As outlined in the first and second posts in this series, anxiety is a common experience that affects millions of people globally. While it’s normal to feel anxious occasionally, chronic anxiety can have a significant impact on a person’s quality of life. Anxiety disorders can manifest in different forms, each with its own set of symptoms and triggers. In the UK, around 10% of the population will be suffering with an anxiety disorder at any one time1. Understanding the different faces of anxiety can help individuals and those around them to better identify and manage their experiences. Here’s a closer look at four primary forms of anxiety: Generalised Anxiety Disorder (GAD), panic disorder, social anxiety disorder and health anxiety.
Generalised Anxiety Disorder (GAD): the persistent worry
Each week in the UK, 6 in every 100 people are diagnosed with Generalised Anxiety Disorder (GAD)2. It is characterised by excessive, uncontrollable worry about various aspects of life, from health and finances to relationships and work. Unlike occasional anxiety which is often tied to specific events, GAD is pervasive, with individuals often feeling anxious even in the absence of a clear cause.
– Symptoms:People with GAD may experience a range of symptoms that affect both their mind and body. Common mental symptoms include persistent worry, difficulty concentrating and feeling ‘on edge’. Physical symptoms such as muscle tension, fatigue, and trouble sleeping are also common. Because GAD affects people over an extended period, it can lead to chronic stress, potentially impacting physical health as well.
– Causes & triggers: The causes of GAD are complex and involve a combination of genetic, environmental, and psychological factors. Some individuals may be genetically predisposed to anxiety, while others develop GAD due to life experiences such as trauma, abuse or prolonged stress. Major life changes such as a new job, relocation, or a relationship breakdown, can also trigger or exacerbate GAD.
– Prevalence: The numbers of people suffering with GAD are typically much higher than those recorded because many do not obtain treatment. GAD is often linked with other health issues with over 60% of sufferers having experienced an instance of depression.
Panic Disorder: the sudden onset of fear
Panic disorder is an anxiety disorder that involves sudden, unexpected panic attacks – episodes of intense fear that peak within minutes and can cause severe physical reactions. While it’s normal to feel panicked in certain high-stress situations, people with panic disorder experience these attacks repeatedly, often without an identifiable trigger. More than 1 in 10 people have occasional panic attacks but sufferers with panic disorder – approximately 1 in 50 people – experience repeated attacks of varying frequency 3.
– Symptoms:Panic attacks can be overwhelming with physical symptoms that often mimic those of a heart attack. Individuals may experience a racing heart, sweating, shaking, chest pain, dizziness and shortness of breath. These intense physical reactions, combined with a sense of impending doom, make panic attacks terrifying. They typically last between 5 and 20 minutes but can extend to up to an hour. People with panic disorder often fear having another attack, which can lead them to avoid certain places or situations which eventually impacts their daily lives.
– Causes & triggers: The exact cause of panic disorder remains unclear but researchers believe it is linked to a combination of genetic and environmental factors, as well as abnormal neurotransmitter activity in the brain. For some people, the disorder may be triggered by major life stress, such as losing a loved one, experiencing trauma, or significant life changes. Once someone experiences a panic attack, the fear of recurrence can perpetuate a cycle of anxiety and avoidance.
Social Anxiety Disorder: the fear of social situations
Social anxiety disorder, also known as social phobia, is a type of anxiety that involves an intense fear of social or performance situations. People with social anxiety often fear being judged, embarrassed or humiliated in front of others, which can make everyday interactions difficult. This disorder goes beyond shyness and can significantly impact an individual’s ability to engage in social, academic, or professional situations.
– Symptoms: Social anxiety disorder can manifest both physically and mentally. Physical symptoms include blushing, sweating, trembling, and a rapid heartbeat when faced with social situations. Mentally, individuals may experience intense worry about upcoming social events, a strong fear of negative evaluation, and a tendency to avoid social settings altogether. These symptoms can hinder the person’s ability to make friends, advance in their career, or even accomplish daily tasks that involve interaction with others.
– Causes & triggers: Like other anxiety disorders, social anxiety disorder can stem from a mix of genetic predisposition and environmental factors. Some studies suggest that people with an overactive amygdala, the part of the brain responsible for processing fear, may be more prone to social anxiety. Environmental factors, such as childhood experiences, bullying, or a history of negative social encounters, can also contribute to the development of social anxiety. Even seemingly routine social events, such as speaking in front of a group or attending a social gathering, can trigger intense anxiety. It can be common for people with social anxiety disorder to also experience panic attacks.
Health Anxiety: the fear of illness
Health anxiety, also known as illness anxiety disorder or hypochondria, involves an excessive preoccupation with health and a persistent fear of having or developing a serious illness. People with health anxiety may fixate on physical sensations, interpret minor symptoms as signs of severe illness, and engage in repeated checking or reassurance-seeking from healthcare professionals. This worry is often irrational but persistent and it can significantly affect a person’s quality of life.
– Symptoms: Health anxiety can manifest physically, mentally and behaviourally. Physical symptoms include heightened awareness of physical sensations such as muscle tension, stomach discomfort and a racing heart together with stress related symptoms e.g. headaches, chest pain or gastrointestinal issues and disturbed sleep and fatigue acerbated by anxiety. Mentally, individuals often feel an overwhelming worry about their health, catastrophic thinking, hyper vigilance to bodily sensations and difficulties reassuring themselves. Behavioural symptoms include excessive checking of their bodies e.g. repeatedly measuring blood pressure, feeling lymph nodes or examining skin moles, frequently asking loved ones or healthcare providers for reassurance and undergoing unnecessary medical tests. Paradoxically, some may avoid healthcare providers or medical information out of fear that they will learn something “bad”.
– Causes & triggers: Some individuals may be more biologically predisposed to anxiety disorders due to genetics. A family history of anxiety or mood disorders can increase the likelihood of health anxiety. Growing up with a parent or family member who was overly concerned about health can instil similar anxieties. Having experiences of illness or witnessing a loved one suffer a serious illness or a traumatic medical experience may reinforce health fears. Additionally, high-stress situations or exposure to medical information in the media can trigger health anxiety. Searching for symptoms online, also known as “cyberchondria,” is a common behaviour among those with health anxiety. Online searches can lead individuals to believe that minor symptoms are related to severe illnesses, amplifying their anxiety.
– Comorbidity: People with GAD, obsessive-compulsive disorder (OCD) or depression are more likely to develop health anxiety. The underlying thought patterns and cognitive distortions associated with these conditions can fuel fears about health.
Recognising symptoms: the first step to getting help
Recognising the symptoms of these different forms of anxiety is the first step towards seeking help. Each of these anxiety disorders requires its own tailored approach, and treatment may vary based on the individual’s specific needs and experiences. Many people find that a combination of therapy, medication, and lifestyle changes offers the most effective relief.
Whilst living with an anxiety disorder can be challenging, treatment options and coping mechanisms can help individuals lead fulfilling lives. GAD, panic disorder, social anxiety disorder and health anxiety may have distinct characteristics and often coexist, but they share the common feature of significantly impacting the individual’s emotional and physical wellbeing. By understanding and addressing these different faces of anxiety, individuals can take control of their mental health and work toward a more balanced, peaceful life.
1 Mental Health UK (2024). What is anxiety disorder? Retrieved from https://mentalhealth-uk.org/help-and-information/conditions/anxiety-disorders/what-is-anxiety/ [Accessed 01/11/2024]
2 Mind (2024). Mental health facts and statistics. Retrieved from https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-facts-and-statistics/ [Accessed 01/11/2024]
3 NICE (2020). Generalised anxiety disorder and panic disorder in adults: management. Retrieved from https://www.nice.org.uk/guidance/cg113 [Accessed 01/11/2024]
