Anxiety Disorders

What is the difference between fear and anxiety, and normal anxiety and an anxiety disorder?

Anxiety disorders are the most common mental health problem affecting Australians.
Anxiety disorders affect 9.7% or 1.3 million adult Australians (12% women and 7.1% men) during a 12 month period (Australian Bureau of Statistics, 1997).
The onset of anxiety disorders is generally in early to late adolescence. Various research studies report anxiety disorder prevalence rates between 5.7% to 15.4% in children ranging in age from 7 to 11 years old, and rates of 8.7% to 17.7% in adolescents aged 12 to 18 years old.
The population of people in Victoria who will suffer from an anxiety disorder, at some time during their life, is estimated to be 600,000.
Anxiety disorders affect people from all walks of life.
The causes of anxiety disorders are likely to be a complex interaction between several factors, including genetics, brain chemistry, personality and life events.
The progressive development of symptoms in an anxiety disorder, including increasing frequency, complexity and severity of symptoms, is a consequence of a reinforcement cycle inherent in the symptoms themselves, and other factors which have a significant impact on a person's emotional, mental and physical well-being.
Common or core features of all of the anxiety disorders include - excessive worry; hyper-vigilance; avoidance; emotional distress and tension; faulty and irrational thinking; physical anxiety reactions.
The thoughts and behaviours associated with an anxiety disorder are generally extreme or excessive versions of normal thoughts and behaviours.
While the impact of an anxiety disorder can be severe and debilitating on a person's life, anxiety disorders do not impair a person's intellectual capacity, level of insight or awareness of reality.
Severity in an anxiety disorder is generally associated with social isolation, inability to leave the home, no or little respite from symptoms, depression, and consequential negative impacts on relationships, education, employment and finances.
People with anxiety disorders generally seek to hide their symptoms and problems from their family, work or school peers and the community, due to strong feelings of embarrassment and shame regarding their difficulties.
People with severe anxiety disorders may experience difficulties in their ability to undertake many routine and life-sustaining activities and become highly dependent upon carers and family members, which may lead to significant distress and problems in the family.
Many people with an anxiety disorder also suffer with depression, sleep disorders, and physical health problems that are related to stress.
Anxiety disorders are treatable with psychological therapies, or medication, or both.
Recovery from an anxiety disorder is possible with specialist treatment, education, support and self-management skills.

Types of anxiety disorders

Obsessive compulsive disorder - people with OCD experience recurrent and persistent thoughts, images or impulses that are intrusive and unwanted (obsessions), and perform repetitive and ritualistic behaviours that are excessive, time consuming and distressing (compulsions). Common obsessions include fears of contamination and fears of harm to self or others. Common compulsions include excessive handwashing, showering, checking and repeating rituals. These compulsions and obsessions may take up many hours of a person's day. They may intrude into every activity and action - for example, walking, eating and reading may involve complex rituals.
Social anxiety disorder - People with social anxiety disorder (or social phobia) have a persistent fear of social and/or performance situations, due to fears of scrutiny and negative evaluation by others. Social anxiety may include acute physical anxiety symptoms which may lead to avoidance of the feared situation(s). Physical anxiety symptoms which often accompany social anxiety fears include heart palpitations, faintness, trembling, blushing and sweating.
Panic disorder with or without agoraphobia - A panic attack is a brief episode of intense fear. It is accompanied by multiple physical and cognitive symptoms that occur repeatedly and unexpectedly in the absence of any external threat. People with panic disorder experience recurrent and unexpected panic attacks and persistent fears of repeated attacks. Anticipatory fears of having panic attacks in public places, or where no help or escape seems possible may lead to the individual becoming housebound and the development of agoraphobia.
Generalised anxiety disorder - people with GAD experience excessive and persistent anxiety and worry, occurring more days than not over a six month period. The worries are about events or activities related to work or study, health, finances, family issues or other general concerns. People with GAD find it difficult to control their worrying, and experience associated physical and emotional symptoms such as restlessness or feeling on edge; being easily fatigued; difficulty in concentrating or mind going blank; irritability; muscle tension; shallow, uneven breathing; and sleep disturbance.
Specific phobias - people with specific phobias experience persistent and excessive anxiety cued by a specific object or situation. The anxiety reaction is generally inappropriate and excessive to the object or situation. Phobias often lead to avoidance. If the phobic object or situation is not easily avoided the person may suffer with acute anticipatory anxiety and/or chronic stress.
Separation anxiety disorder - separation anxiety most commonly occurs in children. It is experienced as excessive anxiety about separation from the home and/or parents or carers to whom the child is emotionally attached, and is beyond what would be expected for the child's level of development. Separation leads to preoccupation with worries about accidents or illnesses occurring to parents/carers and fears of long-term loss.
Substance induced anxiety disorder - people with a substance-induced anxiety disorder experience strong anxiety symptoms (panic attacks, obsessions or compulsions) that are due to the direct physiological effects of a substance, as determined by the person's history, physical examination or medical tests.
Post-traumatic stress disorders - post traumatic stress may develop after a person is exposed to severe physical and/or mental trauma. Recurrent thoughts, images and nightmares of the trauma occur, and changes in mood. Emotional reactivity, memory and concentration difficulties are some of the symptoms experienced.

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