The common feature of all anxiety disorders is that of threat intolerance.  For those affected by anxiety disorders there is the perception that harm will occur if threat is not avoided entirely.  The threat of harm could be real or imagined.  Harm can also be to physical and emotional well-being or to status and position.  Everyone worries.  What separates the chronically anxious from others is the persistence of symptoms that disrupt the person’s social, relationship and work-life performance.  Anxiety disorders are the most common mental disorders in society affecting about 18% of the U.S. adult population[1].

The brain is hardwired to experience anxiety.  There are real threats, so anxiety is protective in nature.  For some, there is an overreaction to stress perhaps resulting from the interaction of genetic predisposition and the environment or what is termed stressors.  It is known that anxiety disorders tend to run in families.  Anxiety disorders are carry a high comorbidity with other mental disorders such as depression and substance abuse.   The National Institute of Mental Health characterizes the following anxiety disorders[2]:

• Generalized Anxiety Disorder (GAD): persistent worry about life circumstances such as in employment, finances, relationships, and health. The worry is excessive despite the circumstances, and although recognized as unwarranted, individuals are not easily able to calm themselves;
• Social Anxiety Disorder (SAD):  a chronic fear of being negatively evaluated and judged by other individuals.  Persons with SAD may habitually avoid certain social situations or tolerate them with extreme discomfort.  They are prone to being embarrassed easily thus affecting the formation and maintenance of relationships;
• Panic Disorder: an intense, unexpected, and sudden fear reaction characterized by heart palpitations, sweating, a feeling of impending doom, unreality, and shortness of breath that becomes associated with a specific activity such as driving and going to a public event.  Avoidance of those activities can become chronic and disabling;
• Specific Phobia:  an intense fear reaction to a specific object or situation that is unrealistic and persistent.  Common specific phobias include heights, insects, public speaking, and flying.  If the situation is avoided, anxiety is not typically experienced, but the consequences to lifestyle and personal enjoyment can be profound;
• Post-Traumatic Stress Disorder (PTSD): as the name implies this is an anxiety disorder that develops after experiencing a potentially life threatening trauma and/or upon witnessing the sudden death of people to war, physical and sexual assault, accident, natural disaster and crime.  Extreme fight-or-flight occurs when affected persons are exposed to triggers such as flashbacks, memories, thoughts, feelings, dreams, and places or situations that are like the original trauma.  Anxiety persists long after the danger has passed.  In severe cases, affected persons associate those situations with danger and they are avoided at all costs.

The most effective treatment for anxiety disorders is Cognitive Behavioral Therapy (CBT).  CBT teaches folks to feel better through a variety of techniques such as thought restructuring, behavioral activation, exposure, and experiments to test assumptions and disconfirm faulty beliefs.  CBT is effective in helping individuals to get the most out of life and to accomplished their most cherished goals in life

[1] Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.

[2] Any Anxiety Disorder Among Adults. (n.d.). Retrieved from https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml