Anxiety refers to a group of disorders that are collectively the most common mental health condition in Australia (Healthdirect 2022).
What is Anxiety?
Anxiety is an evolutionary safety mechanism that exists to keep humans safe from harm or danger by triggering the ‘fight or flight’ response (Black Dog Institute 2022).
It activates in response to a stressor, causing psychological and physical changes within the body so that the individual can confront the situation (Harvard Health Publishing 2020).
Every person experiences anxiety during their life - it’s normal and often helpful. However, in some cases, anxiety is unnecessarily constant and overwhelming, and interferes with a person’s ability to go about their daily lives. This could indicate an anxiety disorder (Smith et al. 2023; Healthdirect 2022).
Anxiety disorders may disrupt several aspects of a person’s life, including their ability to concentrate, sleep or perform daily tasks. It may also cause an individual to avoid certain situations or leaving the house. In some cases, it can cause physical symptoms such as shortness of breath, a pounding heart or trembling hands (Healthdirect 2022).
Types of Anxiety Disorders
As per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), anxiety is separated into two categories:
Anxiety Disorders
Generalised anxiety disorder
An intense and constant worry that interferes with daily activities.
Panic disorder
A person experiences frequent panic attacks (sudden feelings of overwhelming and intense fear and distress).
Specific phobia
An intense and irrational fear towards a specific object or situation.
Agoraphobia
A fear of being in a situation where the individual is not able to easily escape if they experience a panic attack.
Social anxiety disorder
Severe anxiety and fear relating to social situations.
Separation anxiety disorder
A persistent and inappropriate fear of being separated from people the individual is attached to.
Obsessive-Compulsive and Related Disorders
Obsessive-compulsive disorder
A person experiences recurring obsessions (thoughts or images that cause anxiety) and feels an overwhelming need to perform compulsions (rituals or behaviours) in order to alleviate the obsessions.
Body dysmorphic disorder
A preoccupation with perceived flaws related to physical appearance, causing an individual to perform repetitive behaviours and thinking.
Hoarding disorder
A persistent difficulty with getting rid of possessions due to a perceived need to keep them. Throwing items out can cause significant distress for the person.
Trichotillomania
A disorder where an individual pulls out their own hair, usually from the scalp, eyebrows and eyelids.
Excoriation disorder
A disorder where an individual repeatedly picks at their own skin to the extent that it causes lesions.
(APA 2021a, b, 2022a, b)
How Common is Anxiety?
The most recent National Survey of Mental Health and Wellbeing conducted by the Australian Bureau of Statistics (2022) found that almost 17% of Australians had experienced an anxiety disorder in the past 12 months.
Anxiety is more common in women, with 21% of women experiencing an anxiety disorder during the past 12 months compared to 12.4% of men (ABS 2022).
Causes of Anxiety
It’s believed that anxiety disorders are caused by a combination of factors, including genetics, brain chemistry, personality and stressful life events such as:
Unpredictable new situations (e.g. changing schools or jobs, or travelling)
Pregnancy and childbirth
Relationship issues
Bereavement
Financial or work problems
Abuse
Excessive use of drugs or alcohol
Physical health problems.
(SANE 2023; Healthdirect 2022)
Signs and Symptoms of Anxiety
The symptoms of each specific anxiety disorder are set out in the DSM-5-TR, each with individual diagnostic criteria that should be met.
In a more general sense, there are some common symptoms that will often apply to anxiety disorders:
Psychological Symptoms
An individual may:
Have excessive feelings of worry and fear about the past, present or future
Feel apprehensive or powerless
Feel as if something bad or dangerous is about to happen
Have difficulty thinking about anything other than anxious thoughts
Be tense and on edge
Feel nervous or scared
Panic
Be irritable or agitated
Worry that they are ‘going crazy’
Feel detached from their body.
(Black Dog Institute 2022; Healthdirect 2022)
Psychical Symptoms
Physical symptoms are responses to fight or flight mode that would occur in the case of real danger (SANE 2018). They include:
Pounding heart
Shortness of breath
Dizziness
Trembling or twitching
Sweating
Nausea
Abdominal pain
‘Pins and needles’
Difficulty concentrating
Difficulty sleeping
Excessive thirst.
(Black Dog Institute 2022; Healthdirect 2022)
Behavioural Symptoms
Avoidance of certain situations that may cause anxiety, which can impact the person’s everyday life.
(Healthdirect 2022)
Diagnosing Anxiety
Refer to the DSM-5-TR for the full list of diagnostic criteria for anxiety disorders.
Anxiety Treatment and Management
There is a range of effective treatments for anxiety. Treatment generally falls within three categories:
Psychological treatments including cognitive-behavioural therapy (CBT), exposure therapy, mindfulness therapy, counselling etc.
Medication
Self-help and alternative therapies such as exercise, meditation, relaxation techniques, yoga and acupuncture.
(Black Dog Institute 2020)
Treatment may differ depending on the kind of anxiety disorder a person is experiencing and may involve a combination of the above strategies. Treatment should be individualised (Black Dog Institute 2020).
Anxiety is treatable and can be managed so that its impact on a person’s life lessens significantly. In some cases, it can be eliminated entirely (SANE 2023).
If you’re in crisis and need support, call Lifeline on 13 11 14. Lifeline is open 24 hours a day, 7 days a week.
Topics
References
American Psychiatric Association 2022a, The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), American Psychiatric Association Publishing, US.