Worried that you worry too much? Everyone worries or gets scared sometimes. But feeling extremely worried or afraid much of the time, or repeatedly feel panicky, may be signs of an anxiety disorder.
Anxiety disorders include panic attacks, post-traumatic stress disorder, and obsessive-compulsive disorder. They are among the most common mental illnesses, affecting roughly 40 million American adults. A person has an anxiety disorder if she or he has persistent worry for more days than not, for at least several months. Some people with anxiety feel they have always been worriers, even since childhood or adolescence. In other people, anxiety comes on suddenly, triggered by a crisis or a period of stress, such as the loss of a job, a family illness, the death of a relative, or other tragedy.
Numerous therapies can help control anxiety. These include psychotherapy and medication, ideally supported by good nutrition, sleep, and regular exercise. People who are anxious tend to reach for unhealthy "comfort" food—and then worry about it. Or they completely avoid food, skipping meals or even fasting—and worry that something is wrong, such as an undiagnosed cancer. Healthy eating can avoid these anxiety triggers.
Not getting enough sleep can boost a person's anxiety level. On the flip side, getting enough sleep can help control stress and anxiety. So can getting regular exercise—aim for 30 minutes of moderate-intensity exercise five days a week.
In obsessive-compulsive disorder (OCD), a person is troubled by intrusive, distressing thoughts (obsessions) and feels the pressure to carry out repetitive behaviors (compulsions).
Neuroscientists believe that the brain pathways involved with judgment, planning and body movement are altered in OCD. Environmental influences, such as family relationships or stressful events, can trigger or worsen OCD symptoms.
OCD affects an estimated 2% to 3% of people in the United States. The percentage is about the same in Canada, Korea, New Zealand and parts of Europe. About two-thirds of people with OCD have the first symptoms before they are 25 years old. Only 15% develop their first symptoms after age 35. There is strong evidence that the illness has a genetic (inherited) basis, since about 35% of people with OCD have a close relative who also has the condition. Although 50% to 70% of patients first develop OCD after a stressful life event – such as a pregnancy, a job loss or a death in the family – experts still do not understand exactly how stress triggers the symptoms of this illness.
Sometimes people with OCD manage their obsessions without giving any external sign that they are suffering. Usually, however, they try to relieve their obsessions by performing some type of compulsion: a repeated ritual that is aimed at soothing their fears. For example, a woman who has the obsession that her hands are dirty may develop the compulsion to wash them 50 times a day. A man who fears that his front door is unlocked may feel compelled to check the lock 10 or 20 times each night.
A phobia is a persistent, excessive, unrealistic fear of an object, person, animal, activity or situation. It is a type of anxiety disorder. A person with a phobia either tries to avoid the thing that triggers the fear, or endures it with great anxiety and distress.
There are three major types of phobia:
Specific phobia (simple phobia). With this most common form of phobia, people may fear specific animals (such as dogs, cats, spiders, snakes), people (such as clowns, dentists, doctors), environments (such as dark places, thunderstorms, high places) or situations (such as flying in a plane, riding on a train, being in a confined space). These conditions are at least partly genetic (inherited) and seem to run in families.
Social phobia (social anxiety disorder). People with social phobia fear social situations where they may be humiliated, embarrassed or judged by others. They become particularly anxious when unfamiliar people are involved.
Agoraphobia. Agoraphobia is a fear of being in public places where it would be difficult or embarrassing to make a sudden exit.
Childhood phobias occur most commonly between the ages of 5 and 9, and tend to last a short while. Most longer-lasting phobias begin later in life, especially in people in their 20s. Adult phobias tend to last for many years, and they are less likely to go away on their own. Without proper treatment, phobia can increase an adult's risk of other types of psychiatric illness, especially other anxiety disorders, depression and substance abuse.