Anxiety Disorders

Risk Factors and Diagnosis

Anxiety disorders sometimes run in families, but no one knows for sure why some people have them while others don't. Anxiety disorders are more common among younger adults than older adults, and they typically start in early life. However, anyone can develop an anxiety disorder at any time.

Below are risk factors for these anxiety disorders.

  • Generalized Anxiety Disorder (GAD)
  • Social Anxiety Disorder (Social Phobia)
  • Panic Disorder

Generalized Anxiety Disorder - Risk Factors

Generalized anxiety disorder (GAD) affects about 6.8 million American adults, including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age. The average age of onset is 31 years old.

Social Phobia - Risk Factors

Social phobia affects about 15 million American adults. Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved.

Panic Disorder - Risk Factors

Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.

Diagnosis Can Be Difficult

There are a number of reasons why it can be difficult to accurately diagnose an anxiety disorder in older adults.

  • Anxiety disorders among older adults frequently occur at the same time as other illnesses such as depression, diabetes, heart disease, or a number of other medical illnesses. Problems with cognition (thinking) and changes in life circumstances can also complicate matters. Sometimes the physical signs of these illnesses can get mixed up with the symptoms of anxiety, making it difficult to determine if a person has a true anxiety disorder. For instance, a person with heart disease sometimes has chest pain, which can also be a symptom of a panic disorder.
  • Doctors can have difficulty distinguishing between anxiety caused by adapting to difficult life changes, and a true anxiety disorder. For example, if you fell and broke a hip, you may be justifiably fearful of going out for a while. But that would not mean you have developed an anxiety disorder.
  • Sometimes the worrying symptoms of a medical illness can lead to an anxiety disorder. Or, sometimes the side effects of medication can cause anxiety. Also, a disability or a change in lifestyle caused by a medical illness may lead to an anxiety disorder. Muscle tightness, feeling very tense all the time, and difficulty sleeping can also be symptoms of a physical illness or an anxiety disorder, complicating diagnosis.


Here is how these anxiety disorders are diagnosed.

  • Generalized Anxiety Disorder (GAD)
  • Panic Disorder
  • Social Anxiety Disorder (Social Phobia)

Generalized Anxiety Disorder (GAD) - Diagnosis

GAD can be diagnosed once a person worries excessively about a variety of everyday problems for at least 6 months.

People with GAD may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with headaches or trouble falling asleep, which can be symptoms of GAD, but they don't always get the help they need right away. It may take doctors some time to be sure that a person has GAD instead of something else.

Social Phobia - Diagnosis

A doctor can tell that a person has social phobia if the person has had symptoms for at least 6 months. Social phobia usually starts during youth. Without treatment, it can last for many years or a lifetime.

Panic Disorder - Diagnosis

People with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in most cases to certain kinds of medication or certain kinds of cognitive psychotherapy, which help change thinking patterns that lead to fear and anxiety.

If You Have Symptoms

Anxiety disorders are treatable. If you think you have an anxiety disorder, talk to your family doctor. Your doctor should do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may refer you to a mental health specialist.

You should feel comfortable talking with the mental health specialist you choose. If you do not, seek help elsewhere. Once you find a mental health specialist you are comfortable with, you should work as a team and make a plan to treat your anxiety disorder together.

Talk About About Past Treatment

People with anxiety disorders who have already received treatment for an anxiety disorder should tell their doctor about that treatment in detail. If they received medication, they should tell their doctor what medication was used, what the dosage was at the beginning of treatment, whether the dosage was increased or decreased while they were under treatment, what side effects may have occurred, and whether the treatment helped them become less anxious. If they received psychotherapy, they should describe the type of therapy, how often they attended sessions, and whether the therapy was useful.

For a list of helpful resources, visit the National Institute of Mental Health (NIHM).