Anxiety Disorders

Prevalence rate

Prevalence rates of anxiety disorders vary for different countries and age groups. For Chinese Hong Kong residents aged 16-75, prevalence rate of generalised anxiety disorder is 4.2%, while other anxiety disorders have a prevalence rate of 1.5%.

Gender ratio

The proportion of female to male patients for anxiety disorders is approximately 2:1, but there is no significant gender difference for social anxiety disorder.

Age of onset

Most cases of separation anxiety and specific phobias develop during childhood; most cases of social anxiety disorder develop in adolescence or early adulthood; most cases of panic disorder and generalised anxiety disorder develop during later adulthood, with a greater dispersion of onset age. Certainly, there are individual differences for illness onset.

Genetic and environmental factors are both involved. A family history of anxiety disorder, traumatic experience in childhood, heightened anxiety in parents, stressful life events, and insufficient coping strategies, etc. all contribute to the risk of anxiety disorders.

Below are some major symptoms of anxiety disorders:

Below are the symptoms of common types of anxiety disorders:

Specific phobia

Specific phobia is characterised by excessive and irrational fear to a particular object or situation. Sometimes, panic attack can be triggered. Commonly feared objects and situations include flying, heights, animals, receiving an injection, and seeing blood, etc. In extreme cases, the fear response is not only cued by the real object or situation, but also at the mere mentioning or sight of visual representations of it, leading to avoidance behaviours. Some patients may suffer from more than one type of specific phobia at the same time.

Social anxiety disorder

Social anxiety disorder is characterised by persistent strong fears of social situations where others’ judgment and evaluation are expected. This fear can be so strong that individuals may avoid places or events where they may act in a way that will be negatively evaluated, or they would remain quiet in social situations to avoid drawing others’ attention. When around other people, they may palpitate, blush, tremble, draw a blank, stutter, sweat, or even have difficulty breathing and feel dizzy.

Generalised anxiety disorder

Generalised anxiety disorder (GAD) is characterised by multiple excessive worries persisting for few days or even months. Worries can widely involve various kinds of daily events, such as job, safety of family members, finances, or infection, etc. These worries are often uncontrollable and shifting. Patients are usually overwhelmed by persistent symptoms including fatigue, fidgeting, difficulty concentrating, irritability, insomnia, and so forth.

Panic disorder

Panic disorder is characterised by repeated ‘panic attacks’, which, under no obvious threats, lead to intense fear and physical symptoms such as palpitation, shortness of breath, sweating, trembling, chest discomfort, and dizziness etc. Patients often perceive these symptoms as signs of life-threating illnesses, and worry for losing control or even imminent death. To prevent intense physical symptoms and distress, patients often make great efforts to avoid certain places or situations. But such avoidance can increase feelings of fear and anxiety, resulting in a vicious cycle of panic and anxiety. Some patients with panic disorder may also develop agoraphobia, which is an avoidance of crowded places or places where immediate escape is difficult (e.g. railway station, intercity buses, or unfamiliar subway).

Separation anxiety disorder

Separation anxiety disorder often occurs during childhood. Patients show developmentally inappropriate and excessive anxiety when being separated from their attachment figures, such as their parents or caregivers. Cognitively, they often worry about being abandoned by their parents or losing them due to accidents. As a result, they are unwilling to be left alone. Behaviourally, they may call their parents excessively to seek assurance during separation, or simply refuse to go to school.

In addition to children, separation anxiety disorder can also occur during adolescence or adulthood. The figure of attachments can be their parents, caretakers, spouse or offspring.

Tips for caregivers:

Avoid blaming:

People with anxiety disorders may get anxious from situations that are difficult for others to understand; they may avoid social contact, isolate themselves, or be involved in various kinds of inconveniences. Families should try to learn more knowledge about the disorders and avoid blaming them to prevent adding further distress to them.

Be a good listener:

Encouraging, but not forcing, them to share their feelings and difficulties, listening to them patiently, showing acceptance, and giving time and appropriate supports to them.

Maintain regular life:

Providing a peaceful and comfortable environment for them, and facilitating them to engage in regular daily activities as far as possible.

Encourage social interactions:

Encouraging them to maintain personal interactions with others, such as keeping contacts with those they have good relationship or they feel comfortable to meet.

Get more understandings:

Helping them to gain more understanding of their course of illness, and encouraging or accompanying them to seek treatment and cooperate with mental health care professionals.

Monitor regularly:

It is not uncommon for people with anxiety disorders also suffer from depressed mood. Pay attention to any changes in mood and mental state of the individual. If any self-harming behaviours and/or abnormal behaviours are noted, one should seek help from health care professionals as soon as possible.

Take care of yourself:

Supporting emotionally disturbed people is a long-term challenge. So carers need to look after their own physical and mental health, to rest and regenerate, and then to accompany patients to get out from troubled time. Ask for help when necessary.