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Anxiety disorders

Anxiety disorders are conditions in which symptoms of anxiety are so severe or occur so regularly, they start to interfere with everyday life. About 14 percent of Australian adults are affected by an anxiety disorder in any one year. This equates to about one in seven people.

About anxiety disorders 

Anxiety is a feeling of unease. Everybody gets anxious when faced with a stressful situation, for example an exam or interview, or during a worrying time such as illness. It's also normal to feel anxious when you face something difficult or dangerous. Mild anxiety can often be positive and useful, particularly if you're better at working under pressure.

However, an anxious mood becomes an anxiety disorder when it's long-lasting, severe and interferes with your everyday activities. Excessive anxiety is often associated with other mental health problems such as depression.

Types of anxiety disorder 

Below are some examples of anxiety disorders.

Phobias

A phobia is a fear that's out of proportion to any real danger. If a phobia interferes with your ability to lead a normal life, then it may be considered an anxiety disorder. Common phobias include fears of heights, spiders, mice, blood, injections or enclosed spaces.

Social anxiety disorder

Social anxiety disorder, also known as social phobia, is a powerful and persistent fear of social or performance situations. If you have this condition you fear being closely observed or negatively judged by others to such an extent that you'll avoid certain social situations or experience severe distress if you do involve yourself in them. You may also limit what you do in front of others, such as eating in public, or even isolate yourself from others in order to avoid social interaction.

Panic disorder

If you have panic disorder, you can suddenly develop intense periods of fear known as panic attacks. You may find that something specific triggers your panic attacks, or they may develop for no apparent reason. Panic attacks usually last five to 10 minutes but they can last longer.

Obsessive-compulsive disorder

If you have obsessive-compulsive disorder (OCD), you may have repeated obsessions and/or compulsions that make you feel anxious. OCD symptoms vary from mild to severe. They include obsessions (recurrent ideas that make you feel distressed or anxious) and compulsions (actions or rituals which you feel necessary to cancel out the obsessions).

Post-traumatic stress disorder

You can develop post-traumatic stress disorder (PTSD) if you've had or witnessed a traumatic event. PTSD symptoms include anxiety, which may come and go, and recurring thoughts, memories, images, dreams or distressing flashbacks of the trauma. PTSD may develop years after the traumatic event occurred.

Generalised anxiety disorder

Anxiety can be a long-term disorder where you feel worried most of the time about things that might go wrong. This is called generalised anxiety disorder (GAD). If you have GAD, you may also have panic attacks and some phobias.

Symptoms of anxiety disorders 

Anxiety disorders can cause both psychological and physical symptoms.

If you have an anxiety disorder, your main symptom will be feeling anxious. However, this can lead to other psychological symptoms such as:

  • sleeping difficulties (insomnia)
  • feeling tired
  • being irritable or quick to get angry
  • being unable to concentrate
  • a fear that you're 'going mad'
  • feeling out of control of your actions, or detached from your surroundings.

When you're anxious, you may also have a range of physical symptoms. This is caused by the release of the hormone adrenaline - your body's so-called 'fight or flight' response. Physical symptoms of anxiety include:

  • discomfort in your abdomen (tummy)
  • diarrhoea
  • dry mouth
  • rapid heartbeat or palpitations
  • tightness or pain in your chest
  • shortness of breath
  • dizziness
  • needing to urinate more often than usual
  • difficulty swallowing
  • shaking

These symptoms may be caused by problems other than anxiety disorders. If you have any of these symptoms, see your doctor for advice.

Causes of anxiety disorders 

There are many different causes of anxiety. It may not be clear why you have anxiety, but you may be more likely to develop an anxiety disorder if you:

  • go through a stressful, life-changing event such as a bereavement, or witness something traumatic
  • have another mental health condition, such as depression or alcohol dependence
  • have a physical illness, such as a thyroid disorder
  • take illegal substances such as amphetamines, LSD and ecstasy
  • are withdrawing from long-term use of some medicines, such as tranquillisers.

Some people seem to be born with a tendency to be more anxious than others. This means anxiety disorders may be genetically inherited. Equally, people who are not naturally anxious can become so if they're put under intense pressure.

Diagnosis of anxiety disorders 

If you think feelings of anxiety are affecting your day-to-day life, visit your GP.

Your GP will want to identify what's causing your anxiety. They will ask about your symptoms and examine you.

In some circumstances your GP may refer you to a counsellor, therapist or psychiatrist for further diagnosis to help determine what treatment is appropriate for you.

Treatment of anxiety disorders 

Self-help

There are various lifestyle changes you can make to help reduce feelings of anxiety. For example, taking part in regular physical activity, avoiding stimulants such as cigarettes and alcohol and eating a healthy diet can help to improve your symptoms.

A good source of support and advice can be charities and patient groups where you can get into contact with and talk to other people who have anxiety disorders. Your GP may be able to advise you about services available in your area.

Talking therapies

Your GP may refer you to a counsellor or a therapist for treatment. Talking through your problems with a counsellor may help you to deal better with your anxiety. Counselling may be particularly helpful if you have a panic disorder, social phobia or GAD, especially in the short term, but it isn't suitable for everyone.

Cognitive behavioural therapy (CBT) is a short-term psychological treatment. CBT helps to challenge negative thoughts, feelings and behaviour, and is particularly suitable if you have problems such as phobias or panic attacks.

More information about finding a mental health professional for further help.

Medicines

There are a number of different types of medicines that can be used to treat anxiety disorders. Your GP may prescribe you one of the following medicines, depending on how much your anxiety affects you.

  • Antidepressants are the main drug treatment of choice for anxiety. They can be used on their own for chronic anxiety or in combination with a benzodiazepine.
  • Benzodiazepines may be used for the short-term relief of severe anxiety. They aren't prescribed for long-term use because of the risk of addiction.
  • Beta-blockers may help to reduce some of your physical symptoms, such as rapid heartbeats or palpitations and shaking. However, they don't help with the psychological symptoms of anxiety.

Always ask your doctor for advice, and read the accompanying consumer medicines information leaflet.

Complementary therapies

Some relaxation techniques, such as meditation, low impact yoga or tai chi exercises, may help you to deal with your anxiety. However, there isn't enough research on these types of therapy to tell if they're effective or not. You should always speak with your GP before you start any complementary therapy courses or treatments.

If you want to talk to someone urgently

Lifeline Australia
13 11 14
www.lifeline.org.au

Kids help line
1800 55 1800
www.kidshelp.com.au

Further information 

SANE Australia
1800 18 7263
www.sane.org/

Beyondblue
1300 22 4636
www.beyondblue.org.au

Headspace (aimed at younger people)
(02) 6201 5343
www.headspace.org.au

Sources 

Australian Centre for Posttraumatic Mental Health (ACPMH). Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder: Practitioner guide. [online] East Melbourne, VIC: ACPMH. 2007 [Accessed 4 Jul 2011] Available from: http://www.acpmh.unimelb.edu.au/resources/resource-asdptsd_guidelines.html

Australian Institute of Health and Welfare. Australia's health 2010. Cat. no. AUS 122. [online] Canberra, ACT: AIHW. Jun 2010. [Accessed 4 Jul 2011] Available from: http://www.aihw.gov.au/publication-detail/?id=6442468376

AIHW. Young Australians: their health and wellbeing 2011 . Cat. no. PHE 140. [online] Canberra, ACT: AIHW. Jun 2011. [Accessed 8 Jul 2011] Available from: http://www.aihw.gov.au/publication-detail/?id=10737419261

Beyondblue. Anxiety disorders, fact sheet 21. [online] Hawthorn West, VIC: beyond blue. Sept 2008 [Last modified 15 Feb 2011, accessed 4 Jul 2011] Available from: http://www.beyondblue.org.au/index.aspx?link_id=7.980&tmp=FileStream&fid=1139

Beyondblue. A guide to what works for anxiety disorders. [online] Hawthorn West, VIC: beyond blue. May 2010 [Last modified 5 Jul 2011, accessed 5 Jul 2011] Available from: http://www.beyondblue.org.au/index.aspx?link_id=7.980&tmp=FileStream&fid=1747

Bower P Rowland N. Effectiveness and cost-effectiveness of counselling in primary care. Cochrane Database of Systematic Reviews. 2006, Issue 3. doi:10.1002/14651858.CD001025.pub2

Krisanaprakornkit T Sriraj W Piyavhatkul N et al. Meditation therapy for anxiety disorders. Cochrane Database of Systematic Reviews. 2009, Issue 1. doi:10.1002/14651858.CD004998.pub2

National Institute for Health and Clinical Excellence (NICE). Obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD). [online] Nov 2005 [accessed 5 Jul 2011] Available from: http://guidance.nice.org.uk/CG31

National Mental Health Strategy. What is an anxiety disorder? [online] Canberra, ACT: Commonwealth of Australia. 2007 [Accessed 4 Jul 2011] Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-w-whatanx

RANZCP Clinical Practice Guidelines Team for Panic Disorder and Agorophobia. Australian and New Zealand clinical practice guidelines for the treatment of panic disorder and agoraphobia. [online] 2003 [Accessed 7 Jul 2011] Available from: http://www.ranzcp.org/

Rossi S (ed). Australian Medicines Handbook. Adelaide: Australian Medicines Handbook. 2011.

SANE Australia. Anxiety factsheet. [online] Melbourne, VIC: SANE. 2011 [Accessed 4 Jul 2011] Available from: http://www.sane.org/information/factsheets-podcasts/158-anxiety-disorders

Simon C Everitt H van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press. 2010: 990-93.

Western Australia Psychotropic Drugs Committee. Anxiety disorders drug treatment guidelines. [online] 2008 [accessed 4 Jul 2011] Available from: http://www.watag.org.au/wapdc/guidelines.cfm#Anxiety

Yates WR. Anxiety disorders. [online] New York, NY: WebMD LLC. [last updated 28 Jun 2011, accessed 5 Jul 2011] Available from: http://emedicine.medscape.com/article/286227-overview

Last published: 30 July 2011

Disclaimer
This information has been developed and reviewed for Bupa by health professionals and to the best of their knowledge is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

Bupa Australia Pty Ltd makes no warranties or representations regarding the completeness or accuracy of the recommendations or assessments and is not liable for any loss or damage you suffer arising out of the use of or reliance on the information, except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health. For more details on how we produce our health content, visit the About our health information page.

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