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Anxiety disorders are the most common mental health problem, and include panic disorders, agoraphobia, generalized anxiety disorder, social anxiety, and post-traumatic stress disorder. Anxiety disorders are caused by both a genetic predisposition and environmental factors.

Generalized anxiety disorder,a relatively common disorder affecting 3-4% of the population, turns daily life into a state of worry, anxiety, and fear. This disorder is characterized by excessive worry and rumination over everyday events which even the sufferer recognizes as being excessive. Physical symptoms include of generalized anxiety may include headaches, trembling, twitching, irritability, frustration, inability to concentrate, and insomnia. Mild symptoms of social phobia and/or panic may sometimes occur, such as feelings of self-consciousness and fear of being trapped in enclosed spaces. Symptoms can vary from hour to hour or day to day.

Social anxiety disorder,or social phobia, affects 7-8% of the population. This type of anxiety disorder affects 15 million Americans in any given year. Sufferers feel as though they are being watched and judged in every social interaction, and become so fearful that they avoid people altogether. Sufferers know that their fear is irrational, but they cannot overcome it, and often become reclusive.

People with panic disorders have acute physical symptoms which can lead them to believe that they have a serious physical disease. They may fear that they are having a heart attack, that they're about to lose control, or that they're going crazy. Patients with panic disorders may have sensations of breathlessness, suffocation, dizziness, and lightheadedness. Often these patients make repeated use of emergency medical facilities, convinced they are having heart attacks or that their lives are danger from some acute physical disorder.

Agoraphobia is a reaction to panic attacks that occur unpredictably and frequently in many places, thus making the person with agoraphobia feel unsafe when leaving the familiarity of their homes. Panic/agoraphobia affects approximately 5-6% of the population.

Posttraumatic stress disorder (PTSD) is an anxiety disorder usually occurs after an individual experiences or witnesses severe or life-threatening trauma. In the US, Post Traumatic Stress Disorder has a lifetime prevalence of 8-10% and accounts for considerable disability and morbidity. One study found the prevalence of PTSD in a sample of adolescent boys to be 3.7% and adolescent girls to be 6.3%. Approximately 30% of men and women who have spent time in a war zone experience PTSD.

The individual initially responds to the precipitating event with intense fear, helplessness, or horror. The patient later develops a disorder characterized by persistently re-experiencing the event, with symptoms of numbness, avoidance, and hyperarousal, resulting in significant distress or functional impairment. To meet the full criteria for PTSD, these symptoms should be present for a minimum of 1 month following the initial traumatic event.

Events which cause PTSD include natural disasters, violent personal or sexual assaults, war, or severe accidents. PTSD can be acute (symptoms lasting <3 mo), chronic (symptoms lasting >3 mo), or of delayed onset (6 mo elapses from event to symptom onset).

PTSD is associated with brain changes in the amygdala, a structure in the brain which processes primitive emotions such as fear and the fight/flight response. Traumatic events can lead to fear conditioning with resultant activation of the amygdala and associated structures such as the hypothalamus, locus ceruleus, periaqueductal gray, and parabrachial nucleus. This activation and the accompanying autonomic neurotransmitter and endocrine activity produce many of the symptoms of PTSD. The orbitofrontal cortex exerts an inhibiting effect on this activation. The hippocampus also may have a modulating effect on the amygdala. However, in people who develop PTSD, the orbitofrontal cortex appears less capable of inhibiting this activation.

Females may be at a higher risk than males because of higher rates of traumatic events, such as being victims of crimes and abuse in personal relationships. Sexual assault probably has the most impact on women, and trauma from combat is more likely to cause the disorder in men. PTSD can occur at any age, including during childhood.

The National Center for Post-Traumatic Stress Disorder (PTSD) was created within the Department of Veterans Affairs created the National Center for PTSD in 1989, in response to a Congressional mandate to address the needs of veterans with military-related PTSD. Their website provides an educational resource concerning PTSD and other enduring consequences of traumatic stress, for both military and non-military audiences.

In all anxiety disorders, cognitive behavioral therapy is often helpful, combined with anxiolytic drugs to ease acute symptoms. Patients with anxiety often also suffer from depression, and antidepressants are often also used.

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