Understanding Anxiety Disorders Prevalence

The ever-increasing pace of life, coupled with new complexities in modern society, has brought to the forefront many mental health conditions, anxiety disorders being one of the most prevalent. With over 284 million people affected globally, anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder, have become a central focus in the mental health landscape. This post aims to shed light on the importance of seeking anxiety treatment, help, and therapy, focusing on the various accessible routes to address these disorders.

What is Anxiety?

Anxiety disorders are more than just a fleeting feeling of fear or worry. They involve a group of related conditions, rather than a single disorder, and can look very different from person to person. While they're generally characterized by feelings of anxiety and fear, it's the persistence, intensity, and interference with daily activities that distinguish anxiety disorders from ordinary worry or stress.

Anxiety disorders are characterized by excessive and persistent worry and fear about everyday situations. Symptoms may start during childhood or the teen years and continue into adulthood. While it is perfectly normal to have anxiety about specific events or tasks, people with anxiety disorders often have intense, excessive, and persistent worry and fear about everyday situations. These feelings of anxiety often interfere with daily activities, are difficult to control, are out of proportion to the actual danger, and can last a long time.

Each anxiety disorder has distinct symptom profiles, but all are connected by the common thread of excessive, irrational fear and dread. It's important to remember that experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive, and persistent worry and fear about everyday situations, which can significantly impact their daily activities.

Given the many different types of anxiety disorders and their impact on people's lives, it's crucial to seek professional help if you're experiencing symptoms. There are effective treatments available that can help manage and even alleviate these symptoms, improving the quality of life for those affected by these disorders.

How Common are Anxiety Disorders?

Anxiety disorders are among the most common mental health disorders worldwide. Let's take a deeper look into the different types of anxiety disorders and their prevalence:

• Generalized Anxiety Disorder: GAD is characterized by persistent and excessive worry about various different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. According to the Anxiety and Depression Association of America, GAD affects 6.8 million adults in the U.S., or 3.1% of the U.S. population, in any given year. Women are twice as likely to be affected.

• Panic Disorder: This disorder involves recurrent, unexpected panic attacks, as well as fear of experiencing more episodes. Panic disorder affects 6 million adults in the U.S., or 2.7% of the population. Women are twice as likely to have panic disorder compared to men.

• Social Anxiety Disorder: SAD is characterized by a significant amount of fear in one or more social situations causing considerable distress and impaired ability to function in parts of daily life. According to ADAA, SAD affects 15 million adults, or 6.8% of the U.S. population. It's equally common among men and women and typically begins around age 13.

• Specific Phobias: A specific phobia is an excessive and irrational fear of a specific object, situation, or activity that is generally not harmful. Patients know their fear is excessive, but they can't overcome it. Specific phobias affect 19 million adults, or 8.7% of the U.S. population. Women are twice as likely to have a phobia compared to men.

• Obsessive-Compulsive Disorder (OCD) and Posttraumatic Stress Disorder (PTSD): While they are not technically classified as anxiety disorders according to the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), they're closely related to anxiety disorders. OCD is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions), affecting 2.2 million adults, or 1.0% of the U.S. population. PTSD, on the other hand, can occur after an individual witnesses or experiences a traumatic event and affects 7.7 million adults, or 3.5% of the U.S. population.

While these numbers focus on the U.S. population, it's important to note that anxiety disorders are a global issue, with the World Health Organization (WHO) estimating that globally, one in 13 people suffer from anxiety.

What Contributes to the Prevalence of Anxiety Today?

Anxiety disorders are common for a combination of reasons that often involve both nature (genetics) and nurture (environment). The prevalence of anxiety disorders can be attributed to the following key factors:

• Genetic Factors: Just like physical traits, mental health conditions, including anxiety disorders, can run in families. Research suggests that if a person has a close family member, like a parent or sibling, with an anxiety disorder, they may be at a higher risk of developing an anxiety disorder themselves.

• Brain Structure and Chemistry: Certain structures in the brain are more active in people with anxiety disorders. For example, the amygdala, which is responsible for processing emotions, is often more reactive in people with these disorders. Moreover, imbalances in neurotransmitters, chemicals that transmit signals in the brain, can also contribute to anxiety.

• Environmental Factors: Situations or events in a person's life can trigger anxiety disorders. This can include traumatic experiences, such as physical or sexual abuse, neglect, or witnessing a traumatic event. Even prolonged exposure to high-stress environments, like an abusive household or a high-stress job, can lead to anxiety disorders.

• Personality Traits: People with certain personality traits are more prone to anxiety disorders. For example, individuals who are perfectionists, easily flustered, timid, inhibited, lack self-esteem, or want to control everything, are more likely to develop anxiety disorders.

• Physical Health Conditions: Certain physical health conditions, like heart disease, diabetes, or thyroid problems, can also contribute to anxiety. Symptoms of these conditions can trigger or exacerbate anxiety symptoms.

• Other Mental Health Disorders: Having another mental health disorder, like depression, can increase the risk of an anxiety disorder. These conditions often co-occur, with symptoms feeding off each other.

Lastly, it's important to note that the high prevalence of anxiety disorders might be due, in part, to increased recognition and understanding of these conditions. As society becomes more aware of mental health and reduces the stigma surrounding it, more people are likely to seek help and receive a diagnosis.

However, despite their prevalence, anxiety disorders are treatable, and a majority of people with these conditions can lead normal, productive lives with the right treatment and support. If you or someone you know is struggling with symptoms of anxiety, it's essential to reach out to a mental health professional for help.

Anxiety Treatment Options

Early diagnosis and intervention significantly improve the prognosis for recovery, hence the importance of awareness and access to professional help. Effective treatments for anxiety disorders are available, and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives.

Before diving into the treatment options, it's crucial to understand that seeking help for anxiety is an act of courage. Acknowledging that you're struggling is the first step towards anxiety help. Once you've taken that step, there are numerous anxiety treatment options available.

• Psychotherapy: Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive-behavioral therapy is a common form of psychotherapy, effective in treating anxiety disorders. This therapy teaches you different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations. While traditional routes like psychotherapy are significant, they are not the only ways to seek anxiety help. More and more people are now turning to alternative and complementary approaches for anxiety treatment.

• Lifestyle changes: Sometimes, small changes can make a big difference. Regular physical activity and exercise can help manage symptoms of anxiety by boosting your mood and acting as a natural stress reducer. Incorporating a balanced diet, limiting caffeine and alcohol, and prioritizing good sleep hygiene can also be beneficial.

• Mindfulness and relaxation techniques: Techniques such as deep breathing, meditation, and yoga can help to reduce symptoms of anxiety. These practices aim to create a sense of peace and calm within the mind and body, providing relief from stress and anxiety.

Anxiety Treatment: Therapy Options for Those With an Anxiety Disorder

Anxiety therapy, whether it's psychotherapy or a more holistic approach, can be a lifeline for those grappling with anxiety disorders. It's not a sign of weakness but rather an empowering step towards reclaiming your life.

Cognitive-behavioral therapy (CBT): As mentioned before, CBT is one of the most effective forms of therapy for treating anxiety disorders. It helps you identify and challenge thought patterns that lead to harmful behaviors and feelings of anxiety.

Exposure therapy: This is a form of CBT that is particularly useful for specific phobias and obsessive-compulsive disorder. It involves gradually exposing you to the object or situation that causes anxiety, helping you feel less fearful over time.

Dialectical behavioral therapy (DBT): DBT is used for various mental health conditions, including anxiety. It focuses on teaching skills to cope with stress, regulate emotions, and improve relationships with others.

Online therapy has emerged as a popular and accessible form of anxiety therapy. It allows you to receive therapy from the comfort of your own home, providing a sense of safety and convenience. Especially with the ongoing COVID-19 pandemic, online therapy has proved to be a crucial tool for mental health support.

In conclusion, understanding anxiety disorders and their prevalence in today's society is just the first step in battling this global issue. The importance of seeking anxiety treatment, help, and therapy cannot be overstated. Remember, the bravest thing one can do is ask for help when they need it. It's a sign of strength, not weakness. With the wide range of treatments and therapies available, you or a loved one dealing with anxiety don't have to face this journey alone. Help is available, and recovery is within reach. Always reach out to a healthcare provider or mental health professional if you or someone you know is struggling with anxiety. It's never too late to seek help.

What is generalized anxiety disorder?

Generalized anxiety disorder (GAD) is a type of anxiety disorder characterized by persistent and excessive worry and anxiety about everyday events and activities. People with GAD experience chronic and uncontrollable worry that is disproportionate to the actual level of threat or concern. This worry can occur across multiple areas of life, including work, school, relationships, and health.

In addition to excessive worry, people with GAD may also experience a range of physical symptoms, such as muscle tension, fatigue, irritability, restlessness, difficulty sleeping, and difficulty concentrating. These symptoms can be distressing and may interfere with daily life activities.

The exact causes of GAD are not fully understood, but it is believed to be influenced by a combination of genetic, environmental, and psychological factors. GAD is a treatable condition, and treatment typically involves a combination of psychotherapy and medication.

Cognitive-behavioral therapy (CBT) is an effective treatment for GAD, which focuses on identifying and challenging negative thought patterns that contribute to anxiety and worry. Other therapies, such as mindfulness-based stress reduction, relaxation techniques, and exposure therapy, may also be helpful in reducing symptoms of GAD.

At the Anxiety Treatment Center of Denver, we offer evidence-based treatment for GAD. Learn more or contact us today.

Treating Multiple Anxiety Issues with a Single Treatment

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is a transdiagnostic treatment for emotional disorders, meaning it was designed to be used for all issues of emotion, including all forms of depression and anxiety. This treatment is administered in 16 sessions, and, according to the creators, represents “a more efficient and possibly a more effective strategy in treating emotional disorders” over single disorder treatments (Barlow, Allen, & Choate, 2016).

The rationale behind this design is the theory that all emotional disorders share certain characteristics and underlying processes which manifest differently for different persons. By targeting those processes, you reduce both the current symptoms (such as panic) while reducing the likelihood other symptoms will emerge (such as generalized anxiety or depression). In addition, the UP has a major advantage over single-diagnosis treatments: clinicians need only learn this one treatment for all emotional disorders, rather than separate treatments for each. This makes it easier, and cheaper to learn. It also gives clinicians more practice (since they are using it with many more clients), leading to quicker proficiency, and then mastery.

The UP contains seven modules (usually delivered in 1-3 weeks) that are taught in order. The modules consistent of CBT concepts and exercises which have been shown to be beneficial across diagnoses. The modules are: motivational enhancement, psychoeducation on emotions, emotion tracking, mindfulness of emotions, thought challenging, psychoeducation on avoidance, exposure to physical sensations, and exposure to emotion-provoking situations.

Previous studies have shown this intervention to be effective at treating generalized anxiety disorder (GAD). One study of 223 persons with GAD found the UP lead to a significant reduction of anxiety symptoms over the waitlist control condition after 16 sessions, and at a 6 month follow up (Barlow, et al., 2017). The UP has also been shown to be effective at reducing symptoms of depression on both subject and clinician measures after 16 sessions, and at 12 months post-treatment (Sauer-Zavala, 2020).

One meta-analysis of the Unified Protocol examined 15 studies totaling 1244 participants (Sakiris & Berle, 2019). This study found the UP yielded a reduction of symptoms with large effect sizes for: anxiety, depression, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder (both with and without agoraphobia), and social anxiety disorder. There were also significant improvements seen in measures of emotional regulation, functional impairment, and quality of life.

Another study found the Unified Protocol to be an effective treatment for some persons diagnosed with borderline personality disorder (BPD)(Lopez et al., 2015). In this study of eight individuals with BPD who received the UP, three showed clear reductions in BPD symptoms, while four others demonstrated small reductions. While these results were not as impressive when compared to persons with anxiety or depression, the UP is much shorter, cheaper, and easier to deliver than other BPD treatments. 

Significantly, clients also tend to see reductions in symptoms that are not the primary target of treatment (Reinholt et al., 2017). For example, clients who are primarily seeking treatment for anxiety also see reductions in depression, and vice versa. This suggests the UP is especially beneficial for persons with co-morbid mood disorders and unclear or shifting symptomology.

The Unified Protocol has also been shown to be effective in clients presenting with a complex combination of symptoms. One case study by Bentley (2017) used the UP to treat a client who met criteria for social anxiety disorder and generalized anxiety disorder that was also regularly engaging in nonsuicidal self-injury (NSSI). This client was also experiencing symptoms of depression, PTSD, and an eating disorder. After 16 weeks of the UP, the client reported moderate drops in anxiety, with a significant increase in their ability to regulate intense emotions, and a significant decrease in NSSI behavior.

How does the Unified Protocol, which is designed to treat a wide range of disorders, compare to disorder specific treatments? One study to examine this question compared the use of disorder specific CBT treatments to the UP (Steele at al., 2018). The authors found that both groups showed significant drops in symptoms and improvements on measures of anxiety, social anxiety, and depression, each with large effect sizes. However, there were no significant between-groups differences. This suggests the UP was just as effective. In addition, it has the added benefit of being easier to learn and master (compared to learning many different disorder specific treatments).

One study examined the use of the UP modules separately, to determine if each is beneficial and necessary (Sauer-Zavala et al., 2017). This study found that five of eight participants showed improvement on each individual skill when they received the modules separately. This suggests the program is well designed without significant overlap, that each module is necessary, and that overall symptom improvement is likely the product of a synergistic effect achieved by learning all of the modules.

Research indicates that the UP is an excellent treatment for emotional issues, including generalized anxiety, worry, panic, and depression. Contact us today to learn if the UP is the best treatment for your anxiety or depression.

What is Panic Disorder?

A panic attack is defined by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) as a discrete period of intense fear or discomfort accompanied by at least four physical or cognitive symptoms from a list of 13 (such as palpitations, shortness of breath, derealization, and fear of dying) (American Psychiatric Association, 2013). Panic disorder is characterized by recurrent panic attacks (requiring at least a panic attack followed by fear of another attack for at least a month, or at least one panic attack followed by maladaptive behaviors related to the attack).

Approximately 2.7% of American adults experience a panic attack each year (National Institute of Mental Health). Among persons who have panic attacks, about half (44.8%) have panic disorder that can be categorized as “serious,” with a high degree of impairment across multiple domains. Women are more likely to experience a panic attack than men in any given year (3.8% for females, and 1.6% for males). The numbers for adolescents are similar, with 2.3% of Americans aged 13-18 meeting diagnostic criteria for Panic Disorder (2.6% for women and 2.0% for men). White Americans are the racial group most likely to endorse symptoms of panic disorder (5.1%), higher than Hispanic Americans (4.1%), African Americans (3.8%), and Asian Americans (2.1%)(Asnaani, Richey, Dimaite, Hinton, & Hofmann, 2010).

Panic disorder is considered to be highly treatable. For example, one study found that a CBT intervention for panic was effective at reducing panic attacks to zero at three months post-treatment, and almost half of the subjects were panic free 24 months post-treatment with no additional treatment (Ham, Waters, & Oliver, 2005). However, only about 40% of persons with panic disorder seek treatment (Anxiety and Depression Association of America). Many persons do not receive adequate treatment because they are not diagnosed, or misdiagnosed. Panic and related anxiety disorders are very common, and many persons seeking mental health care could potentially benefit from more effective diagnosis and treatment. This also applies to social workers who are not working primarily as mental health providers but who nonetheless encounter many clients for whom anxiety treatment, or a referral for anxiety treatment, would be very beneficial.

Many persons with panic disorder present to their primary care physician or the emergency room, and they are six times more likely than the general population to be admitted to a psychiatric hospital. Misdiagnoses, missed diagnoses, and improper treatment of panic attacks, panic disorder, and other anxiety disorders, places an unnecessary burden on emergency and psychiatric facilities. Proper diagnosis and treatment of panic disorder is an essential skill for any person who treats emotional disorders, works in community mental health, or works in any social work agency.

At ATC-D, we offer an anxiety treatment program that is very effective at treating panic disorder. Contact us to learn how we can help you beat your panic, for good.