Anxiety disorders

An anxiety disorder is when you worry excessively and are apprehensive and fearful about future uncertainties, real or imagined. An anxiety disorder is more severe than anxious feelings; it interferes significantly with daily life and causes a high level of emotional and physical distress.

Over any 12 month period, 18% of women will experience an anxiety disorder. Over the course of their lifetime, at least one in three Australian women (32%) will have an anxiety disorder. Anxiety is more common than depression. You can have both anxiety and depression at the same time.

“I can’t fly. I will not walk through those plane doors. The feelings of panic are so intense when I even think of taking a holiday somewhere far away I will not do it. What if I have a panic attack on the plane? I might die and no one will be able to help me and I won’t be able to get out.” 
Michelle, 38 years

“It has got to the stage that I can’t even drive to the shops. I am so frightened that something bad will happen. For every bump I think I have hit something. I turn the car around and go back and check and then start off again. I might get five metres down the road and think I hear something and then I have to stop and check again. Once I have checked I calm down and tell myself it is okay. I start driving and the panic just rises.  Imagine if I hit someone, or a little animal. I would rather not drive.”
Robyn, 54 years

What happens when you have an anxiety disorders

There are many common symptoms of anxiety disorders. Some of these symptoms, particularly the physical symptoms, are also common with anxiety but anxiety tends to come and go whereas an anxiety disorder means you are likely to be having these symptoms frequently. The symptoms include:

Physical symptoms	Psychological symptoms	Behavioural symptoms
Pounding, racing heart Rapid breathing Sweating Nausea and feeling sick A tightness in your chest Muscle tension Dizziness or lightheadedness Feeling like you have a ‘lump’ caught in your throat Tingling or numbness Poor sleep Dry mouth	Irritability Feelings of: Restlessness Dread Being detached/ that you are not really present Thinking you are going to die Difficulty concentrating Overwhelming sense you are losing control Feeling you are “going crazy”	Avoiding the things you think create your anxiety Escape and running away to try and calm down Feeling like you to have act in a certain way or something bad might happen Isolating yourself

There are many different types of anxiety disorders but some of the major disorders include:

Types of anxiety disorder	What it is
Generalised anxiety disorder (GAD)	Constant, excessive worrying and fear about many different things that: Can come at any time Are hard to control Make it difficult to get on with daily life Are extremely upsetting and distressing
Panic disorder	An apparently random, sudden and intense feeling of fear resulting in a panic attack with symptoms like: Racing heart Sweating Feeling sick Thinking you are going to die Wanting to run away
Phobia (including social, specific and agoraphobia)	A phobia is an intense fear of a situation or thing which may cause you to have a panic attack and/or try to avoid that situation or thing A social phobia is a fear of being judged and/or watched while in public situations A specific phobia is more likely to be of an object or event such as spiders, snakes, heights, flying Agoraphobia is fear of being in places where you feel exposed and vulnerable to panic attacks - agoraphobia generally causes you stay in familiar places like your home
Obsessive Compulsive Disorder (OCD)	OCD involves repetitive thoughts and behaviours. Repetitive thoughts might include: Fear of getting sick That everything needs to be in a set order That you didn’t lock the door That you didn’t turn off an electrical appliance Behaviours that you feel driven to do, focus on and/or repeat might include: Checking and re-checking Cleaning Washing Rearranging things Counting Repeating the behaviours may initially help to decrease the feelings of anxiety, however with OCD the thoughts regularly come back. The thoughts are distressing and hard to eliminate – they usually centre around the notion - “If I don’t do this action something bad will happen”
Post Traumatic Stress Disorder (PTSD)	PTSD can occur after experiencing a frightening event where you felt your life was threatened (actual harm may have occurred or not). The event may be either watching or experiencing an accident, abuse, physical harm or a disaster. PTSD can cause you to have memories (flashbacks) to the event, nightmares and severe anxiety. Often the anxiety that comes with PTSD makes you feel so overwhelmed it is difficult to get on with daily life

Causes of anxiety disorders

Unhelpful or distorted thinking is likely to be one of the biggest causes of anxiety. There are many types of unhelpful ways of thinking such as:

• Focusing on the negative
• Jumping to conclusions (usually inaccurate)
• Using words like “should”, “can’t”, “must”
• Blaming yourself for everything that goes wrong
• Thinking you are a “failure” or “hopeless”
• Catastrophising (thinking that the worst possible thing could happen)

Distorted thinking can lead to changes in brain chemistry, which can then cause anxious feelings in your body. These physical feelings like sweaty palms, a racing heart and fast breathing are uncomfortable and can be scary and you tend to want to avoid them so you end up avoiding the very thing that caused the thoughts and feelings to happen in the first place. It becomes a cycle of fear.

There is debate about whether anxiety disorders are influenced by genetics. The relationship between genes and anxiety is likely to be complex and it may be that genes interact with your personality, your patterns of thinking, the events that happen in your life and other causes like illness. It may be that you inherit a sensitive nervous system, which causes you to be more alert to the symptoms of anxiety and panic such as a racing heart and sweaty palms.  This then sets off negative and anxious thoughts and before you know it, the panic attack is rising within you. It is also known that growing up in a household with over protective and anxious care-givers can cause you to be more anxious. Having a family member with an anxiety disorder does not mean you will automatically inherit anxiety.

The role of the brain may also be important. When a traumatic event occurs, you have a normal adrenalin response to prepare to fight or flee from the threat. If you have PTSD it may be that your brain is more sensitive to this adrenalin response and a pattern of adrenalin release keeps happening long after the event. The adrenalin adds to the distressing physical feelings of anxiety.

Other causes that can make anxiety worse, and lead to anxiety disorders include:

• A previous traumatic experience, particularly if it happened when you were growing up
• A significant stressful event such as losing someone you loved
• Abuse including physical, mental, emotional and sexual abuse
• A lack of positive coping skills such as problem solving skills or strategies to deal with stress
• Poor relationships with friends, family and/or a partner

What to do

There are many effective ways to manage all of these anxiety disorders. You can significantly limit the effect and impact they have on your life.

The most important thing you can do when you have an anxiety disorder is to face the very things that are causing you to be so frightened and distressed. Avoiding situations in case something bad might happen may make you feel better in the short term, but will make your anxiety worse in the long term. Challenging negative and unhelpful thinking along with calming the physical symptoms of anxiety are important to the successful treatment of anxiety disorders also.

If you would like to know more about anxiety disorders at different times in your life click on one or more of the stages of life relevant to you. For each stage you will find information on the specific causes of anxiety disorders and a ‘Toolkit’ to give you strategies to help.