Anxiety: Symptoms, Causes, And Medications

Anxiety, a pervasive condition characterised by a profound sense of unease, worry, or fear, can significantly impact an individual’s daily life and well-being. Manifesting through a variety of symptoms ranging from physical sensations like increased heart rate and sweating to psychological disturbances such as restlessness and a constant sense of dread, anxiety disorders are among the most common mental health issues faced in Australia. Understanding and addressing anxiety is crucial for improving quality of life and promoting mental health resilience.

What Is The Prevalence Of Anxiety Disorder in Australia?

In Australia, the prevalence of anxiety disorders among individuals aged 16–85 years was reported at 17.2% during the period 2020-2022. This statistic highlights anxiety as the most common group of mental disorders among Australians within this age bracket, indicating a significant impact on the nation’s mental health landscape according to the Australian Bureau of Statistics.

Generally, anxiety disorders are more commonly reported among females compared to males. This difference is thought to be influenced by a combination of biological, psychological, and social factors.

However, anxiety disorders are not necessarily impacted by racial and ethnic differences. The occurrence of anxiety disorder varies and may be influenced by factors such as socioeconomic status, exposure to racism or discrimination, cultural attitudes towards mental health, and access to mental health services.

What Exactly Is Anxiety Disorder?

Anxiety disorder, scientifically recognised as a collection of mental health conditions, is characterised by excessive fear, worry, or anxiety that persists for an extended period and significantly interferes with daily activities. Unlike the occasional anxiety experienced by individuals as a normal response to stress, anxiety disorders are persistent and can escalate over time, leading to severe impairment in functioning.

From a scientific perspective, anxiety disorders are believed to result from a complex interplay of genetic, environmental, psychological, and developmental factors. These disorders are associated with alterations in brain circuits that regulate mood and fear. Neurotransmitters, such as serotonin, dopamine, and gamma-aminobutyric acid (GABA), play crucial roles in these circuits, and imbalances in these chemicals can contribute to anxiety symptoms.

There are also several different types of anxiety disorders. Here are the most common types:

5 most common types of anxiety disorders
  • Generalised Anxiety Disorder (GAD)
    Generalised Anxiety Disorder (GAD) is a mental health condition characterised by persistent and excessive worry about various aspects of daily life, such as work, health, or finances, which is disproportionate to the actual source of worry. Individuals with GAD find it challenging to control their anxiety and may experience symptoms such as restlessness, difficulty concentrating, irritability, muscle tension, and sleep disturbances. 
The vicious cycle of panic disorder and its symptoms
  • Panic Disorder
    Panic Disorder is characterised by recurrent, unexpected panic attacks—sudden periods of intense fear or discomfort that peak within minutes. These attacks are accompanied by physical symptoms such as heart palpitations, chest pain, shortness of breath, dizziness, or abdominal distress. Individuals may also experience fear of losing control, having a heart attack, or dying. 
  • Social Anxiety Disorder (Social Phobia)
    Social Anxiety Disorder, also known as Social Phobia, is a mental health condition characterised by an intense, persistent fear of being watched, judged, or embarrassed in social situations. This fear can significantly impair an individual’s ability to function in daily life, affecting work, school, and other activities. 
  • Specific Phobias
    Characterised by significant fear of a specific object or situation, such as heights, flying, or spiders.
The symptoms of OCD (Obsessive Compulsive Disorder)
  • Obsessive-Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder (PTSD)
    While these are closely related to anxiety disorders, they are classified separately under the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

What Causes Anxiety?

Anxiety, a complex and multifaceted emotion, arises from a confluence of factors, encompassing genetic predispositions, environmental influences, psychological components, and brain chemistry. It’s an inherent part of the human condition, serving as an evolutionary response to perceived threats, yet for some, it escalates into persistent and excessive worry that impairs daily functioning.

Genetic Factors
Research suggests a hereditary component to anxiety, indicating that it can run in families. Studies involving twins have shown that if one twin has an anxiety disorder, the other is more likely to have one as well, underscoring the genetic link.

Brain Chemistry
Anxiety disorders have been linked to disturbances in the brain’s neurotransmitters, chemicals that transmit signals in the brain. Imbalances in serotonin and dopamine, which regulate mood and behaviour, can contribute to anxiety.

Life Events
Traumatic or stressful life events, such as abuse, the death of a loved one, divorce, or job loss, can trigger anxiety disorders. Chronic stress and coping with significant pressures can also heighten one’s predisposition to anxiety.

Environmental Factors
The environment, including upbringing and exposure to stressful or negative experiences, can influence the development of anxiety disorders. For instance, children raised in environments lacking stability or those who experience bullying are at a higher risk.

Medical Conditions
Certain medical conditions or the stress of dealing with a serious illness can induce anxiety. Moreover, anxiety can be a side effect of medication or a symptom of a different disorder, such as heart disease or diabetes.

Personality Traits
Individuals with certain personality traits, such as perfectionism or a tendency towards timidity, are more susceptible to anxiety disorders. Personality influences how one perceives and interacts with the world, potentially heightening anxiety under stress.

Substance Use
Abuse of alcohol, drugs, or even caffeine can exacerbate anxiety symptoms, leading to or worsening anxiety disorders.

Understanding the causes of anxiety is crucial for effective treatment, which may include therapy, medication, lifestyle changes, or a combination of these approaches. For individuals struggling with anxiety, seeking professional help is a vital step towards managing their symptoms and improving their quality of life.

Treatment Options For Anxiety

Treatment for anxiety is multifaceted and can be tailored to the individual’s specific symptoms, severity, and personal preferences. The main treatment options include psychotherapy, medication, lifestyle changes, and  complementary therapies:

Treatment options for anxiety

Psychotherapy

Cognitive Behavioral Therapy (CBT)
CBT is based on the principle that our thoughts, feelings, and behaviours are interconnected, and that changing negative thought patterns and behaviours can lead to changes in feelings. In the context of anxiety, CBT helps individuals identify and challenge irrational or distorted thoughts (cognitive distortions) that contribute to their anxiety. Through techniques such as cognitive restructuring, individuals learn to reframe their thoughts in a more realistic and positive manner. 

CBT also involves behavioural experiments and activities that challenge anxiety-provoking situations gradually, helping reduce avoidance behaviours. Scientific studies have shown that CBT can effectively reduce symptoms of anxiety by altering brain activity associated with these cognitive and behavioural patterns, particularly in areas involved in emotional regulation, such as the prefrontal cortex and amygdala.

Exposure Therapy
Exposure Therapy is a subset of CBT that involves the deliberate and systematic confrontation of feared stimuli, situations, or thoughts without engaging in avoidance or escape behaviours. The underlying mechanism is based on the principles of habituation and extinction learning. Repeated exposure to the feared object or situation in a controlled and safe environment can lead to a decrease in the anxiety response over time. 

Scientifically, this process is understood to modify the conditioned fear responses in the brain, particularly within the amygdala, and to enhance the individual’s sense of control and mastery over their fear. Exposure Therapy has been particularly effective for specific phobias, social anxiety disorder, and PTSD.

Acceptance and Commitment Therapy (ACT)
ACT is a therapeutic approach that guides individuals to embrace their thoughts and emotions, rather than resist or feel guilty about them. It highlights the importance of psychological flexibility, which is the capacity to fully engage with the present moment consciously and adapt or maintain behaviours aligned with personal values. ACT incorporates mindfulness techniques, enabling individuals to observe their thoughts and feelings neutrally, without judgement. This approach fosters a healthier relationship with one’s inner experiences, facilitating a life led by values rather than avoidance. 

Scientifically, ACT is thought to reduce the impact of negative thoughts and feelings by promoting detachment from them (cognitive defusion) and redirecting attention and action towards valued life directions (values clarification). This shift can reduce the influence of anxiety on behaviour and decision-making. Research suggests that ACT influences neural pathways involved in emotional regulation and self-referential processing.

Medication

Antidepressants
Antidepressants, particularly Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), are commonly prescribed for anxiety disorders. These medications work by affecting neurotransmitters in the brain, which are chemicals that neurons use to communicate with each other.

  • SSRIs work by boosting the levels of serotonin, which is a brain chemical linked with feeling good. They do this by stopping serotonin from being taken back up into the brain cells that released it. This leaves more serotonin floating around in the brain, helping to lift your mood and ease anxiety.
  • SNRIs work similarly but affect both serotonin and norepinephrine, another neurotransmitter involved in mood and stress response. By preventing the reuptake of these neurotransmitters, SNRIs can help alleviate symptoms of anxiety.

These medications do not work immediately; they typically require several weeks to show their full effect, suggesting their action might also involve long-term adaptations in the brain, such as neurogenesis or changes in receptor sensitivity.

Benzodiazepines
Benzodiazepines act on the gamma-aminobutyric acid (GABA) neurotransmitter system, enhancing the effect of GABA, the primary inhibitory neurotransmitter in the brain. By increasing GABA activity, benzodiazepines induce a sedative effect, decrease the brain’s arousal system, and thus reduce anxiety symptoms. These medications are effective in quickly relieving anxiety but are generally recommended for short-term use due to risks of dependency, tolerance, and withdrawal symptoms.

Beta-Blockers
Beta-blockers, such as propranolol, are typically used to manage cardiovascular conditions but can also be effective in treating the physical symptoms of anxiety, especially in social anxiety disorder or performance anxiety. They work by blocking the effects of norepinephrine, a hormone similar to adrenaline that is part of the body’s natural stress response. 

Beta-blockers prevent the increase in heart rate, blood pressure, and tremors associated with anxiety. While they do not directly affect the psychological aspects of anxiety, they can help manage physical symptoms that are often a source of further anxiety.

Complementary Therapies

Yoga

Yoga, an ancient practice combining physical postures (asanas), breath control (pranayama), and meditation, impacts anxiety management through several physiological and psychological mechanisms:

  • Regulation of the Stress Response
    Yoga has been shown to decrease the activation of the hypothalamic-pituitary-adrenal (HPA) axis and reduce levels of cortisol, the body’s primary stress hormone. By modulating the stress response, yoga can help alleviate symptoms of anxiety.
  • Enhancement of GABA Levels
    Studies have indicated that yoga can increase levels of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain that plays a key role in regulating nerve activity. Low levels of GABA are associated with anxiety and mood disorders, so increasing GABA through yoga can contribute to a reduction in anxiety symptoms.
  • Improvement in Autonomic Nervous System Function
    Yoga practices, particularly those focusing on breathing and meditation, can enhance parasympathetic nervous system activity (the “rest and digest” response) and decrease sympathetic nervous system activity (the “fight or flight” response). This shift can lead to decreased heart rate, lower blood pressure, and a state of relaxation.
  • Mindfulness and Body Awareness
    Yoga encourages mindfulness, which involves paying attention to the present moment without judgement. This can help individuals detach from negative thoughts or worries contributing to anxiety, promoting a state of mental calmness.

Nature

Nature offers a multitude of benefits that are crucial for the well-being of humans and the earth’s ecosystems. Here are some key points that highlight the importance of nature:

  • Physical Health
    Exposure to green spaces is not only a balm for the mind but also offers profound health benefits that can indirectly impact those dealing with anxiety. Reduced risks of type II diabetes, cardiovascular diseases, premature death, preterm birth, stress, and high blood pressure are all associated with spending time in natural environments. Furthermore, engaging in physical activities such as hiking or gardening within these settings contributes to improved fitness and aids in combating obesity. These physical health benefits complement mental health improvements, creating a holistic approach to well-being. The act of connecting with nature and participating in physical exercise can serve as a powerful tool in managing anxiety, enhancing overall health, and fostering resilience against stress.
  • Mental Health
    Spending time in nature has been consistently linked with mood improvements and significant reductions in anxiety levels. The tranquillity and beauty of natural landscapes play a pivotal role in mental restoration, aiding individuals in recovering from mental fatigue while providing a serene backdrop to cope with stress and depression. The restorative power of nature offers a therapeutic haven, offering a peaceful refuge that fosters emotional balance and enhances the ability to manage life’s pressures more effectively.
  • Social Benefits
    Parks and natural environments serve as crucial social spaces that not only foster a sense of community but also facilitate the building of social ties and enhancement of support networks, aspects that are vital for individuals dealing with anxiety. These outdoor settings provide a backdrop for activities that encourage social interaction and connection, contributing to a supportive community environment. Engaging in social activities within nature can help reduce feelings of isolation and promote a sense of belonging, offering both psychological and emotional support through strengthened social bonds.
  • Cognitive Benefits
    Interacting with nature has demonstrated remarkable benefits in improving concentration, enhancing creativity, and fostering cognitive development, particularly in children, which can be especially relevant for those researching anxiety management strategies. Moreover, nature-based education programs have been linked to notable improvements in science test scores, suggesting that the incorporation of natural environments into learning and development not only enriches educational outcomes but also contributes to the overall mental well-being of individuals. This connection between nature interaction and enhanced cognitive and academic performance underlines the potential of natural settings as therapeutic landscapes that support both mental health and educational achievements.
  • Environmental Benefits
    The benefits of green spaces extend beyond personal well-being to encompass economic advantages. Access to such areas not only boosts property values but also underpins the eco-tourism and recreational industries, which rely heavily on the allure of natural environments. This symbiosis not only generates significant revenue and job opportunities but also highlights the therapeutic potential of nature. Engaging with these spaces offers a dual advantage: promoting mental health through nature-based activities while supporting economic vitality in sectors dedicated to environmental stewardship and leisure.
  • Economic Benefits
    Access to green spaces not only contributes to increased property values but also plays a crucial role in supporting eco-tourism and recreational industries that rely on natural environments. The economic vitality of these sectors highlights the value of nature as a source of healing and relaxation. Engaging with natural spaces can provide therapeutic benefits, generating significant revenue and job opportunities in industries that promote well-being through nature-based activities.
  • Spiritual and Cultural Benefits
    Across various cultures, natural landscapes like rivers, mountains, and forests hold deep spiritual and religious importance, offering solace and a sense of connection for many. These natural settings have also inspired artists, writers, and musicians throughout history, providing a wellspring of calm and inspiration that can be particularly resonant for those seeking comfort and understanding in their journey with anxiety.
  • Therapeutic Benefits
    Incorporating nature into healing practices, such as forest bathing (shinrin-yoku) and horticultural therapy, has shown significant benefits in promoting well-being. The presence of gardens and green spaces in hospitals has also been associated with accelerated recovery rates for patients, highlighting the therapeutic power of the natural environment in the healing process.

Acupuncture
Acupuncture, a key component of traditional Chinese medicine, involves the insertion of fine needles into specific points on the body. It’s proposed to help with anxiety by:

  • Modulation of Neurotransmitters
    Acupuncture may influence the release of neurotransmitters, such as endorphins (the body’s natural painkillers) and possibly serotonin and dopamine, which play roles in mood regulation and anxiety.
  • Regulation of the HPA Axis
    Similar to yoga, acupuncture may help regulate the stress response by modulating the HPA axis, leading to reduced cortisol levels and alleviation of stress and anxiety.
  • Stimulation of the Nervous System
    The insertion of acupuncture needles is thought to stimulate the body’s nervous system to release chemicals into the muscles, spinal cord, and brain. These chemicals can change the experience of pain and lead to a sensation of relaxation and well-being.
  • Enhancement of Parasympathetic Activity
    Acupuncture can promote relaxation by enhancing parasympathetic nervous system activity, thereby reducing anxiety symptoms.

Medical Cannabis
Medical cannabis therapy can potentially help with anxiety through its interaction with the body’s endocannabinoid system (ECS), a complex system involved in regulating various physiological processes, including mood, memory, appetite, and stress response. The ECS consists of cannabinoid receptors (primarily CB1 and CB2 receptors), endocannabinoids (molecules produced by the body that bind to these receptors), and enzymes that help synthesise and degrade endocannabinoids.

  • Modulation of the Endocannabinoid System
    Cannabinoids from cannabis, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), interact with the ECS. THC binds to CB1 receptors in the brain, which can produce both anxiolytic (anxiety-reducing) and, in some cases, anxiogenic (anxiety-inducing) effects, depending on the dose and individual sensitivity. CBD, on the other hand, does not bind directly to CB1 or CB2 receptors but is thought to work by enhancing the activity of the body’s own endocannabinoids and interacting with other receptors involved in anxiety, such as serotonin receptors.
  • Serotonin Receptor Modulation
    CBD has been shown to interact with serotonin receptors in the brain, particularly the 5-HT1A receptor, which is known to play a key role in anxiety regulation. By modulating serotonin receptor activity, CBD can exert anxiolytic effects, which may help alleviate symptoms of anxiety.
  • Neurogenesis
    Some studies suggest that CBD can promote neurogenesis, particularly in the hippocampus, an area of the brain associated with emotions and memory. Neurogenesis (the formation of new neurons) can contribute to the reduction of anxiety symptoms.
  • Reduction of Inflammation
    Chronic inflammation has been linked to anxiety and depression. Both THC and CBD have anti-inflammatory properties, which may help reduce inflammation and its impact on anxiety.

While anecdotal reports suggest that medical cannabis can be effective in managing anxiety, scientific research is still evolving. The complexity of cannabis, with its many cannabinoids and terpenes, makes it challenging to study. Furthermore, individual responses to cannabis can vary widely, and factors such as the specific cannabinoid profile of the cannabis used, dosage, and the individual’s own ECS functioning can influence the therapeutic outcomes.

It’s important to approach medical cannabis therapy with caution, especially considering that high doses of THC can exacerbate anxiety in some individuals. Medical supervision is essential to ensure the safe and effective use of cannabis for anxiety.

Insights on Anxiety: Symptoms, Causes, and Management

The complexity of anxiety disorders arises from a web of genetic, environmental, psychological, and neurochemical factors. Key among these are alterations in brain circuits and neurotransmitter imbalances, contributing to the symptoms experienced. Various anxiety disorders, including Generalised Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder, and Specific Phobias, each present unique challenges, underlining the importance of a nuanced understanding and approach to treatment.

Addressing anxiety involves a multifaceted strategy tailored to the individual’s specific needs and symptoms. Psychotherapeutic interventions, particularly Cognitive Behavioral Therapy (CBT) and Exposure Therapy, play a critical role in managing anxiety by altering detrimental thought patterns and behaviours. Medications like SSRIs, SNRIs, and benzodiazepines offer chemical support by modulating neurotransmitter activity, although their use requires careful management to avoid potential dependencies or side effects. Complementary therapies, including yoga, acupuncture, and medical cannabis, provide alternative avenues for alleviating anxiety symptoms, emphasising the importance of a holistic approach to treatment. As understanding of anxiety deepens, the emphasis on personalised, evidence-based treatment strategies offers hope for those affected, promoting resilience and an improved quality of life.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

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