Anxiety Disorders: Everything you need to know

Anxiety is the most common mental health condition¹ in Australia, with more than one in 6 or around 3.4 million people experiencing it².

Everybody gets anxious when faced with a stressful situation. Mild anxiety can even be useful, particularly if you’re better at working under pressure. But when an anxious mood becomes excessive, long-lasting and interferes with your everyday activities, it’s time to seek help.

Anxiety disorder is a mental health condition that causes fear, dread and other symptoms generally considered to be out of proportion to the situation.

Anxiety-related conditions affect people of all ages and from all walks of life. The good news is that with the right treatment, it can be successfully managed.

What causes anxiety is not yet fully understood, but it does involve a complex interplay of genetic, environmental and psychological factors.

Anxiety can sometimes run in families. While some experts believe there may be a genetic component, many now suggest that anxiety may have a ‘learned’ element, so you might be more susceptible as a result of growing up among anxious people³.

Environmental factors that can cause anxiety include stressful, life-changing events such as bereavement, or witnessing or experiencing something traumatic. Illness, such as depression, alcohol dependence, chronic pain, heart failure, asthma or thyroid disease, can also trigger anxiety conditions.⁴

Taking illegal substances such as amphetamines and cocaine may cause anxiety. Stopping some medicines after taking them for a long time may have a similar result.

Always speak to your doctor before stopping medications.

Anxiety can affect people in many different guises, with people reacting and experiencing anxiety differently. Here are some of the main types of anxiety disorders.

A phobia is a fear or panic that’s out of proportion to any real danger. Common phobias include fear of heights, spiders, injections or enclosed spaces. If a phobia interferes with your ability to lead a normal life, it may be considered an anxiety disorder. People often go to great lengths to avoid whatever makes them phobic, or tolerate it with dread. Sometimes, just catching a glance of something on TV can trigger a reaction.

Social anxiety disorder, also known as social phobia, is a powerful and persistent fear of social or performance situations. It may cause you to avoid social situations, or feel distressed if you have to be involved. You may also limit what you do in front of others, such as talking or eating.

Panic disorder is signalled by repeated, sudden and intense periods of anxiety, known as panic attacks. These are often accompanied by physical symptoms such as increased heart rate, excessive sweating, dizziness or feeling faint. During an attack you may even feel you’re going to collapse or die. There may be specific triggers for panic attacks, or they may develop for no apparent reason.

Experiencing repeated obsessions and/or compulsive behaviour could be telltale signs of obsessive–compulsive disorder (OCD). Obsessions are defined as recurrent ideas or impulses that make you feel distressed or horrified, which in turn leads to anxiety. Compulsions are particular actions or rituals that you feel you must do to prevent what’s worrying you from occurring, regardless of knowing logically that they won’t. Your anxiety gets worse if you don’t carry out these rituals. OCD symptoms vary from mild to severe, are often accompanied by other mental health problems, such as depression or an eating disorder.

You can develop post-traumatic stress disorder (PTSD) after experiencing or witnessing a traumatic event. That might be anything from a natural disaster such as a bushfire, to acts of war, an accident, assault or abuse. PTSD may develop weeks or months after the event occurred. Symptoms include extreme fear or panic, being on constant alert, and recurring thoughts, memories, images, dreams or distressing flashbacks of the trauma. Those with PTSD often feel detached from other people, and experience anxiety and depression.

Generalised Anxiety Disorder (GAD) is a condition that causes you to worry about everyday situations and issues. GAD is usually diagnosed when your worrying happens on most days, for at least six months. It is often a long-term disorder.

GAD might also cause fatigue, restlessness, muscle tension, grouchiness, and trouble sleeping.  GAD often goes hand-in-hand with panic attacks and phobias.

The key symptom of an anxiety disorder is feeling anxious and worried, along with the urge to avoid situations that trigger or worsen your anxiety. Anxiety disorders can manifest in extra psychological and physical symptoms that interfere with everyday life.

Psychological symptoms might include:

• sleeping difficulties (insomnia)
• feeling tired
• feeling restless or on edge
• being irritable or quick to get angry
• being unable to concentrate
• a fear that you're 'going mad'
• feeling out of control of your actions, or detached from your surroundings

Physical symptoms are caused by the body’s release of the hormone adrenaline.

These might include:

• dry mouth
• rapid heartbeat or palpitations
• tightness or pain in your chest
• shortness of breath
• dizziness
• needing to pee more often than usual
• difficulty swallowing
• shaking
• diarrhoea

If anxiety is affecting your daily life, talk to your doctor. They will want to identify what’s causing your anxiety, so they’ll ask about your symptoms, your family history, specific triggers and what medications you are taking.

Your doctor may refer you to a mental health professional such as a counsellor, psychologist or psychiatrist for a more comprehensive diagnosis and treatment plan. They may also refer you to a relevant specialist if they suspect a medical condition may be causing or contributing to your anxiety.

Most anxiety disorders are highly treatable with psychotherapy (talk therapy) and/or medicines, complemented by self-help support and advice. The aim is to help you break the cycle of anxiety and avoidance of its causes.

Treatment will depend on the type and severity of the anxiety disorder you have, and usually takes 4 to 6 weeks to take effect.

Some lifestyle changes may help reduce feelings of anxiety, and monitoring your symptoms and triggers will help you feel more in control. Regular physical activity, eating a healthy diet and avoiding stimulants such as cigarettes, excessive caffeine⁵ and alcohol is also a key part of helping you get well and stay well. Some people find groups and forums useful. See resources below.

Talking through your problems with a qualified mental health professional may help you better manage your anxiety. Cognitive behavioural therapy (CBT) is an effective therapy to help identify and address negative and unhelpful thoughts, feelings and behaviours. It can be accessed face-to-face or online.

Other therapies include behavioural therapy, mindfulness and problem-solving, relaxation and breathing techniques, and specifically for people with PTSD, a therapy called eye movement desensitisation and reprocessing (EMDR).

Your doctor may prescribe medicines to help manage your anxiety condition.

• Antidepressants can be used on their own or in combination with other medications.
• Benzodiazepines may be prescribed if other treatments have failed to manage your anxiety sufficiently. These medicines are generally prescribed for short-term use.
• Beta-blockers may be prescribed to help reduce some of the physical symptoms of anxiety, such as rapid heartbeat or palpitations and shaking.

Always read the accompanying medicine information leaflet and contact your doctor or pharmacist if you have any questions.

If yours or someone else’s life is in danger, dial 000 immediately.

Lifeline Australia offers 24/7 crisis support online and on the phone at 13 11 14.

Beyond Blue offers 24/7 mental health information and support online and on the phone at 1300 224 636.

13YARN offers a national crisis support line for First Nations People on 13 92 76. The support line is available 24/7.

1800Respect is a 24/7 support service for people experiencing domestic violence. You can find support, counselling and information online or on the phone at 1800 737 732.

PANDA (Perinatal Anxiety & Depression Australia) supports the mental health of parents and families online and on the phone at 1300 726 306.

MensLine is a counselling service for men. You can get 24/7 support online and on the phone at 1300 78 99 78.

QLife offers LGBTQIA+ peer support online and over the phone on 1800 184 527.