Anxiety

What is anxiety?

Anxiety is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress — for example, before an exam or an important decision. A little anxiety can help you focus. But for people with anxiety disorders, the fear is not temporary and can be overwhelming.

What are anxiety disorders?

Anxiety disorders are conditions in which anxiety does not go away and can get worse over time. The symptoms can interfere with daily life — work, studies, and relationships. Anxiety disorders are among the most common mental health conditions worldwide: the WHO estimated 359 million people were living with one in 2021. Effective treatment exists — but globally, only about 1 in 4 people who need treatment receive it. Common barriers include lack of awareness, social stigma, and limited access to mental health services.

What are the types of anxiety disorders?

There are several types of anxiety disorders, including:

• Generalised anxiety disorder (GAD). People with GAD worry about ordinary issues such as health, money, work, and family. Their worries are excessive, and they have them almost every day for at least 6 months.
• Panic disorder. Sudden, repeated periods of intense fear, when there is no real danger. Attacks come on quickly and can last several minutes or more.
• Phobias. An intense fear of something that poses little or no actual danger — spiders, flying, crowded places, or social situations (known as social anxiety).

What causes anxiety disorders?

The exact cause of anxiety disorders is unknown. Genetics, brain chemistry, stress, and your environment may all play a role.

Who is at risk for anxiety disorders?

Risk factors vary by type. GAD and phobias are more common in women, while social anxiety affects men and women equally. General risk factors include:

• Certain personality traits, such as being shy or withdrawn in new situations
• Traumatic events in childhood or adulthood
• A family history of anxiety or other mental disorders
• Some physical conditions, such as thyroid problems or arrhythmia

What are the symptoms of anxiety disorders?

Different anxiety disorders have different symptom patterns, but they share a combination of:

• Anxious thoughts or beliefs that are hard to control. They make you feel restless and tense, and interfere with daily life.
• Physical symptoms — a pounding or rapid heartbeat, unexplained aches, dizziness, shortness of breath
• Changes in behaviour, such as avoiding things you used to do

Caffeine, certain other substances, and some medicines can make symptoms worse.

How are anxiety disorders diagnosed?

To diagnose an anxiety disorder, a doctor will ask about your symptoms and medical history. You may also have a physical exam and lab tests to rule out other causes.

If no physical cause is found, you may get a psychological evaluation — either from your doctor or a mental health professional.

What are the treatments for anxiety disorders?

The main treatments are psychotherapy (talk therapy), medicines, or both:

• Psychotherapy helps you recognise and change troubling emotions, thoughts, and behaviours. Cognitive behavioural therapy (CBT) teaches new ways of thinking and reacting. Exposure therapy helps you confront fears you've been avoiding. Acceptance and commitment therapy uses mindfulness and goal-setting.
• Medicines — selective serotonin reuptake inhibitors (SSRIs) and related antidepressants are the usual first-line medicines for anxiety disorders. Benzodiazepines are effective for short-term relief but are generally NOT recommended for long-term use because of the risk of dependence; WHO specifically advises against them as an ongoing treatment. Work closely with your doctor to find the right medicine — you may need to try more than one.

Alongside treatment, several self-help practices can reduce anxiety symptoms — they are not a replacement for treatment, but they add up:

• Slow breathing and progressive muscle relaxation — evidence-based techniques that calm the nervous system. Pranayama (yoga-based breathing) works through the same mechanism.
• Regular exercise — walking, running, swimming, or yoga can meaningfully reduce anxiety and improve sleep.
• Regular sleep, on a consistent schedule
• Regular meals, and limiting caffeine and alcohol (both can worsen anxiety)
• Mindfulness or meditation practice, even a few minutes a day
• Talking about your feelings — with a friend, family member, or professional counsellor. Support groups can also help.

In India, mental health care can be accessed through private practitioners, general-hospital psychiatry wards, and district-level government mental-health services. A general doctor can refer you to a specialist if needed.