What Is Anxiety Disorder? – Symptoms, Causes and Treatment

What is Anxiety Disorder?

Anxiety disorder is a mental health condition characterised by excessive and persistent feelings of fear, worry, or dread, which can interfere with daily life. Unlike occasional anxiety that we all experience in stressful situations, an anxiety disorder involves ongoing, intense anxiety that occurs frequently and without clear reason. It often affects an individual’s ability to function, causing emotional, physical, and behavioural symptoms that may worsen over time if left untreated.

Experiencing stress, panic attacks, and anxiety, including phobias, can significantly impact one’s quality of life. Anxiety disorders often manifest in various forms and can arise from numerous sources, affecting individuals both emotionally and physically. At its core, anxiety is a fear of the future, where we imagine we lack the resources to cope with what lies ahead.

Anxiety disorder is common in Singapore, with an estimated 10% of the population affected at some point in their lives (Institute of Mental Health, Singapore). Globally, around 3.6% of the population suffers from anxiety disorders (World Health Organization). Despite its prevalence, anxiety can be incredibly debilitating, especially in situations like social anxiety, job stress, fear of losing employment, or experiencing panic attacks. It can feel isolating when others do not understand or minimise what you’re going through.

Anxiety disorders often present as persistent worry, overthinking, stress, and fear of being judged. Left untreated, anxiety can worsen over time, leading to feelings of breakdown and an overwhelming urge to cry. Anxiety is frequently misunderstood and can be mistaken for traits like shyness, nervousness, or difficulty concentrating. For example:

• Shyness: Social anxiety disorder may cause someone to appear shy or avoid social situations due to fear of judgement or embarrassment.
• Nervousness: Generalised anxiety disorder (GAD) can lead to ongoing nervousness about everyday events, making the person seem excessively worried.
• Difficulty Concentrating: Anxiety can affect focus, making it difficult to complete tasks or stay attentive, often mistaken for a lack of interest.

The constant uneasiness and fear that accompany anxiety disorders can trigger a fight-or-flight response, making daily functioning challenging. This response may lead to irrational thoughts, such as quitting a job or, in extreme cases, contemplating suicide. Anxiety can profoundly affect work performance, strain family relationships, and create a frustrating cycle that can feel impossible to break.

Types of Anxiety Disorders

Anxiety disorder is more than just feeling worried or stressed—it’s an overwhelming sense of fear or dread about the future, often accompanied by the feeling of being unprepared to handle what lies ahead. Anxiety can manifest in different ways and become debilitating when it affects daily functioning. Here is a comprehensive list of anxiety disorders, as outlined in the DSM-5:

  1. Generalised Anxiety Disorder (GAD)

Persistent and excessive worry about a wide range of everyday matters for at least six months. Individuals with GAD often feel restless, fatigued, and have difficulty concentrating. For example, someone with GAD may constantly worry about family safety or work performance, even when there is no specific reason to be concerned.

  2. Panic Disorder

Characterised by recurrent, unexpected panic attacks—sudden periods of intense fear that can include sweating, chest pain, dizziness, and shortness of breath. These attacks often occur without warning. For example, a person may experience a panic attack in a crowded shopping centre, causing them to avoid similar locations in the future.

  3. Agoraphobia

Intense fear of being in places or situations where escape might be difficult or help unavailable. This could include being in open spaces, public transport, or crowds. Individuals with agoraphobia often avoid leaving their homes. For instance, a person may avoid travelling far from home due to the fear of having a panic attack.

  4. Social Anxiety Disorder (Social Phobia)

A deep fear of social situations where one might be judged, embarrassed, or humiliated. This often leads to avoiding social interactions, public speaking, or meeting new people. For example, someone with social anxiety might avoid speaking in meetings at work, fearing judgement.

  5. Specific Phobias

An extreme, irrational fear of specific objects or situations that pose little to no actual danger. Common phobias include fear of heights, spiders, flying, or blood. These fears can severely limit one’s daily life. For example, someone with a fear of flying might avoid all air travel, even when it’s necessary for work or personal reasons.

  6. Separation Anxiety Disorder

Excessive fear or anxiety about being separated from significant attachment figures, typically parents or loved ones. This disorder, more common in children, can also affect adults. For example, a child may refuse to attend school due to fear of being away from their parents, or an adult might experience anxiety about their partner travelling.

  7. Selective Mutism

Consistent failure to speak in specific social situations (e.g., school or work) where speaking is expected, despite speaking normally in other settings. This is more common in children. For example, a child may speak freely at home but remain silent when at school.

Causes of Anxiety Disorders

 Anxiety disorders can develop from a variety of factors, including biological, psychological, and environmental causes. Below is a list of common causes and how they contribute to the development of anxiety:

  1. Biological Causes

Anxiety can be linked to chemical imbalances in the brain, particularly involving neurotransmitters such as serotonin, dopamine, and gamma-aminobutyric acid (GABA). An excess of cortisol, often referred to as the “stress hormone,” can also increase anxiety levels. These imbalances can affect how the brain regulates mood and stress responses, making a person more prone to anxiety.

  2. Genetics

A family history of anxiety disorders can increase the likelihood of developing an anxiety disorder. Genetic factors may influence how the brain responds to stress and fear, and if close family members have anxiety, there’s a higher chance you might experience it too. However, genetics alone aren’t the sole cause—environmental factors also play a role.

  3. Upbringing and Early Life Experiences

Exposure to trauma or highly stressful situations during childhood can predispose someone to anxiety later in life. Childhood neglect, abuse, or witnessing domestic violence can create deep-rooted feelings of insecurity and fear. These early experiences can shape how a person responds to stress as an adult.

  4. Personality Traits

Some individuals are naturally more prone to anxiety due to certain personality traits. People who are more sensitive, perfectionistic, or have low self-esteem may be more likely to develop anxiety disorders, particularly when facing stressful situations.

  5. Triggers and Environmental Factors

Anxiety can also be triggered or worsened by specific life events or environmental factors. These triggers can range from stressful life changes to ongoing pressures in daily life. Some common triggers include:

• • Stressful Life Events:
    Major changes or traumas, such as the death of a loved one, divorce, job loss, or significant financial difficulties, can all contribute to heightened anxiety. These events may lead to feelings of loss of control or uncertainty, which are common triggers for anxiety.

  • Social Situations:
    People with social anxiety disorder may find interactions such as public speaking, meeting new people, or attending large gatherings to be highly stressful. The fear of being judged or humiliated can cause extreme anxiety in these situations.

  • Health Concerns:
    Chronic illnesses, such as heart disease, diabetes, or cancer, can lead to ongoing anxiety. Additionally, individuals with a history of trauma or abuse may develop anxiety as a long-term consequence of their experiences.

  • Certain Substances:
    Caffeine, alcohol, and certain drugs (both recreational and prescription) can trigger or exacerbate anxiety symptoms. Stimulants like caffeine can heighten feelings of nervousness, while withdrawal from substances like alcohol can lead to increased anxiety.

  • Environmental Factors:
    External stimuli such as loud noises, bright lights, or crowded, confined spaces can act as triggers for anxiety, especially for individuals who are already prone to stress. For example, being in a busy, noisy environment may increase anxiety levels in people who are sensitive to their surroundings.

Anxiety Disorder Symptoms

Anxiety disorder is more than just occasional worry or stress—it involves a persistent, pervasive sense of fear or dread that can significantly affect both physical and mental well-being. The symptoms of anxiety disorder can vary widely, but they generally fall into two categories: physical and psychological. Here’s a detailed look at both:

Physical Symptoms

Anxiety often causes noticeable changes in the body. These symptoms are related to the body’s “fight-or-flight” response, which is triggered even when there is no real danger:

1. Increased Heart Rate:
   Many people with anxiety experience palpitations or a racing heart, often feeling as though their heart is pounding uncontrollably. This is a direct result of the body preparing itself for a perceived threat.

2. Sweating:
   Excessive sweating, especially in social situations, is common. This can happen even in cool environments, particularly when you’re feeling nervous or anxious.

3. Trembling or Shaking:
   Anxiety can cause noticeable shakiness or trembling, particularly in the hands or legs. This is another manifestation of the body’s stress response.

4. Shortness of Breath:
   Feeling breathless or having difficulty breathing is a common symptom of anxiety. People with anxiety often describe feeling as though they can’t get enough air, even when they are not physically exerting themselves.

5. Chest Pain:
   Anxiety can cause tightness or discomfort in the chest, which can sometimes be mistaken for a heart condition. Chest pain during anxiety episodes is typically related to muscle tension or hyperventilation.

6. Nausea:
   Anxiety often affects the digestive system, leading to feelings of nausea, queasiness, or even digestive issues such as diarrhoea or indigestion.

7. Muscle Tension:
   Anxiety can lead to chronic muscle tension, causing stiffness or muscle aches. Common areas affected include the neck, shoulders, and back, contributing to general discomfort.

8. Headaches:
   Frequent headaches or migraines can result from the prolonged stress and tension that accompany anxiety.

9. Fatigue:
   Anxiety can be exhausting, both mentally and physically. Many individuals with anxiety disorders feel unusually tired or fatigued, even when they haven’t exerted themselves.

Psychological Symptoms

Along with physical symptoms, anxiety disorder impacts emotional and mental well-being. These symptoms often affect how a person thinks and behaves:

1. Excessive Worry:
   People with anxiety disorders experience persistent, uncontrollable worry about various aspects of life, such as work, health, or personal relationships. This worry is often disproportionate to the actual situation.

2. Restlessness:
   Anxiety can make it difficult to relax, leaving you feeling constantly on edge or unsettled. Restlessness may also manifest as an inability to sit still or focus.

3. Irritability:
   Anxiety often leads to increased irritability or moodiness. Even minor frustrations can feel overwhelming, causing more frequent or intense reactions than usual.

4. Difficulty Concentrating:
   Anxiety can make it hard to focus or think clearly. People with anxiety may find it difficult to concentrate on tasks or have trouble remembering things, often feeling like their mind is constantly racing.

5. Sleep Disturbances:
   Trouble falling asleep, staying asleep, or experiencing restless, unrefreshing sleep is a common symptom of anxiety. This often leads to further fatigue during the day.

6. Avoidance:
   People with anxiety may start to avoid situations or activities that trigger their anxiety. For example, someone with social anxiety might avoid social gatherings or public speaking, which can limit their daily functioning.

7. Catastrophic Thinking:
   Anxiety often leads to worst-case-scenario thinking, where individuals imagine the worst possible outcomes for even minor situations. This type of thinking can fuel their worry and increase feelings of helplessness.

Self-Help Tips for Managing Anxiety Disorders 

Here are some self-help strategies that can complement therapy:

1. Mindfulness and Meditation:
   Practising mindfulness helps you stay in the present moment, reducing the tendency to overthink future events. By focusing on your breath or your surroundings, mindfulness helps calm the mind and body.

2. Grounding Techniques (5-4-3-2-1):
   The 5-4-3-2-1 grounding technique is a helpful way to bring yourself back to the present. Identify:

   • 5 things you can see
   • 4 things you can touch
   • 3 things you can hear
   • 2 things you can smell
   • 1 thing you can taste
     This method helps reduce anxiety by focusing your mind on your immediate surroundings.

3. Orienting and Creating Space:
   Orienting yourself by gently moving your neck and stretching can help release tension. Creating space around you and noticing one object that attracts your attention in the room can anchor you to the present moment, reducing feelings of overwhelm.

4. Anxiety Box (Treasure Box):
   Consider creating an anxiety box or treasure box where you can mentally or physically place troubling thoughts. The idea is to acknowledge your worries and set them aside in the box, to be dealt with later when you feel more emotionally equipped. This technique helps you avoid becoming consumed by anxiety and provides a tangible way to manage overwhelming thoughts until you have more resources or energy to address them.

5. Keeping a Cherished Item or Talisman:
   Having a cherished item, such as a special stone or something meaningful to you, close by can provide comfort during moments of anxiety. This object serves as a grounding tool that offers reassurance and calm.

6. Breathing Exercises (Box Breathing):
   Box breathing is an effective way to regulate your body’s stress response. Inhale for four counts, hold for four, exhale for four, and hold again for four. This helps reduce physical symptoms of anxiety and promotes a sense of control.

7. Feeling Safe:
   When anxiety takes hold, remind yourself that you are safe in the present moment. Find a quiet space, breathe deeply, and focus on your environment to reassure yourself.

8. Regular Physical Activity:
   Exercise helps release endorphins, the body’s natural mood boosters. Engaging in regular physical activity, such as walking, swimming, or yoga, can reduce anxiety and promote well-being.

9. Healthy Lifestyle Choices:
   A healthy diet, sufficient sleep, and reducing stimulants like caffeine can improve anxiety levels. Limiting alcohol and sugar can also help stabilise your mood and reduce anxiety spikes.

10. Journalling:
    Writing down your thoughts can help you process emotions and recognise anxiety triggers. Journalling provides an outlet for expressing your worries and can help you gain perspective on the issues causing anxiety.

11. Recognising Resources:
    Anxiety can make you feel powerless, but acknowledging your resources—whether internal (strengths and past coping strategies) or external (support from loved ones)—can remind you of your ability to manage anxiety effectively.

While these strategies have been helpful for many, they should not replace professional therapy. It’s important to work with a mental health professional for a tailored approach to managing anxiety. If your anxiety is persistent or severe, seeking professional help is crucial. At Listening Ear Counselling & Consultancy Pte. Ltd., we offer personalised support to help you navigate your anxiety.

When to Seek for Anxiety Therapy 

While occasional anxiety is a normal part of life, persistent or overwhelming anxiety can significantly impact your daily functioning and well-being. If you’re unsure when to seek help, here are some signs that it may be time to consider professional anxiety therapy:

1. Chronic Anxiety:
   Anxiety that lasts for several weeks or months, without relief, may be a sign that professional help is needed. Chronic anxiety often interferes with daily activities and makes it hard to manage everyday stressors.

2. Severe Symptoms:
   If anxiety symptoms are intense enough to disrupt your daily life, work, or relationships, it may be time to seek therapy. For example, feeling unable to leave the house due to overwhelming anxiety is a clear sign that intervention may be helpful.

3. Avoidance Behaviour:
   Avoiding important activities, such as social gatherings, work commitments, or family responsibilities, because of anxiety can reduce your quality of life. Therapy can help address avoidance patterns and provide strategies for overcoming them.

4. Physical Health Issues:
   Anxiety can lead to physical symptoms, including high blood pressure, chronic headaches, or digestive problems. If your anxiety is causing long-term health issues, seeking professional support can help manage both the mental and physical symptoms.

5. Panic Attacks:
   Frequent panic attacks or a constant fear of having another panic attack may indicate the need for therapy. Panic attacks can be frightening, and professional support can help manage and reduce the frequency of these episodes.

6. Substance Use:
   Turning to alcohol, drugs, or other substances to cope with anxiety can signal a deeper issue that requires therapeutic intervention. Therapy can offer healthier coping mechanisms for managing anxiety without relying on harmful substances.

7. Impact on Quality of Life:
   If anxiety is diminishing your overall quality of life—making you feel constantly on edge, unable to enjoy activities, or affecting your relationships—it’s important to seek help. Therapy can help restore a sense of balance and well-being.

8. Depressive Symptoms:
   Anxiety and depression often co-occur, and symptoms such as feelings of hopelessness, low mood, or thoughts of self-harm should never be ignored. Seeking therapy can help address both anxiety and any co-existing mental health issues.

Taking the Next Step

Feeling overwhelmed by anxiety? You don’t have to manage it alone. Our dedicated team at Listening Ear Counselling & Consultancy Pte. Ltd. in Singapore provides personalised, professional support to help you regain control and find relief. If anxiety is impacting your daily life, relationships, or work, take the first step toward a calmer mind. Contact us today for a anxiety counselling, and let’s start your journey to healing together.