e. All of the above
7. True or False?
   Anxiety disorders often occur with other illnesses.
8. True or False?
   Most people successfully take control of the symptoms of anxiety disorders by sheer willpower and personal strength.

ANSWERS TO QUIZ

1. Which of the following are disorders of the brain?
   Answer: e. All of the above.
   Brain research demonstrates that disorders as different as stroke, anxiety disorders, alcohol addiction, anorexia, learning disabilities, and Alzheimer's all have their roots in the brain. Every American will be affected at some point in his or her life, either personally or by a family member's struggle, with a brain disorder.
2. Post-Traumatic stress disorder, once referred to as shell shock or battle fatigue, is a condition that only affects war veterans.
   Answer: False.
   Individuals who have experienced a traumatic event or ordeal, such as a tornado, a rape or mugging, or a car wreck, can be at risk for developing post-traumatic stress disorder (PTSD). Many people with this anxiety disorder repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day. They may also experience sleep problems, depression, feeling detached or numb, or being easily startled.
3. Someone who feels compelled to spend a great deal of time doing things over and over again such as washing their hands, checking things, or counting things has an anxiety disorder.
   Answer: True.
   A person plagued by the urgent need to engage in certain rituals, or tormented by unwelcome thoughts or images, may be suffering from an anxiety disorder called obsessive-compulsive disorder (OCD). Most healthy people can identify with having some of the symptoms of OCD, such as checking the stove several times before leaving the house. But the disorder is diagnosed only when such activities consume at least an hour a day, are very distressing, and interfere with daily life. OCD affects men and women equally. It can appear in childhood, adolescence, or adulthood, but on the average, it first shows up in the teens or early adulthood.
4. What is the most common mental health problem in the United States?
   Answer: c. Anxiety Disorders
   Anxiety disorders are the most common mental health problem in America. More than 19 million Americans suffer from anxiety disorders, which include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, phobias, and generalized anxiety disorders.
5. Which of the following diseases/disorders are real medical illnesses?
   Answer: d. All of the above.
   Anxiety disorders, diabetes, and high blood pressure are all real medical illnesses. Brain scientists have shown that anxiety disorders are often related to the biological makeup and life experiences of the individual, and they frequently run in families. Unfortunately, misconceptions about mental illnesses like anxiety disorders still exist. Because many people believe mental illness is a sign of personal weakness, the condition is often trivialized and is left untreated. The good news is that effective treatments are available for anxiety disorders.
6. Which of the following are symptoms of an anxiety disorder known as panic disorder?
   Answer: e. All of the above.
   Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. Left untreated, people with panic disorder can develop so many phobias about places or situations where panic attacks have occurred that they become housebound.
7. Anxiety disorders often occur with other illnesses.
   Answer: True.
   It is common for an anxiety disorder to accompany depression, eating disorders, substance abuse, or another anxiety disorder. Anxiety disorders can also co-exist with illnesses such as heart disease, high blood pressure, irritable bowel syndrome, thyroid conditions, and migraine headaches. In such instances, the accompanying disorders will also need to be treated. So, it is important, before beginning any treatment, to have a thorough medical examination to determine the causes of symptoms.
8. Most people successfully take control of the symptoms of anxiety disorders by sheer willpower and personal strength.
   Answer: False.
   Many people misunderstand anxiety disorders and other mental illnesses and think individuals should be able to overcome the symptoms by sheer willpower. Wishing the symptoms away does not work-but there are treatments that can help. Treatment for anxiety disorders often involves medication, specific forms of psychotherapy, or a combination of the two.

Source: National Institute of Mental Health, National Institutes of Health, January 1999