Understanding anxiety disorders: Early symptoms and common types
Mental Wellness2024-10-14
8 Mins Read
Anxiety disorders are prevalent mental health conditions in modern society, affecting individuals of various ages and backgrounds. Research indicates that approximately one in fourteen people worldwide (7.3%) suffers from an anxiety disorder. This condition not only causes stress and unease for the affected individuals but can also impact their work, studies, daily life, and relationships.
Anxiety is a natural emotion that everyone experiences; moderate levels of anxiety are a part of everyday life. It can protect our safety in sudden emergencies and motivate us to plan for the future. However, when a person experiences persistent and excessive anxiety across emotional, cognitive, behavioural, and physical dimensions, they may have an anxiety disorder. This article will discuss how to recognise the symptoms of anxiety disorders so that individuals, along with their family and friends, can take proactive steps toward addressing them and emerging from the shadows of anxiety.
What is an anxiety disorder?
An anxiety disorder is a group of mental health disorders characterised by excessive and persistent feelings of anxiety, fear, and/or avoidance of perceived threats. It is classified as a mental illness and typically begins in childhood, adolescence, or early adulthood. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), anxiety disorders encompass several types, including Generalised Anxiety Disorder, Panic Disorder, and Social Anxiety Disorder.
Symptoms of anxiety disorders
The symptoms of anxiety disorders can be categorised into emotional, cognitive, behavioural, and physical aspects, and different types of anxiety disorders exhibit various symptoms. Here are the common symptoms associated with anxiety disorders:
1. Emotional symptoms
- Persistent worry and fear: Individuals may feel a constant sense of tension and unease, excessively worrying about the future or uncontrollable situations.
- Irritability or frustration: Due to the ongoing anxiety, patients might become easily agitated or overreact to minor issues.
2. Cognitive symptoms
- Difficulty concentrating: Anxiety can lead to decreased focus, making it hard for individuals to concentrate and often causing distractions.
- Confused thinking: During anxiety episodes, individuals may experience muddled thoughts, making it challenging to make decisions or think rationally.
- Overthinking or ruminating: Individuals may obsessively think about past events or potential future problems and find it difficult to stop negative thought patterns.
3. Behavioural symptoms
- Avoidant behaviour: To prevent triggering anxiety, patients often actively avoid certain people, places, or situations, such as social gatherings or public speaking.
- Compulsive behaviour: Some anxiety disorder patients may repeatedly perform specific actions, such as compulsively checking locks or washing hands, to alleviate their anxiety.
4. Physical symptoms
- Rapid heartbeat: Anxiety attacks can trigger an overreaction of the autonomic nervous system, resulting in an accelerated heartbeat.
- Breathing difficulties: Patients may frequently feel short of breath or experience chest tightness, sometimes mistaking it for a heart problem.
- Muscle tension: Anxiety keeps the body in a constant state of tension, leading to stiffness or pain in muscles and affecting sleep quality.
- Dizziness and fatigue: Prolonged anxiety can deplete the body of energy, resulting in frequent feelings of tiredness or dizziness.
These symptoms typically persist for at least six months and significantly affect the individual's daily life. If not treated promptly, anxiety disorders can worsen, impacting quality of life and mental health.
Is anxiety disorder a mental illness?
Anxiety disorder is not classified as a mental illness (Psychotic Disorder) but rather a common emotional disorder. Anxiety disorder primarily involves persistent or excessive worry, whereas psychotic disorders generally refer to severe mental health conditions that can lead to significant detachment from reality in terms of thought, emotion, and behaviour.
Main types of anxiety disorders
Anxiety disorders can be categorised into several types based on their characteristics and symptoms. Below are the main types of anxiety disorders and their features:
1. Generalised anxiety disorder (GAD)
- Characteristics: Individuals with GAD experience excessive and persistent worry about various everyday activities, which is often uncontrollable and not limited to specific events or situations.
- Symptoms: Ongoing anxiety, irritability, muscle tension, fatigue, difficulty concentrating, and sleep disturbances. This anxiety usually lasts for at least six months and significantly affects daily life.
2. Panic disorder
- Characteristics: Panic disorder is characterised by sudden and intense panic attacks, which are typically unpredictable and without clear triggers, often accompanied by severe physiological symptoms.
- Symptoms: Rapid heartbeat, sweating, chest pain, difficulty breathing, dizziness, or feelings of impending doom. These panic attacks may lead to a fear of recurrence, resulting in further anxiety and avoidance behaviours.
3. Social Anxiety Disorder (SAD)
- Characteristics: Individuals with SAD experience intense fear of social situations or public performances, worrying that they may embarrass themselves or receive negative evaluations.
- Symptoms: Extreme nervousness in social or performance contexts, often accompanied by rapid heartbeat, sweating, blushing, or trembling, along with strong avoidance behaviours. These symptoms can adversely affect personal relationships and career development.
4. Phobias
- Characteristics: Phobias involve intense and irrational fears of specific objects, situations, or activities, leading individuals to actively avoid these triggers.
- Specific phobias: Excessive fear of specific things (e.g., animals, heights, blood, open or crowded places).
5. Obsessive-compulsive disorder (OCD)
- Characteristics: Individuals with OCD frequently experience uncontrollable obsessive thoughts (obsessions) and perform certain behaviours (compulsions) repetitively to alleviate anxiety.
- Symptoms: Obsessions may include fears of contamination or extreme perfectionism, while compulsions may involve repetitive handwashing, checking locks, etc. Although these compulsive behaviours can provide temporary relief, they ultimately disrupt daily life.
6. Post-traumatic stress disorder (PTSD)
- Characteristics: PTSD is triggered by experiencing significant traumatic events (e.g., war, disasters, violence), leading individuals to relive the traumatic experience repeatedly.
- Symptoms: Intrusive memories or nightmares about the trauma, heightened alertness, avoidance of trauma-related situations, and emotional numbness or loss of interest. These symptoms can severely impact daily functioning.
7. Separation anxiety disorder
- Characteristics: Commonly seen in children, separation anxiety can also affect adults, manifesting as intense anxiety and fear when separated from significant others.
- Symptoms: Fear of separation or reluctance to leave home, even physical symptoms like nausea or headaches during separation. This anxiety often disrupts social and daily functioning.
These types of anxiety disorders may occur simultaneously or in alternating episodes; therefore, professional assessment is crucial for accurate diagnosis and treatment.
How to determine if you have anxiety disorder
You can use self-check methods and assessment tools to initially evaluate whether you may have an anxiety disorder. Here are some methods for self-assessment:
1. Self-check methods
You can assess your anxiety levels through the following steps:
- Observe emotional changes: Do you frequently feel persistent worry and fear? Are these emotions difficult to control and disproportionate to the actual situation?
- Check physical reactions: Do you often experience physical symptoms such as palpitations, chest tightness, dizziness, gastrointestinal discomfort, or muscle tension? Do these symptoms occur alongside feelings of anxiety?
- Evaluate behavioural changes: Do you frequently avoid certain situations or activities out of fear that they will trigger anxiety? Has anxiety impacted your social life, work, or studies?
- Monitor sleep quality: Are you finding it hard to fall asleep due to anxiety, or do you wake up frequently during the night feeling more anxious?
2. Record duration and intensity of symptoms
- Duration: Symptoms of anxiety disorder typically persist for at least six months before being diagnosed as such. Therefore, tracking the duration of symptoms is crucial for diagnosis. If your anxiety symptoms last more than six months and affect your daily life, it's essential to take note.
- Intensity: In addition to duration, the intensity of the symptoms is also a critical indicator. You can record the intensity of your anxiety daily (on a scale of 1 to 10) to observe whether anxiety increases or decreases in different situations.
3. Common assessment questionnaires
Here are some common self-assessment tools for anxiety that can help you systematically check your anxiety levels. You can search for these tools online:
- Beck Anxiety Inventory (BAI): This is a self-report questionnaire containing 21 items designed to assess the level of anxiety. Each question is scored based on the frequency or intensity of anxiety symptoms, and the final score can help you understand the severity of your anxiety.
- Generalised Anxiety Disorder 7-item (GAD-7): This is a simple questionnaire consisting of seven questions that evaluate anxiety symptoms over the past two weeks. Scoring is based on frequency (e.g., ‘not at all,’ ‘several days,’ ‘more than half the days,’ ‘nearly every day’), with a total score over 10 potentially indicating moderate anxiety.
- Hospital Anxiety and Depression Scale (HADS): This questionnaire is commonly used in hospitals or clinics to assess symptoms of anxiety and depression. It consists of 14 questions divided into two sections, one for anxiety and one for depression, with seven questions each. Scores can help identify the severity of anxiety and depression.
4. Maintain a symptom diary
When self-assessing, keeping a diary to record daily anxiety symptoms can help track changes in anxiety levels. You can record:
- Time: When the symptoms occur and how long they last.
- Context: The situations or events that trigger anxiety.
- Physical reactions: The physical responses you experienced (e.g., rapid heartbeat, shortness of breath).
- Emotional reactions: The intensity of your emotions at that time (rated from 1 to 10).
These records can help observe whether symptoms worsen or improve over time and provide reference information for healthcare professionals.
How to treat anxiety disorders*
There are various treatment options for anxiety disorders, typically including psychotherapy, medication, and behavioural therapies.
1. Cognitive Behavioural Therapy (CBT)
Principle: CBT is a structured psychotherapy method designed to help patients identify and change negative thought patterns and behaviours. Individuals with anxiety disorders often exhibit unrealistic thinking and excessive worry. CBT assists patients in challenging these irrational thoughts and learning healthier thinking patterns to alleviate anxiety.
Methods:
- Cognitive restructuring: Identifying and challenging distorted thoughts, such as overgeneralisation or catastrophic thinking, and replacing them with more realistic perspectives.
- Behavioural experiments: Designing and implementing behavioural experiments to test and evaluate whether expectations about anxiety-provoking situations are accurate, thereby reducing sensitivity to feared scenarios.
- Exposure therapy: Systematically exposing patients to anxiety-inducing situations to help them gradually acclimatise, thus lowering anxiety levels.
Effectiveness: CBT has been proven effective for various types of anxiety disorders and typically requires 10 to 20 sessions. It not only alleviates anxiety symptoms but also helps patients develop long-term coping skills.
2. Medication
Medication usually takes several weeks to show significant effects and should be conducted under a doctor's guidance, as individuals may respond differently to medications and may require dosage adjustments or changes in medication.
3. Mindfulness-based therapy
Principle: Mindfulness therapy aims to help patients focus on the present moment, reducing worries about the past or future by cultivating mindfulness. This therapy includes mindfulness meditation and other relaxation techniques to enhance awareness of one’s emotions and thoughts.
Methods:
- Mindfulness meditation: Encouraging patients to focus on their breath, bodily sensations, or sounds in their environment, fostering non-judgmental awareness to reduce anxiety and stress.
- Mindful self-acceptance: Learning to accept one’s emotions and thoughts instead of trying to control or escape from them.
- Mindfulness-based stress reduction (MBSR): A systematic mindfulness therapy typically comprising an eight-week programme with weekly group classes and personal practice.
Effectiveness: Research indicates that mindfulness therapy can effectively reduce anxiety symptoms, improve emotional regulation, and enhance overall mental health.
*This information is for reference only. If you have any questions, please consult your doctor or a mental health professional.
Lifestyle changes to improve anxiety symptoms
In addition to the formal treatments mentioned above, certain lifestyle changes can also help alleviate anxiety symptoms:
1. Exercise
Regular physical activity promotes the release of endorphins, which are natural chemicals that reduce anxiety. Exercise also improves sleep quality, lowers stress levels, and enhances the body’s resilience to stress. Research suggests that 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or cycling, can significantly alleviate anxiety symptoms. Exercise not only serves as an adjunct therapy for anxiety but also boosts overall mental and physical health, helping patients establish a positive lifestyle.
2. Nutrition
A balanced diet is crucial for emotional stability. Foods rich in omega-3 fatty acids (such as fish and flaxseeds), B vitamins (such as whole grains and leafy greens), and antioxidants (such as berries and nuts) contribute to better mental health. In contrast, high-sugar and high-caffeine foods can cause blood sugar fluctuations that may exacerbate anxiety symptoms. Therefore, dietary adjustments can improve physical health and stabilise emotions, thereby reducing anxiety.
3. Social support
Maintaining good connections with family and friends can provide emotional support and practical assistance, reducing feelings of loneliness. Social support can offer understanding and encouragement, helping patients cope with anxiety. Joining support groups or mental health workshops and increasing interactions with others can also provide effective coping strategies. Research shows that actively participating in social activities can reduce anxiety and enhance life satisfaction.
Learning to coexist with anxiety and embrace a brighter tomorrow
Anxiety disorders are common yet often overlooked psychological conditions. Early identification of anxiety symptoms and timely treatment are crucial for restoring normalcy in life and enhancing overall quality of life. If anxiety symptoms are not addressed promptly, they can progressively worsen, affecting overall well-being and life satisfaction, as well as impacting work, studies, and interpersonal relationships. Therefore, recognizing anxiety symptoms early and implementing effective treatment measures is key to breaking free from the cycle of anxiety.
While anxiety may lead patients to feel isolated and helpless, support is always within reach for those willing to take the first step. With the support of family and friends, alongside professional treatment, individuals with anxiety disorders can eventually find their path to recovery. They can learn to coexist with anxiety, gradually rediscovering their passion for life and the hope for a better future.
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