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There are several types of anxiety disorders including panic disorder,social anxiety disorder,

specific phobias, and generalized anxiety disorder.

Anxiety is a normal human emotion that everyone experiences at times. Many people feel
anxious, or nervous, when faced with a problem at work, before taking a test, or making an
important decision.Anxiety disorders, however, are different. They can cause such distress that
it interferes with a person's ability to lead a normal life.
An anxiety disorder is a serious mental illness. For people with anxiety disorders, worry and fear
are constant and overwhelming, and can be crippling.
Phobias -- See What Makes Some People Afraid

What Are the Types of Anxiety Disorders?

There are several recognized types of anxiety disorders, including:

Panic disorder: People with this condition have feelings of terror that strike suddenly
and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain,
palpitations (unusually strong or irregular heartbeats), and a feeling of choking, which may make

the person feel like he or she is having aheart attack or "going crazy."
Social anxiety disorder: Also called social phobia, social anxiety disorder involves
overwhelming worry and self-consciousness about everyday social situations. The worry often
centers on a fear of being judged by others, or behaving in a way that might cause

embarrassment or lead to ridicule.

Specific phobias: A specific phobia is an intense fear of a specific object or situation,
such as snakes, heights, or flying. The level of fear is usually inappropriate to the situation and

may cause the person to avoid common, everyday situations.

Generalized anxiety disorder: This disorder involves excessive, unrealistic worry and
tension, even if there is little or nothing to provoke the anxiety.

What Are the Symptoms of an Anxiety Disorder?

Symptoms vary depending on the type of anxiety disorder, but general symptoms include:

Feelings of panic, fear, and uneasiness

Problems sleeping

Cold or sweaty hands and/or feet

Shortness of breath

Heart palpitations

An inability to be still and calm

Dry mouth

Numbness or tingling in the hands or feet


Muscle tension


What Causes Anxiety Disorders?

The exact cause of anxiety disorders is unknown; but anxiety disorders -- like other forms of
mental illness -- are not the result of personalweakness, a character flaw, or poor upbringing. As
scientists continue their research on mental illness, it is becoming clear that many of these
disorders are caused by a combination of factors, including changes in the brain and
environmental stress.
Like other brain illnesses, anxiety disorders may be caused by problems in the functioning
of brain circuits that regulate fear and other emotions. Studies have shown that severe or longlasting stress can change the way nerve cells within these circuits transmit information from one
region of the brain to another. Other studies have shown that people with certain anxiety
disorders have changes in certain brain structures that control memories linked with strong
emotions. In addition, studies have shown that anxiety disorders run in families, which means
that they can at least partly be inherited from one or both parents, like the risk for heart
disease or cancer. Moreover, certain environmental factors -- such as a trauma or significant
event -- may trigger an anxiety disorder in people who have an inherited susceptibility to
developing the disorder.

How Common Are Anxiety Disorders?

Anxiety disorders affect millions of adult Americans. Most anxiety disorders begin in childhood,
adolescence, and early adulthood. They occur slightly more often in women than in men, and
occur with equal frequency in whites, African-Americans, and Hispanics.

How Are Anxiety Disorders Diagnosed?

If symptoms of an anxiety disorder are present, the doctor will begin an evaluation by asking
you questions about your medical history and performing a physical exam. Although there are
no lab tests to specifically diagnose anxiety disorders, the doctor may use various tests to look
for physical illness as the cause of the symptoms.
If no physical illness is found, you may be referred to a psychiatrist,psychologist, or another
mental health professional who is specially trained to diagnose and treat mental illnesses.
Psychiatrists and psychologists use specially designed interview and assessment tools to
evaluate a person for an anxiety disorder.

The doctor bases his or her diagnosis on the patient's report of the intensity and duration of
symptoms -- including any problems with daily functioning caused by the symptoms -- and the
doctor's observation of the patient's attitude and behavior. The doctor then determines if the
patient's symptoms and degree of dysfunction indicate a specific anxiety disorder.

How Are Anxiety Disorders Treated?

Fortunately, much progress has been made in the last two decades in the treatment of people
with mental illnesses, including anxiety disorders. Although the exact treatment approach
depends on the type of disorder, one or a combination of the following therapies may be used
for most anxiety disorders:

Medication: Drugs used to reduce the symptoms of anxiety disorders include antidepressants and anxiety-reducing drugs.
Psychotherapy: Psychotherapy (a type of counseling) addresses the emotional
response to mental illness. It is a process in which trained mental health professionals help

people by talking through strategies for understanding and dealing with their disorder.
Cognitive-behavioral therapy: This is a particular type of psychotherapy in which the
person learns to recognize and change thought patterns and behaviors that lead to troublesome

Dietary and lifestyle changes.

Relaxation therapy.

Can Anxiety Disorders Be Prevented?

Anxiety disorders cannot be prevented; however, there are some things you can do to control or
lessen symptoms:

Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola,

energy drinks, and chocolate.

Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal

remedies. Many contain chemicals that can increase anxiety symptoms.

Seek counseling and support if you start to regularly feel anxious with no apparent

The symptoms of anxiety are sometimes not all that obvious as they often develop
gradually and, given that we all experience some anxiety at some points in time, it can be
hard to know how much is too much.
Some common symptoms include:

hot and cold flushes

racing heart

tightening of the chest

snowballing worries

obsessive thinking and compulsive behaviour.

These are just some of a number of symptoms that may be experienced. If you are familiar with any of these
symptoms, check the more extensive list of symptoms common to the different types of anxiety disorders below. They
are not designed to provide a diagnosis for that you need to see a doctor but they can be used as a guide.

Generalised anxiety disorder

For 6 months or more, on more days than not, have you:

felt very worried

found it hard to stop worrying

found that your anxiety made it difficult for you to do everyday activities (e.g. work, study, seeing friends and

If you answered yes to all of these questions, have you also experienced 3 or more of the following:

felt restless or on edge

felt easily tired

had difficulty concentrating

felt irritable

had muscle pain (e.g. sore jaw or back)

had trouble sleeping (e.g. difficulty falling or staying asleep or restless sleep)?

Find out more

Generalised anxiety disorder

Treatments for anxiety

Phobias (specific and social)

Have you felt very nervous when faced with a specific object or situation? For example:

flying on an aeroplane

going near an animal

receiving an injection

going to a social event?

Have you avoided a situation because of your phobia? For example, have you:

changed work patterns

not attended social events

avoided health check-ups

found it hard to go about your daily life (e.g. working, studying or seeing friends and family) because you are
trying to avoid such situations?

Find out more

Social phobia

Specific phobias

Treatments for anxiety

Panic disorder
Within a 10 minute period have you felt 4 or more of the following:



increased heart rate

short of breath


nauseous or pain in the stomach

dizzy, lightheaded or faint

numb or tingly

derealisation (feelings of unreality) or depersonalization (feeling detached from yourself or your


hot or cold flushes

scared of going crazy

scared of dying?

If you answered yes to all of these questions, have you also: felt scared, for 1 month or more, of experiencing these
feelings again?

Find out more

Panic disorder

Treatments for anxiety

Post-traumatic stress disorder

Have you:

experienced or seen something that involved death, injury, torture or abuse and felt very scared or helpless?

had upsetting memories or dreams of the event for at least 1 month?

found it hard to go about your daily life (e.g. work, study, getting along with family and friends)?

If you answered yes to all of these questions, have you also experienced at least 3 of the following:

avoided activities that remind you of the traumatic event

had trouble remembering parts of the event

felt less interested in doing things you used to enjoy

had trouble feeling intensely positive emotions (e.g. love or excitement)

thought less about the future (e.g. about career or family goals)?

and have you experienced at least 2 of the following:

had difficulties sleeping (e.g. had bad dreams, or found it hard to fall or stay asleep)

felt easily angered or irritated

had trouble concentrating

felt on guard

been easily startled?

Find out more

Post-traumatic stress disorder

Treatments for anxiety

Obsessive compulsive disorder

Have you:

had repetitive thoughts or concerns that are not simply about real life problems (e.g. thoughts that you or
people close to you will be harmed)

Done the same activity repeatedly and in a very ordered, precise and similar way each time e.g.:
constantly washing your hands or clothes, showering or brushing your teeth

constantly cleaning, tidying or rearranging things at home, at work or in the car in a very particular


constantly checking that doors and windows are locked and/or appliances are turned off

felt relieved in the short term by doing these things, but soon felt the need to repeat them

recognised that these feelings, thoughts and behaviours were unreasonable

found that these thoughts or behaviours take up more than 1 hour a day and/or interfered with your normal
routine (e.g. working, studying or seeing friends and family)?

Effective treatment helps people with anxiety to learn how to control the condition so it doesnt control them. The type
of treatment will depend on the type of anxiety being experienced. Mild symptoms may be relieved with lifestyle
changes (e.g. regular physical exercise) and self-help (e.g. online e-therapies). Where symptoms of anxiety are
moderate to severe, psychological and/or medical treatments are likely to be required.

Medical treatments for anxiety

Medical treatments for anxiety

Research shows that psychological therapies are the most effective in helping people
with anxiety. However, if symptoms are severe, some medical treatments may be helpful.

Antidepressant medication
Some types of antidepressant medication can help people to manage anxiety, even if they are not experiencing
symptoms of depression.
Research indicates that when people have an anxiety disorder, there are specific changes that occur in the brain's
chemicals serotonin, noradrenaline and dopamine. Antidepressant medication is designed to correct the imbalance
of chemical messages between nerve cells (neurones) in the brain. Learn about the different classes of
antidepressant medication.

What are the side effects?

Like any other medication, some people who take antidepressant medication experience some side effects. While
they can vary depending on which medication is taken, common side effects can include nausea, headaches, anxiety,
sweating, dizziness, agitation, weight gain, dry mouth and sexual difficulties (e.g. difficulty becoming/staying
Some of these side effects are short-lived, but there are still ways of minimising them so keep the doctor informed.

How long are antidepressants usually needed?

Like any medication, the length of time a person needs to take antidepressants for depends on the severity of their
illness and how they respond to treatment. Some people only need to take them for a short time, while others may
need them on an ongoing basis to manage their condition. Its just like someone who uses insulin to manage their
diabetes, or ventolin for asthma.
Antidepressants are safe, effective and not addictive. People sometimes want to stop taking antidepressants quickly
because they are concerned they're addictive. This may be because they confuse them with other types of
medications (e.g. benzodiazepines, sedatives), but stopping medication should only be done gradually, on a doctor's
recommendation and under supervision.

Benzodiazepines (sometimes called sedatives) are a class of drug commonly prescribed in the short term to help
people cope with anxiety and panic attacks. Benzodiazepines reduce tension without making people drowsy but they
are not recommended for long-term use as they can be addictive. They may be useful for a short period of time (two
or three weeks) or if used intermittently as part of a broad treatment plan, but not as the first or only treatment.

Changes to scheduling of alprazolam by 1 February 2014

Alprazolam is a benzodiazepine drug most commonly used in the treatment of panic disorder and short term
treatment of anxiety. From 1 February 2014 there will be a change to the way alprazolam is prescribed and supplied
throughout all of Australia which your doctor and pharmacist are legally required to follow.

Other sources of support

Other source s of support

Depression and anxiety can go on for months, even years, if left untreated, and can have
many negative effects on a person's life.
Whatever treatments are used, they are best done under the supervision of a GP or mental health professional. If you
have taken the first step and enlisted the help of your GP or another health professional, there are additional things
you might like to try to get your recovery underway.
Just remember that recovery can take time, and just as no two people are the same, neither are their recoveries.

Family and friends

Family members and friends play an important role in a person's recovery. They can offer support, understanding and
help. People with depression and anxiety often don't feel like socialising, but spending time alone can make a person
feel cut off from the world, which makes it harder to recover. That's why it's important for them to take part in activities
with family members and close friends, and to accept social invitations, even though it's the last thing they may want
to do. Staying connected with people helps increase levels of wellbeing, confidence and the chance to participate in
physical activities.

A number of studies have found that exercise is a good way to help prevent or manage mild to moderate depression
and anxiety. Research shows that keeping active can help lift mood, improve sleep, increase energy levels, help
block negative thoughts and/or distract people from daily worries, increase opportunities to socialise, and generally
increase wellbeing. Exercise may also change levels of chemicals in the brain, such as serotonin, endorphins and
stress hormones.

Food can play a vital role in maintaining mental health as well as physical health. In general, eating a nourishing diet
gives people an overall sense of wellbeing. There are also some specific nutritional strategies that can help improve
mood, maintain healthy brain functioning and help people with depression and anxiety.

Support groups and online forums

Mutual support groups for people with depression and anxiety are conducted by people who have experienced similar
problems. These groups can provide an opportunity to connect with others, share experiences and find new ways to
deal with difficulties. Contact your local community health centre or the mental health association/foundation in your
state or territory to find your nearest group, or try searching online.
Some people prefer to share their stories and information, or seek and offer support, via online forums. You can visit
the Australian Government's mindhealthconnect website to find trusted communities, or join beyondblue's online

Relaxation training
Relaxation training is used as a treatment for anxiety. Because anxiety can lead to depression, it may reduce
depression as well. People with anxiety are thought to have tense muscles. As relaxation training helps to relax
muscles, it may also help to reduce anxious thoughts and behaviours. Relaxation training may also help people feel
as if they have more control of their anxiety.
There are several different types of relaxation training. The most common one is progressive muscle relaxation. This
teaches a person to relax voluntarily by tensing and relaxing specific groups of muscles. Another type of relaxation
training involves thinking of relaxing scenes or places. Relaxation training can be learned from a professional or done
as self-help. Recorded instructions are available for free on the internet or they can be bought on CD and/or MP3.

Listen to a guided progressive muscle relaxation exercise

E-therapies, also known as online therapies or computer-aided psychological therapy, can be just as effective as
face-to-face services for people with mild to moderate anxiety and depression.
Cognitive behaviour therapy (CBT) and behaviour therapy are helpful for anxiety and depression when delivered by a
professional. The structured nature of these treatments means they are also well suited to being delivered
Most e-therapies teach people to identify and change patterns of thinking and behaviour that might be keeping them
from overcoming their anxiety or depression. An individual works through the program by themselves, and although
e-therapies can be used with or without help from a professional, most programs do involve some form of support
from a therapist. This can be via phone, email, text or instant messaging, and will help the person to successfully
apply their newly learnt skills to everyday life.
This online mode of delivery has several advantages. It:

is easy to access

can be done from home

can be of particular benefit for people in rural and remote areas

can be provided in many cases without having to visit a doctor.

You can visit the Australian Government's mindhealthconnect website to find a library of online programs.

Other approaches
It's not uncommon for people with depression or anxiety to try to manage the illness themselves. It's important to
know that while there are other non-medical or alternative treatment approaches available, these may differ in
effectiveness. Some non-medical treatments have undergone scientific testing and there's no harm in trying them if
the depression or anxiety is not severe or life threatening.
The beyondblue booklets, A guide to what works for depression, A guide to what works for anxiety and A guide to
what works for depression in young people (links below), provide a summary of what the scientific evidence says
about each treatment.
However, when a treatment is shown to have some effect in research, this does not mean it is available, used in
clinical practice, will be recommended or will work equally well for every person. There is no substitute for the advice
of a mental health practitioner, who can advise on the treatment options available. The best approach is to try a
treatment that works for most people and that you are comfortable with. If you do not recover quickly enough, or
experience problems with the treatment, then try another.

Psychological treatments (talking therapies) have been found to

be an effective way to treat anxiety. They may not only help a
person to recover, but can also help to prevent a recurrence of
There are several different types of psychological treatments, including cognitive behaviour therapy (CBT) and
behaviour therapy. These psychological therapies can be undertaken with a professional, and increasingly, via
structured sessions delivered via the internet (with or without support from a professional).

Cognitive behaviour therapy (CBT)

CBT is a structured psychological treatment, which recognises that a person's way of thinking (cognition) and acting
(behaviour) affects the way they feel. In CBT, a person works with a professional to look at the patterns of thinking
and acting that are either predisposing them to anxiety, or keeping them from improving once they become anxious.
Once these patterns are recognised, the person can consciously and deliberately make changes to replace these
patterns with new ones that reduce anxiety and enhance their coping skills.
For example, thinking that focuses on catastrophising (thinking the worst, believing something is far worse than it
actually is, anticipating things will go wrong) is often linked with anxiety. In CBT, the person works to change these
patterns to use a way of thinking that is more realistic and focused on problem-solving. Anxiety is also often
heightened when a person actively avoids the things of which he/she is afraid. Learning how to face up to situations
that are anxiety-inducing is also often helpful.
Professionals may use a range of techniques in CBT. Examples include:

Encouraging people to recognise the difference between productive and unproductive worries, teaching
people how to let go of worries and solve problems.

Teaching relaxation and breathing techniques, with muscle relaxation in particular, to control anxiety and the
physical symptoms of tension.

CBT can be conducted one-on-one with a professional, in groups, or online (see E-therapies, below). CBT is often
combined with behaviour therapy.
Do you live in Adelaide, Canberra or North Coast NSW? NewAccess is a free and confidential service that
provides support in the form of a coach. The program includes six free sessions tailored to your individual

Behaviour therapy
Behaviour therapy is a major component of cognitive behaviour therapy (CBT). However, it is different to CBT
because it focuses exclusively on increasing a person's level of activity and pleasure in their life.
Anxiety problems often persist because the person avoids fearful situations. Avoiding these situations means that the
person does not have the opportunity to learn that he/she can actually cope with the fear. Behaviour therapy for
anxiety relies mainly on a treatment called 'graded exposure'. There are a number of different approaches to
exposure therapy, but they're all based on exposing people to the specific things that make them anxious. The person
learns that their fear will diminish without having to dodge the need to avoid or escape the situation and that their
fears about the situation often do not come true or are not as bad as they thought.

E-therapies, also known as online therapies or computer-aided psychological therapy, can be just as effective as
face-to-face services for people with mild to moderate anxiety. CBT and behaviour therapy are helpful for anxiety
when delivered by a professional. The structured nature of these treatments means they are also well suited to being
delivered electronically.
Most e-therapies teach people to identify and change patterns of thinking and behaviour that might be keeping them
from overcoming their anxiety. An individual works through the program by themselves, and although e-therapies can
be used with or without help from a professional, most programs do involve some form of support from a therapist.
This can be via telephone, email, text, or instant messaging, and will help the person to successfully apply what they
are learning to their life.
This online mode of delivery has several advantages. It:

is easy to access

can be done from home

can be of particular benefit for people in rural and remote areas

can be provided in many cases without having to visit a doctor.

You can visit the Australian Government's mindhealthconnect website to find a library of online programs.

To find out about other psychological treatment approaches and the level of evidence behind them,
download A guide to what works for anxiety.