Anxiety & Phobias

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Anxiety and Phobias

It’s natural to feel a little anxious when confronting a difficult situation, like going to a job interview or on a first date. Anxiety is a normal reaction to stress and can even be useful when it alerts you to danger. For some people though, anxiety is a real disorder that can disrupt relationships and the ability to carry out daily activities at home, school, or in the workplace.

Anxiety disorders are more than just nerves and are characterised by uncontrollable feelings of panic, fear and discomfort that can arise with no clear cause. This level of anxiety can disrupt your enjoyment of life, and if left untreated, can eventually lead to other health concerns.

There are a wide variety of anxiety disorders including post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, and phobias.

Phobias are a common type of anxiety that manifest as an overwhelming and irrational fear of an object or situation that poses little real danger. There are many types of phobias such as a fear of confined spaces, a fear of heights, flying or of snakes.

Anxiety, in whatever form, can be treated with counseling, medications, or by making certain lifestyle changes. Once you understand your anxiety disorder, there are steps you can take to ease your anxiety and regain control of your life.

In this section, you will learn more about the causes and risk factors associated with anxiety disorders, as well as how best to reduce the impact of your symptoms.

There is also information on the different types of anxiety disorders, how they are diagnosed, and what treatment options are available. We have also researched alternative ways to treat Anxiety & Stress.

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Irrational and intense fear or worry is the biggest indication of an anxiety disorder. Alongside this, common symptoms of anxiety include:

Feelings of dread and apprehension

Feeling powerless

Having a sense of impending danger, panic or doom

Having trouble concentrating or feeling like your mind’s going blank

Feeling restless and irritable

Feeling fatigued, weak or tired

Pounding heart


Difficulty breathing

Breathing rapidly or hyperventilating



Frequent urination or diarrhea

Muscle tension



With phobias, the symptoms may vary depending on how close you are to the source of your fear, and how hard it is to escape that object or situation. Symptoms typically include:

Feeling of uncontrollable anxiety and panic when exposed to your fear

Feeling an intense need to do anything possible to escape your fear

The knowledge that you’re overreacting, but feeling powerless to control your fear

Difficulty breathing

Racing or pounding heart

Trembling or shaking

Hot or cold flushes


Chest pain or tightness

Feeling dizzy or lightheaded

In children, possibly tantrums, clinging or crying

If you can identify with these symptoms, and feel like it is seriously disrupting your life, then it is important to see your doctor. Anxiety disorders, including phobias, may be easier to treat if you address them early. If left untreated, these symptoms may actually get worse over time.

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Much is still unknown about the exact causes of anxiety disorders or phobias. Scientists currently believe that they arise from a combination of genetic, environmental, psychological, and developmental factors.  Certain risk factors have been identified that may increase the likelihood of developing an anxiety disorder. These are:

  • Your sex: Women are more likely than men to be diagnosed with an anxiety disorder, including phobias.
  • Your age: Most phobias usually develop early in life, before age 25.
  • Childhood trauma: Children who suffered abuse or witnessed traumatic events are at higher risk of developing an anxiety disorder during their lifetime. More specific to phobias, being attacked by an animal or experiencing some other traumatic event can trigger the development of a phobia.
  • Stress buildup: A big event, such as a death in the family, can cause an anxiety disorder to surface. A buildup of smaller stressful life situations, for e.g. ongoing worry about finances, can also lead to the development of an anxiety disorder.
  • Family history: Having blood relatives with an anxiety disorder can increase your likelihood of developing the disorder too. If someone in your immediate family has a specific phobia, you are also more likely to be diagnosed with it.
  • Underlying health issues: Anxiety symptoms can sometimes be the first indicators of an underlying health issue such as heart disease, diabetes, thyroid problems or drug abuse.
  • Personality: People with certain personality types are more prone to anxiety disorders than others. Some personality disorders, such as borderline personality disorder, may also be linked to anxiety disorders.
  • Drugs or alcohol: Drug or alcohol abuse can cause or worsen anxiety.


There are 5 major types of anxiety disorders: generalised anxiety disorder, obsessive-compulsive disorder, panic disorder, phobias and post-traumatic stress disorder. Below is a brief description of each.

  • Generalised anxiety disorder (GAD): GAD is characterised by at least 6 months of persistent, excessive and unrealistic worry about everyday things. Worries typically concern money, health, family and work. Anxiety related to GAD often shows up as physical symptoms like insomnia, stomach upset, restlessness, and fatigue.
  • Obsessive-compulsive disorder (OCD): People with OCD suffer from unwanted thoughts that seem impossible to stop or control (obsessions). This compels them to perform repetitive behaviours (compulsions), such as washing their hands over and over again, to try to ease their anxiety.
  • Panic disorder (also known as anxiety attacks): Panic disorder is diagnosed in people who experience repeated and unexpected panic attacks, and are preoccupied with the fear of a recurring attack. Symptoms of a panic attack include heart palpitations, chest pain, sweating, trembling and shortness of breath.
  • Phobias: Phobias are deep-seated fears that are extreme, irrational and can affect a person’s quality of life. There are 3 main categories of phobias:
    • Specific phobia: Specific phobias are characterised by major anxiety when exposed to a specific object or situation. There are many specific phobias including a fear of enclosed spaces, animals (such as spiders, snakes or mice), heights, dentists or injections.
    • Social phobia: Social phobia, also called social anxiety disorder, is the extreme fear of being scrutinised or judged by others in social situations. Although people with social phobia can recognise that the fear is excessive or unreasonable, they feel powerless against their anxiety and terrified that they will humiliate themselves in front of others. This fear may also lead them to avoid certain social situations they would otherwise enjoy.
    • Agoraphobia (fear of open places): Agoraphobia is a fear of open and public spaces, and often develops as a complication of panic attacks. Afraid of having another panic attack, people with agoraphobia become anxious about being in crowded places like malls, elevators and movie theatres, with no easy means of escape if they start to feel panicky.
  • Post-traumatic stress disorder (PTSD): PTSD often occurs in the aftermath of a traumatic or life-threatening event. It causes intense emotional and physical reactions, including flashbacks, nightmares and the desire to avoid situations that might remind you of the event.
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To determine whether you have an anxiety disorder, including a phobia, a doctor must conduct a thorough diagnostic evaluation to find out if the symptoms you are experiencing are caused by an anxiety disorder or a medical condition. This should include questions about your symptoms, as well as your medical, psychiatric and social history.

To diagnose an anxiety disorder, most doctors or mental health professionals will be guided by criteria spelled out in leading publications, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association, or the International Statistical Classification of Diseases (ICD) issued by the World Health Organisation.

If an anxiety disorder is diagnosed, the type of disorder or the combination of disorders must be identified, as well as any coexisting conditions, such as substance abuse or depression. The presence of coexisting conditions can make diagnosis and treatment more challenging. 

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In general, anxiety disorders respond very well to treatment. The specific treatment approach your doctor or mental health practitioner will take depends on the type and severity of the anxiety disorder. Nonetheless, the two main treatments for anxiety disorders are behaviour therapy and medication, or a combination of the two. Complementary and alternative treatments may also be effective.

  • Behaviour therapy: This is also called psychotherapy or psychological counseling, and involves working with a therapist to reduce your anxiety symptoms. The two main forms of behaviour therapy used in anxiety disorders are cognitive behaviour therapy and exposure therapy.
    • Cognitive behaviour therapy: This approach helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety. This form of therapy teaches you to develop a sense of control over your thoughts and feelings.
    • Exposure therapy: Exposure therapy encourages you to confront your fears in a safe, controlled environment. Through gradual, repeated exposures to the feared object or situation, your anxiety slowly diminishes.
  • Medications: Many different types of medications are used to treat anxiety disorders, including those below. It’s important to discuss the benefits, risks and possible side effects of these medications with your doctor.
    • Antidepressants: These medications influence the activity of brain chemicals thought to play a role in anxiety disorders. Examples of antidepressants used to treat anxiety disorders include fluoxetine (Prozac), imipramine (Tofranil), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and venlafaxine (Effexor XR).
    • Buspirone: This is an anti-anxiety medication that may be used on an ongoing basis. As with most antidepressants, it can take several weeks to become fully effective.
    • Sedatives: In limited circumstances, medications called benzodiazepines may be prescribed by your doctor to relieve anxiety symptoms. These include alprazolam (Niravam, Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan). Sedatives need to be used with caution because they can be addictive. These should be avoided if you have a history of alcohol or drug abuse.
  • Alternative medicine: Relaxation techniques like yoga and meditation have been recommended as tools to manage the symptoms associated with anxiety disorders. Herbal remedies such as kava, valerian and passionflower have also been used in the treatment of anxiety disorders. However, before taking herbal remedies, speak with your doctor to make sure they are safe and won’t interact with other medications you are taking.
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There's no sure way to prevent a person from developing an anxiety disorder since the exact causes are not yet known. But there are steps you can take to reduce the impact of symptoms if you’re feeling anxious.

Stay physically active: Make sure you are physically active most days of the week. Exercise is a powerful stress reducer and can improve your mood and help you stay healthy.

Get help early:  Treating anxiety is often easier if you seek help early.

Avoid alcohol and drug use: Alcohol and drug use can cause or worsen anxiety disorders. If you need help quitting, see your doctor or find a support group to help you.

Quit smoking and coffee: Both nicotine and caffeine can worsen anxiety.

Use relaxation techniques: Meditation, yoga and visualisation techniques reduce stress and can ease anxiety.

Get sufficient sleep: Make sleep a priority and aim for the prescribed 8 hours of quality sleep a night. Good sleep can have an extremely positive effect on your mood and ability to handle stress.

Eat healthy food: A diet full of vegetables, fruits, wholegrains and fish is great for your overall health and is also thought to reduce anxiety. Avoid fried, fatty, sugary and processed foods.

Learn time management techniques: You can reduce anxiety by learning how to carefully manage your time and energy.

Keep a journal: Keeping a journal can help you identify situations that trigger stress, as well as factors that help to ease your anxiety.

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