There are many types of anxiety disorders that include panic disorder, obsessive compulsive disorder, post traumatic stress 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.
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 (irregular heartbeats), and a feeling of choking, which may make the person feel like he or she is having a heart attack or “going crazy.”
- Obsessive-compulsive disorder (OCD) : People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.
- Post-traumatic stress disorder (PTSD) : PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.
- 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 usually is 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
- Uncontrollable, obsessive thoughts
- Repeated thoughts or flashbacks of traumatic experiences
- Nightmares
- Ritualistic behaviors, such as repeated hand washing
- Problems sleeping
- Cold or sweaty hands and/or feet
- Shortness of breath
- Palpitations
- An inability to be still and calm
- Dry mouth
- Numbness or tingling in the hands or feet
- Nausea
- Muscle tension
- Dizziness
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 personal weakness, 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 certain illnesses, such as diabetes, anxiety disorders may be caused by chemical imbalances in the body. Studies have shown that severe or long-lasting stress can change the balance of chemicals in the brain that control mood. Other studies have shown that people with certain anxiety disorders have changes in certain brain structures that control memory or mood. In addition, studies have shown that anxiety disorders run in families, which means that they can be inherited from one or both parents, like hair or eye color. 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 about 19 million 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 laboratory 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 or psychologist, mental health professionals who are 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 : Medicines used to reduce the symptoms of anxiety disorders include anti-depressants 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: People suffering from anxiety disorders often participate in this type of psychotherapy in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.
- Dietary and lifestyle changes
- Relaxation therapy
Types of anxiolytics
Benzodiazepines
Benzodiazepines are prescribed for short-term relief of severe and disabling anxiety. Benzodiazepines may also be indicated to cover the latent periods associated with the medications prescribed to treat an underlying anxiety disorder. They are used to treat a wide variety of conditions and symptoms and are usually a first choice when short-term CNS sedation is needed. Longer-term uses include treatment for severe anxiety. There is a risk of a benzodiazepine withdrawal and rebound syndrome after continuous usage for longer than two weeks. There is also the added problem of the accumulation of drug metabolites and adverse effects.Benzodiazepines include:
- Alprazolam (Xanax)
- Chlordiazepoxide (Librium)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Lorazepam (Ativan)
Benzodiazepines exert their anxiolytic properties at moderate dosage. At higher dosage hypnotic properties occur.
Azapirones
Azapirones are a class of 5-HT1A receptor agonists. They lack the sedation and the dependence associated with benzodiazepines and cause much less cognitive impairment. They may be less effective than benzodiazepines in patients who have been previously treated with benzodiazepines as they do not provide the sedation that these patients may expect or equate with anxiety relief. Currently approved azapirones include buspirone (Buspar) and tandospirone (Sediel). Gepirone (Ariza, Variza) is also in clinical development.
Barbiturates
Barbiturates exert an anxiolytic effect linked to the sedation they cause. The risk of abuse and addiction is high. Many experts consider these drugs obsolete for treating anxiety but valuable for the short-term treatment of severe insomnia, though only after benzodiazepines or non-benzodiazepines have failed. They are rarely prescribed anymore.
Hydroxyzine
Hydroxyzine (Atarax) is an old antihistamine originally approved for clinical use by the FDA in 1956. It possesses anxiolyticproperties in addition to its antihistamine properties and is also licensed for the treatment of anxiety and tension. It is also used for its sedative properties as a premed before anesthesia or to induce sedation after anesthesia. It has been shown to be as effective as benzodiazepines in the treatment of generalized anxiety disorder while producing fewer side effects.
Pregabalin
Pregabalin’s therapeutic effect appears after 1 week of use and is similar in effectiveness to lorazepam, alprazolam and venlafaxine but pregabalin has demonstrated superiority by producing more consistent therapeutic effects for psychic and somatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance and additionally unlike benzodiazepines it does not disrupt sleep architecture and produces less severe cognitive and psychomotor impairment; it also has a low potential for abuse and dependence and may be preferred over the benzodiazepines for these reasons.
Herbal treatments
Certain herbs are reputed to have anxiolytic properties, including the following:
- Rhodiola rosea (Arctic Weed/Golden Root)
- Bacopa monnieri (Brahmi)
- Hypericum perforatum (St. John’s Wort)
- Matricaria recutita (German Chamomile)
- Mitragyna speciosa (Kratom)
- Nepeta persica (Catnip-Catmint)
- Piper methysticum (Kava)
- Sceletium tortuosum (Kanna)
- Scutellaria spp. (Skullcap)
- Valeriana officinalis (Valerian)
Of these, only Kava and Brahmi have shown anxiolytic effects in randomized clinical trials, and only Kava’s effect has been independently replicated.
In mice, trials have shown anxiolytic effects at 50 mg kg−1. However an increase in the dose of N. persica exerted stimulation rather than sedation as is the case for many other herbs.
A team from Brazil found cannabidiol (a constituent of cannabis; also called CBD) to be an effective anti-psychotic and anxiolytic. “CBD induced a clear anxiolytic effect and a pattern of cerebral activity compatible with anxiolytic activity. Therefore, similar to the data obtained in animal models, results from studies on healthy volunteers have strongly suggested an anxiolytic-like effect of CBD.”
Pineapple sage, or salvia elegans, is used as a treatment for anxiety in traditional Mexican medicine, and a preliminary study on mice has yielded some support for both anxiolytic and antidepressant properties.
Over-the-counter
Chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl) are reported to have mild anxiolytic properties (off-label use). These drugs are approved by the FDA for allergies, rhinitis, and urticaria.
Alternatives to medication
Psychotherapy (e.g., cognitive behavioral therapy (CBT)) is often useful as an adjunct to medication or as an alternative to medication. Research has demonstrated better long-term results for general anxiety when treated with psychotherapy as opposed to pharmacotherapy alone.
Meditation is also known for its tendency to reduce anxiety.
Drugs rating:
| Title | Votes | Rating | ||
| 1 | Stelazine (Trifluoperazine) | 1 |
|
(10.0/10) |
| 2 | Niravam (Alprazolam) | 12 |
|
(9.7/10) |
| 3 | Xanax (Alprazolam) | 1189 |
|
(8.7/10) |
| 4 | Tranxene T-Tab (Clorazepate) | 36 |
|
(8.6/10) |
| 5 | Valium (Diazepam) | 185 |
|
(8.0/10) |
| 6 | Librium (Chlordiazepoxide) | 23 |
|
(7.8/10) |
| 7 | Ativan (Lorazepam) | 987 |
|
(7.7/10) |
| 8 | Clomipramine | 30 |
|
(7.7/10) |
| 9 | Imipramine | 26 |
|
(7.6/10) |
| 10 | Doxepin | 86 |
|
(7.5/10) |
| 11 | Midazolam | 4 |
|
(7.5/10) |
| 12 | Serax (Oxazepam) | 27 |
|
(7.4/10) |
| 13 | Hydroxyzine HCl | 107 |
|
(7.2/10) |
| 14 | Tofranil (Imipramine) | 136 |
|
(6.7/10) |
| 15 | Anafranil (Clomipramine) | 155 |
|
(6.6/10) |
| 16 | Vistaril (Hydroxyzine) | 150 |
|
(6.0/10) |
| 17 | Mebaral (Mephobarbital) | 0 |
|
(0/10) |
| 18 | Equanil (Meprobamate) | 0 |
|
(0/10) |
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 your consumptionofproducts that contain caffeine, such as coffee, tea, cola, 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 after a traumatic or disturbing experience.