Most of us are intimately familiar with anxiety. We experience it as we walk towards the room to where our job interview is held, when we stand up to give a speech at our best friend’s wedding, or when we find ourselves in conversation with someone we want to impress.

Anxiety is experienced physically as butterflies in the stomach, facial flushing, or trembling hands. It may affect your behaviour – for instance, when you find yourself looking at everything in the room except the person you want to communicate with. You may also recognise the voice of anxiety in your thoughts, when you say things to yourself such as “this is impossible”, “I can’t do this”, or “she/he will think I’m stupid, I won’t be able to think of anything to say”.

Anxiety can be uncomfortable, but it’s also an important motivator. A level of anxiety is important for performance, and it assists us by focusing our attention on the things that we need to achieve. When preparing for an examination or to compete in a sport, anxiety motivates us to study or to practise.

In 1908, researchers described the relationship between arousal and performance as an inverted “U” – where both too little arousal and too much arousal are detrimental to performance. But anxiety may not always have a detrimental effect on performance. Research suggests that people experiencing significant anxiety may do as well as those less anxious much of the time, although it takes a lot of effort to achieve the same outcome. This may help to explain why anxiety is so exhausting.

Different types of anxiety disorders

Generalised anxiety disorder (GAD) refers to chronic, persistent worry that is seen as excessive compared to the level of danger or threat involved. Many people worry when they know that their job is under threat because of organisational restructuring, but a person with GAD may worry about their job security, their own or their children’s safety, or their financial situation, without being able to identify any reason for their worry.

Panic disorder is characterised by fear of having an unexpected panic attack that may cause people to avoid places where panic attacks have occurred in the past. A panic attack is a sudden, intense feeling of fear and discomfort associated with physical sensations such as sweating, trembling, numbness, nausea and a racing heart that seems to come from nowhere. These symptoms are severe and frightening, and many people experiencing a panic attack think they’re having a heart attack or dying.

Social anxiety disorder occurs in social or performance situations where a person fears they will be evaluated. These fears, and associated difficulties with communication coupled with feelings of inferiority, create problems for people achieving their potential in educational and work settings, and in developing supportive social relationships.

Obsessive-compulsive disorder (OCD) is a condition where people experience intrusive and distressing thoughts and images that they often respond to with ritualised behaviours aimed at reducing distress. A person with OCD may have recurrent thoughts about illness and contamination from contact with other people through minor occurrences, such as shaking hands or bumping into someone in a crowd. These events create intense anxiety relieved by compulsive washing of their hands, body, clothing, or cleaning their home. Apart from the severe distress that those with OCD experience, compulsive behaviours are very time consuming.

Post-traumatic stress disorder (PTSD) occurs after a traumatic experience such as experiencing or witnessing an assault or serious injury. For some people, the experience is vividly and repeatedly “relived”. People with PTSD generally avoid places, people, and topics that remind them of the trauma. They often experience a sense of emotional numbing and feel detached from their close friends and family.

While there are important differences between these conditions, what they have in common is the experience of excessive anxiety that causes serious distress and problems in important areas of life, including work, study, and relationships.

Many factors influence whether a particular person will experience an anxiety disorder. These include genetics, personality traits, exposure to trauma and current stressors, such as problems with work, family or relationships.

Prevalence and treatment

According to the 2007 National Survey of Mental Health and Wellbeing (NSMHW), about 20% of Australians will experience the symptoms of a diagnosable mental illness, most commonly an anxiety disorder (14.4%), in any 12-month period.

Anxiety disorders affect women more than men, and in the NSMHW almost 18% of women compared to 11% of men reported an anxiety disorder in the past 12 months. Over a lifetime, as many as 25% of people will experience an anxiety disorder.

Although anxiety disorders are both common and distressing, many people with anxiety disorders don’t seek professional help and may live with these distressing and impairing conditions for decades. But the good news is that anxiety disorders are treatable. Medication can provide some relief from the symptoms of anxiety. There is also a great deal of evidence to suggest that cognitive behaviour therapy (a psychological approach that targets the physical, behavioural and cognitive aspects of anxiety) is very effective in treating anxiety disorders.

If you are experiencing anxiety that’s holding you back, causing you distress and affecting your relationships then take the first step towards putting it behind you. Like all bullies, anxiety feeds on avoidance and melts away when you stand up and say “no more”.

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