Anxiety Disorders: A Plain-English Guide

Reading time: about 5 minutes. General education only, not medical advice.

What is it?

Everyone feels anxious sometimes, for example before a test or a job interview. That kind of worry is normal and can even help. An anxiety disorder is different. The worry or fear is stronger, lasts longer, and doesn't go away when the stressful moment passes. It can get in the way of work, school, relationships and daily life.

Anxiety disorders are among the most common mental health conditions. They are not a weakness or a character flaw. They often start in childhood or the teen years. They are treatable, and many people learn to manage them well.

There are several kinds, including:

  • Generalised anxiety disorder (GAD): constant worry about many everyday things.
  • Panic disorder: sudden, intense waves of fear called panic attacks.
  • Social anxiety disorder: strong fear of being judged or embarrassed around others.
  • Phobias: intense fear of a specific thing or situation, such as heights or flying.

Common signs and experiences

In the mind:

  • worrying a lot and finding it hard to stop
  • feeling on edge, restless or easily irritated
  • expecting the worst
  • trouble concentrating or feeling your mind go blank

In the body:

  • a fast heartbeat, sweating or shaking
  • feeling short of breath
  • tense muscles, headaches or stomach upset
  • feeling tired, or trouble sleeping

In behaviour:

  • avoiding places, people or situations that trigger fear

A panic attack can feel like a heart attack, with chest pain, dizziness and a sense of doom. If you are not sure, get checked by a doctor.

How it's diagnosed

A doctor or mental health professional asks about your worries, how long they have lasted and how they affect your life. They may use a short questionnaire. They may also check for physical causes that can feel like anxiety, such as thyroid problems, heart problems, caffeine or some medicines.

Usual treatments today

  • Talking therapy. Cognitive behavioural therapy (CBT) is one of the best-studied treatments. It helps people change anxious thinking and slowly face feared situations. Guided self-help can help with milder anxiety.
  • Medication. Some antidepressants (such as SSRIs) are often used. Other medicines may be used short term. All have possible side effects, so talk them through with your doctor.
  • Self-care and support. Exercise, regular sleep, cutting back on caffeine and alcohol, relaxation skills and support groups can help.

Many people use a mix of these.

Where metabolic health fits in

Metabolism is how the body turns food into energy. Mitochondria are tiny parts inside our cells that make most of that energy.

Researchers are interested in metabolism and anxiety for a few reasons:

  • Anxiety often happens alongside depression and physical conditions such as obesity and diabetes.
  • The body's stress system and its energy system are closely linked. Swings in blood sugar can cause shakiness and a racing heart that may feel like anxiety.
  • Animal studies suggest mitochondria and the gut may play a part in how the brain handles stress.

Studies of diet, exercise, the gut and ketogenic diets for anxiety are still at an early stage. Many are small, done in animals, or look at anxiety only as a side measure in studies about depression or other conditions.

This is emerging research, not established treatment, and it is not a cure. Healthy eating, movement and sleep are good for general health, but they are not a replacement for proven treatment.

Safety first. Do not start a ketogenic or other therapeutic diet on your own. These diets can change how some medicines work, including mood stabilisers and diabetes medicines. They can cause side effects, and they may not be safe for everyone, for example during pregnancy or with some kidney, liver or eating problems. In studies, people were followed by doctors and dietitians.

When to get help

See a doctor if worry or fear is hard to control, lasts for weeks, or stops you doing things you need or want to do. Get help right away if you have chest pain you are unsure about, or if anxiety comes with thoughts of hurting yourself.

  • US: call or text 988 (Suicide & Crisis Lifeline), or chat at 988lifeline.org.
  • Emergency: call 911 or go to the nearest emergency room.
  • Outside the US: contact your local emergency number.

Research posts on this condition are coming soon.

Disclaimer

This page is for general education only. It is not medical advice, and it is not a diagnosis or treatment plan for anyone. We are not able to review anyone's situation. Metabolic psychiatry is a young field, and research summaries here may be incomplete or out of date, so please read the original sources. Always talk with your own doctor, psychiatrist or other qualified clinician before changing a diet, starting a supplement, or starting, stopping or changing any medication. Stopping psychiatric medication suddenly can be dangerous. Read the full disclaimer.

If you are in crisis in the US, call or text 988. For emergencies, call 911.

Sources