Anxiety and related disorders

The essentials

Anxiety is a diffuse, vague, very unpleasant feeling of fear and apprehension. Everyone feels anxious sometimes, but in anxiety disorders the anxiety is intense, long-lasting and interferes with life. Symptoms include rapid heart rate, shortness of breath, diarrhoea, loss of appetite, fainting, dizziness, sweating, sleeplessness and tremors.

Key points

• Generalised anxiety disorder: prolonged, vague, unexplained and intense fears not attached to any particular object.
• Panic disorder: recurrent panic attacks, sudden episodes of intense terror with physical symptoms like breathlessness and palpitations.
• Phobias: irrational fears of specific objects, people or situations. Types: specific phobias (for example fear of certain animals or closed spaces), social anxiety disorder (intense fear of being judged in social situations) and agoraphobia (fear of entering unfamiliar situations; many avoid leaving home).
• Separation anxiety disorder: excessive fear of being separated from attachment figures, seen in children.
• Obsessive-compulsive disorder (OCD): obsessions are persistent unwanted thoughts; compulsions are repeated behaviours such as washing or checking. Related disorders include hoarding disorder, trichotillomania (hair-pulling) and body dysmorphic disorder (preoccupation with imagined physical defects).
• Trauma- and stressor-related disorders: post-traumatic stress disorder (PTSD) after events like disasters, accidents or violence, with recurrent dreams, flashbacks, impaired concentration and emotional numbing.
• Somatic symptom and related disorders: physical symptoms without a physical cause. Somatic symptom disorder (persistent body-related complaints), illness anxiety disorder (preoccupation with having a serious illness) and conversion disorder (loss of a body function, such as paralysis or blindness, linked to psychological stress).
• Dissociative disorders: severance of connections between ideas and emotions. Dissociative amnesia (inability to recall important personal information, often after trauma), dissociative identity disorder (two or more distinct personalities) and depersonalisation/derealisation (feeling detached from oneself or that the world is unreal).

Common mistakes

• Obsessions are thoughts; compulsions are actions.
• Illness anxiety is worry about having an illness; conversion disorder involves an actual loss of function.