What condition is considered an anxiety disorder?

From the Guidelines

Anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, separation anxiety disorder, and agoraphobia, are considered anxiety disorders, characterized by excessive fear or worry that interferes with daily activities. These conditions are distinct from normal stress reactions due to their persistence, disproportionate response to the situation, and significant impact on functioning 1. According to the DSM-5, anxiety disorders are characterized by developmentally inappropriate, excessive worry or distress associated with separation from a primary caregiver or major attachment figure, and include specific phobias, social anxiety, panic disorder, agoraphobia, generalized anxiety, substance/medication-induced anxiety, and anxiety due to another medical condition 1.

Key Characteristics of Anxiety Disorders

• Excessive fear or worry that interferes with daily activities
• Physical symptoms such as increased heart rate, rapid breathing, restlessness, trouble concentrating, and difficulty sleeping
• Persistent and disproportionate to the situation
• Significant impact on functioning

Diagnosis and Treatment

Anxiety disorders can be diagnosed using standardized screening instruments, such as the Level 1 Cross-Cutting Symptom Measures developed by the American Psychiatric Association 1. Treatment typically involves psychotherapy, medication, or a combination of both approaches, as well as lifestyle modifications such as regular exercise, stress management techniques, adequate sleep, and limiting caffeine and alcohol 1. Early intervention is crucial, as anxiety disorders are highly treatable but often require ongoing management.

Importance of Early Intervention

Anxiety disorders can begin in childhood and can have a significant impact on daily life, social relationships, and overall well-being 1. Early identification and treatment can help prevent long-term consequences, such as comorbid conditions like substance use and posttraumatic stress disorder, and improve quality of life 1. Therefore, it is essential to prioritize early intervention and treatment for anxiety disorders to improve morbidity, mortality, and quality of life outcomes.

From the FDA Drug Label

Anxiety Disorders Alprazolam tablets are indicated for the management of anxiety disorder (a condition corresponding most closely to the APA Diagnostic and Statistical Manual [DSM-III-R] diagnosis of generalized anxiety disorder) Generalized anxiety disorder is characterized by unrealistic or excessive anxiety and worry (apprehensive expectation) about two or more life circumstances, for a period of 6 months or longer, during which the person has been bothered more days than not by these concerns Panic Disorder Alprazolam tablets are also indicated for the treatment of panic disorder, with or without agoraphobia

The conditions considered anxiety disorders are:

• Generalized anxiety disorder: characterized by unrealistic or excessive anxiety and worry about two or more life circumstances for a period of 6 months or longer
• Panic disorder: characterized by recurrent unexpected panic attacks, with or without agoraphobia 2

From the Research

Definition and Characteristics of Generalized Anxiety Disorder

• Generalized Anxiety Disorder (GAD) is a chronic mental illness characterized by extreme persistent worry, mostly about minor problems, involving pathological fear with high occurrences of vegetative disturbance 3.
• GAD is defined as excessive worry and anxiety that occur on most days for at least 6 months that affect daily functioning 4.
• The condition impairs work capacity, relations, and leisure activities, and aggravates concurrent somatic diseases 5.

Diagnosis and Screening

• Patients with symptoms of GAD should be assessed for conditions such as hyperthyroidism, hyperparathyroidism, and cardiac arrhythmia before confirmation of an anxiety disorder diagnosis 4.
• The 7-item Generalized Anxiety Disorder (GAD-7) scale is an option for screening for GAD 4.
• The GAD-7 and Patient Health Questionnaire for PD are validated screening tools that can aid in diagnosis and assessment 6.

Treatment and Management

• First-line treatments for GAD are Serotonin selective reuptake inhibitors (SSRIs), Selective serotonin- and norepinephrine reuptake inhibitors (SNRIs) and pregabalin, an atypical anxiolytic 3.
• Management with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors in combination with psychotherapy has been shown to be effective for GAD 4.
• Cognitive behavioral therapy (CBT) is a valid alternative to pharmacotherapy, depending on patient preference 5.
• Benzodiazepines are not recommended for first-line therapy or long-term use because of adverse reactions, risk of dependence, and higher mortality 6, 7.