Overview of Anxiety Disorders

The causes of anxiety disorders are not fully known, but the following may be involved:

An anxiety disorder can be triggered by environmental stresses, such as the breakup of a significant relationship or exposure to a life-threatening disaster.

When a person's response to stresses is inappropriate or a person is overwhelmed by events, an anxiety disorder can arise. For example, some people find speaking before a group exhilarating. But others dread it, becoming anxious with symptoms such as sweating, fear, a rapid heart rate, and tremor. Such people may avoid speaking even in a small group.

Anxiety tends to run in families. Doctors think some of this tendency may be inherited, but some is probably learned by living with anxious people.

Anxiety can arise suddenly, as in panic, or gradually over minutes, hours, or days. Anxiety can last for any length of time, from a few seconds to years. It ranges in intensity from barely noticeable qualms to a full-blown panic attack Panic Attacks and Panic Disorder A panic attack is a brief period of extreme distress, anxiety, or fear that begins suddenly and is accompanied by physical and/or emotional symptoms. Panic disorder involves recurrent panic... read more , which may cause shortness of breath, dizziness, an increased heart rate, and trembling (tremor).

Anxiety disorders can be so distressing and interfere so much with a person's life that they can lead to depression Depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more . People may develop a substance use disorder Substance Use Disorders Substance use disorders generally involve behavior patterns in which people continue to use a substance (for example, a recreational drug) despite having problems caused by its use. The substances... read more . People who have an anxiety disorder (except for certain very specific phobias Specific Phobic Disorders Specific phobic disorders involve persistent, unrealistic, intense anxiety about and fear of specific situations, circumstances, or objects. The anxiety caused by a phobic disorder can interfere... read more , such as fear of spiders) are at least twice as likely to have depression as those without an anxiety disorder. Sometimes people with depression develop an anxiety disorder.

Deciding when anxiety is severe enough to be considered a disorder can be complicated. People's ability to tolerate anxiety varies, and determining what constitutes abnormal anxiety can be difficult. Doctors usually use the following specific established criteria:

Doctors look for other disorders that may be causing anxiety, such as depression Depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more or a sleep disturbance Overview of Sleep Sleep is necessary for survival and good health, but why sleep is needed and exactly how it benefits people are not fully understood. One of sleep's benefits is its restorative effect on people's... read more . Doctors also ask whether relatives have had similar symptoms, because anxiety disorders tend to run in families.

Doctors also do a physical examination. Blood and other tests may be done to check for other medical disorders that can cause anxiety.

Accurate diagnosis is important because treatment varies from one anxiety disorder to another. Additionally, anxiety disorders must be distinguished from anxiety that occurs in many other mental health disorders, which involve different treatment approaches.

If the cause is another medical disorder or a drug, doctors aim to correct the cause rather than treat the symptoms of anxiety. Anxiety should subside after the physical disorder is treated or the drug has been stopped long enough for any withdrawal symptoms to abate. If anxiety remains, antianxiety drugs or psychotherapy (such as behavioral therapy) is used.

For people who are dying, certain strong pain relievers, such as morphine Opioid Pain Relievers Pain relievers (analgesics) are the main drugs used to treat pain. Doctors choose a pain reliever based on the type and duration of pain and on the drug's likely benefits and risks. Most pain... read more , may relieve both pain and anxiety.

If an anxiety disorder is diagnosed, drug therapy or psychotherapy Psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more (such as behavioral therapy Behavioral therapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more ), alone or in combination, can significantly relieve the distress and dysfunction for most people. Benzodiazepines (such as diazepam) are commonly prescribed for acute anxiety. For many people, antidepressants, Drug Therapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more such as selective serotonin reuptake inhibitors (SSRIs), work as well for anxiety disorders as they do for depression. Specific treatments depend on which anxiety disorder is diagnosed.

All of the anxiety disorders can occur along with other psychiatric conditions. For example, anxiety disorders often occur along with an alcohol use disorder Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,... read more . It is important to treat all of these conditions as soon as possible. Treating the alcohol use disorder without treating the anxiety is unlikely to be effective since the person may be using alcohol to treat the anxiety. On the other hand, treating the anxiety without addressing the alcohol disorder may be unsuccessful because daily changes in the amount of alcohol in the blood can cause levels of anxiety to fluctuate.