Our ability to feel fear and anxiety is natural. However, if the anxiety, fear or panic become chronic and impair your quality of life, you may be suffering from an anxiety disorder, a panic disorder, fear of social or public situations or an obsessive-compulsive disorder.
Disorders involving anxiety and fear are quite common; at least one in ten people are affected during their lifetime. Milder symptoms of anxiety, nervousness and fear are considerably more common.
Anxiety disorders usually begin in adolescence and early adulthood and are more common in women. Memories related to traumatic events or physical ailments may expose a person to anxiety disorders. In elderly people, such disorders may stem from loneliness, a loss of purpose or the fear of death.
Generalised anxiety disorder makes you unreasonably worried and anxious about things and events related to various aspects of your life. The disorder often makes it difficult to manage your usual routines and work as it impairs your ability to focus, your sleep quality, general energy levels and problem-solving skills.
The symptoms may also be somatic, such as heart palpitations, elevated blood pressure, dry mouth, shortness of breath, sweating, loss of appetite, a lump in one’s throat, trembling, dizziness or dilated pupils.
Anxiety is often connected with psychiatric disorders and drug use, but a generalised anxiety disorder is continuous and is not related to a specific situation. A generalised anxiety disorder is diagnosed if the symptoms continue for at least six months.
A panic disorder involves recurring, severe bouts of anxiety known as panic attacks. Symptoms of a panic attack may include heart palpitations, chest pain, sweating, trembling, shortness of breath, feeling of suffocating or choking, nausea, upset stomach, dizziness, feeling faint, numbness, tingling, cold shivers or hot flushes.
The symptoms often lead to the fear of losing self-control, going mad or dying, derealisation (feeling of unreality) or depersonalisation (feeling like you are outside of your body).
The symptoms develop quickly and the attack usually lasts about 30 minutes or less. If the attacks become recurring, the person usually becomes afraid and starts to avoid situations or locations where the risk of an attack is heightened.
Fear of social situations
If a person is constantly afraid or nervous about situations where they have to deal with strangers or feel observed, evaluated and judged by others, they probably suffer from a fear of social situations.
The fear may set off a reaction similar to a panic attack and may, at its worst, restrict the person’s everyday life and interaction with other people. Sometimes, the fear of social situations may be restricted to public speaking.
Fear of public places
Fear of public places or agoraphobia means becoming anxious of ending up in a crowd, in a closed space, in an open space or in another place that is difficult to escape. The person may start avoiding such places and situations, such as crowded transportation, queues, large festivities or other public events. The fear of a panic attack may also play a role in wanting to avoid certain places or situations.
Obsessive-compulsive disorder (OCD)
In an obsessive-compulsive disorder, the person repeatedly experiences unpleasant or distressing obsessive thoughts or behaviour.
Examples of obsessive or intrusive thoughts include a recurring fear of contagious illnesses or falling ill, suspicions of accidentally causing harm, obsessive need for symmetry or organisation and intrusive aggressive or sexual thoughts. The thoughts and behaviour are disruptive and time-consuming, distressing and unpleasant, repeatedly intrude the mind and feel strange and alien.
Compulsions can be visible, such as repeated washing, organising or checking locks, or mental compulsions, such as praying, counting or repeating words. The person uses compulsions to try and reduce the anxiety related to obsession or prevent something scary from happening.
Treating anxiety disorders
With appropriate treatment, symptoms of anxiety can even be completely eliminated. Even if the susceptibility to anxiety, fear or panic remains, it is possible to learn to live with it without any impairment of a normal, good life.
Therapy, including cognitive psychotherapy, is often the most effective, long-lasting form of treatment. SSRI antidepressants can also be used to alleviate the symptoms, especially in acute cases.