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The 5 types of anxiety disorders and how to know if you have one

therapy

  • There are five main anxiety disorders: phobias, panic disorder, agoraphobia, social anxiety, and generalized anxiety. 
  • These types of anxiety disorders have similar, overwhelming symptoms of fear and worry, and these symptoms will have a significant negative impact on your daily life.
  • It's possible to treat each anxiety disorder with a combination of therapy and medication, and it's important to check in with a doctor to determine the best treatment method for you. 
  • This article was medically reviewed by David A. Merrill, MD, PhD, psychiatrist and director of the Pacific Brain Health Center at Pacific Neuroscience Institute at Providence Saint John's Health Center. 
  • Visit Insider's Health Reference library for more advice.

Most people will experience feelings of anxiety or worry at some point in their life. But about 40 million Americans have an anxiety disorder.

An anxiety disorder is diagnosed when there is a disproportionate amount of anxiety, which interferes with daily functioning for an extended period of time. 

Here's what you need to know about the types of anxiety disorders, the general symptoms, and most common treatment methods. 

Types of anxiety disorders

There are five main anxiety disorders, according to the National Institute of Mental Health. 

  • Simple or specific phobias. If you're intensely afraid of heights, blood, needles, spiders, or other certain objects or scenarios, you have a specific phobia. While we often feel fear on, say, old elevators, specific phobias only become a disorder when the fear makes it harder to work, adapt to a normal routine, impair self-esteem, or harm relationships. 
  • Panic disorder is characterized by anticipatory fear of recurrent panic attacks. A panic attack usually involves accelerated heart rate, feelings of impending doom, trembling or shaking, and shortness of breath. For panic attacks to become panic disorder, a person has to fear having additional panic attacks.
  • Agoraphobia involves the fear of being outside the home alone and is related to attempted avoidance of panic attacks. This includes being in open spaces like a park, being in enclosed spaces like a crowded supermarket, using public transportation, or being in a crowd. People feel fear in these situations partly because they're afraid they won't be able to escape if they have a panic attack. 
  • Social anxiety disorder is the general intense fear of social situations or performances, such as giving a speech. People with social anxiety disorder often worry about other people thinking poorly about them or judging them, or that they'll embarrass themselves in front of others. 
  • Generalized anxiety is characterized by excessive worry about two or more aspects of your life — for example, your finances or social interactions). Excessive worry can lead to fatigue, trouble with focus, irritability, and insomnia. For it to be a disorder, this worry has to occur for more than six months and impair the quality of your life. 

Symptoms

Most anxiety disorders exhibit the same underlying symptoms, says Shannon O'Neill, PhD, an assistant professor in psychiatry at Mount Sinai West. 

These mainly include: 

  • Difficulty tolerating uncertainty or the unknown
  • Rumination about the future
  • Cognitive rigidity, or the inability to adapt to new situations
  • A need for control, even in situations that are out of your control 

O'Neill emphasizes anxiety orders should be characterized only if these feelings begin impairing someone's life for an extended period of time — including their productivity at work or school, relationships with friends and family, or ability to function on a daily basis. 

This can manifest into further problems, such as: 

  • Difficulty controlling worry
  • Inability to feel or remain calm
  • Feeling tense
  • Gastrointestinal problems
  • Fatigue
  • Insomnia, or sleeping troubles
  • Obsessive thoughts
  • Ritualistic behaviors to assuage anxiety symptoms
  • Avoiding daily activities

Diagnosis 

If you feel like you have an anxiety disorder, consider seeking help from a licensed mental health professional — such as a therapist, psychiatrist, or psychologist. 

To diagnose anxiety disorders, O'Neill talks with her patients about how their feelings of anxiety are affecting their life. Often, she'll ask patients to take a brief self-assessment, which is based on the criteria for anxiety disorders in the DSM-5

In addition, underlying health conditions and family medical history are important — anxiety disorders are often influenced by genetics and your family environment

Treatment 

If a doctor determines an anxiety disorder is present, there are usually two main treatment methods: therapy and medication. 

Cognitive behavioral therapy 

Cognitive behavioral therapy, or CBT, can help change the thoughts or behavioral patterns that are causing an anxiety disorder. 

Specifically, it can help teach you: 

  • How to overcome anxiety triggers. During CBT, a therapist can often work with you to figure out what triggers your anxiety and test different solutions to better regulate your response.
  • How to change your perspective. Rigidity, or psychological inflexibility, is often the source of anxiety. CBT can help you accept that certain things are outside of your control. If you can learn to better adapt to changing circumstances, your mental health will improve. 
  • How to physically calm yourself. Anxiety often manifests itself physically, especially in the form of panic attacks. During CBT, relaxation techniques can help people focus on their breathing patterns and learn how to slow their heart rate to calm anxiety. 

Overall, CBT is very effective — it's estimated that about 60% of those with anxiety disorders who participate in CBT will experience improvement in their mental health and have a better ability to deal with anxiety. 

Medication 

Though anti-anxiety drugs such as antidepressants and benzodiazepines don't treat the underlying causes of anxiety disorders, they can make it easier to function in everyday life. In fact, antidepressants are a first-line medical treatment for anxiety disorders.

O'Neill says she'll introduce to her patients the possibility of medication if she notices that their anxiety is so severe it obstructs necessary daily activities like school or work. 

In addition, medication can be used to facilitate and improve someone's time in CBT. "The medication lowers the symptoms enough for them to be able to get engaged in the treatment and learn the new exercises," O'Neill says. 

Though the right time to stop taking anti-anxiety medication varies from person to person, it may be necessary if you experience side effects, feel too dependent on the medication, or feel like the medication is becoming less effective. 

Benzodiazepines may not be appropriate for middle aged or older adults worried about their memory or balance, as long term use of these medications is associated with increased risk of Alzheimer's disease and hip fractures.

Always talk to your doctor or therapist, though, before changing your medication routine. 

Related articles from Health Reference:

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