Anxiety Disorders

Your heart is racing; it’s pounding so hard you feel like it is coming out of your chest. Your mouth has gone dry but at the same time, sweat has broken out all over your body. Dizziness and nausea are threatening to overwhelm you and you can’t catch your breath. Do you have an anxiety disorder?

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We all have times when we are nervous or fearful about a particular situation, and we experience any or all of the symptoms described above. Your nervousness can even temporarily interfere with your ability to cope; this is normal. However, if these symptoms create ongoing, significant distress that causes disruption in daily living, you may have an anxiety disorder.

Symptoms

The following symptoms can affect any individual for a short period of time. It is only when they are prolonged, severe and disruptive to your life, which you may need to consider if you have an anxiety disorder. Symptoms can include:

  • Racing pulse, heart palpitations, possibly even chest pain;
  • Shortness of breath, panting, dry mouth;
  • Blushing;
  • Nausea and/or vomiting;
  • Trembling, shaking, muscle tension;
  • Dizziness;
  • Hot flashes and sweating, or chills;
  • Difficulties with sleep;
  • Inability to concentrate.

There are different kinds of anxiety disorders:

  • Panic Disorders – “Panic attacks” are associated with these disorders. They can strike without warning and are accompanied by feelings of terror that range from mild to extreme. The fear experienced by those with a panic disorder is powerful, unpredictable and overwhelming. After experiencing a panic attack, some people become so frightened of having another, they avoid any situation where they cannot escape or find help. As a result, they will not take public transit, go to shopping malls, or in some cases venture outside their homes. This is called a panic disorder with agoraphobia.
  • Social Anxiety Disorder – Social anxiety disorder involves intense fear of being embarrassed or evaluated negatively by others. As a result, people avoid social situations. This is more than shyness. It can have a big impact on work or school performance and relationships.
  • Phobias – Phobias are usually divided into two categories: specific and social. People with a specific phobia have an uncontrolled, irrational fear of something in particular. It could be an object, situation, animal, activity or anything else that is significant to that person. Whatever it is, the individual experiences inexplicable levels of fear and will often go to extremes to avoid encountering it. Social phobias describe excessive anxiety over social situations. These fears go beyond average apprehension over such things as mingling at a party or self-consciousness, but extend to extreme feelings of anxiety. People with social phobias would rather avoid a gathering of people than suffer the anxiety that accompanies the situation.
  • Post-Traumatic Stress Disorder (PTSD) – Following a life-threatening experience or one that caused physical or emotional harm, a person can experience PTSD. Examples of incidents that can cause PTSD include rape, child abuse, war or natural disaster. With this disorder, people not only experience symptoms described previously, they can also have flashbacks of the incident, nightmares, depression, uncontrolled anger and irritability.
  • Obsessive-Compulsive Disorder (OCD) – People with OCD have unwanted, persistent thoughts (obsessions) and a need to perform repetitive activities (compulsions) that can overtake their lives. A person with obsessions often knows that their thoughts are irrational and excessive, but they cannot ignore them. Examples of obsessive thought include worrying about contamination, fears and worries over things done or not done, sexual or religious fixations. In an attempt to relieve their intrusive thoughts, people with OCD resort to compulsive habits, which have very specific “rules”. These excessive habits provide temporary relief, however the obsessive thoughts soon return. Examples of compulsive behaviour include things like repetitive hand washing, constant organizing and endless checking and counting.
  • Generalized Anxiety Disorder (GAD) – Repeated, exaggerated worrying for more than six months characterizes GAD. People with GAD have disproportionate levels of worry over routine events and activities that others feel are of minor concern; they are always expecting the worst, and constantly “disasterizing”. Many people experience physical symptoms too, including muscle tension and sleep problems.

Anxiety disorders can affect anyone at any age, and they are the most common mental health problem. Sometimes, anxiety disorders are triggered by a specific event or stressful life experience. Anxiety disorders may be more likely to occur when we have certain ways of looking at things (like believing that everything must be perfect) or learn unhelpful coping strategies from others. But sometimes there just doesn’t seem to be a reason. Anxiety disorders are not the “fault” of the person experiencing them, nor are they a weakness in character. In fact, research shows that these disorders are most likely a combination of complex biological and psychological factors, as well as exposure to challenging situations earlier in life. Scientists have discovered that the biological factors of anxiety disorders include possible genetic causes (as these disorders often run in families), changes in brain chemicals called neurotransmitters, and alterations in certain areas of the brain.

Psychological factors include the ways people learn to think about certain situations or cues, the fears they associate with things, and the amount of control they believe they have over events or situations. Termed the “cognitive behavioural” factors, they also form the basis of treatment. Some researchers also include “developmental” factors as a pre-cursor to an anxiety disorder. These factors are the result of childhood experiences that shape the way an adult deals with anxiety. How we think and react to certain situations can affect anxiety. Some people may perceive certain situations to be more dangerous than they actually are (e.g., fear of flying). Others may have had a bad experience and they fear this will happen again (e.g., a dog bite). Some psychologists believe that childhood experiences can also contribute to anxiety.

Researchers know that problems with brain chemistry can contribute to the development of anxiety disorders. Certain neurotransmitters (chemical messengers) in the brain involved in anxiety include serotonin, norepinephrine, and gamma-aminobutyric acid (GABA). Researchers have also shown that changes in activity in certain areas of the brain are involved in anxiety. Many anxiety disorders run in families and likely have a genetic cause. Certain medical conditions such as anemia and thyroid problems can also cause symptoms of anxiety. As well, other factors such as caffeine, alcohol, and certain medications can cause anxiety symptoms. Traumatic life events such as the death of a family member, witnessing a death, war, and natural disasters such as hurricanes and earthquakes may trigger anxiety disorders.

Many people who experience an anxiety disorder think that they should just be able to ‘get over it’ on their own. Others may need time to recognize how deeply anxiety affects their life. However, anxiety disorders are real illnesses that affect a person’s well-being. It’s important to talk to a doctor about mental health concerns. Some physical health conditions cause symptoms of anxiety. A doctor will look at all possible causes of anxiety. Normal, expected anxiety is part of being human. Treatment should look at reducing unhelpful coping strategies and building healthy behaviours that help you better manage anxiety. If you suspect that you or someone you care about has an anxiety disorder, the first thing you should do is talk to your family doctor. Have a complete physical examination to make sure there are no underlying ailments such as anemia or a thyroid problem mimicking the signs of an anxiety disorder.

If your family doctor feels you have an anxiety disorder, they will discuss treatment options. Two main types of treatment are often prescribed:

  1. Cognitive-behavioural Therapy (CBT) – One-on-one CBT, or in small group is very effective in helping with anxiety disorders. During the cognitive portion of the sessions, a therapist assists individuals in identifying their anxiety-producing thoughts and then in evaluating their validity. When focusing on the behavioural portion of therapy, individuals are challenged in small, manageable steps, to face the situations that provoke their anxiety, and through gradual exposure, learn to control their fears. Depending on the disorder, CBT may be prescribed as the only treatment approach.
  2. Medication – Due to the biological factors contributing to anxiety, prescribed medications targeted at the brain’s chemical messengers can also be helpful. It may also make anxious thoughts less frequent or intense, so it can be easier to learn helpful coping strategies. Some people take medication until their anxiety is controlled enough to try therapies like CBT. These include classes of drugs known as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI) and benzodiazepines.

Let’s not forget about the things you can do on your own. You need to be an active member of your mental health team. Take a proactive role in your well-being and make lifestyle choices that are mindful and healthy.

  • Join a support group if your community has one: It is important for you to network with others who are also asking questions about their illness and looking for coping strategies to help them with their disorder;
  • Eat a healthy diet: A well-balanced, nutritious diet is important for overall health;
  • Avoid alcohol, caffeinated beverages and illegal drugs: While it is tempting to seek emotional relief from substances, they often increase your anxiety and can trigger panic attacks;
  • Stop smoking: Try to cut down or even quit smoking. As you cultivate a healthy body, you will feel great about getting rid of this habit;
  • Exercise: Get active and stay active. Physical activity has been proven to improve mood and a sense of calm;
  • Stress management: Find a course on stress management and seek ways to reduce your stressors and your perception of them;
  • Try meditation and other activities that calm the mind: Sitting or moving meditations such as tai chi and yoga are beneficial to calming the mind;
  • Get a good night’s sleep: You need sufficient sleep to help you feel good the next day, so be sure to get enough rest at night;
  • Share your feelings: Nurture your relationships just as they in turn nurture you. Empower your own capacity to heal by making lifestyle choices that work for your mental health. A healthy body helps a healthy mind.

Supporting a loved one who is experiencing an anxiety disorder can be difficult. You may not understand why your loved one feels or acts a certain way. Some people who experience an anxiety disorder feel like they have to do things a certain way or avoid things or situations, and this can create frustration or conflict with others. You may feel pressured to take part in these behaviours or adjust your own behaviours to protect or avoid upsetting a loved one. Support can be a delicate balance, but you should expect recovery—in time. Here are some general tips:

  • Remind yourself that the illness is the problem— anger, frustration, or behaviours related to anxiety are nobody’s fault.
  • Be patient—learning and practicing new coping strategies takes time.
  • If your loved one is learning new skills, offer to help them practice.
  • Listen and offer support, but avoid pushing unwanted advice.
  • Set boundaries and seek support for yourself, if needed.
  • If other family members are affected by a loved one’s anxiety disorder, consider seeking family counselling.

Reach Out for Help

Whether you or someone you care about, is experiencing an anxiety disorder, the future does not have to be bleak. Don’t let fear or embarrassment stop you – find out more about the help that is available in your community. We can help you turn the tables and gain control of your life. Take the first step and reach out for help today. You can also contact the Canadian Mental Health Association – Calgary Region for more information at
(403) 297-1700 or email: info@cmha.calgary.ab.ca.