Julie Watts, Clinical Psychologist

Anxiety disorders are one of the most common psychological problems, affecting up to 25% of the population at some point in their lifetime. Most anxiety disorders do not tend to go away on their own if left untreated. They tend to stay the same or get worse over time, with an increasing impact on people’s quality of life, work and relationships. There are several different types of anxiety disorders. The most common are Generalised Anxiety Disorder (GAD), panic disorder, social phobia, specific phobias, Acute and Posttraumatic Stress Disorder (PTSD), and Obsessive Compulsive Disorder (OCD).

The main symptoms of GAD are excessive worry for at least 6 months that causes significant distress or impaired functioning, restlessness, muscle tension, and difficulty concentrating, irritability and sleep disturbance. Approximately 5% of the population will suffer from GAD at some time in their lives.

Panic disorder is characterised by recurrent and unexpected panic attacks, where an intense surge of fear is experienced, along with physical symptoms including heart palpitations, shortness of breath, feeling dizzy of faint, trembling or shaking, tingling, sweating or hot or cold flushes, nausea or “butterflies", feelings of unreality, fear of dying, losing control or going mad. There is also worry about the consequences of panic attacks, fear of the bodily sensations associated and at least one month of persistent worry about possible future panic attacks. It also leads to avoidance of places or activities.

Social phobia is characterised by an excessive and persistent fear of being scrutinised or evaluated by others and usually results in avoidance of certain situations (e.g., public speaking, social gatherings, eating or writing in front of others, etc.). The lifetime prevalence is about 13%, with 70% being female.

Specific phobia is a marked, persistent and excessive fear of a particular object (e.g., spider, needles) or situations (e.g., enclosed spaces, flying, heights). Exposure to these results in intense fear and panic attack, an urge to flee and usually leads to avoidance of those objects or situations, About 11% of the population have a specific phobia at some time in the lifetime yet most never seek professional help.

PTSD is outlined in article on Trauma. In OCD the individual experiences unpleasant, bizarre, intrusive and distressing obsessional thoughts that are difficult to control (e.g., fear of germs, harming oneself or another). These thoughts then lead to excessive and uncontrollable compulsive behaviours (e.g., cleaning, hand washing, checking) or mental rituals (e.g., counting, praying) in an attempt to supress or control the unwanted thoughts, reduce the anxiety or prevent the dreaded event from happening. OCD causes marked distress and usually significantly interferes with daily routines and social functioning.

There are very effective psychological treatments available for anxiety disorders, including Mindfulness, Acceptance and Commitment Therapy (ACT), Cognitive Behaviour Therapy (CBT), Hypnotherapy, EMDR and sometimes longer term therapies particularly for complex and long standing PTSD. The type and length of treatment approach depends on the type of disorder, the severity and duration of the problem and the needs of the person. There can be a useful role for medication is some anxiety disorders. However, there are also many difficulties as frequently benzodiazapines are prescribed which provide short term relief but if they are used frequently or for more than a couple of weeks are very addictive and can be very hard to come off. Often people with an anxiety disorder will be prescribed an antidepressant even if they do not also present with depression as some of these also are effective in treating anxiety.