Anxiety disorders rank among the most common mental health conditions and contribute substantially to disability, impaired occupational functioning, and reduced quality of life according to the World Health Organization. Causal pathways combine genetic vulnerability, neurobiological differences in fear circuitry, and environmental stressors such as trauma or chronic social adversity, a multifactorial model articulated by David H. Barlow at Boston University. Cultural factors shape symptom expression and help-seeking behaviors, with territorial variations in service access and stigma influencing the course of illness and the availability of effective care.
Psychological therapies
Cognitive behavioral therapy has the strongest and most consistent evidence base across anxiety disorders, with efficacy demonstrated in multiple randomized controlled trials and systematic reviews summarized by the Cochrane Collaboration. Core elements include cognitive restructuring and behavioral exposure, the latter forming the active ingredient for specific phobias and panic-related avoidance in protocols developed and evaluated by David M. Clark at University of Oxford. Format adaptations such as group therapy, guided self-help, and internet-delivered CBT expand reach while maintaining measurable benefit. Psychological interventions frequently show durable effects on relapse prevention relative to monotherapy with pharmacological agents.
Pharmacological treatments
Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are identified as first-line pharmacotherapy by the American Psychiatric Association and by the National Institute for Health and Care Excellence, with consistent symptom reduction across generalized anxiety disorder, panic disorder, social anxiety disorder, and related conditions. Short-term use of benzodiazepines provides rapid anxiolysis but carries risks of dependence and cognitive side effects that limit long-term suitability, a point emphasized in guideline syntheses from national agencies. Evidence synthesized by the Cochrane Collaboration indicates that combined treatment with psychotherapy and pharmacotherapy can accelerate symptom relief in severe presentations, while psychotherapy contributes to longer-term maintenance of gains. Health systems guided by stepped-care frameworks balance accessibility, clinical severity, and patient preference in determining when psychological, pharmacological, or combined approaches are most appropriate.
