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What do Psychiatrists Mean by Anxiety?

The Letter, Issue 64, Spring 2017, Pages 15 - 26


Brendan D. Kelly

In contemporary psychiatry, the term ‘anxiety disorders’ covers a broad range of conditions including phobias, panic disorder, generalised anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder and other conditions with varying relationships with anxiety, such as acute stress reaction, adjustment disorder, conversion disorder and somatoform disorder. Anxiety disorders are treatable conditions. Treatment tends to involve combinations of psychological therapies, medication and social inputs. Psychotherapy, chiefly cognitive-behaviour therapy, is usually the mainstay of treatment, augmented by other measures as indicated. For all patients and families, psychoeducation, self-help and support groups can also be extremely helpful. The vast majority of people with anxiety disorders are treated successfully in primary care or as outpatients, and the outlook for improvement is very good in the absence of complicating factors (e.g. alcohol misuse) and provided there is sensible, sustained treatment in the context of a good, steady therapeutic relationship. A wider diversity of psychotherapeutic approaches is, however, needed, in order to reflect the wide diversity of anxiety disorders that present, and the even wider diversity of people who present with them.

Keywords: anxiety; cognitive behavior therapy; medication; psychoanalysis; psychiatry

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