Anxiety Disorders

Anxiety States, Neuroses, Neurosis

What is Anxiety?

This describes a very broad range of disorders, characterized by anxiety and distress over some circumstance. There is typically an effort to avoid the uncomfortable situation, with the distress experienced as something unacceptable and unwanted. In neurotic disorders, the person's general sense of reality is intact, without the characteristics of psychotic disorders such as hallucinations, delusions, or highly unusual and socially abnormal behavior. Nevertheless, the neurosis usually impairs functioning in some important area of life (incidentally, the terms "neurosis" and "neurotic" are becoming obsolescent in psychiatry, being replaced by more specific diagnoses).

There is no known organic cause of neurotic disorders. The traditional view is that neurotic symptoms are due to an unconscious psychological conflict that is unacceptable to the individual's concept about him or herself. If the conflict were acknowledged, it would threaten some aspect of their psychological life. So, a defense mechanism keeps the deeper conflict from entering awareness.

Neurotic (anxiety) disorders are by far the most common kind of mental disorder.

Several types of anxiety are recognized: Acute situational anxiety, adjustment disorders, generalized anxiety disorder, panic disorder, post-traumatic stress disorder,phobias, obsessive-compulsive disorder.

What is the most common symptom of anxiety disorders?

People with anxiety disorders experience intense anxiety on a regular basis that is not rational or not proportional to the situation. Symptoms related to anxiety disorders may differ slightly depending on the type of disorder. For example, people with panic disorder may experience panic attacks that include rapid heartbeat, heavy perspiration and shortness of breath, whereas those with obsessive-compulsive disorder may find themselves unable to stop thinking certain thoughts or performing certain rituals repeatedly, to the point that the rituals become extremely time consuming and greatly interfere with their everyday lives.

Anxiety signs and symptoms

  • Feeling that something undesirable or harmful is about to happen.
  • Dry mouth; swallowing difficulty or hoarseness.
  • Rapid breathing and heartbeat, palpitations.
  • Twitching or trembling.
  • Muscle tension; headaches; backache.
  • Sweating.
  • Difficulty concentrating.
  • Dizziness or faintness.
  • Nausea; diarrhea; weight loss.
  • Sleeplessness.
  • Irritability.
  • Fatigue.
  • Nightmares.
  • Memory problems.
  • Sexual impotence.

Who can I contact to find out if I have an anxiety disorder?

Despite being among the most common mental illnesses in America, anxiety disorders are largely underdiagnosed. In fact, only one-third of people who experience symptoms of anxiety disorders actually visit a doctor. This is unfortunate, because most anxiety disorders can be successfully treated with medication, psychotherapy or a combination of the two.

If you suspect that you may have an anxiety disorder, contact your primary care physician (or a mental health professional who is qualified to diagnose anxiety disorders) as soon as possible. The sooner you take this step, the sooner you can put your feelings of apprehension behind you.

How is Anxiety diagnosed?

  • History can be of many possible troublesome symptoms. The anxiety may be a fear of a specific situation or object (phobia), fear of harm unless a ritual is performed repeatedly (obsessive-compulsive disorder), fear of bodily illness (hypochondriasis), or fear of impending doom (panic disorder). A neurosis may also manifest as a sexual dysfunction, slipping into a trance state (dissociative disorder), a generalized anxiety disorder, or as irritability, mental and physical fatigue, sleep disturbances, and a general sense of instability (neurasthenia).
  • Physical exam might note a skin disorder or high blood pressure. Observation of the individual's orientation, dress, mannerisms, behavior and content of speech provide essential signs to diagnose the illness.
  • Tests are not helpful in these diagnoses.

Are medications always needed to treat anxiety disorders?

Treatment may differ depending on which type of anxiety disorder is present. People diagnosed with anxiety disorders have a number of effective treatment options. In many cases, a combination of therapy and medications is the most effective treatment. In other cases, one form of treatment may be more beneficial than another.

Individual and group psychotherapy are used to bring the unconscious conflict into awareness and/or to develop coping skills. Anti-anxiety medication may be prescribed temporarily or long-term.

What does psychotherapy typically involve?

During psychotherapy, commonly known as therapy, you'll be encouraged to discuss your anxiety and any related issues with a mental health professional, such as a psychiatrist, psychologist or clinical social worker. This treatment method is based on the theory that people can improve their emotional well-being and mental health by talking about their concerns or problems with a therapist, who in turn, can help them find better ways to cope, solve problems and set realistic goals for improvement.

Psychotherapy for people with anxiety disorders may vary in length and may be conducted in an individual or group setting, and it is particularly effective for certain anxiety disorders, such as social phobia and panic disorder.

Will my child develop an anxiety disorder because I have one?

It's difficult to say because the exact cause of most anxiety disorders is unknown. However, a combination of psychological, biological, genetic and environmental factors are believed to play a role in the development of anxiety disorders.

How common are anxiety disorders among women?

About 40 million Americans are affected by anxiety disorders. In many cases, anxiety disorders affect women more often than men. However, some disorders - such as generalized anxiety disorder - affect men and women almost equally.

Is it possible that I might have more than one anxiety disorder?

Yes. If you're diagnosed with one form of anxiety disorder, there's a good chance that you may be diagnosed with a second type of anxiety disorder. In addition, many people with anxiety disorders are also diagnosed with other disorders, such as depression and eating disorders.

Additional Information


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No special diet. Avoid caffeine and other stimulants, as well as alcohol.

What might complicate it?

Complications include alcohol or prescription anti-anxiety drug abuse, an eating disorder, irritable bowel syndrome, peptic ulcers, or high blood pressure.

Predicted outcome

Outcome will depend on a specific diagnosis.


Caffeine or amphetamine/cocaine intoxication can resemble an anxiety disorder. Medical conditions such as low blood sugar (hypoglycemia), an overactive thyroid gland (hyperthyroidism), or chronic lung disease (emphysema) can cause episodes of anxiety. Avoidant personality disorder is another possibility.

Appropriate specialists

Psychiatrist, psychologist, or other mental health professionals.