Anxiety disorders are the most common mental illnesses, affecting 1 in 4 people in their lifetime. Painfully, 60% of patients don't seek treatment. Anxiety isn't a personality trait or weakness — it's a disruption in brain signaling. The ClinicsJo Editorial Team reviews types and treatments.
Normal vs Pathological Anxiety
- Normal anxiety: a fitting response to real challenges (exam, interview), eases after the event, motivates achievement.
- Pathological anxiety: persistent, exaggerated, occurs without cause or for trivial reasons, disrupts life.
Types of Anxiety Disorders
1. Generalized Anxiety Disorder (GAD)
- Excessive persistent worry about ordinary matters (health, money, work).
- >6 months continuously.
- Difficulty controlling the worry.
- Physical symptoms: muscle tension, headache, fatigue.
2. Panic Disorder
Sudden attacks of intense fear lasting minutes:
- Severe heart racing.
- Shortness of breath.
- Sweating and trembling.
- Chest pain (resembling a heart attack).
- Dizziness.
- Sense of impending doom.
- Numbness.
3. Social Anxiety
Intense fear of social situations and being judged.
4. Specific Phobia
Irrational fear of a specific thing (heights, insects, enclosed spaces, needles).
5. Obsessive-Compulsive Disorder (OCD)
- Intrusive obsessive thoughts.
- Repetitive compulsive behaviors (rituals).
- Repeated handwashing, checking, ordering.
6. Post-Traumatic Stress Disorder (PTSD)
- Symptoms returning to memories of past trauma.
- Nightmares, flashbacks.
- Avoidance of triggers.
- Hyperarousal.
7. Separation Anxiety
In children and adults afraid to separate from loved ones.
Physical Symptoms
- Racing heart and palpitations.
- Shortness of breath.
- Muscle tension.
- Sweating.
- Trembling.
- Nausea and abdominal pain.
- Dizziness.
- Headache.
- Sleep disturbances.
- Numbness.
- Mental fog.
- Dry mouth.
- Chills or hot flashes.
Causes
- Genetics.
- Brain chemistry.
- Childhood trauma.
- Chronic stress.
- Physical illness (hyperthyroidism, heart disease).
- Medications and stimulants (caffeine, steroids).
- Alcohol and drugs.
- Personality disorders.
Psychotherapy
Cognitive Behavioral Therapy (CBT) — Most Effective
Teaches you to:
- Identify anxiety-provoking thoughts.
- Challenge their validity.
- Replace them with realistic thoughts.
- Gradually expose yourself to feared situations.
Exposure Therapy
For phobias, OCD, and PTSD.
Mindfulness
Present-focused awareness without judgment.
EMDR
For PTSD.
Medications
1. SSRI / SNRI
First-line for chronic anxiety. Like depression: sertraline, escitalopram, venlafaxine. Take 4–6 weeks.
2. Benzodiazepines
- Alprazolam (Xanax).
- Lorazepam (Ativan).
- Clonazepam (Rivotril).
Fast-acting but addictive and habit-forming. Used only short-term (<4 weeks) in crises.
3. Buspirone
For GAD, non-addictive.
4. Beta-Blockers
For physical symptoms only (palpitations, tremor), especially before social events.
5. Pregabalin (Lyrica)
For resistant GAD.
How to Handle a Panic Attack
- Remember: the attack won't kill you or cause a heart attack. It will pass within minutes.
- 4-7-8 breathing: 4 seconds in, 7 hold, 8 out.
- 5-4-3-2-1 grounding:
- 5 things you see.
- 4 things you touch.
- 3 sounds you hear.
- 2 things you smell.
- 1 thing you taste.
- Don't resist: accept the feelings instead of fighting them.
- Remember the past: "It's passed before and it will pass now."
Daily Anxiety Management Techniques
- Deep breathing 10 minutes daily.
- Exercise: very effective, 30 minutes 5 times weekly.
- Meditation and yoga.
- Journaling feelings.
- Reduce caffeine and alcohol.
- Regular sleep.
- Social connection.
- Hobbies and pleasure.
- Reduce social media and news time.
Supplements and Herbs
- Magnesium: 200–400 mg daily.
- L-Theanine: in green tea.
- Omega-3.
- Chamomile.
- Valerian: for sleep.
- Ashwagandha.
Medical tip: Anxiety responds excellently to treatment. Combining CBT + medication yields better results than either alone. Don't suffer in silence.
When to Go to the ER
- Self-harm thoughts.
- Panic attack with severe persistent chest pain (to rule out heart attack).
- Anxiety preventing eating, drinking, or sleeping for days.
- Visions or hallucinations.
If you have pathological anxiety, book an appointment with a psychiatrist or GP on ClinicsJo.
