Anxiety, what you should know.
What to know about anxiety
Anxiety is a natural emotion. However, it can also cause physical symptoms, such as shaking and sweating. Anxiety disorders can affect daily life and can improve with treatment.
Anxiety disorders form a category of mental health diagnoses that lead to excessive nervousness, fear, apprehension, and worry.
This article discusses the symptoms, causes, and treatments for anxiety.
What is anxiety?
According to the Anxiety and Depression Association of America (ADAA), around 40 million people in the United States have an anxiety disorder. It is the most common group of mental illnesses in the country. However, only 36.9% of people with an anxiety disorder receive treatment.
The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure.”
Knowing the difference between typical feelings of anxiety and an anxiety disorder requiring medical attention can help a person identify and treat the condition.
Anxiety and anxiety disorders
Anxiety is a complex response to real or perceived threats. It can involve cognitive, physical, and behavioral changes.
Real or perceived danger causes a rush of adrenaline, a hormone and chemical messenger in the brain, which in turn triggers these anxiety reactions in a process called the fight-or-flight response. Some people may experience this response in difficult social situations or around important events or decisions.
The duration or severity of feelings of anxiety can sometimes be out of proportion to the original trigger or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop. These responses move beyond anxiety into an anxiety disorder.
Once anxiety reaches the stage of a disorder, it can interfere with daily function.
Symptoms
There are several different anxiety disorders, which can present with different symptoms. Typical symptoms of anxious feelings include the following:
- restlessness
- uncontrollable feelings of worry
- increased irritability
- difficulty concentrating
- sleep difficulties
While many people will occasionally experience these symptoms in daily life, people with general anxiety disorder (GAD) will experience them at persistent or extreme levels.
GAD
This chronic disorder involves excessive, long lasting anxiety and worries about nonspecific life events, objects, and situations. GAD is the most common anxiety disorder, and people with it are not always able to identify the cause of their anxiety.
Panic disorder
Brief or sudden attacks of intense terror and apprehension characterize panic disorder. These attacks can lead to shaking, confusion, dizziness, nausea, and breathing difficulties. Panic attacks tend to occur and escalate rapidly.
Panic disorders usually occur after frightening experiences or prolonged stress but may also occur without a trigger.
Specific phobia
This is a fear and avoidance of a particular object or situation. Phobias are not like other anxiety disorders, as they relate to a specific cause.
A person with a phobia might acknowledge fear as illogical or extreme but remain unable to control feelings of anxiety around the trigger. Triggers for a phobia range from situations and animals to everyday objects.
Agoraphobia
This is a fear and avoidance of places, events, or situations from which it may be difficult to escape or where help would not be available in emergencies.
People often misunderstand this condition as a phobia of open spaces and the outdoors. A person with agoraphobia may fear leaving home or using elevators and public transport.
Selective mutism
Some children experience this form of anxiety, in which they cannot speak in certain places or contexts, even though they may have excellent verbal communication skills around familiar people.
Social anxiety disorder
This is a fear of adverse judgment from others in social situations or of public embarrassment. Social anxiety disorder includes a range of feelings, such as stage fright, a fear of intimacy, and anxiety around humiliation and rejection.
Separation anxiety disorder
High anxiety levels after separation from a person or place that provides feelings of security or safety characterize separation anxiety disorder. Separation anxiety is most common in young children but can affect people of all ages.
Causes
The causes of anxiety disorders are complicated. Many might occur at once, some may lead to others, and some might not lead to an anxiety disorder unless another is present.
Possible causes include:
- environmental stressors, such as relationship problems or family issues
- genetics
- medical factors, such as disease symptoms or the effects of a medication
- substance withdrawal
Treatment
Treatment often consists of psychotherapy, behavioral therapy, and medication.
Sometimes, alcohol dependence, depression, or other underlying conditions require treatment before treating an anxiety disorder can take place.
Self-treatment
Sometimes, a person can treat an anxiety disorder at home without clinical supervision. However, this may not be effective for severe or long-term anxiety disorders.
There are several exercises and actions to help a person cope with milder, more focused, or shorter-term anxiety disorders, including:
- stress management
- relaxation techniques
- maintaining support networks
- physical exercise
Counseling
A standard way of treating anxiety is psychological counseling. This can include cognitive behavioral therapy (CBT), psychotherapy, or a combination of therapies.
CBT is a type of psychotherapy that aims to recognize and change harmful thought patterns that form the foundation of anxious and troublesome feelings.
Learn more about different types of therapy here.
Medications
A person can support anxiety management with several types of medication.
Medicines that might control some physical and mental symptoms include antidepressants, benzodiazepines, and tricyclic antidepressants.
- Benzodiazepines: A doctor may prescribe these for certain people with anxiety, but they can cause addiction. Diazepam, or Valium, is a common benzodiazepine.
- Antidepressants: These commonly help with anxiety, even though they also target depression. Serotonin reuptake inhibitors (SSRIs), fluoxetine, and citalopram are examples.
- Tricyclic antidepressants: These are an older class of drugs that benefit most anxiety disorders other than obsessive-compulsive disorder (OCD). Imipramine and clomipramine are two examples of tricyclics.
Additional drugs a person might use to treat anxiety include:
- monoamine oxidase inhibitors (MAOIs)
- beta-blockers
- buspirone
Seek medical advice if the adverse effects of any prescribed medications become severe.
Learn more about anxiety medications here.
Prevention
There are ways to reduce the risk of anxiety disorders. Remember that anxious feelings are a natural factor of daily life, and experiencing them does not always indicate the presence of a mental health disorder.
People may benefit from the following:
- reducing caffeine intake
- checking with a health professional before using over-the-counter or herbal remedies
- maintaining a balanced, nutritious diet
- keeping a regular sleep pattern
- regularly exercising
- avoiding alcohol, cannabis, and other recreational drugs
Learn about some foods that can help prevent anxiety.
Frequently asked questions
Below are some commonly asked questions about anxiety.
What coping skills help with anxiety?
The Anxiety & Depression Association of America recommend a person with anxiety try the following coping strategies:
- take a time-out
- eat well-balanced meals
- limit alcohol and caffeine
- get enough sleep
- exercise daily
- take deep breaths
- learn what triggers their anxiety
How to calm down anxiety?
The National Health Service (NHS) of the UK recommend a person try the following breathing exercises to calm anxiety:
- Let your breath flow as deep down into their belly as is comfortable, without forcing it.
- Try breathing in through your nose and out through your mouth.
- Breathe in gently and regularly. Some people find it helpful to count steadily from 1 to 5.
- Then, let it flow out gently, counting from 1 to 5 again.
- Keep doing this for at least 5 minutes.
What makes anxiety worse?
Stressful life events and sleep deprivation may worsen anxiety, which is why it is important a person with anxiety finds stress management techniques that work for them.
Also, the Anxiety & Depression Association of America claims that alcohol and caffeine can worsen anxiety and trigger panic attacks.
Should a person see a primary care doctor or psychiatrist?
A person can see both a primary care doctor or psychiatrist for anxiety.
Generally speaking, if a person has mild to moderate anxiety, they can often get effective treatment from their primary care doctor, but if their condition is more severe or complex, they probably need to see a psychiatrist.
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Takeaway
Anxiety is not a medical condition but a natural emotion that is vital for survival when an individual faces danger.
An anxiety disorder develops when this reaction becomes exaggerated or out-of-proportion to the trigger that causes it. There are several types of anxiety disorders, including panic disorder, phobias, and social anxiety.
Treatment involves a combination of therapy, medication, and counseling alongside self-help measures.
An active lifestyle with a balanced diet can help keep anxious emotions within healthy limits.