Anxiety Disorders

Overview

Everyone experiences symptoms of anxiety, but they are generally occasional and short-lived, and do not cause problems. But when the cognitive, physical and behavioural symptoms of anxiety are persistent and severe, and anxiety causes distress in a person’s life to the point that it negatively affects his or her ability to work or study, socialize and manage daily tasks, it may be beyond the normal range.


The main categories of anxiety disorders are:

• specific phobia  
• panic disorder  
• agoraphobia
• generalized anxiety disorder  
• social anxiety disorder  
• selective mutism
• separation anxiety disorder.

People with anxiety disorders may feel anxious most of the time or for brief intense episodes, which may occur for no apparent reason. They may have anxious feelings that are so uncomfortable that they avoid daily routines and activities that might cause these feelings. Some people have occasional anxiety attacks so intense that they are terrified or immobilized.

People with anxiety disorders are usually aware of the irrational and excessive nature of their fears. When they come for treatment, many say, “I know my fears are unreasonable, but I just can’t seem to stop them.”

Signs & Symptoms

Each of these anxiety disorders is distinct in some ways, but they all share the same hallmark features:

• irrational and excessive fear
• apprehensive and tense feelings
• difficulty managing daily tasks and/or distress related to these tasks.

Cognitive, behavioural and physical symptoms include:

• anxious thoughts (e.g., “I’m losing control” )
• anxious predictions (e.g., “I’m going to fumble my words and humiliate myself”)
• anxious beliefs (e.g., “Only weak people get anxious”)
• avoidance of feared situations (e.g., driving)
• avoidance of activities that elicit sensations similar to those experienced when anxious (e.g., exercise)
• subtle avoidances (behaviours that aim to distract the person, e.g., talking more during periods of anxiety)
• safety behaviours (habits to minimize anxiety and feel “safer,” e.g., always having a cell phone on hand to call for help)
• excessive physical reactions relative to the context (e.g., heart racing and feeling short of breath in response to being at the mall).

The physical symptoms of anxiety may be mistaken for symptoms of a physical illness, such as a heart attack.

Causes & Risk Factors

Like most mental health problems, anxiety disorders appear to be caused by a combination of biological factors, psychological factors and challenging life experiences, including:

• stressful or traumatic life event
• family history of anxiety disorders
• childhood development issues
• alcohol, medications or illegal substances
• other medical or psychiatric problems.

Diagnosis & Treatment

Several factors determine whether the anxiety warrants the attention of mental health professionals, including:

• the degree of distress caused by the anxiety symptoms
• the extent to which the anxiety symptoms affect the person’s ability to work or study, socialize and manage daily tasks
• the context in which the anxiety occurs.

Many psychological treatments, such as relaxation training, meditation, biofeedback and stress management, can help with anxiety disorders. Many people also benefit from supportive counselling or couples or family therapy. However, experts agree that the most effective form of treatment for anxiety disorders is cognitive-behavioural therapy (CBT). Medications have also been proven effective, and many people receive CBT and medication in combination.

Related Programs and Services

• Treatment at CAMH: Access CAMH
• Help for families from CAMH 
• ConnexOntario
• Kids Help Phone at 1 800 668-6868

Additional Resources

• Anxiety Disorders: An Information Guide
• A free tutorial on anxiety disorders is available on the Mental Health 101 page.
• CAMHTV video - Ask Dr. Goldbloom: Anxiety  
• Anxiety in Older Adults
• What Older Adults, Their Families and Friends Need to Know about… Anxiety (PDF) 
• Cognitive-Behavioural Therapy: An Information Guide  (PDF)
• Understanding Psychiatric Medications: Anti-anxiety medications (Benzodiazepines)