Anxiety disorders

Compared to normal and healthy feelings of anxiety, anxiety disorders involve excessive stress, fear, anxiety and panic—even causing panic attacks. Fortunately, medications and therapy usually provide immense relief.

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Causes, triggers and common symptoms of anxiety disorders

Many factors can combine to cause anxiety disorders, but the two main causes are genetics and the environment.

Some families have a higher-than-average number of anxiety disorders, and some events, like a traumatic experience, can result in an anxiety disorder—anything related to these events can be a trigger for symptoms to appear.

Each type of anxiety disorder has unique symptoms, but all anxiety disorders share the symptom of persistent and excessive fear or worry in nonthreatening situations. Persons with anxiety disorders may also experience:

  • Depression and constant negative thoughts.
  • Feelings of apprehension or dread.
  • Headaches, fatigue and insomnia.
  • Pounding or racing heart and shortness of breath.
  • Restlessness, irritability or jumpiness.
  • Sweating, tremors and twitches.
  • Upset stomach, frequent urination or diarrhea.
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If any of these symptoms are interfering with your daily life, make an appointment with your primary care provider for help.

When to see your doctor — and what to ask

It’s time to see your doctor if you:

  • Are worrying so much that it is interfering with your life.
  • Have trouble with drinking or drugs because of your anxiety.
  • Have other mental health concerns along with anxiety.

Without treatment, symptoms of anxiety disorder may get worse over time, so get treatment as soon as you think you might need it.

If you have suicidal thoughts or behaviors, get emergency treatment immediately.

When you see your provider, discussing these topics will help you both develop the right treatment plan for your case:

  • Cause(s) of your symptoms.
  • Medications that you take now.
  • Medications that can treat your condition.
  • Other possible issues or physical health problems.
  • Referral to a psychiatrist, psychologist or other mental health professional.
  • Tests.
  • Treatment recommendations.

Diagnosing an anxiety disorder

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Your provider will take your medical history and perform a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition. Your provider might then order blood, urine or other tests.

If a physical condition is ruled out, your provider or a mental health professional would then use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to identify the specific type of anxiety disorder causing your symptoms, as well as any other possible disorders that may be involved.

Types of anxiety disorders

There are several types of anxiety disorders, each with different symptoms. According to the National Alliance on Mental Illness, the most common types of anxiety disorders are:

Generalized anxiety disorder (GAD). GAD produces chronic, exaggerated worrying about everyday life that can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

Obsessive-compulsive disorder (OCD). Patients have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.

Panic disorder. Characterized by panic attacks and sudden feelings of terror, sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.

Phobias. Certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

Social anxiety disorder. More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g., saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Other anxiety disorders include:

  • Selective mutism.
  • Separation anxiety disorder.
  • Substance/medication-induced anxiety disorder, involving intoxication or withdrawal or medication treatment.

Post-traumatic stress disorder (PTSD) is an associated psychiatric disorder with some symptoms in common with anxiety disorder, but requires a specialized treatment approach.

Treatment options for anxiety disorders

Different anxiety disorders have their own distinct sets of symptoms. Your provider will work with you on a treatment plan based on your condition and symptoms, which will start with medications and psychotherapy:


  • Anti-anxiety medications. Reduce the emotional and physical symptoms of anxiety, but because they only treat symptoms, they are not necessarily a long-term solution.
  • Antidepressants. Can also be useful for preventing anxiety, especially if your anxiety is connected to your depression.


  • Cognitive behavioral therapy (CBT). Focuses on your reactions to events rather than the events, and also gives you strategies to reduce the beliefs and behaviors that lead to anxiety symptoms.
  • Exposure and response prevention. Used for specific anxiety disorders like phobias and social anxiety. You would “expose” yourself to that fear repeatedly so that you develop specific coping tools and experience less anxiety over time.

Complementary health approaches

Your provider will also discuss complementary health approaches that you can manage yourself, such as:

  • Exercise. Aerobic exercise can have a positive effect.
  • Self-management strategies. Our patients who become experts on their condition and its triggers gain more control and feel better. One tool is allowing for specific periods of time each day for worrying.
  • Stress and relaxation techniques. Breathing exercises and focused attention can calm the mind and body.
  • Yoga. The combination of exercise and meditation can be very helpful.

Many of our patients have found lifestyle changes to be helpful additions to their medication and therapy treatments.

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Lifestyle and home remedies

Avoid alcohol and recreational drugs, as they can worsen anxiety. And quit smoking and cut back or quit drinking coffee, as both nicotine and caffeine can worsen anxiety. And keep in mind the following:

  • Eat healthy. Plenty of vegetables, fruits, whole grains and fish.
  • Physical activity. A routine to keep you active most days of the week can improve your mood and help you stay healthy.
  • Relaxation techniques. Visualization techniques, meditation and yoga can help.
  • Sleep habits. Make sure you are getting enough sleep. See your primary care provider if you need help.

You can also try herbal remedies and supplements, which have helped some of our patients. Keep in mind that more research is needed to fully understand the risks and benefits of these treatments.

Alternative medicine remedies and supplements

  • Kava
  • Passionflower
  • Theanine
  • Valerian


National Institute of Mental Health (NIMH). Anxiety Disorders (

U.S. Department of Health & Human Services (HHS). What are the five major types of anxiety disorders? (

MedlinePlus: National Library of Medicine. Anxiety (