Anxiety, Panic Disorder, and Phobias

Anxiety is a natural response to stress, with signs ranging from an increased heart rate and loss of appetite to general nervousness. A variety of sources might trigger anxiety including job interviews, public speaking, and starting a new job. Some of the situations experienced by university students also cause anxiety, including separation from family, adjusting to the academic demands of university, and living in unfamiliar surroundings without access to their familiar sources of support. In some cases, if the anxiety is prolonged and severe, it may interfere with or severely disrupt a student's academic functioning, affecting attention and concentration, the ability to process information, comprehension, and memory. Anxiety may also contribute to difficulties in managing time and tasks effectively, significantly affecting sleep, and result in feelings of exhaustion and demoralization.

To effectively manage mild-to-moderate levels of anxiety, students may benefit from relaxation and stress management techniques, as well as guidance in study skills, time management, and handling procrastination. Where the anxiety is more disruptive, these strategies are helpful in addition to counselling or Cognitive-Behavioural Therapy to help the student learn to manage stress and to reduce the impact of patterns (such as perfectionism and self-criticism), which maintain the anxiety. In some circumstances, medication may be a component of treatment.

Panic Disorder

A person who experiences recurrent panic attacks, at least one of which leads to a month or more of increased anxiety or avoidant behaviour, is said to have panic disorder. Panic attacks appear to occur without a specific trigger and consist of high levels of arousal (racing heartbeat, sweating, shallow breathing) and intense fear (feeling out of control, fear of imminent death). They typically last between five and 15 minutes. During the attack, the physical and emotional symptoms intensify quickly and then subside; however, it can take much longer for the person to feel calm again. A person who has experienced a panic attack may feel anxious and jittery for many hours afterward.

What are the symptoms of panic disorder?

To be diagnosed with a panic disorder, a person must experience at least four of the following symptoms during a panic attack: sweating, hot or cold flashes, choking or smothering sensations, racing heart, labored breathing, trembling, chest pains, faintness, numbness, nausea, disorientation, and feelings of dying, losing control, or losing one's mind.

How is panic disorder treated?

Cognitive-Behavioural Therapy (CBT) is the treatment of choice for panic disorder; anti-depressant medication, which reduces the distressing symptoms of panic, is sometimes also used.


Phobias are intense fears of objects or situations which in reality pose little danger. People who have phobias can experience very high levels of anxiety when confronted with the situation or object about which they are phobic.

Phobias are divided into three types:

  • Specific (simple) phobia: an unreasonable fear of specific circumstances or objects, such as traffic jams or snakes.
  • Social phobia: an extreme fear of looking foolish, stupid, or unacceptable in public that causes people to avoid public occasions or areas

  • Agoraphobia: an intense fear of being trapped in a situation, especially in public places, combined with an overwhelming fear of having a panic attack in unfamiliar surroundings

What treatments are available for phobias?

Phobias are typically treated either with psychotherapy (Behaviour Therapy or Cognitive-Behavioural Therapy, usually involving gradual exposure to the feared object or situation) or with a combination of psychotherapy and medication.

Next Up: Post-Traumatic Stress Disorder (PTSD)