What are the symptoms of anxiety disorders
· 5 min read
Fear and anxiety are evolutionarily ancient mechanisms that have helped people avoid danger for thousands of years. The problem starts when this mechanism switches on too often, too strongly, or for no clear reason, and begins to get in the way of normal life. At that point we are no longer talking about ordinary anxiety but about an anxiety disorder.
How the World Health Organization defines it
According to the World Health Organization, anxiety disorders are characterised by excessive fear and anxiety and associated behavioural disturbances, with symptoms severe enough to cause significant distress or functional impairment. The WHO distinguishes several main types of anxiety disorder: generalised anxiety disorder, marked by excessive, hard-to-control worrying; panic disorder, dominated by recurrent panic attacks; social anxiety disorder, marked by intense fear of being judged in social situations; and separation anxiety disorder, linked to excessive fear of being apart from a close person. Effective psychological treatment exists for most of them, and depending on age and symptom severity, drug treatment is also considered. The scale of the phenomenon is considerable: according to World Health Organization data, around 470 million people worldwide were living with some form of anxiety disorder in 2023, including 146 million children and adolescents, making this group of disorders one of the most common among all mental health problems.
Primary and secondary anxiety
Clinical practice distinguishes between primary anxiety, which is not linked to other mental or physical disorders, and secondary anxiety, which appears as part of the course of other conditions, for example depression or states related to alcohol withdrawal. The co-occurrence of several disorders at once is usually associated with more severe symptoms and greater treatment difficulty, which is why a reliable diagnosis needs to take in the whole clinical picture, not just the anxiety itself.
Is every instance of anxiety a disorder
No. Fear and anxiety in the face of a real threat are a normal, adaptive bodily response. An anxiety disorder differs from this in the sense of uncontrolled threat, which can appear without any direct, identifiable cause and which has a potentially devastating effect on everyday functioning. Since judging whether a given fear is rational is often subjective and difficult, it is worth focusing on specific symptoms rather than trying to judge whether the fear is justified.
Three dimensions of anxiety symptoms
An extensive scientific review published in 2021 in The Lancet by Brenda Penninx, Daniel Pine, Emily Holmes and Andreas Reif describes anxiety disorders as a group of disorders characterised by excessive fear and avoidance of perceived threats, which are persistent and impair functioning, and which are underpinned by disrupted functioning of the brain circuits responsible for responding to danger. The review's authors point out that the risk of developing these disorders is influenced by both genetic and environmental factors and their mutual, epigenetic interactions, and that anxiety disorders often co-occur with one another and with other mental disorders, particularly depression, as well as with physical illnesses. Anxiety symptoms can be divided into three interrelated dimensions, which often overlap and mask one another.
The first is psychopathological symptoms, covering both the emotional sphere, meaning a sense of threat, terror, irritability and intense worry, and the cognitive sphere, including difficulty concentrating, memory disturbances and a sense of detachment from reality. The second dimension is behavioural symptoms, which can take the form of hyperactivity, for example restlessness or an impulsive urge to flee, or conversely the form of freezing, such as speech disturbance or a stunned, immobile state. The third dimension is autonomic and somatic symptoms: a racing heart, chest pain, an upset stomach, frequent urination, excessive sweating, trembling, hyperventilation, a feeling of a tight throat, or sleep disturbance.
In generalised anxiety disorder, clear, hard-to-control worry about everyday matters predominates, accompanied by constant tension, fatigue, irritability and muscle tension lasting at least six months. Panic disorder is characterised by recurrent, unexpected panic attacks with numerous physical symptoms, such as a racing heart, breathlessness or dizziness, and requires at least a month of such episodes before it can be called a disorder. Social anxiety, in turn, involves a clear, disproportionate fear of negative judgement by others, leading to avoidance of social situations for a period of at least six months.
When it is worth seeking help
If the symptoms described persist for a long time and genuinely limit functioning at work, at school or in relationships, it is not worth waiting for them to pass on their own. Anxiety disorders are among the well-understood and effectively treated conditions, and the earlier they are diagnosed, the easier it is to regain balance. Diagnosis and choice of treatment should always be left to a specialist, not to self-assessment based on an article online. It is also worth remembering that despite how common anxiety disorders are, many people with recognisable symptoms never seek professional help, often out of fear of stigma or a belief that severe anxiety is something you have to cope with on your own. Yet this is one of those areas of medicine in which early intervention genuinely shortens the period of suffering.
Where kava fits into this picture
Kava is sometimes described as a plant with anti-anxiety properties, and some clinical trials have indeed shown it to outperform placebo in easing anxiety symptoms, although the results of other, larger trials are less clear-cut. Even in the most optimistic scenario, kava can at best be a support for coping with tension day to day, not a medicine or a substitute for therapy or drug treatment for anxiety disorders. It also should not be combined with alcohol or with medications metabolised by the liver, including anxiolytics and antidepressants, because both combinations can increase the load on that organ and the risk of adverse effects. You can read more about anxiety itself and what the research on kava says about it in the articles kava and anxiety: a review of the research and experts on kava.