Anxiety, phobias and obsession

By contrast, a disastrous event such as a serious car or aircraft accident, a fire, shipwreck, rape or war can trigger a severe, long-lasting anxiety known as post-traumatic stress disorder. Its cause is extremely clear, although its start is often delayed for some considerable time after the incident. The symptoms are those of a serious GAD and include reliving the event.

How is GAD treated?
Many cases of GAD are not very severe and supportive treatment with discussion and explanations from the doctor are all that is required. Relaxation treatment, including yoga exercises, can also help. Cognitive behaviour therapy in combination with relaxation is also an effective way of managing anxiety. Drugs can also be used to bring symptoms under control quickly when the anxiety is serious and other methods do not work.

Panic disorder
Panic attacks are episodes of severe and sudden anxiety with physical symptoms that reinforce the attack. When panic attacks are severe and frequent (four or more in four weeks) they constitute panic disorder. One to two people in 100 aged 18-65 suffer from panic disorder at some time in their lives. It is about twice as common in women as in men. Panic attacks of lesser severity are about five times as common.

What causes panic disorder
There are three main theories on the cause of panic disorder: a chemical abnormality in the brain, over-breathing and a form of psychological 'feedback'.

The psychological feedback or cognitive theory is based on the observation that people who have panic disorder are often more concerned about health than others. This causes them to be over-concerned about the physical symptoms of their anxiety.

How is panic disorder treated?
Treatment is usually by drugs or cognitive behaviour therapy. Anxiolytic drugs are less effective in treating panic disorder than in GAD. Cognitive behaviour therapy tries to show sufferers that the symptoms that alarm them so much are easily explained.