What is a psychological disorder in which an individual has an irrational overwhelming persistent fear of a particular object or situation?

Anxiety is the most common mental health condition in Australia. Up to 1 in 3 women and 1 in 5 men will experience an anxiety disorder in their lifetime.

Everyone experiences anxiety at times. Anxiety is a natural and helpful physical response to a threat. It elevates our energy and alertness to help us escape from danger. However, for some people, this is an ongoing experience which does not go away.

People with anxiety disorders experience excessive and irrational fears, worries or thoughts which become very distressing. Their anxiety affects their daily lives and impairs their ability to carry out ordinary tasks like work, study or sleep. It often hurts relationships and may lead to social isolation. It is common for people with anxiety disorders to experience co-occurring mental health problems like depression and substance abuse.

Anxiety can be treated and managed. In this article, we introduce the most common anxiety disorders and how they can be diagnosed and treated.

Here’s everything you will need to know:

Types of anxiety and their symptoms

The most common anxiety disorders are generalised anxiety disorder (GAD), specific phobias, social phobia or social anxiety disorder (SAD), panic disorder and agoraphobia. Obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are no longer classified as anxiety disorders in the DSM-5, but we will include them in this article as they often have a significant anxiety component.

Other types of anxiety disorders include separation anxiety disorder, selective mutism, substance/medication-induced anxiety disorder and anxiety disorder due to another medical condition.

Features and symptoms of anxiety

• Chronic (constant) fears or thoughts that are distressing and interfere with daily life
• Going to extra lengths to avoid a potentially anxiety-inducing situation
• Panic or anxiety attacks and/or a fear of these attacks
• Physical reactions like trembling, sweating, feeling faint or dizzy, nausea, rapid heartbeat, breathing difficulties, numbness or tingling, gastrointestinal problems, “out-of-body” sensation, muscle tension and soreness.

The following section provides an overview of the most common anxiety disorders.

Generalised anxiety disorder (GAD)

Generalised anxiety disorder (GAD) is characterised by excessive ongoing worry about many things for no apparent reason. People with GAD cannot stop worrying about family, friends, health, work, money or school. Their worries are often unrealistic and out of proportion to the situation. They constantly feel a sense of impending danger or disaster and are always in a state of worry, tension, fear, and dread.

This leads them to feel nervous, irritable, restless, or edgy. They have difficulty concentrating and/or sleeping and may often feel weak or fatigued. This overwhelming anxiety impedes their ability to perform routine tasks, affects work or school, and impacts their relationships and social life. If a person experiences these symptoms on most days over a six-month period, they may have GAD.

Nearly 6% of Australians will experience GAD in their lifetime (source). It is common in all age groups and more common in women than in men. It comes on gradually and can begin at any time in life. People with GAD often also have other anxiety disorders, depression or problems with drug or alcohol misuse.

Specific phobias

Specific phobias refer to an intense, persistent, and irrational fear of a particular object or situation. This fear is so severe that exposure to a specific object or situation brings about an immediate reaction, causing intense distress and/or panic attacks.

Types of specific phobias:

• Animal phobias: e.g. fear of dogs, snakes, insects
• Situational phobias: e.g. fear of flying, driving, elevators, bridges, tunnels, confined spaces (claustrophobia)
• Natural environment phobias: e.g. fear of storms, heights, water
• Blood-Injection-Injury phobias: e.g. fear of blood, injury, injections, blood tests
• Other phobias: e.g. fear of falling down, clowns, vomiting.

People with specific phobias experience anticipatory anxiety about the possibility of encountering their phobia. They often go out of their way to avoid specific situations, objects, people, or places. This can significantly restrict their lives and interfere with their ability to function. Adults with specific phobias often recognise that their fear is excessive or unreasonable but are unable to overcome it.

Specific phobias affect 11% of Australians. Women are twice as likely than men to be diagnosed with this. Specific phobias often develop during childhood and adolescence. Over 75% of people with a specific phobia experience multiple phobias over their lifetime.

Social phobia (social anxiety disorder)

People with social phobia or social anxiety disorder (SAD) have an intense and overwhelming fear of being judged, embarrassed or humiliated. This fear causes them to avoid social encounters or public situations where they think they could be humiliated. This avoidance of people and activities impedes their ability to function. For some, it could even lead to severe isolation.

It is normal to feel nervous in certain social situations – for instance, most of us get anxious about giving a presentation but are able to get through it. For people with social phobia or social anxiety disorder, this stress is unbearable. They feel extremely uncomfortable and self-conscious in social or public situations and would go to extra lengths to avoid social contact.

Common situations that may affect people with social anxiety:

• Talking to strangers
• Public speaking
• Using public toilets
• Eating in public
• Starting conversations
• Making small talk
• Dating
• Making eye contact
• Going to parties
• Going to school or work.

People with society anxiety disorder spend a lot of time worrying about an upcoming event and experience intense anxiety right before the event. After the event, they usually spend lots of time and energy worrying about how they acted.

Up to 13% of Australians may develop social phobia during their lifetime. It tends to affect more women than men. The condition often starts in childhood or adolescence.

Panic disorder and agoraphobia

People with panic disorders have frequent and recurring panic attacks. A panic attack is a sudden, intense episode of fear resulting in physical symptoms like breathlessness, lightheadedness, sweating, shaking, chest pain and heart palpitations. Some people may feel like they’re choking or having a heart attack. They may also feel out of control or detached from themselves and their surroundings. A panic attack could occur suddenly without any triggers.

Many people experience panic attacks. However, panic disorders only affect about 2% of the Australian population. A person with a panic disorder would typically have at least four panic attacks each month. These feelings of overwhelming distress often come on spontaneously and may not be related to any specific situation. Their panic attacks are unpredictable and could happen whether they’re feeling anxious or calm. They live in constant fear of having another panic attack.

A person with panic disorder may also have agoraphobia. This means they fear public places as they may trigger a panic attack. They are afraid to leave what they consider to be their “safe” environments. In some cases, a person with agoraphobia may not leave their home for days, months or even years.

Obsessive-compulsive disorder

People with obsessive-compulsive disorder (OCD) experience persistent and intrusive thoughts, images or impulses (obsessions), which cause repetitive and ritualistic behaviours (compulsions) as a way of controlling or eliminating those thoughts. This ends up being very distressing and time-consuming, interfering with their daily life.

Common obsessions and compulsions:

• Obsessive fear of germs or contamination leading to compulsive need to wash and clean
• Obsessive worries about forgetting to lock doors or turn off appliances leading to compulsive need to check things like taps, locks, or stoves
• Obsessive preoccupation with following certain patterns leading to compulsive need to count objects like lines on the pavement
• Other common compulsions include hair pulling, skin picking, hoarding, excessive praying and more.

Most people with OCD are aware that their behaviours are irrational and excessive but are unable to control their obsessions or resist their compulsions. They often feel embarrassed about their condition and try to keep it a secret. This may prevent them from seeking help. However, OCD is curable and they should seek treatment as soon as possible to regain control of their lives.

OCD affects 2-3% of the Australian population. It usually begins in late childhood or early adolescence. It can become a chronic condition without proper treatment. People who suffer from OCD are also more likely to develop other anxiety disorders or depression.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a condition that may occur after a traumatic event. It can be caused by experiencing, witnessing, or being threatened with a traumatic event such as serious injury, violence, or death.

For people with PTSD, their feelings of fear and avoidance associated with the event do not go away. These distressing feelings remain for a long time, causing symptoms that interfere with their ability to cope with daily life.

Symptoms of PTSD include:

1. Re-experiencing the trauma

• Uncontrollable, repetitive, intrusive memories or flashbacks
• Disturbing memories or thoughts triggered by smells, sounds, words, or other things
• Nightmares

2. Avoiding reminders of the event

• Avoiding places, people, or objects that may trigger memories of the event
• Changing routines and behaviour to avoid triggers
• Avoiding talking or thinking about the event

3. Negative changes in thoughts and mood

• Intense worry, depression, anger, guilt
• Negative beliefs about oneself and the world
• Unreasonable blame towards oneself or others
• Emotional detachment and numbness

4. Increased arousal or edginess

• Chronic and excessive alertness
• Irritability or aggressiveness
• Poor concentration
• Sleeping difficulties

12% of Australians experience PTSD (source), with women being at almost twice the risk of men. Symptoms could appear in the month after the traumatic event or may sometimes stay dormant for years. If a person experiences these symptoms longer than a month after the event, it could be a sign of PTSD.

Diagnosis

If you are experiencing symptoms of anxiety which are causing distress or interfering with your daily life, it is important to seek professional help. Your GP can give you a referral to a psychologist and a Mental Health Treatment Plan which will let you access 20 Medicare-subsided psychology sessions.

Your psychologist will seek to understand your symptoms and use tools and tests to provide a diagnosis on the type of anxiety disorder or mental health condition you’re experiencing. From there, they will be able to create a treatment plan tailored to your specific condition and needs.

To start, you may want to try this Anxiety and Depression Checklist to measure your current range of distress. This checklist does not give a diagnosis but can help you seek support. Bring your responses to your GP and psychologist who will then help with your diagnosis and treatment.

Recovery is possible with treatment

Good news – it is possible to recover from anxiety! Anxiety disorders can be managed with treatment. It is essential to get the right support and understand your treatment options. Many people who have received treatment are able to live healthy and fulfilling lives. If left untreated, anxiety can worsen and last for a long time.

Psychological therapy is the most effective treatment for anxiety. Many people are able to reduce or eliminate symptoms within a few months of therapy, with many experiencing improvements after their first few sessions. Therapy also helps to prevent relapse in the long-term.

Common psychological treatments for anxiety:

• Cognitive behaviour therapy (CBT) — aims to change problematic patterns of thinking and behaviours that fuel anxiety
• Exposure therapy – gradual exposure to fears in a safe and controlled environment
• Interpersonal therapy (IPT) – focuses on relationships and social functioning to help alleviate anxiety
• Acceptance and commitment therapy (ACT) – accepting problematic thoughts and committing to behavioural change to align with life values
• Mindfulness-based therapy (MBT) – using mindfulness techniques like meditation to increase self-awareness, stay present and calm the mind
• Narrative therapy – separates the individual from their lived experiences to understand and re-write the stories that shape their lives

Your exact treatment will depend on your specific anxiety disorder and its severity. Your psychologist will also consider your personal preferences and requirements. In some cases, medicine may be recommended in combination with therapy. Your psychiatrist will determine whether this is suitable or necessary for you.

Where to get help

Your local community

• GP
• Psychologist
• Psychiatrist
• Counsellor
• Social worker
• Occupational therapist
• Mental health nurse
• National Mental Health Helpline 1300 MHF AUS (643 287)

Online options

• myCompass – free self-help program proven to relieve symptoms in people experiencing mild-to-moderate anxiety and depression
• MoodGYM – free self-help program to teach CBT skills to people vulnerable to depression and anxiety
• HeadGear – free app that guides you through a 30–day mental fitness challenge designed to build resilience and prevent depression and anxiety
• This Way Up – online courses with clinically-proven strategies for anxiety
• OnTrack – free online mental health programs and resources
• Head to Health – free mental health resources from the Australian Government
• Mental Health Online – free mental health services and programs
• e-couch – online programs with evidence-based strategies for anxiety
• MindSpot Clinic – free online assessment and treatment for anxiety

For young people under 25

• BITE BACK
• eHeadspace
• ReachOut
• Youthbeyondblue
• OCD? Not me!

If you are thinking about self-harm or suicide, seek help immediately by calling an ambulance on 000 or Lifeline on 13 11 14.

Frequently asked questions

Are anxiety disorders genetic?

Genetics could be a contributing factor. Anxiety disorders can run in families and have a biological basis. Often, anxiety disorders develop from a complex set of factors.

What causes anxiety disorders?

Anxiety disorders are caused by a complex mix of factors including genetics, brain chemistry and environmental stress.

Some risk factors may make you more likely to develop an anxiety disorder. These include a history of mental health conditions, trauma, negative life events, chronic illness and substance abuse.

Can anxiety disorders cause physical illness?

Anxiety comes with physical symptoms. If left untreated, prolonged anxiety can affect your physical health. Studies show that people with intense anxiety have a higher risk of hypertension. This can cause damage to the heart, kidneys and blood vessels. Anxiety can also cause abdominal aches and gastrointestinal problems.

What is the difference between anxiety and depression? How common is it to have both?

Anxiety is characterised by persistent worry and fear about everything or specific situations. Depression is characterised by low mood, loss of interest or enjoyment in activities and feelings of hopelessness.

They are different conditions but share similar symptoms such as sleeping difficulties, irritability, appetite changes, fatigue, concentration issues, muscle tension and headaches.

Many people with depression have a history of an anxiety disorder. While there’s no evidence that one causes the other, it is common for people to suffer from both disorders.

What age do anxiety disorders develop?

Anxiety can develop at a young age or later in life. It affects people of all ages.

Is it possible to get rid of anxiety or is this just my personality? Will anxiety go away on its own?

Everyone experiences anxiety at times – it comes and goes as a natural part of the human experience. Usually, anxiety is related to a specific situation and would go away after the situation has ended.

However, if your anxiety is persistent regardless of the situation, it could interfere with your daily activities and impair your ability to function. This could be an anxiety disorder and it is unlikely to go away on its own without any treatment. It is possible to recover from anxiety; you don’t have to live with it for the rest of your life. If you find that your anxiety is affecting your everyday life, it is important to seek professional help. There are various types of treatments which can help you manage symptoms and improve your quality of life.

How long does it take to recover from anxiety?

Anxiety responds very well to psychological treatments. How long it takes for you to recover depends on your individual condition, type of treatment and whether you have other coexisting mental health conditions.

Psychological therapy is the most effective treatment for anxiety. Many people who have gone to therapy report improvements within a few sessions, and many are able to reduce or eliminate symptoms within a few months.

Do I need to take medication for anxiety?

This will depend on the severity of your anxiety disorder, other medical conditions and your individual circumstances. Medication could be a short or long-term option used in conjunction with therapy. Your psychiatrist will be able to help you determine whether medication is required for your specific condition.

Are OCD and PTSD anxiety disorders?

OCD and PTSD used to be classified as anxiety disorders in the DSM-5. In 2013, they were moved to the “obsessive-compulsive and related disorders” category and “trauma and stress-related disorders” category respectively.