Anxiety Disorders

Suddenly your heart is racing, palms are sweaty, stomach’s churning. Your muscles are tense and your senses alert. Your mind is flooded with worries and fears that something bad will happen. This is anxiety; and we have all had it. When faced with a threatening event such as a physical attack or a natural disaster, most people feel anxiety or fear. Our bodies give us a surge of adrenaline and our instincts take over. This gives us the strength we need to get out of the situation and survive. Anxiety is our body’s response to stress and danger, but in today’s world most of the ‘dangers’ we face day to day are not ones we can fight with our fists or run away from easily. These modern ‘dangers’ are many and can be anything from a heavy work load at your job to family conflicts, aggressive drivers or money troubles. Some anxiety from time to time is normal and healthy; it can help motivate us and help get us out of tough situations. But when anxiety lasts for weeks or months, develops into a constant sense of dread or begins to affect your everyday life, you may have an anxiety disorder.

On this page:

• What is it?
• Who does it affect?
• Could I have an anxiety disorder?
• Am I having a panic attack?
• What can I do about it?
• Where do I go from here?

What is it?

Anxiety disorders describe a group of related mental illnesses. A very common myth is that anxiety disorders are the same thing as problems with stress. Anxiety and stress problems can have a lot in common. The difference is that in an anxiety disorder, the symptoms are extreme and don’t go away once the stress is over. There are several different types of anxiety disorders:

• Generalized anxiety disorder—is when someone has unusually high levels of anxiety and worry about aspects of daily life like health and well-being, finances, family or work.
• Panic disorder—is when a person has panic attacks and is afraid of having more panic attacks. A panic attack is a sudden, unexpected rush of intense anxiety symptoms that can last anywhere from a few seconds to several minutes. Not everyone who has panic attacks has panic disorder.
  • Panic disorder can also exist with agoraphobia. Agoraphobia is a strong fear of and urge to avoid being in places where escape may be difficult or embarrassing (like crowds and public places).
• Post-traumatic stress disorder (PTSD)—is when someone is a part of or witnesses one or more traumatic events. This can be harmful to their mental health. Some examples of traumatic events are war, assault and other crimes, accidents and natural disasters. In addition to other symptoms, a person suffering from post-traumatic stress disorder can relive these events long after they’re over, through nightmares and flashbacks.
• Social anxiety disorder—is when a person is terrified of social settings because they feel other people are judging them and they fear they’ll embarrass themselves. This is also known as social phobia.
• Separation anxiety—is when a child or teenager experiences extreme anxiety when they are separated or expecting to be separated from their parents or caregivers.
• Specific phobias—is when a person experiences extreme or unreasonable terror when confronted with a certain object, situation or activity. This terror can lead to a strong need to avoid that object or situation. The objects of phobias are diverse and can include fear of dogs, flying, enclosed spaces, water, and blood among others.
• Obsessive-compulsive disorder (OCD)—is when a person has recurring, unpleasant thoughts (these are called obsessions), like thinking their hands are always dirty. As a result, they may develop repetitive and time-consuming behaviours to try and reduce anxiety or distress (these are called compulsions), like washing their hands hundreds of times a day.

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Who does it affect?

Anxiety is the most common type of mental disorder affecting 12% of BC’s population, or one in eight people, in any given year. There are a number of things about who you are that can put you at greater risk of developing an anxiety disorder:

• Gender: Women are twice as likely as men to be diagnosed with an anxiety disorder. There are a number of reasons for this including women’s hormonal changes, caregiving stress, and greater comfort seeking help than men.
• Age: Anxiety disorders most often appear in youth, with phobias and OCD showing up in early childhood and panic disorders and social phobias in the teen years. An estimated 6.5% of BC youth have an anxiety disorder.
• Personality factors: Children who are shy and worrisome are more likely than other children to suffer from an anxiety disorder later in life. People who tend to be perfectionists are also more prone to anxiety disorders.
• Family history: Anxiety disorders run in families. In addition to possible genetic influences, the role a child may play within their families can also be a factor in developing an anxiety disorder in the future.
• Social factors: People with a lack of social support are more likely to develop anxiety disorders.
• Occupational risks: One kind of anxiety disorder, post-traumatic stress, can be linked to people’s jobs. For example, emergency personnel and military personnel are at high risk.
• Chronic illness: People who have chronic mental or physical illnesses often worry about their illness, their treatments and the effect the illness has on their lives and the lives of those around them. This constant worry can sometimes lead to the development of an anxiety disorder.

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Could I have an anxiety disorder?

• I’ve had panic attacks and worry about having more and about what will happen if I do
• I frequently have trouble concentrating or sleeping because I worry about work or home or money or my family’s health
• I go out of my way to avoid objects or situations that make me anxious
• I feel anxious about things more often and more intensely than other people around me do
• I feel I can’t move on with my life after a trauma and keep reliving it over and over again
• I have a deep worry of being embarrassed in public
• I often find myself repeating a behaviour like hand washing, organizing, re-checking or mental acts like counting or repeating words in my head
• I’m experiencing one or more of the above symptoms and it’s impacting my life and causing me distress. I also know it’s unreasonable but I can’t seem to stop it.

If this last item plus one or more of the others sounds like you, talk to your doctor about it. You may also want to try our online self-tests* which can be printed out and taken to your doctor.
See www.heretohelp.bc.ca/screening-self-tests

^{*available in English, French and Traditional Chinese}

Am I having a panic attack?

• I feel like something terrible is about to happen
• I’m having trouble catching my breath
• My heart is pounding
• My body/hands are shaking
• I’m breaking out into a sweatI feel lightheaded or dizzy
• I have goose bumps or ‘chills’I feel tingling in my hands and feet
• I feel disconnected from realityI feel nauseous

If the first symptom plus several or more of the others come on suddenly, you may be experiencing a panic attack. Panic attacks usually peak within a few seconds or a few minutes. Talk to your doctor about your attacks and work together to figure out ways to prevent and treat them.It’s important to know that having a panic attack doesn’t mean you have panic disorder. A third of adults will experience a panic attack in their lifetime and most of them will not develop panic disorder. Panic attacks can also be part of other anxiety disorders.

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What can I do about it?

Anxiety disorders are among the most treatable mental illnesses. There are a few different things you can do that have been shown by research to help the most:

• Counselling: Many people with anxiety disorders benefit from a special form of counselling called cognitive-behavioural therapy or CBT. A mental health professional trained in the CBT approach can help you work through the thoughts, emotions, behaviours and triggers contributing to your anxiety problems. They can also teach you coping skills. Part of CBT may involve slowly introducing you to things that you may have been avoiding or extremely afraid of until you feel more comfortable with them. CBT is a short-term treatment and requires you to practice the skills during and after treatment.
• Medication: Anti-anxiety medications can be used in combination with counselling to reduce your body’s response to anxiety.
• Support groups: You are not alone. Anxiety disorder support groups are a great way to share your experiences and learn from the experiences of others.
• Self-help: There are some things you can do on your own to help keep you feeling better. Regular exercise, eating well, managing stress, spending time with friends and family, spirituality, and monitoring your use of alcohol and other drugs can help keep anxiety from getting worse or coming back. Talking to your doctor, asking questions, and feeling in charge of your own health are also very important. Always talk to your doctor about what you’re doing on your own.

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Where do I go from here?

If you think you have an anxiety disorder, it’s important to see a doctor first to rule out other explanations for your symptoms. In addition to talking to your family doctor, check out the resources below for more information on anxiety disorders.

Other helpful resources available in English only are:

AnxietyBC
Visit www.anxietybc.com or call 604-525-7566 for information and community resources.

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca. See our section on anxiety disorders including our Anxiety Disorders Toolkit. The Toolkit is full of information, tips and self-tests to help you understand your anxiety disorder.

Resources available in many languages:
*For the service below, if English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. Through 811, you can also speak to a registered nurse about symptoms you’re worried about, or talk with a pharmacist about medication questions.

Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call310-6789(do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

© 2013

This info sheet was prepared by CMHA BC Division on behalf of the BC Partners for Mental Health and Addictions Information and HeretoHelp. Funding was provided by BC Mental Health and Substance Use Services, an agency of the Provincial Health Services Authority. For more resources visit HeretoHelp.bc.ca.