Quick summary: Anxiety disorders are marked by excessive fear or worry that gets in the way of everyday life, and they show up in the body, in behaviour and in thinking. They range from generalised anxiety, panic disorder and phobias to obsessive-compulsive and related conditions such as body dysmorphic disorder, hoarding, trichotillomania and skin picking. Understanding the symptoms and the mechanisms behind them is the first step towards effective treatment and support.

Everyone feels anxious from time to time, but anxiety disorders are something different. Their hallmark is excessive fear or anxiety that interferes with day-to-day functioning, and it shows up through a mix of physical, behavioural and cognitive features. Many people spend years assuming that what they feel is ordinary stress, so it helps to know how to recognise the common signs of anxiety that are easy to miss.

Physical, behavioural and cognitive features

Physical signs of anxiety include trembling, sweating, an elevated heart rate, lightheadedness and gastrointestinal distress. These reactions often come from the body’s fight-or-flight response. The behavioural side is about avoidance, because people with anxiety disorders may steer clear of situations that make them anxious. That can mean staying away from social situations, public areas or particular circumstances that trigger their fears.

Cognitive features include intrusive thoughts, persistent anxiety and a skewed sense of danger. People may overreact to events, convinced that the worst is about to happen.

The major types of anxiety disorders

The textbook Abnormal Psychology in a Changing World (Nevid, Rathus and Greene, 2020, 9th edition, published by Pearson) sets out five major types:

• Generalised anxiety disorder (GAD): characterised by excessive and ongoing worry about a variety of life issues, such as relationships, employment and health. The NHS has plain-language guidance on generalised anxiety disorder.
• Panic disorder: characterised by frequent, unplanned panic episodes and a lingering fear of more attacks.
• Social anxiety disorder (SAD): the fear of embarrassment or a poor evaluation.
• Specific phobias: characterised by an overwhelming fear of particular things or circumstances, which causes avoidance behaviour.
• Agoraphobia: the fear of being in circumstances from which one may not be able to escape, or where assistance may not be available. It frequently results in a fear of public places.

The cognitive-biological model of panic disorder

According to the cognitive-biological model, panic disorder is caused by a confluence of cognitive distortions and biological vulnerabilities. Some individuals may be physiologically more sensitive to their body’s sensations. When they feel physical symptoms, they may mistakenly think the symptoms are disastrous, which can make them more anxious and even bring on panic attacks. When people then start to avoid situations where they think an attack might happen, this cycle can prolong the disorder. The NHS explains more about panic disorder and its symptoms.

Theoretical perspectives on phobias

Several theoretical perspectives help explain the development of phobias:

• Behavioural perspective: phobias are learned reactions, frequently brought on by classical conditioning, in which a neutral stimulus comes to evoke fear.
• Cognitive perspective: this emphasises how faulty thought patterns, such as exaggerating the threat and underestimating coping skills, support the persistence of phobias.
• Biological perspective: people may be more susceptible to developing phobias because of neurobiological and genetic predispositions.

Obsessive-compulsive and related disorders

Obsessive-compulsive disorder (OCD) is marked by obsessions, which are intrusive, unwanted thoughts, and by compulsions, which are repetitive actions taken to ease the distress the obsessions bring on. Even when people are aware of the irrationality of their actions, they frequently feel driven to carry out these behaviours to avoid a feared consequence. The NHS offers an overview of OCD. Several related conditions sit alongside it:

• Body dysmorphic disorder (BDD): an obsession with perceived defects in physical appearance, which causes severe distress and impairment. Compulsive behaviours include excessive grooming and seeking validation for one’s appearance.
• Hoarding: the accumulation of items to the extent that it disrupts living arrangements and day-to-day activities. The idea of throwing things away often causes distress, which results in a lot of clutter.
• Trichotillomania: also known as hair pulling syndrome. People with trichotillomania experience frequent, uncontrollable urges to pull out their hair, which causes noticeable hair loss. The behaviour is frequently used as a coping strategy to control anxiety or stress.
• Skin-picking disorder (excoriation): like trichotillomania, it is characterised by obsessive skin picking that causes severe distress and skin lesions. The behaviour is frequently employed as a coping mechanism for negative emotions.

Why understanding these conditions matters

Obsessive-compulsive disorders, anxiety disorders and related disorders include a variety of conditions that affect people’s mental, emotional and physical health. For effective treatment and support, it is crucial to understand the complex nature of these disorders, including their symptoms and underlying mechanisms.

Jordaine Placide is a writer and creative with an interest in faith, psychology, personal development and research. Through her writing, she hopes to share knowledge and inspire readers to see everyday experiences from new perspectives. You can find her on LinkedIn and Instagram.