Anxiety Disorders: Signs, Types, & Treatments

What Are Anxiety Disorders?

An anxiety disorder is a type of psychological condition that may occur due to fear, dread, worry, or distress.  

Anxiety disorders can also manifest as physical symptoms like a pounding heart, excessive sweating, shaking, or vomiting.  

In general, anxiety is a normal and sometimes even helpful emotion. We may feel anxious during an interview, before an exam, or while making an important decision like choosing our career options.

Sometimes, anxiety also helps us stay alert in dangerous situations. For example, you may feel anxious walking alone in an isolated street. This is your brain telling you to get to safety as soon as possible.

However, when our anxiety becomes so disproportionate to the situation, it is then that it affects our daily lives negatively. The out of proportion anxiety, if experienced frequently and for a long time, may result in an anxiety disorder.

An anxiety disorder may occur when:

• It negatively influences your ability to function (eg working, meeting friends)
• You find it hard to control your emotions during distress
• You cannot control your responses to situations 

Anxiety disorders can affect your work, relationship with parents, friendships, school performance, self-care, and other interpersonal relationships.

Fortunately, anxiety disorders can be treated. Interventions such as psychotherapy and CBT have proven effective in managing and reducing symptoms of anxiety.  

Types of Anxiety Disorders

There are several types of anxiety disorders. In this section, we will look into the 5 most common types of anxiety disorders.  

1. Generalised Anxiety Disorder

Generalised anxiety disorder, or GAD, involves persistent and uncontrollable worry about everything all the time that may affect a person’s quality of life.  

This persistent anxiety may also result in physical symptoms such as fatigue, chronic muscle pain, restlessness, or indigestion.  

GAD may also affect a person’s sleep, concentration, attention span, memory, and other cognitive abilities.  

In fact, GAD can make it hard to maintain relationships and function normally. For example, a person with GAD in a romantic relationship may constantly wonder if their boyfriend actually loves them.  

Similarly, a working employee may feel anxious about getting fired every day even if their work is efficient and meets the company’s needs.  

Other aspects of life that can be affected by GAD may include family health, physical health, social relationships, friendships, job responsibilities, healthcare, and minor tasks such as grocery shopping or making appointments.  

2. Panic Disorder

Panic disorders may occur when a person has recurrent, sudden, and intense panic attacks with or without a trigger.  

Panic attacks are an extreme fear response that may include a combination of mental and physical symptoms.  

Some of these signs may include the following:

• Palpitations or pounding heart
• Sweating, shaking, or feeling faint
• Chest pain
• Shortness of breath or smothering feelings
• A feeling of choking or nausea
• Abdominal pains
• Chills or muscle pains
• Fear of losing control
• Fear of death 

People who have panic attacks may believe that they are about to die or that they are having a heart attack due to the severity of the symptoms.  

Panic attacks can occur due to specific phobias or may even appear for no reason.  

A specific phobia is an intense fear of a particular object, situation, or event that is not generally harmful.

For example, people with agoraphobia may fear open spaces, enclosed spaces, crowds and specific situations. These people may experience severe panic attacks if they are triggered.  

3. Social Anxiety Disorder

Social anxiety disorder involves distressing thoughts and feelings of being embarrassed, humiliated, rejected, or hated by others during social interactions.  

People with social anxiety may become convinced that they have terrible social skills and that nobody likes them.  

Due to these negative thoughts, the person may completely avoid:

• Meeting new people
• Going out to places where they may see strangers
• Their friends
• Family members
• Social events like weddings or parties
• Graduation ceremonies
• Workplace or business events 

Fear or anxiety may prevent a person from living the life that they want. For example, they may struggle to maintain relationships or perform well in school.

The symptoms may usually appear during teenage years, and a person may be clinically diagnosed if the symptoms last for at least six months.  

4. Separation Anxiety Disorder

Separation anxiety disorder involves an extreme fear of separation from a loved one or from someone a person is strongly attached to.  

In most cases, the fear of separation is beyond what is appropriate for an individual’s age, lasts six months in adults, and affects daily functioning.  

Children are diagnosed with separation anxiety disorder if they experience the symptoms for more than four weeks.  

The person may constantly worry about losing the person closest to them and may be reluctant to part with them. For example, this person may refuse to leave their loved one’s side even during an important work trip, personal outings, or other events.  

They may fear separation so much that they have nightmares about distressing things happening if they leave their partner.  

Most symptoms of this disorder may occur during the childhood. However, the symptoms can manifest in completely unique ways for different adults.  

For example, while some people may struggle to fall asleep alone, others may struggle to stop thinking about their loved ones but can perform daily activities independently.  

Mental, behavioural, and physical symptoms of separation anxiety disorder can affect a person’s overall quality of life.  

5. Selective Mutism
Children and teenagers may usually have an anxiety disorder called selective mutism, where they do not speak or engage in some social situations.  

However, these are situations in which students may be expected to participate actively. For example, a student may not speak during a presentation, at school, or even with their teacher.  

The lack of communication may affect children’s lives and well-being in schools and workplaces, as people often misunderstand and resort to harmful methods to force the child to speak.  

The lack of speech may also influence their friendships, relationships with family members, and social communication.  

Selective mutism could po lead to other problems, such as a lack of social skills, isolation, loneliness, and depression.  

Children or adults with selective mutism may experience extreme shyness and fear of social embarrassment and may struggle with social anxiety.  

Behaviour modification techniques may sometimes be harmful for those with selective mutism.  

However, with sensitive and meaningful therapeutic interventions, children can learn to cope in school by practising other means of communication.

Symptoms of an Anxiety Disorder

The common symptoms of an anxiety disorder can be categorised into physical, mental, and behavioural symptoms.  

The signs may vary based on the type and severity of the anxiety disorder.  

For example, people with GAD may be anxious all the time about everything. In contrast, those with social anxiety may feel fear and dread only when thinking about or engaging in social situations.  

In general, however, all anxiety disorders may share a certain pattern in the signs and symptoms.  

The common physical symptoms of an anxiety disorder include:

• Sweating or shaking
• Cold and sweaty hands
• Dry mouth and gastrointestinal issues
• Numbness or tingling throughout the body
• Headaches or muscle pain  
• Shortness of breath 

Common psychological signs of an anxiety disorder may include:

• Fear of dying or harm
• Intrusive thoughts
• Feeling like something is wrong  
• Anticipating the worst in all situations
• Feeling panic and uneasiness
• Nightmares and obsessions 

Common behavioural symptoms may include:

• Restlessness
• Compulsive behaviours like checking the lock repeatedly
• Staying up all night or sleeping all day
• Engaging in maladaptive behaviours like alcohol dependency  
• Self-harm
• Impulsiveness 

Causes and Risk Factors

Anxiety disorders do not have a single cause. Rather, a combination of factors such as chemical imbalance, environmental and heredity factors may contribute to anxiety.  

It is important to note that anxiety disorders do not occur due to personal weakness, personality flaws, or inherent nature.  

Common causes include:

• Chemical imbalance: Prolonged and intense chronic stress can cause ruptures in the chemical balance that controls our moods and emotions. Having a lot of stress for a long time can trigger an anxiety disorder.
• Environmental factors: Experiencing traumatic events such as childhood abuse, harassment, or bullying can lead to an anxiety disorder.  
• Heredity: If someone in your close family has anxiety, the chances of you developing an anxiety disorder can be high.  

Common risk factors of an anxiety disorder could include the following:

• Stress due to physical health conditions or serious and chronic issues
• A buildup of excessive stress over a period of time (eg death of a loved one, stress at work)
• People with a history of other mental health disorders like OCD may develop anxiety disorder
• Depending too much on substances such as alcohol could potentially worsen the condition 

Treatments for Anxiety Disorders

Once a Singaporean psychologist diagnoses you with an anxiety disorder, you may then explore the different types of interventions.  

The therapeutic plan can help you gain control over your emotions and lead a more happy and sustainable life.  

Common treatments for anxiety disorders include:

• Psychotherapy: Interventions such as CBT and acceptance and commitment therapy can help you manage symptoms of various types of anxiety.  
• Alternative interventions: Techniques such as mindfulness, yoga, and stress management can help you regain control in life. However, note that Therapists can also provide mindfulness-based approaches.  
• Psychiatrists or medical doctors may prescribe medications along with psychotherapy to effectively treat the physical symptoms of anxiety.  

A professional psychotherapist can help you learn tools to identify and control your triggers. This can prevent you from experiencing an anxiety attack.  

You can review the profiles of TYHO Therapists to judge who can help you and understand your unique condition.  

If you find that the Therapist is not the right match, you can change your Therapist. It may take some time to find the right psychologist, so try to give yourself enough time to assess whether the treatment is effective for you.  

When to See a Psychologist

A Singaporean psychologist diagnoses agoraphobia based on your symptoms and unique experience.  

Your psychologist may ask you about your symptoms, personal history, mental health history, family history, and relationship dynamics to gain a big picture of your problems.

You may also have to ask how frequently you have these symptoms and when they started.  

Sometimes, the psychologist may refer you to a medical doctor to perform blood tests. This is done to rule out any physical health issues that may overlap with symptoms of agoraphobia.  

To be formally diagnosed with agoraphobia, your symptoms must meet the diagnostic criteria given in the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

The DSM is an official manual that mental health professionals may use to diagnose mental health disorders.  

The diagnostic criterion for agoraphobia includes an intense fear or anxiety in two or more of the below events. These include fear of:

• Public transportation, such as a train or flight
• Open spaces like beach
• Enclosed spaces like a car
• Crowded areas
• Being alone at home or going out alone 

Additional criteria for a diagnosis of agoraphobia include having recurrent panic attacks, followed by a fear of:

• Having more panic attacks
• Facing the consequences of a panic attack, like vomiting or fainting
• Change in one’s behaviour due to panic attacks (eg avoiding hanging out with friends or dating) 

Moreover, your Therapist in Singapore may also assess your symptoms to make sure that they don’t indicate any other mental health issues like addiction or eating disorders.