What is an anxiety disorder?

An anxiety disorder is an excessive or inappropriate stress response that leaves you with feelings of apprehension, uncertainty and fear, and can inappropriately paralyze you into inaction or withdrawal. While an anxiety disorder may provoke feelings similar to a case of "nerves," it is the severity and duration of symptoms that distinguish the two. Without treatment, an anxiety disorder can significantly disrupt your life as you become tormented by panic attacks, irrational thoughts and fears, compulsive behaviors or rituals, flashbacks, nightmares or countless frightening physical symptoms.

Who gets this illness and why?

Anxiety disorders strike men and women of all races, ages and social status, but (except for OCD) they are twice as common in women and they tend to strike more often in young adulthood. Anxiety disorders can be caused by biological, chemical or genetic factors; can be brought about by family background; or can be attributed to certain medical conditions or medications.

Are there different types of anxiety disorders?

Yes, there are several types of anxiety disorders, including:

• Generalized anxiety disorder is characterized by at least six months of a more-or-less constant state of tension and worry not related to any event.

• Panic disorder is characterized by repeated, unprovoked attacks of anxiety or terror generally lasting about 10 minutes.

• Phobias are irrational, involuntary and overwhelming fears that lead a person to avoid, or endure with great anxiety, common objects, events or situations, including social situations and being out in public.

• Obsessive-compulsive disorder is characterized by recurrent, persistent and intrusive thoughts or impulses that the person feels can be controlled by performing repetitive behaviors.

• Post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

How can I tell if I have an anxiety disorder?

If you feel "on edge" most of the time; if you experience panicky feelings, sweating, rapid heartbeat, and difficulty breathing around specific objects or situations; if you feel compulsions to perform specific and time-consuming rituals; if you have recurrent disturbing thoughts; if you regularly experience distressing sleeplessness, irritability, difficulty concentrating; and if these feelings persist or impair normal functioning, you should discuss them with your health care professional.

How are anxiety disorders treated?

Most anxiety disorders respond well to treatment, usually medication and/or cognitive-behavior therapy. Specific medications have been developed to combat anxiety, with antidepressant medications such as SSRIs particularly useful. Behavioral therapies help patients regain control of their reactions to stress and feared objects or situations.

Do anti-anxiety medications have side effects? How long will I have to take this medication?

The newer antidepressants, including serotonin reuptake inhibitors, cause fewer side effects than the older types of drugs used to treat anxiety. Both types of medication can cause side effects such as nausea, drowsiness, gastrointestinal upset, anxiety and insomnia, which may subside after about a month. Most people make the mistake of stopping the medication when they first start to experience side effects or without speaking to their health care professional about the side effects. Sexual dysfunction (impotence, loss of desire, inability to reach orgasm) is a common side effect of some medications. Because many types of anti-anxiety medications are available, it is likely that one can be identified that produces the fewest side effects with best results. Most people don't have to take anti-anxiety medications forever. Once your anxiety subsides, you can determine with your health care team what the best course is for you. Short-term treatment, from six months to one year, is common. But longer treatment may be necessary to prevent a recurrence. People who have recurrent anxiety disorder may need to take medication for the rest of their lives.

Can anti-anxiety medications be taken during pregnancy or breast feeding?

If you are nursing, pregnant, plan to become pregnant, or could possibly become pregnant, you should discuss with your health care professional the possible effects of any medications. If the mental health of an expectant mother depends on taking antidepressants during pregnancy, many health care professionals recommend that she continue taking the drugs, so she can care for herself and her family. Research is unclear about how antidepressants may affect a nursing baby though it is known that these drugs pass through to breast milk. Most health care professionals suggest that a woman who is taking anti-anxiety medication and is concerned about breast-feeding options consider the risks of taking medication along with the potential benefits that nursing could provide.

What's the first step in getting treatment?

If you think you may have an anxiety disorder, talk to a primary care physician about your symptoms and ask for a referral to a medical professional who can diagnose and treat anxiety. There are many good sources of information about anxiety and other types of mental illness on the Web, through libraries and from mental health organizations. Many organizations have hotlines to help get you started talking about symptoms. If you feel suicidal, seek help immediately.