Millions of Americans suffer from some kind of anxiety disorder, but many of them don't know what the condition is or how to cope with it. Although anxiety disorder is one of the most highly treatable conditions, only a small portion of sufferers receive help.

This article explains:

• The Six Kinds of Anxiety Disorder
• What Treatments are Available
• How to Find Help and Make Treatment More Effective

By understanding how the disorder develops and what symptoms it can cause, it may be possible to control the condition, before it takes control of a person’s life.

The Six Kinds of Anxiety Disorder

There are six types of anxiety disorder--generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, obsessive-compulsive disorder and post-traumatic stress disorder. While symptoms and causes vary for each kind, they all share one thing in common: an overwhelming feeling of panic and fear. They all cause physical and emotional symptoms, and often seem to strike from out of nowhere. Because of this, sufferers may not know what is wrong with them or how to control it.

Generalized Anxiety Disorder (GAD)

People with generalized anxiety disorder worry all the time. They may fret over one specific cause, such as work, money, health or family, or they may suffer from an overall feeling of dread with no clear cause. While it’s natural to have a little anxiety now and then, for people with GAD the fear is consuming and debilitating. In fact, it can often be a challenge just to make it through each day. Though their fears are usually unfounded, they are powerful, and sufferers expect the worst from every situation.

GAD is a chronic condition with emotional and physical symptoms that can be terrifying. Sufferers frequently have trouble falling asleep and relaxing, startle easily and find it difficult to concentrate. They may also suffer from fatigue, irritability, headaches and muscle tension and aches. In more severe cases, they may tremble, twitch, sweat profusely, have hot flashes and have trouble swallowing. They may also feel out of breath or like they need to go to the bathroom frequently, and they may feel lightheaded and nauseated.

Panic Disorder

With symptoms similar to those of a heart attack, panic disorder is one of the most frightening and misunderstood anxiety disorders. Panic attacks usually strike without warning, and can even occur while a person is sleeping. A person with panic disorder may feel fine most of the time, but at times suffer from an overwhelming sense of fear for no apparent reason. Because the physical symptoms are so severe, people often believe they’re having a heart attack or are about to die.

During a panic attack, sufferers may begin to feel dizzy, faint or weak. Their heart may pound, they may begin to sweat and they may have tingling or numbness in their hands. Frequently, they feel like they’re losing control, and their sense of reality can become distorted. They often feel an overwhelming, inexplicable feeling of doom. Panic attacks usually don’t last very long, reaching their peak in about 10 minutes. However, they can last longer. People with panic disorder often don’t realize they’re suffering from an emotional condition, instead believing they are physically ill. They may seek medical treatment for years before discovering the true cause of their symptoms.

Social Anxiety Disorder

For sufferers of social anxiety disorder, something as simple as talking to another person can be traumatic. With this condition, everyday social situations can be a source of fear and dread. Sufferers feel self-conscious and anxious in front of other people, and may feel like others are watching or judging them. For some people, the fear is specific, such as being nervous when speaking in public. For other people, however, their anxiety is wide-ranging, and they may fear any situation where they must interact with others. They may become so terrified of being around other people that they start skipping school or work.

The situation is often made worse by the physical symptoms that accompany it. Sufferers may sweat profusely, have trouble speaking, blush, shake and become nauseated. Already self-conscious, they are even more embarrassed by their behavior and may avoid public situations entirely. People with social anxiety disorder usually know their fears are unwarranted, but the terror is so powerful that they are unable to control it.

Specific Phobias

Unlike many anxiety disorders, which may seem to have no clear trigger, or which may be triggered by many different things, specific phobias are centered on one situation that causes intense panic. Victims suffer from a debilitating fear of something that poses little or no real danger, but that produces overwhelming anxiety. The phobia often develops during childhood or adolescence, and usually continues into adulthood. Frequently, the phobia seems to have no obvious cause, arising suddenly and seemingly without any reason. Sufferers usually understand that their fears are not based in fact and are probably unfounded, but they are unable to overcome them nonetheless. The terror can be so intense that even thinking about the source of their fear can cause a panic attack.

Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder is characterized by a preoccupation with certain thoughts and behaviors that the person cannot control. The obsessions come in many forms. Some people are obsessed with germs or dirt and wash their hands over and over, sometimes so frequently that their hands become raw and sore. Other people are consumed by persistent thoughts of violence, and a fear that they will hurt someone. Others are obsessed with counting or with certain numbers. They may have to count every step they take, or they may have to do everything a certain number of times. And for other people, self-doubt overwhelms them, and they feel the need to check things repeatedly, such as making sure appliances are unplugged or doors are locked.

In an effort to ease the anxiety associated with their compulsions, sufferers develop rituals they perform again and again. However, these rituals only result in short-lived relief, and the distress soon returns. Adults with OCD usually know that their obsessions are irrational, but children frequently are unable to understand this. They may believe there’s nothing wrong with their actions, and even that their behavior is perfectly normal and acceptable. Obsessive compulsive disorder can be an all-consuming and life-altering condition. The various rituals accompanying it can take up a great deal of the person’s time, interfering with daily activities and the person’s ability to function. For some people, the condition is so debilitating that it completely overwhelms them.

Post-Traumatic Stress Disorder (PTSD)

While most anxiety disorders seem to have no apparent cause, post-traumatic stress disorder stems from a very real, very frightening event in a person’s life. It arises after someone suffers or witnesses a traumatic event such as rape, kidnapping, abuse, accident or disaster. It may also develop in people close to someone who has experienced a traumatic event. The disorder can cause irritability, aggression and violence. Or, sufferers may feel numb and detached from the world around them, and may be unable to feel affection or establish and maintain close relationships with other people. Nightmares and other sleep problems are common, and people with PTSD often startle easily. Sufferers also have flashbacks, in which they relive the trauma even years after the event. Flashbacks can occur when the person is awake or asleep, and can be brought on by even seemingly unrelated situations. When a flashback occurs, the person may believe they’re actually experiencing the event all over again. They may see, smell or hear things associated with the trauma, and may begin to lose touch with reality.

What Treatments are Available

All of the anxiety disorders can be treated, either with medication or with psychotherapy, also called talk therapy. The type of therapy used will depend on what the patient and doctor feel most comfortable with, and with the type of disorder involved.

Medications

Several types of medications are used to treat anxiety disorder, and are classified according to two broad categories: antidepressants and anti-anxiety medications.

Antidepressants

Originally developed for the treatment of depressive conditions, antidepressants have also been found effective against anxiety disorders. They need several weeks to take effect, so patience is key to making the treatment plan work.

Selective serotonin reuptake inhibitors, or SSRIs, are some of the newest antidepressants to be introduced, and also have fewer side effects than previous antidepressants. They work directly on the brain, by controlling the amount of serotonin, a chemical messenger. They can cause nausea and jitteriness at first, but these symptoms usually pass with time. Sexual dysfunction can also occur, but adjusting the dosage or switching to another SSRI will usually correct any adverse effects. There are several types of SSRIs, including fluoxetine, sertraline, paroxetine and citalopram, which are used for panic disorder, social anxiety, obsessive compulsive disorder and post-traumatic stress disorder. A related drug, venlafaxine, is used to treat generalized anxiety disorder. SSRIs are started at low doses and gradually increased.

Other antidepressants called tricyclics have been in use longer than SSRIs and have been studied more extensively in relation to anxiety. They are generally as effective as SSRIs, except for obsessive compulsive disorder, but have more side effects, including dizziness, dry mouth, drowsiness and weight gain. For this reason, many patients and doctors prefer the newer antidepressants.

The oldest group of antidepressant medications are called monoamine oxidase inhibitors, or MOAIs. Phenelzine is the most commonly used MOAI, prescribed for panic disorder and social anxiety disorder. Two other MOAIs, tranylcypromine and isoprocarboxazid, are also used. MOAIs can interact with food, beverages and other medications, so patients are placed on a restrictive diet and medications are closely monitored to prevent complications.

Anti-anxiety Drugs

Potent and fast-acting, benzodiazepines have few side effects and are used for a variety of anxiety disorders. However, patients can develop a tolerance to the drugs, meaning they would have to take an increased amount to receive the same therapeutic effect. Because of this, they are usually prescribed only for short periods of time, except in the case of panic disorder, when they are sometimes taken for six months to a year. Though benzodiazepines are very effective, not everyone is a good candidate for them. People who have a history of drug or alcohol problems may become dependant on the medication. There are other drawbacks, as well. Discontinuing the drug can cause withdrawal symptoms, and the anxiety disorder can return when the drug is stopped. Because of these difficulties, many physicians do not use the drugs, or prescribe them in insufficient amounts. The kinds of benzodiazepines include:

• clonazepam, used for social anxiety and generalized anxiety disorder
• alprozolam, used for panic disorder and generalized anxiety disorder
• lorazepam, used for panic disorder

There is also a newer kind of anti-anxiety drug called buspirone, which belongs to a class of drugs known as azipirones. Buspirone is used for generalized anxiety disorder, and must be taken regularly for two weeks before any effect is achieved. Side effects can include dizziness, headaches and nausea.

Psychotherapy

Psychotherapy, also called talk therapy, involves talking to a trained mental health professional about the problem. The form of psychotherapy most effective against anxiety disorder seems to be cognitive-behavioral therapy, or CBT. The therapy has two goals: to change thinking patterns that prevent people from overcoming their phobias, and to alter how people respond to the situations that cause anxiety.

The cognitive aspect of the therapy focuses on helping patients see the situation from a different perspective. For instance, a person with social anxiety disorder can be helped by being shown that the people around them aren’t watching them and judging their behavior.

The behavioral aspect focuses on helping people develeop more realistic and effective ways to respond to the things that cause them anxiety. One of the primary ways of accomplishing this is through exposure, a process in which the patient is encouraged to face the things that cause them fear and anxiety. A person with social anxiety, for example, would be encouraged to spend more time around people, to help them realize that social situations aren’t necessarily traumatic experiences. By interacting with people more frequently, they should become more at ease in public, and eventually the anxiety should dissipate.

CBT usually lasts about 12 weeks, and is conducted either in group or private sessions. It can be combined with medications, which is the preferred approach in many cases. The therapist often gives the patients “homework” assignments, specific tasks for the patient to accomplish or work on in between treatment sessions.

How to Find Help and Make Treatment More Effective

When seeking help for an anxiety disorder, it is best to first visit a family physician, who can help the patient determine if the condition is purely psychological, or due to some underlying medical condition. If the problem is determined to be psychological, the physician will usually refer the patient to a mental health professional. There are several types of mental health professionals, including psychiatrists, psychologists, social workers and counselors. The most important thing to look for is someone with specialized training in cognitive-behavioral therapy. The person should also be willing to combine medication and psychotherapy. But most of all, it is important to work with a therapist the patient feels comfortable with. If the patient is uneasy either with the therapist or the treatment, it is best to seek either another counselor or another form of therapy.

There are several ways the patient can make the treatment process more effective. Joining a self-help group can provide much-needed support, because the patient can share their setbacks, concerns and accomplishments with other people who understand what they’re dealing with. The patient’s family and friends also play an important role, and can provide a support network the person can turn to.

Patience and support from family members is vital--if they tend to downplay the severity of the condition, or if they expect the person to automatically get better, they can actually cause setbacks in the person’s recovery. In addition, employing stress management techniques and using meditation and other relaxation exercises can enhance the effectiveness of therapy. However, they should not be used as a substitute for therapy, though they can work quite well in conjunction with medical treatment.

The most important part of the treatment process is remembering that it takes patience and hard work to achieve results. By giving the therapy time to work, and by taking the treatment seriously, it may be possible to gain control over anxiety disorder and lead a happy, normal life.