What is an Anxiety Disorder?
Anxiety is a normal and often healthy emotion characterized by feelings of unease, nervousness, worry, or fear. When a person regularly feels disproportionate levels of anxiety, it might become a type of mental health condition. Anxiety disorders are the most common mental disorders in most countries. General symptoms of anxiety disorders can include:
- Feeling restless or on edge
- Easily fatigued
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep disturbance
There are many different types of anxiety disorders; some of the most common include:
- Generalized Anxiety Disorder (GAD): excessive and unrealistic worry about everyday events and activities.
- Social Anxiety Disorder (SAD): an intense fear of social situations and being judged or evaluated by others.
- Panic Disorder (PD): sudden and unexpected panic attacks, along with persistent fear of future attacks.
- Specific Phobias: an intense fear of specific objects or situations, such as heights or flying.
- Post-Traumatic Stress Disorder (PTSD): severe anxiety, flashbacks, and avoidance behaviours following a traumatic event.
- Separation Anxiety Disorder: excessive anxiety when separated from a primary caregiver or attachment figure.
- Agoraphobia: fear of being in places or situations from which escape might be difficult or help unavailable in the event of a panic attack.
Previously, Obsessive-Compulsive Disorder (OCD) was also categorised as an anxiety disorder. However, in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), OCD is now classified as a separate category called "Obsessive-Compulsive and Related Disorders," reflecting new research findings on the underlying causes and characteristics of OCD.
What is the Purpose of Anxiety?
Anxiety exists for a reason. Humans evolved to have a fight, flight, or freeze response to alert us to danger. It helps us to act in stressful situations. Typically, when appropriate, these responses help us protect ourselves, increase our motivation, develop and improve ourselves, and connect with others.
However, people with anxiety can feel this type of intense physiological response in a variety of situations that feel threatening. At these times, the brain triggers a response meant to help in life-threatening situations for ones that aren't actually dangerous. This response is not unique to only some people, so you are not alone. Anxiety is a very natural and adaptive reaction.
Through extensive studies on the biology of fear and anxiety, researchers have found that the region that may be responsible for fear and anxiety is called the Amygdala. One of its purposes is to scan for 'danger signals', raise the 'alarm' and activate our 'flight', 'fight' or 'freeze' responses. The amygdala has extensive connections to other brain regions and can effectively influence them, as danger is a priority for our survival. It can therefore often 'hijack' the more rational parts of our brain (typically called the Cortex). The amygdala we inherit may be more or less sensitive to danger, often depending on our genetic makeup, our environment and our experiences in life.
The Biology of Fear
The purpose of "fight"
We humans have evolved the fight response so that we are ready to take action when we are faced with a threat (the threat can be physical, social or psychological). When we channel the fight response appropriately in the modern world, we might decide to go on a protest or demonstration for a cause. This response helps us to focus and gives our muscles oxygen and our body energy so that we can fight. If this response is unregulated, it might make us overly aggressive in situations that aren't really threatening — that is, our anxiety or fear leads to the development of anger-related issues.
The purpose of "flight"
We have evolved a flight instinct when presented with something scary or overwhelming in order to keep ourselves safe. When we face something that could actually harm us, this instinct helps to alert us that leaving might be the best way to keep us unharmed. In today's world, many people feel this instinct when presented with a stimulus that won't likely harm them. If this response is unregulated, it might lead to procrastination or isolation, which may result in a low mood.
The purpose of "freeze"
The freeze response allows us some extra time to quickly assess a dangerous situation. It gives us time to decide whether to fight or run away. Likewise, people with anxiety might feel helpless while faced with an obstacle, so they freeze to decide what to do next, or they might go blank and be unable to continue working.
Treatment of Anxiety Disorders
Anxiety disorders are treated by a combination of psychiatric medications and psychotherapy, with the latter being an effective form of treatment for reducing symptoms of anxiety. One form of psychotherapy that has been shown to be particularly effective in treating anxiety is cognitive-behavioural therapy (CBT). CBT is recommended by national and international guidelines for anxiety, and many other mental health conditions.
The cognitive component of CBT focuses on identifying and challenging unhelpful thoughts and beliefs that contribute to anxiety. The behavioural component focuses on changing the behaviours associated with anxiety — for example, gradually exposing oneself to feared situations and learning that they can be handled (exposure therapy). CBT for anxiety is typically short-term, usually lasting for 12 to 20 sessions, with specific goals and homework assignments such as keeping a thought diary or practising exposure.
CBT has been shown to be effective in treating a variety of anxiety disorders, including GAD, SAD, Panic Disorder and OCD, and can also be used in combination with medication for more severe cases. If you are struggling with anxiety, consider talking to a mental health professional about CBT as a treatment option.