Anxiety Disorders

Treatments Work, Part 2
by National Institute of Health

(Page 2 of 2)

Why Me?

Scientists aren't quite sure why some people get anxiety disorders. Different people exposed to the same situation can react in very different ways. Part of this difference may be in the genes they have inherited.

"These disorders run in families," Dr. Charney explains. So if a parent has an anxiety disorder, the chance of their children having one of these conditions is higher. That may be due to the genes they've inherited, but Dr. Charney points out, "The environment that a child is brought up in may be important too. Ultimately, it's probably an interaction between genetic predisposition and environment."

Scientists have recently been gaining insights into the development of anxiety disorders. "Children of parents with panic disorders have a higher incidence of behavioral disorders very early in life, before you would think major environmental impacts would occur," Dr. Charney says.

A growing body of evidence shows that infants who tend to be shy, timid and constrained in social situations - even in the very first weeks of life - have higher rates of anxiety disorders when they get older. "We're actively searching for other behavior manifestations that might relate to the development of other anxiety and mood disorders early in life," Dr. Charney adds. Scientists hope that understanding the development of these disorders will lead them to better ways of preventing and treating them.

Researchers are taking several approaches to figure out the underlying scientific bases for anxiety disorders. Using advanced imaging techniques, they are mapping the brains of people with anxiety disorders to see how they differ from those without the disorders. Much current effort is focused on a region of the brain called the amygdala, which plays a central role in feelings of fear and anxiety.

Scientists are also trying to better understand how the body deals with the stress that accompanies anxiety, a complex reaction that involves another region of the brain called the hippocampus, as well as many other systems of the body. And they are studying the many different chemicals both in the brain and throughout the rest of the body that are involved in the experience of anxiety and fear.

"Anxiety and mood disorders are diseases of the brain and the body, not just the mind," Dr. Charney stresses.

Getting Help

Scientists have found that adolescence is an important period for the diagnosis and treatment of anxiety disorders.

Dr. Charney says, "Of adolescents who have any one of the mood or anxiety disorders, 42 percent still have an anxiety or depressive disorder in adulthood." In contrast, only five percent of adolescents who were healthy go on to develop one of the disorders.

"It is likely that if we aggressively treat adolescents who suffer from mood and anxiety disorders, we can prevent many of these disorders from becoming chronic," Dr. Charney says. "We want to make these diagnoses as early as possible."

But treatments can be effective at any age. If you think you may have an anxiety disorder, don't hesitate to discuss it with your health care provider. There are many different types of treatments available, and these can be tailored to specific problems. In some cases, psychotherapy, or counseling, is sufficient. In other cases, medication alone can be very effective. Some people may need both. Researchers are now looking at ways to define at an early stage who will do well with which treatments.

"Probably in a majority, it's a combination of both medication and psychotherapy that works," Dr. Charney says. "Psychotherapy teaches you things that are very effective and helpful for the long run. But in many patients, that may not be enough because there's also a biology that the psychotherapy may not be able to overcome. The therapy helps you learn better behaviors and the medications help treat the biologic or genetic disturbance."

"The take home message is that treatment can work," Dr. Charney says. "We're working to make it better, and that's why we're doing research at places like NIMH. But there are treatments available now that can work. Patients have to believe in that, because it's true."

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.