Anxiety disorders occur when people have both physical and emotional symptoms. Anxiety disorders interfere with personal relationships with others and affect daily activities. Women are twice as likely as men to have problems with anxiety disorders.

Many people, including children and teenagers, develop anxiety disorders in which many of these symptoms occur when there is no identifiable cause. Many people with an anxiety disorder say they have felt nervous and anxious all their lives. This problem can occur at any age. Children who have at least one parent with the diagnosis of depression are more than twice as likely to have an anxiety disorder than children with non-depressed parents.

Panic attacks occur when a person has distinct periods of intense fear and anxiety when there is no clear cause or danger. These symptoms come on suddenly and without warning. Panic attacks are a common anxiety-related disorder. Panic attacks can sometimes occur in otherwise normal, healthy people and will usually last for several minutes.

Physical symptoms that can occur during a panic attack include feelings of choking or suffocating, chest pain, nausea, shaking, sweating, pounding of the heart, and feeling dizzy or faint. Sometimes these symptoms are so intense that the person fears he or she is having a heart attack.

Phobias are irrational, involuntary fears of specific places, objects, activities, or situations. Most people deal with phobias by avoiding the situation or object that causes them to feel panic (avoidance behavior). Phobias are a common anxiety-related disorder.

A phobic disorder occurs when the avoidance behavior becomes so extreme that it interferes with your ability to participate in your daily activities. There are three main types of phobic disorders:

• Fear of being alone or in public places where help might not be available or escape is impossible (agoraphobia)
• Fear of situations where the individual might be exposed to criticism by others (social phobia)

Obsessive-compulsive disorder (OCD) is when an individual has intrusive and unwanted thoughts and repeatedly performs tasks to get rid of the thoughts. For example, if you have OCD, you may fear that you didn’t turn off the stove and the house will burn down. You may repeatedly check the stove. The effects of OCD range from mild to severe. OCD can disrupt your social life and relationships as well as your ability to work or go to school.

OCD is a chronic or long-term illness, and the symptoms typically increase and decrease over time. Treatment can lessen the severity, but some symptoms may linger after you begin treatment. Anxiety is the most common symptom of OCD. For example, you may have an overall sense that something terrible will happen if you don't follow through with a particular ritual, such as repeatedly checking to see whether the stove is on. If you fail to perform the ritual, you may have immediate anxiety or a nagging sense of incompleteness.

• Obsessions, which are recurring, unwanted thoughts, ideas, and impulses that interrupt normal thinking and cause anxiety or fear. The thoughts may be sexual or violent or create a concern of illness. Examples include:
• Persistent fear of harm to yourself or a loved one.
• An excessive need to do things perfectly or correctly.
• A fear of contamination.
• Compulsions, which are behaviors or rituals that are repeated intentionally to try to control the obsessions. Some people have rituals that are rigid and structured, while others have very complex rituals that change. Examples include:
• Washing or checking.
• Counting, often while doing another compulsive action, such as hand-washing.
• Repeating things or endlessly rearranging items to keep them in perfect alignment.
• Hoarding.
• Praying.

People vary in their understanding of their obsessions and compulsions. Sometimes they may recognize their obsessions and compulsions as unrealistic, and at other times they may be unsure of or believe strongly in their fears. Though one has reoccurring thought of doing something negative such as harming oneself or another person, it rarely is realistic.

Researchers have yet to pinpoint the exact cause of OCD, but they are studying brain abnormalities, genetic (family) influences, and environmental factors. Brain scans in people with OCD have shown that they have different patterns of brain activity than those without OCD and that abnormal functioning of circuitry within a certain part of the brain (striatum) may be related to the disorder. Abnormalities in other parts of the brain and an imbalance of brain chemicals, especially serotonin, may also contribute to OCD.

Treatment for OCD includes counseling and medications. Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (for example, Prozac), are most commonly used. Your doctor may increase the dosage of your medication or change to another SSRI if the first medication prescribed doesn't help. It may take several weeks before you feel the effects of an antidepressant and it begins to affect thoughts and behavior. Therapy is an important component to reduce the symptoms. OCD is more severe when the individual is under stress.