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Anxiety Disorders: Common Types, Symptoms and Treatments

Learn about 4 common anxiety disorders

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Yes, there are people whose brains are genetically wired to love thrills and risks. There was even a pop phrase for them that emerged a few decades back — Type T personalities. But for the majority of us, fear is hardly a favorite emotion. That doesn’t mean we don’t appreciate its role in protecting us from threats. The pounding heart and rapid breathing that accompany fear are important to the body’s “fight or flight” response, which helps us take quick action in a crisis — and then, ideally, get back to a fear-free everyday life.

Anxiety — best defined as worrying about a potential threat — can be protective too. “Anxiety is a normal human emotion,” says Robert Hudak, M.D., associate professor of psychiatry at the University of Pittsburgh. “Without anxiety, you wouldn’t buckle your seatbelt on the way to work in the morning. You wouldn’t look both ways before crossing the street.”  

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Anxiety can become a problem when “the fear is out of proportion to the real threat,” says Danielle Cooper, an assistant professor of clinical psychiatry at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. When a person chronically feels anxiety beyond what is reasonable and it interferes with normal life, doctors often diagnose this as an anxiety disorder. Symptoms include a pervasive sense of distress and physiological signs such as muscle tension, a rapid heartbeat, insomnia, stomach upset and shortness of breath. With an anxiety disorder, “the nervous system reacts as if there’s a threat in the environment, when little or none exists,” Hudak says.

The good news about anxiety disorders? They are treatable, at any stage of life.

Risk factors and triggers

Anxiety disorders can affect anyone, at any time in life, but there are predisposing factors, including a family history of anxiety, certain personality traits, stressful life events and social isolation. Women are more likely than men to suffer from an anxiety disorder, according to the National Institute of Mental Health.  

Corina Laudate, a clinical social worker at McLean Hospital in Belmont, Massachusetts, often sees among her older clients a “cumulative experience of loss and change” at the root of anxiety. “It might be a series of events throughout a lifetime,” she says, or a more recent cascade, such as back-to-back medical illnesses and the loss of a spouse.  

With an anxiety disorder, “the nervous system reacts as if there’s a threat in the environment, when little or none exists."

Robert Hudak, M.D.

Aging-related health changes can provoke anxiety, too. People who have trouble hearing, for instance, might start worrying about not being able to join in conversations. In fact, older adults with hearing loss are more likely to have anxiety, research shows. Loss of physical functioning, or the ability to move about with ease, is another common trigger, says psychiatrist Ramaswamy Viswanathan, M.D., president elect of the American Psychiatric Association. Losing muscle strength can lead to a fear of falling, which can lead to moving less and being more afraid of falling — and so on, in a downward spiral. Concerns about limited finances and losing independence can weigh on older adults, too.

Having more time on your hands can cause long-buried worries to bubble up. “When you're busy, [they] might not be at the forefront of your mind,” Cooper says. But when you retire or are otherwise freed up from preoccupations, issues you avoided might get a foothold, triggering anxiety.

Common anxiety disorders

There are four common types of anxiety disorders:

1.) Generalized anxiety disorder

People who have generalized anxiety disorder, or GAD, worry intensely about lots of things and tend to expect the worst. They have a hard time containing their fear, even when they realize it’s not rational. People with GAD may try to control situations and believe, consciously or unconsciously, that worrying somehow protects them.  

GAD is the most common type of anxiety disorder in older adults. Besides worry, symptoms include irritability, trouble sleeping, a rapid heart rate, rapid breathing, weakness or fatigue and difficulty concentrating. Ongoing headaches or stomachaches are also common.

2.) Social anxiety disorder

Everyone has felt self-conscious or embarrassed in front of others — but people with social anxiety disorder have an intense fear of being watched, judged or rejected. Some people fear social situations across the board, while others fear situations in which they have to speak or otherwise perform in front of others.

People with social anxiety disorder often avoid interacting with others. When they can’t steer clear, they experience extreme distress, including a rapid heart rate, blushing, trembling, feeling their mind go blank and nausea. Without treatment, social anxiety disorder can have profound effects on a person’s social life and work life.

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3.) Panic disorder

Panic attacks are sudden episodes of intense fear that involve extreme symptoms, such as sweating, chest pain, shortness of breath, choking sensations, dizziness and nausea, along with feelings of impending doom or death. They’re as scary as they sound. It’s common for people experiencing panic attacks to end up in an emergency room. Yet, unlike heart attacks, panic attacks typically subside within about 20 minutes.

Panic disorder is diagnosed when people who experience panic attacks become consumed with the fear of having another one. Panic disorder and agoraphobia, the fear of being in a place or situation in which you can’t escape or get help, often occur together.

4.) Specific phobias 

Heights, flying, snakes, needles, dental work — these things make many of us nervous, even scared. But people who have a phobia go to great lengths to avoid the object of their fear. People with a phobia feel powerless to control it, even when they recognize the fear is not based in reality. Symptoms such as rapid heartbeat, nausea, dizziness, fainting and difficulty breathing typically accompany phobias.

Phobias often start early in life, but they can occur any time. Among elderly adults, falling is a common phobia. Although phobias sometimes develop after a traumatic experience, they can also appear out of the blue.

Treatment for anxiety

Symptoms of anxiety overlap with those of other health conditions — for example, a rapid heartbeat could signal heart problems — so it’s important to visit a doctor to look into other medical causes, especially when symptoms start later in life, Laudate says. 

If medical causes are ruled out, cognitive-behavioral therapy, or CBT, is the place to start for all types of anxiety. “CBT should always be the number one option for anxiety disorders,” Hudak says.

Medication can play a role, but “it’s rare that someone should be treated with medication alone,” Hudak adds. Medications known as SSRIs, also used for depression, can be very helpful for some people, he says. One class of fast-acting anti-anxiety drugs, the benzodiazepines, can be habit-forming and come with serious side effects, including cognition and balance problems in older people. In Hudak’s experience, they’re not effective and can interfere with treatment. “I almost never [prescribe] benzodiazepines,” he says.

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How does cognitive behavioral therapy work?

Anyone hesitant about therapy may be relieved to hear that CBT doesn’t entail months exploring your childhood. “We might spend a little time getting clarity about what brought [the anxiety] on,” Cooper says. “What matters more for me is: How is it affecting your life? How can we intervene to try and bring about change?” 

In CBT, a therapist helps you gradually reframe thought patterns — that’s the cognitive part. While acknowledging your feelings, you learn to “check the facts,” Cooper says. If you’re experiencing anxiety about an upcoming trip overseas, for instance, you may ask yourself, “What do I fear will happen?,” “How likely is it?” and “How could I cope if this did happen?” You may learn to recognize the racing thoughts keeping you up at night as a false alarm.


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You also examine your behaviors, things you do — or don’t do. “Avoidance is one of the big things that can really propel the maintenance and worsening of anxiety,” Cooper says. Suppose someone has a bad experience with a dog and starts avoiding all dogs — and then starts “avoiding all animals, and then starts avoiding places where they suspect there might be animals,” she says. Ignoring or distracting yourself from the fear — more avoidance — can make the anxiety snowball even further.

Exposure therapy in CBT

Breaking the cycle of avoidance is key to treatment. Exposure therapy — gradually approaching the things you fear — is useful for all sorts of anxiety-related disorders, Cooper says. For someone with social anxiety related to performing, it might include imagining giving a presentation, then practicing it. In the case of a fear of dogs, you may work your way up to interacting with a dog that you deem friendly and reasonably safe. The goal isn’t to convince yourself that nothing bad will happen. “It’s about creating a more balanced, accurate perspective,” Cooper says.

People with excessive anxiety often underestimate their ability to cope. Through exposure therapy, they can learn that what they fear will happen is less likely than they predicted — and that if it does happen, it’s less catastrophic than they expected. Just as important, they learn “they can tolerate anxiety and distress without doing something to push it away,” Cooper says.

Group therapy can be helpful, in part by getting people to feel socially connected, which is crucial for mental health, Laudate says. Instead of being stuck in “everything’s going bad” mode, you may get another viewpoint and support from group members.

Being able to voice your fears — to a therapist, in a group or to a close friend — can loosen anxiety’s grip. “Life can be difficult. Life can be wonderful. It [can] be scary, it can be stressful, it [can] be all those things,” Cooper says. With support and treatment, you can manage and enjoy it.

Keeping Anxiety at Bay

Along with therapy, there are other ways you can support your mental health and ease anxiety, according to Ramaswamy Viswanathan, M.D., president elect of the American Psychiatric Association:

  • Get involved with a community or religious organization — anything that strengthens your sense of purpose and social connections. “Being meaningfully occupied is quite important,” Viswanathan says.
  • Start an exercise or physical therapy regimen. “If you feel less fragile, if you feel fit, that has a beneficial effect,” Viswanathan says.
  • Address health issues that may contribute to anxiety. Get hearing aids if you need them.
  • Develop a regular relaxation practice, such as deep breathing, yoga or tai chi.
  • Include outdoor activities such as nature walks and gardening in your weekly routine.
  • Learn simple steps to ease in-the-moment-anxiety.
  • Keep a daily gratitude journal to foster positive thinking.

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