ANXIETY DISORDERS

The most common mental illnesses in the United States fall under the category of anxiety disorders, affecting 40 million adults in the U.S. age 18 and older, or 18.1% of the population every year. While anxiety disorders are treatable, only 36.9% of those suffering receive treatment.   (Source: Anxiety and Depression Association of America).

Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events. The feelings of anxiety can interfere with daily activities such as job performance, school work, and relationships.

There are several different types of anxiety disorders. The most common types of anxiety disorders are generalized anxiety disorder and social anxiety disorder.

What are the symptoms of
GENERALIZED ANXIETY DISORDER?


GAD is diagnosed when an individual finds it difficult to control worry on more days than not for at least six months and has three or more of the following symptoms (Source: DSM-5):

  • Difficulty controlling the worry
  • Restlessness or feeling wound-up or on edge
  • Being easily fatigued
  • Difficulty concentrating or having their minds go blank
  • Irritability Muscle tension
  • Sleep problems

Other anxiety disorders, substance abuse, and depression often accompany generalized anxiety disorder.

A thorough assessment to diagnose a patient with possible GAD should include a careful history, an evaluation for symptoms of GAD as well as alternative or comorbid psychiatric disorders, and a physical exam and laboratory studies to rule out organic causes of anxiety.

The most widely used instrument to assess and monitor the severity of symptoms of generalized anxiety disorder is the GAD-7.

WHAT IS
SOCIAL ANXIETY DISORDER?

Commonly known as “social phobia,” social anxiety disorder affects about 15 million adults in the United States. The average age of onset is 13 years old, and about 36% of people with social anxiety disorder suffer from symptoms for 10 or more years before seeking professional help.

Individuals who have social anxiety disorder have a strong fear of being scrutinized and judged by others in social and performance situations. Social anxiety disorder can significantly interfere with daily routines, job performance, and personal relationships.

WHAT ARE the SYMPTOMS OF
SOCIAL ANXIETY DISORDER?

People with social anxiety disorder can experience significant emotional distress in many daily situations, with symptoms including (source: National Institute of Mental Health):

  • Feeling highly anxious about being with other people and having a hard time talking to them
  • Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
  • Worrying for days or weeks before an event where other people will be
  • Having a hard time making friends and keeping friends
  • Blushing, sweating, or trembling around other people
  • Feeling nauseous or sick to your stomach when other people are around

Practitioners can diagnose patients with social anxiety disorder if the individual presents with a marked, persistent fear of one or more social or performance situations involving exposure to unfamiliar people.

The patient usually recognizes that their anxiety or fear is excessive and tends to avoid feared situations or to endure them with distress.

The three-question Mini-Social Phobia Inventory appears to be a useful diagnosis instrument for social anxiety disorder. It has been found to have a high sensitivity (89 percent) and specificity (90 percent) for the DSM-IV generalized type of social anxiety disorder.

The questions ask, on a scale from 0 (not at all) to 4 (extremely), how much the following problems have bothered you during the past week:

    • Fear of embarrassment causes me to avoid doing things or speaking to people.
    • I avoid activities in which I am the center of attention
    • Being embarrassed or looking stupid are among my worst fears

WHAT ARE THE CURRENTLY APPROVED
TREATMENTS FOR ANXIETY DISORDER?

According to the National Institute of Mental Health, the treatment for anxiety disorders is a combination of medication and psychotherapy. Treatments must be tailored individually to each person’s specific anxieties and needs.

Cognitive behavioral therapy (CBT) can help persons with anxiety disorders, teaching them different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations. CBT specifically targets thoughts, physical symptoms, and behaviors to help patients change their relationship to the-the symptoms of generalized anxiety disorder.

While medications don’t cure anxiety disorders, they can be used to help treat symptoms in conjunction with therapy. The most common anti-anxiety medications, SSRIs, are first-line treatments for generalized anxiety disorder.

In the treatment of social anxiety disorder, physicians prescribe beta-blockers to help treat physical symptoms such as shaking, blushing, and rapid heartbeat.

Work with your doctor to help you find the best medication, dose, and duration of treatment for your anxiety disorder.

Although transcranial magnetic stimulation (TMS) has not yet been FDA approved for use with anxiety disorders, many patients have significant improvement in their anxiety symptoms following treatment with TMS.

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