What are anxiety disorders?

Feeling anxious is not necessarily problematic. Many people feel anxious because they have reason to; for example, they may be in prolonged lockdown due to an ongoing global pandemic, be facing economic hardship, be experiencing difficulties with housing or relationships, or may be preparing for a presentation at work. Many people undergoing AOD treatment will experience anxiety which can be a consequence of intoxication, withdrawal, or learning to live without using substances. This anxiety usually reduces over time with a period of abstinence. A person’s anxiety is problematic, however, when it is persistent, or so frequent and intense that it prevents the person from living their life in the way that they would like.

People with anxiety disorders often experience intense feelings of fear and anxiety. Fear is an emotional response that refers to real or perceived imminent threat, and anxiety is the anticipation of future threat. Although fear and anxiety overlap, they are associated with differing autonomic responses. Fear is associated with a flight or fight response, thoughts of immediate danger, and escape. Anxiety is more commonly associated with muscle tension, hypervigilance in preparation for danger, and avoidance. Feelings of panic are also common among people with anxiety disorders.

Panic attacks in themselves are not a specific disorder, but when they are severe and bring about a sustained change in behaviour, they may amount to panic disorder (Table 10). Panic attacks are a symptom common to many of the anxiety disorders. The symptoms of a panic attack are outlined in Table 9, although not all panic attacks include all symptoms. Panic attacks can be terrifying. As many panic attack symptoms mirror those of a heart attack, many people who experience them (particularly for the first time) have a genuine fear that they are going to die. Given the overlap in symptoms (e.g., shortness of breath, chest pain and tightness, numbness and tingling sensations), it is important that a person displaying these symptoms be referred to a medical practitioner.