Mental health disorders are very common, affecting millions of people worldwide. According to the National Institute of Mental Health, nearly 1 in 5 adults in the United States experiences some form of mental illness each year. The two most prevalent mental health conditions are anxiety disorders and depressive disorders. In this article, we will provide an overview of these two common disorders, looking at their symptoms, causes, diagnosis, treatment, and prevalence. Understanding the key features of anxiety and depression can help raise awareness and reduce stigma around mental health issues.
Anxiety Disorders
Anxiety disorders are characterized by excessive, persistent worry and fear about everyday situations. These disorders cause significant distress and interfere with daily activities. There are several different types of anxiety disorders:
Generalized Anxiety Disorder
This involves constant and chronic worrying about many different things that is out of proportion to the actual likelihood of such events happening. Physical symptoms may include restlessness, fatigue, muscle tension, headaches, trembling, and sleep disturbances.
Social Anxiety Disorder
This involves an intense fear of social situations and potential scrutiny or judgment by others. It can cause physical symptoms like blushing, sweating, upset stomach, and rapid heartbeat when around other people.
Panic Disorder
This features sudden, unexpected panic attacks with symptoms like a pounding heart, sweating, shaking, shortness of breath, and sensations of choking. It involves a persistent concern about having another attack.
Phobias
These are marked by irrational fear of specific objects or situations that poses little or no actual danger, such as spiders, flying, crowded places, or blood. This fear leads to avoidance behavior.
Post-Traumatic Stress Disorder (PTSD)
This can develop after exposure to a terrifying or traumatic event involving actual or threatened death, violence, or serious injury. Symptoms include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.
Obsessive-Compulsive Disorder (OCD)
This features a pattern of unwanted, intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions) to attempt to ease anxiety. This could include obsessive cleaning, hand washing, counting, or repeatedly checking things.
Causes & Risk Factors
There are multiple factors that can increase risk for developing an anxiety disorder:
– Trauma – Having experienced a traumatic event like abuse, violence, or disaster makes anxiety more likely.
– Genetics – Anxiety disorders tend to run in families. Genes may predispose someone to an anxiety disorder.
– Brain structure and function – Certain areas of the brain regulate fear and emotion. Irregularities in these areas are linked to anxiety disorders.
– Stress – High levels of stress from work, relationships, school, or financial difficulties can trigger anxiety disorders.
– Drug and alcohol use – Chronic substance abuse can both cause and worsen anxiety. Withdrawal can also provoke anxiety symptoms.
– Medical conditions – Some illnesses, like thyroid disease and heart disease, are associated with higher anxiety risk.
– Childhood mental health disorders – Having an early mental health issue like depression or separation anxiety may lead to later anxiety disorders.
Common Symptoms
While each anxiety disorder has its own distinct features, many share similar symptoms. Common signs and symptoms of anxiety include:
– Excessive fear or worry
– Feeling agitated or on edge
– Avoiding certain situations that cause anxiety
– Racing heart and shortness of breath
– Tense muscles
– Trouble concentrating
– Irritability
– Difficulty controlling feelings of worry
– Sleep problems like insomnia
– Fatigue
– Stomachaches or diarrhea
– Sweating, trembling, dizzy spells
Diagnosis
If anxiety symptoms are frequent and begin to interfere with daily functioning, it is important to talk to a doctor or mental health professional. They can conduct a psychological evaluation involving:
– Asking about symptoms, including when they started and how severe they are
– Using questionnaires to assess anxiety levels
– Looking for any other mental health conditions that may be present
– Considering any general medical conditions that could be causing symptoms
– Asking about alcohol and drug use
– Discussing family medical history
– Performing a mental health examination to assess mood, behavior, thought patterns, and memory
The doctor may also order medical tests to identify any underlying health issue contributing to anxiety. Based on the evaluation, the doctor will determine if criteria is met for a specific anxiety disorder diagnosis.
Treatment
Anxiety disorders are highly treatable through a combination of medications and psychotherapy. Common treatments include:
Medications
– SSRIs – Selective serotonin reuptake inhibitors like Lexapro, Prozac, Zoloft
– SNRIs – Serotonin-norepinephrine reuptake inhibitors like Effexor, Pristiq
– Benzodiazepines – Anti-anxiety drugs like Xanax, Klonopin, Valium
– Beta blockers – Help control physical anxiety symptoms
Psychotherapy
– Cognitive behavioral therapy (CBT) – Identifying negative thought patterns and modifying anxious behaviors
– Exposure therapy – Gradually exposing someone to feared object or situation in a safe, controlled way
– Acceptance and commitment therapy (ACT) – Learning psychological flexibility to handle anxiety
– Support groups – Sharing experiences with others facing similar challenges
Lifestyle changes like getting regular exercise, eating a balanced diet, avoiding alcohol and drugs, and learning relaxation techniques are also helpful. Hospitalization may be required in cases of severe anxiety with safety concerns like self-harm risks or an inability to care for oneself.
Prevalence
Anxiety disorders are very widespread. According to the National Institute of Mental Health:
– 19.1% of U.S. adults experience an anxiety disorder each year
– Phobias are the most common type, affecting 7.7% of people
– Generalized anxiety disorder affects 3.7%
– Social anxiety disorder affects 7.1%
– 2.7% have panic disorder
– 2.2% have OCD
– Women are twice as likely as men to develop anxiety disorders
– Anxiety typically emerges in childhood, the teenage years or early adulthood
– Only around 37% of people with anxiety disorders receive treatment
Depressive Disorders
Depressive disorders involve persistent feelings of sadness, hopelessness, and loss of interest that impair daily life. The two main types are major depressive disorder and persistent depressive disorder.
Major Depressive Disorder
This is characterized by severe, persistent depression and loss of interest in usual activities. Episodes can last weeks, months or years if left untreated. Symptoms include:
– Depressed, sad mood
– Lack of enjoyment in hobbies and activities
– Significant weight loss or gain
– Sleep disturbances like insomnia or sleeping too much
– Physical and mental fatigue, lack of energy
– Feelings of worthlessness and guilt
– Trouble concentrating and making decisions
– Thoughts of death or suicide
Persistent Depressive Disorder
This involves a chronically low, sad mood lasting at least two years in adults or one year in children. It impairs functioning but tends to be less severe than major depression.
Causes & Risk Factors
Like anxiety disorders, depression has no single cause but certain factors can increase risk:
– Family history – Having a parent or sibling with depression raises your risk. Genetics play a role.
– Brain structure – Abnormalities in mood regulation centers of the brain are linked to higher depression vulnerability.
– Childhood trauma – Abuse, neglect, loss of a parent, and household dysfunction in early life increase likelihood of developing depression.
– Substance use – Chronic alcoholism or drug abuse can trigger depressive disorders. Withdrawal can also cause depression symptoms.
– Medical conditions – Illnesses like cancer, heart disease, diabetes, Alzheimer’s, and thyroid disorders are tied to higher rates of depression.
– Medications – Some prescription drugs are associated with increased depression, including steroids, painkillers, and high blood pressure medications.
– Stress – High stress levels from work, financial strain, major life changes, or relationship issues can contribute to depression risk.
Common Symptoms
People with depression experience some combination of the following symptoms most of the day, nearly every day:
– Sad, hopeless, empty mood
– Irritability or frustration
– Loss of interest in previously enjoyable activities
– Changes in appetite and weight
– Sleep disturbances
– Physical and mental fatigue, low energy
– Feelings of worthlessness and guilt
– Difficulty concentrating and making decisions
– Physical symptoms like headaches, stomach aches, back pain
– Thoughts of death or suicide
Diagnosis
If symptoms persist for at least two weeks and impair normal functioning, it is advisable to visit a doctor or mental health professional. They will conduct a full evaluation:
– Asking about symptoms, including their severity, frequency, and how long they have been present
– Screening for other mental health conditions that may co-occur like anxiety disorders
– Considering any medical issues or medications that could contribute to depression
– Discussing family history and previous bouts of depression
– Performing a physical exam and ordering lab tests to check for any underlying illness
– Having the patient fill out a depression questionnaire to quantify symptoms
– Doing a psychiatric assessment of mood, behavior, thought patterns, and cognition
Based on this comprehensive evaluation, the doctor will determine if diagnostic criteria is met for major depressive disorder, persistent depressive disorder, or another depressive illness.
Treatment
A combination of medication and psychotherapy is typically the most effective approach to treating major depression. Treatment options may include:
Medications
– SSRIs – Selective serotonin reuptake inhibitors like Prozac, Zoloft, Lexapro
– SNRIs – Serotonin-norepinephrine reuptake inhibitors like Cymbalta, Effexor
– NDRIs – Norepinephrine-dopamine reuptake inhibitors like Wellbutrin
– MAOIs – Monoamine oxidase inhibitors like Emsam, Marplan, Nardil
– Atypical antidepressants like Remeron and Serzone
Psychotherapy
– Cognitive behavioral therapy (CBT) – Changing negative thought and behavior patterns
– Interpersonal therapy – Focusing on improving relationships and communication issues
– Psychodynamic therapy – Increasing self-awareness and understanding mood patterns
– Group therapy – Sharing experiences and receiving support from others
For optimal results, medication and therapy are often combined. Lifestyle modifications like regular exercise, sufficient sleep, stress management, and a healthy diet also support recovery. Hospitalization may be required for severe depression cases where there are self-harm risks.
Prevalence
According to the National Institute of Mental Health, depression is highly prevalent worldwide:
– An estimated 17.3 million U.S. adults had at least one major depressive episode in 2017
– This equals 7.1% of all American adults
– Rates are higher in women at 8.7% compared to 5.3% in men
– Major depression is most common in young adults age 18-25 at 13.1%
– Only about half of people experiencing depression receive treatment
– Suicide is the 2nd leading cause of death in people age 10-34 in the U.S., and depression is a major risk factor
Conclusion
Anxiety and depressive disorders are the most widespread mental health conditions. They significantly impair quality of life but are treatable through medications, psychotherapy, and lifestyle changes. Raising awareness, reducing stigma, and encouraging those who are struggling to seek help are critical in addressing these common issues. With appropriate treatment, most people with anxiety or depression can manage symptoms, function normally, and enjoy life again. Public education and expanding access to mental healthcare are vital for supporting the millions of people affected by these disorders.