• Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older (18.1% of U.S. population).
  
• Anxiety disorders cost the U.S. more than $42 billion a year, almost one-third of the country’s $148 billion total mental health bill, according to “The Economic Burden of Anxiety Disorders,” a study commissioned by ADAA and published in The Journal of Clinical Psychiatry, Vol. 60, No. 7, July 1999.
  
• More than $22.84 billion of those costs are associated with the repeated use of health care services; people with anxiety disorders seek relief for symptoms that mimic physical illnesses.
  
• People with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders.

NUMBERS AND PERCENTAGES REFER TO ADULTS AFFECTED IN U.S. POPULATION

Generalized Anxiety Disorder (GAD)
6.8 million, 3.1%

• Women are twice as likely to be affected than men.
  
• Very likely to be comorbid with other disorders.

Obsessive-Compulsive Disorder (OCD)
2.2 million, 1.0%

• Equally common among men and women.
  
• One-third of affected adults first experienced symptoms in childhood.
  
• In 1990, OCD cost the U.S. 6% of the total $148 billion mental health bill.
  

Panic Disorder
6 million, 2.7%

• Women are twice as likely to be affected than men.
  
• Very high comorbidity rate with major depression.
  

Posttraumatic Stress Disorder (PTSD)
7.7 million, 3.5%

• Women are more likely to be affected than men.
  
• Rape is the most likely trigger of PTSD, 65% of men and 45.9% of women who are raped will develop the disorder.
  
• Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD.
  

Social Anxiety Disorder (SAD)
15 million, 6.8%

• It is equally common among men and women.
  

Specific Phobias
19 million, 8.7%

Women are twice as likely to be affected as men.

• Common causes of anxiety include these mental conditions:

• These common external factors can cause anxiety:

• The doctor has the often-difficult task of determining which symptoms come from which causes. For example, in a study of people with chest pain that could be heart disease but turned out not to be heart related, 43% were found to have a panic disorder — a common form of anxiety.

Anxiety is a normal human emotion that everyone experiences at times. Many people feel anxious, or nervous, when faced with a problem at work, or before taking a test or making an important decision. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person’s ability to lead a normal life.

An anxiety disorder is a serious mental illness. For people with anxiety disorders, worry and fear are constant and overwhelming, and can be crippling.

What Are the Types of Anxiety Disorders?

There are several recognized anxiety disorders, including:

• Panic disorder : People with this condition have feelings of terror that strike suddenly and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain, palpitations (irregular heartbeats) and a feeling of choking, which may make the person feel like he or she is having a heart attack or “going crazy.”
• Obsessive-compulsive disorder (OCD) : People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.
• Post-traumatic stress disorder (PTSD) : PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.
• Social anxiety disorder : Also called social phobia, social anxiety disorder involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule.
• Specific phobias : A specific phobia is an intense fear of a specific object or situation, such as snakes, heights or flying. The level of fear usually is inappropriate to the situation and may cause the person to avoid common, everyday situations.
• Generalized anxiety disorder : This disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.

What Are the Symptoms of an Anxiety Disorder?

Symptoms vary depending on the type of anxiety disorder, but general symptoms include:

• Feelings of panic, fear and uneasiness
• Uncontrollable, obsessive thoughts
• Repeated thoughts or flashbacks of traumatic experiences
• Nightmares
• Ritualistic behaviors, such as repeated hand washing
• Problems sleeping
• Cold or sweaty hands and/or feet
• Shortness of breath
• Palpitations
• An inability to be still and calm
• Dry mouth
• Numbness or tingling in the hands or feet
• Nausea
• Muscle tension
• Dizziness

What Causes Anxiety Disorders?

The exact cause of anxiety disorders is unknown; but anxiety disorders — like other forms of mental illness — are not the result of personal weakness, a character flaw or poor upbringing. As scientists continue their research on mental illness, it is becoming clear that many of these disorders are caused by a combination of factors, including changes in the brain and environmental stresses.

Like certain illnesses, such as diabetes, anxiety disorders may be caused by chemical imbalances in the body. Studies have shown that severe or long-lasting stress can change the balance of chemicals in the brain that control mood. Other studies have shown that people with certain anxiety disorders have changes in certain brain structures that control memory or mood. In addition, studies have shown that anxiety disorders run in families, which means that they can be inherited from one or both parents, like hair or eye color. Moreover, certain environmental factors — such as a trauma or significant event — may trigger an anxiety disorder in people who have an inherited susceptibility to developing the disorder.

How Common Are Anxiety Disorders?

Anxiety disorders affect about 19 million adult Americans. Most anxiety disorders begin in childhood, adolescence and early adulthood. They occur slightly more often in women than in men, and occur with equal frequency in whites, African-Americans, and Hispanics.

How Are Anxiety Disorders Diagnosed?

If symptoms are present, the doctor will begin an evaluation by asking you questions about your medical history and performing a physical examination. Although there are no laboratory tests to specifically diagnose anxiety disorders, the doctor may use various tests to look for physical illness as the cause of the symptoms.

If no physical illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an anxiety disorder.

The doctor bases his or her diagnosis on the patient’s report of the intensity and duration of symptoms — including any problems with daily functioning caused by the symptoms — and the doctor’s observation of the patient’s attitude and behavior. The doctor then determines if the patient’s symptoms and degree of dysfunction indicate a specific anxiety disorder.

How Are Anxiety Disorders Treated?

Fortunately, much progress has been made in the last two decades in the treatment of people with mental illnesses, including anxiety disorders. Although the exact treatment approach depends on the type of disorder, one or a combination of the following therapies may be used for most anxiety disorders:

• Medication : Medicines used to reduce the symptoms of anxiety disorders include anti-depressants and anxiety-reducing medications.
• Psychotherapy : Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
• Cognitive-behavioral therapy: People suffering from anxiety disorders often participate in this type of psychotherapy in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.
• Dietary and lifestyle changes
• Relaxation therapy

Can Anxiety Disorders Be Prevented?

Anxiety disorders cannot be prevented; however, there are some things you can do to control or lessen symptoms:

• Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola and chocolate.
• Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
• Seek counseling and support after a traumatic or disturbing experience.