Anxiety disorders — guide.

What anxiety disorders are

Anxiety is a normal emotion, a natural response to stress or danger. It becomes a disorder when the worry is excessive, persistent and disproportionate to the situation, affecting everyday life, sleep, relationships and professional activity. Anxiety disorders are among the most common psychiatric conditions, occurring in 15-20% of people over the course of their lifetime, more often in women. In addition to the psychological component (fear, nervousness, catastrophic thoughts), intense physical manifestations appear — palpitations, sweating, tremor, a sensation of choking, dizziness — which can mimic somatic illnesses. The good news is that anxiety responds very well to psychotherapy and, when needed, to medication.

Types

GAD — chronic excessive worry, across multiple domains. Panic — acute attacks with intense physical symptoms. Social phobia — fear of evaluation and of being judged by others. Agoraphobia — fear of places from which escape would be difficult. PTSD — appears after a trauma. OCD — repetitive obsessions and compulsions.

Treatment

Cognitive behavioral therapy (CBT) — the gold standard. Gradual exposure for phobias. Efficacy similar to medication.

Medication (Rx):

• SSRIs (sertraline, escitalopram, paroxetine) — first line, long-term.
• SNRIs (venlafaxine, duloxetine) — for GAD.
• Buspirone — non-sedating alternative.
• Benzodiazepines (alprazolam, lorazepam) — strictly short-term (max 2-4 weeks), risk of dependence.
• Pregabalin — for GAD.
• Propranolol — for the somatic component, performance social phobia.

Adjuvant OTC options

• Ashwagandha 300-600 mg — solid evidence.
• L-theanine 200 mg — relaxation without sedation.
• Magnesium 300-400 mg.
• Valerian, passionflower — mild effect.
• CBD oil — emerging evidence.
• Kava — effective but risk of hepatotoxicity.

Lifestyle

• Aerobic exercise — solid anxiolytic effect.
• Reduce caffeine, nicotine, alcohol.
• Regular sleep.
• Breathing techniques, meditation.
• Mindfulness.
• Limit anxiety-provoking stimuli (news, social media).

Medical disclaimer: the information in this guide is for informational purposes and does not replace the advice of a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.