Anxiety is a functional alarm system evolved to detect danger. It becomes a disorder when the alarm keeps firing in the absence of any real threat.

Coping with anxiety disorders
Anxiety is an alarm system. The problem is not that it fires, but that it fires at the wrong time and will not stop.

When does anxiety become a disorder?

Feeling anxious before an exam or an interview is normal and can even improve performance. To speak of a clinical presentation, the anxiety has to be disproportionate to the situation, persistent and disruptive to functioning.

Commonly reported symptoms

  • Persistent worry and uncontrollable loops of thought
  • Restlessness, tension, a sense of being constantly on guard
  • Palpitations, sweating, shortness of breath, stomach complaints
  • Muscle tension and headaches
  • Difficulty falling asleep
  • Trouble concentrating
  • Avoidance of situations that provoke anxiety

Common types

  • Generalised anxiety disorder: uncontrollable worry across many domains, present most days
  • Social anxiety disorder: fear of evaluation and negative judgement
  • Panic disorder: unexpected panic attacks and fear of having another
  • Specific phobias: intense fear of a particular object or situation
  • Separation anxiety: excessive anxiety about separation from an attachment figure

Why avoidance does not work

Avoidance brings relief in the short term and grows the anxiety in the long term. Every situation you avoid tells your brain that the danger was real, so the next encounter starts from a higher level of anxiety.

Notice the cycle: trigger → anxiety → avoidance or safety behaviour → immediate relief → the anxiety is reinforced. Most of treatment is built around breaking that cycle.

What actually helps?

  • Cognitive behavioural therapy: the approach with the strongest evidence base in anxiety disorders
  • Exposure: planned, graded contact with the avoided situation — it targets the avoidance cycle directly
  • Breathing and relaxation work: supportive, but not sufficient on its own
  • Medication: for moderate and severe presentations, following psychiatric assessment

When to seek support

  1. PersistenceIf anxiety is present most days and has lasted for months.
  2. Growing avoidanceIf the list of places you do not go and things you do not do keeps getting longer.
  3. Physical symptomsIf palpitations and breathlessness persist after medical causes have been ruled out.
  4. FunctioningIf work, study or relationships are being affected.
Note: This article is for general information. It does not diagnose and is not a substitute for professional assessment. If your symptoms are making daily life difficult, consult a mental health professional. If you are having thoughts of harming yourself, call your local emergency number — 112 in Türkiye — or go to the nearest emergency department.

Individual Counselling

In work with anxiety we map the avoidance cycle together and build a graded plan.

Read more →

References

  1. Craske, M. G., & Stein, M. B. (2016). Anxiety. The Lancet, 388(10063), 3048–3059.
  2. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). American Psychiatric Publishing.