Anxiety disorders
Anxiety disorders include generalized anxiety, social anxiety, and panic attacks: persistent worry, fear in social situations, or sudden episodes of intense fear that seem to come from nowhere.
Generalized anxiety brings near constant worry that is hard to switch off. Social anxiety turns everyday interactions into something dreaded. Panic attacks arrive suddenly with a racing heart, shortness of breath, and a sense of doom. All three are common, all three are real, and all three respond to treatment.
Care starts with careful diagnosis, since anxiety overlaps with depression, thyroid problems, and other conditions. Anxiety disorders involve an overactive threat alarm in the brain, and SSRIs and SNRIs gradually turn down the volume on that alarm by adjusting serotonin and norepinephrine signaling. That is why worry loosens its grip over weeks rather than hours. They are designed for steady daily use, not quick sedation. Treatment is individualized and often combines medication with therapy based approaches.
Research and further reading
A few key papers behind how this condition is understood and treated today. Links open the abstract on PubMed, a free public database from the U.S. National Library of Medicine.
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Craske et al. · The Lancet · 2016
Anxiety disorders are common and often persistent, but cognitive behavioral therapy and medications such as SSRIs and SNRIs are effective treatments.
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Efficacy of treatments for anxiety disorders: a meta analysis
Bandelow et al. · International Clinical Psychopharmacology · 2015
Across 234 randomized studies involving 37,333 patients with generalized anxiety, panic disorder, or social anxiety, both medication and individual cognitive behavioral therapy improved symptoms.
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Carpenter et al. · Depression and Anxiety · 2018
In trials comparing cognitive behavioral therapy to placebo, therapy produced meaningfully larger symptom reductions, with the strongest effects in obsessive compulsive disorder, generalized anxiety, and acute stress related conditions. Free full text.
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Goodman et al. · Journal of Affective Disorders · 2005
Across three trials with about 850 adults, escitalopram improved generalized anxiety symptoms more than placebo and was generally well tolerated.
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Baldwin et al. · British Journal of Psychiatry · 2006
In 681 adults, escitalopram at 10 and 20 mg per day reduced generalized anxiety symptoms more than placebo in a 12 week study.
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