All you need to know about: anxiety disorders

The Hindu

23-04-2025

All of us have experienced butterflies in the stomach just ahead of an important exam, nervousness as we're headed for a job interview, or perhaps clammy palms just after we have risked our lives crossing a road in our country. Some amount of anxiety is normal, and even healthy -- it may help alert us to a dangerous situation and focus our attention. An anxiety disorder however, goes beyond this. Anxiety disorders are the world's most common mental disorders, says the World Health Organization (WHO), with an estimated 301 million people affected as of 2019. More women than men are affected by anxiety disorders. In India, as of 2017, a staggering 44.9 million people had anxiety disorders according to the research paper: 'The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017' in The Lancet Psychiatry.
What are anxiety disorders?
Anxiety is different from fear, though the two may often be confused. The American Psychiatric Association states that anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior, whereas fear is an emotional response to an immediate threat and is more associated with a fight or flight reaction – either staying to fight or leaving to escape danger.
People with anxiety disorders experience fear worry that is beyond the occasional -- it can be intense, excessive and hard to control. These feelings, the WHO states, are typically accompanied by physical tension and other behavioural and cognitive symptoms. They are difficult to control, cause significant distress and can last a long time if untreated.
In order for a person to be diagnosed with an anxiety disorder, in general, the anxiety must be out of proportion to the situation and must impact their ability to function normally.
Children, adolescents and adults can all experience anxiety disorders.
What are the types of anxiety disorders?
There are several different types of anxiety disorders. These include: generalised anxiety disorder, panic disorder, specific phobias, agoraphobia, social anxiety disorder, separation anxiety disorder and selective mutism. People can have more than one anxiety disorder.
Generalised anxiety disorder or GAD is the most common type of anxiety disorder. GAD is characterised by constant, excessive worrying, tension and fear, often about everyday responsibilities such as those at work or at home or even about minor, routine tasks and chores. This worrying often can't be controlled, it may be persistent and far more intense than the situation warrants.
GAD can develop slowly, sometimes from childhood or adolescence, or from adulthood.
What are the signs and symptoms of GAD?
Symptoms can be psychological and physical. Some common symptoms include: trouble controlling worries and nervousness, feeling restless and being unable to relax, feeling irritable, having trouble falling asleep or staying asleep, sweating, trembling or shaking, heart palpitations, an inability to concentrate, difficulties in making decisions, dry mouth, sweating, shortness of breath or rapid breathing, nausea and stomach upsets, tingling in the hands or feet, cold, sweaty hands and the urge to avoid things that cause the anxiety.
Anxiety disorders increase the risk for depression and substance use disorders as well as the risk of suicidal thoughts and behaviours, says the WHO.
What causes anxiety disorders?
The exact cause of anxiety disorders is unknown. They are believed to stem from a combination of factors including genetic, environmental and psychological. Researchers believe chemical imbalances of neuro-transmitters and hormones could play a role. Other factors that could increase the risk for an anxiety disorder include severe family or environmental stress, experiencing a traumatic event, living through abuse and long-term illnesses. Genetics also play a role as anxiety disorders can run in families.
According to the WHO, anxiety disorders are closely related to and affected by physical health. Many of the impacts of anxiety (such as physical tension, nervous system hyperactivity or harmful use of alcohol) are also known risk factors for diseases such as cardiovascular disease. In turn, people with these diseases may also find themselves experiencing anxiety disorders due to the difficulties associated with managing their conditions.
How are anxiety disorders treated?
After ruling out physical problems that may be causing the symptoms, your healthcare provider may refer you to a mental health professional for a diagnosis.
Treatment can include a combination of medication and psychotherapy. Medication can include anti-depressants and anti-anxiety medicines. Medicines may take time to work and some people may have to work with their doctors to find the right combinations, dosages and duration of medication.
Cognitive behaviour therapy, which is a form of therapy, is also commonly used to treat anxiety disorders. This involves learning different ways to think, react and behave, after identifying thought patterns that cause anxious feelings.
Self-care can also play an important role. This includes exercising regularly, cutting down on alcohol, quitting smoking, limiting caffeine, learning and practicing relaxation techniques, managing stress, meditation and participating in in-person or online support groups.
Although highly effective treatments for anxiety disorders exist, only about 1 in 4 people in need (27.6%) receive any treatment, the WHO notes. Barriers to care include lack of awareness that this is a treatable health condition, lack of investment in mental health services, lack of trained health care providers, and social stigma.
It is important to see your healthcare provider if you are experiencing symptoms of an anxiety disorder.