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Anxiety Disorder

  • Phobias, panic attacks, social anxiety, OCD, and PTSD can interfere with normal life
  • Symptoms include intense fear of things (spiders, germs, heights) and constant anxiety
  • Treatment includes cognitive behavioral therapy, medications, and habituation (confronting fears)
  • Involves Child Study Center

Overview

Though anxiety is never a comfortable feeling, it can be a useful one. Nervousness and unease about a person, event or situation can provide information that helps keep you safe. 

“Our bodies evolved to learn to be worried about threats,” says Christopher Pittenger, MD, PhD, a Yale Medicine Child Study Center psychiatrists and director of the Yale Medicine Obsessive-Compulsive Disorder Research Clinic. “It is adaptive to be alert and fearful of possible threats, up to a point." 

Anxiety becomes a problem, however, when it interferes with living a normal life. "When anxiety becomes unmoored from real triggers or situations, and is more free-floating, or is out of proportion to the situation, it can become a clinical condition," says Dr. Pittenger. If you suffer from anxiety, our health professionals are well-equipped to help you.

What are some types of anxiety disorders?

  • A specific phobia is an intense fear of something, such as spiders or heights. For example, a person who has a phobia about germs may find it unbearable to be touched by other people.
  • Generalized anxiety disorder is anxiety that feels constant or near-constant. 
  • Panic attacks are sudden feelings of overwhelming fear when there is no real danger. Panic disorder develops when fear of another attack becomes crippling. 
  • Obsessive-compulsive disorder, or OCD, is a form of anxiety brought on by unwelcome, uncomfortable, and persistent thoughts that keep coming into a person's mind. In order to control those thoughts and quell the anxiety, a person might engage in a compulsive behavior, such as hand-washing in response to thoughts about infection.
  • Social anxiety disorder is disproportionate anxiety in response to social interactions, which often causes sufferers to avoid meetings or social situations.
  • Post-traumatic stress disorder, or PTSD, is a form of anxiety that develops in response to a trauma, such as time spent in a war zone or being the victim of a crime.

What other conditions are associated with anxiety disorders?

“I always ask the medical students I teach to name a disorder that isn’t associated with anxiety,” Dr. Pittenger says. “It’s a very common symptom of many other disorders.” Depression and insomnia are among those conditions.

What are the symptoms of anxiety disorders?

“Most people know when they are feeling anxious,” Dr. Pittenger says. “It could be somatic—characterized by a pounding heart, a headache or a stomachache. Or it could manifest itself as worrying thoughts, as is the case with obsessive-compulsive disorder.”

Anxiety from phobia might occur in the face of a triggering object or scenario. Panic attacks, on the other hand, often come out of nowhere. 

Though everyone experiences anxiety, if the anxiety has caused you significant distress, and has impaired your ability to function in life, then it qualifies as a clinical condition and should be treated professionally.

What are the risk factors for anxiety disorders?

The risk factors for anxiety disorders vary across different forms of the condition. All of these conditions have a genetic component. For example, within a military unit exposed to a traumatic situation, only a fraction of its members will get PTSD—perhaps those with a genetic predisposition. Environmental and developmental factors—such as a calmer, more nurturing early life—might enable someone to later withstand traumatic events.

How are anxiety disorders diagnosed?

Anxiety disorders are best diagnosed through an in-depth interview with a psychiatrist or psychologist.

Whether or not someone receives a diagnosis depends in part on how the anxiety appears in daily life. While some anxiety is appropriate and motivating, too much can be debilitating. If you wonder how you can tell if you or a loved one has a clinical level of anxiety, Dr. Pittenger says it is best to speak to a professional.

How are anxiety disorders treated?

A range of treatments are effective in treating anxiety disorders:

  • Cognitive behavioral therapy (CBT) is a short-term therapy that seeks to change the behaviors driven by anxious thoughts, and to challenge the thoughts themselves. “In therapy, we teach people to process anxiety-producing thoughts in a more adaptive way. It’s not about suppressing them—which rarely works—but rather about responding better to them and lessening their potency,” Dr. Pittenger says.
  • Habituation is a CBT technique used for simple phobias. For example, someone who is afraid of heights will climb a ladder in a controlled and supervised setting, and stay there while anxiety subsides.
  • Mindfulness-based therapy combines CBT with meditative techniques.
  • Exercising and improving sleep can help moderate anxiety.
  • Antidepressants such as SSRIs (selective serotonin reuptake inhibitors) can be useful in treating anxiety disorders, although they typically take weeks to work.
  • Benzodiazepines such as Valium and Xanax act quickly to reduce anxiety, but only in the short term. These drugs carry a risk of addiction.

What makes Yale Medicine’s approach to treating anxiety disorders unique?

“For decades, Yale Medicine has shown real dedication to understanding what causes anxiety disorders and what goes on in the minds and the brains of patients,” Dr. Pittenger says. “This primes us to think of new and better treatments, which is our goal.”