Anxiety: Symptoms, types, causes, prevention, and treatment (original) (raw)

Anxiety is a common emotion, and it can cause physical symptoms, such as shaking and sweating. When anxiety becomes persistent or excessive, a person may have an anxiety disorder.

Anxiety disorders are a category of mental health diagnoses that involve excessive nervousness, fear, apprehension, and worry. These symptoms can interfere with a person’s quality of life but are very treatable.

This article discusses the symptoms, causes, and treatments for anxiety.

Anxiety is a feeling of fear, tension, or worry that occurs as a response to real or perceived threats.

This response can help humans escape or avoid danger by supplying more oxygen and blood to the muscles. However, people can also feel anxiety about things that are not dangerous, such as:

• important events or decisions
• public speaking
• social situations

Feeling anxious does not always mean a person has a mental health condition. Many people occasionally feel anxious from time to time.

But when anxiety becomes frequent, out of proportion to a situation, or persists after the situation is over, it can be a sign of an anxiety disorder.

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 type of mental illness in the country. However, only 36.9% of people with an anxiety disorder receive treatment.

The main symptom of anxiety is a feeling of worry. Other symptoms can include:

• elevated heart rate
• faster breathing
• irritability
• restlessness
• muscle tension
• difficulty concentrating
• difficulty falling or staying asleep

If a person has severe anxiety, they may experience a panic attack, which causes an intense feeling of dread or panic that reaches a peak before subsiding. Symptoms may include:

• rapid breathing (hyperventilation)
• pounding heartbeat
• sweating
• shaking or trembling
• a feeling of impending doom or lack of control

How and when these symptoms manifest will depend on the type of anxiety a person has.

The Diagnostic and Statistical Manual of Mental Health Disorders: 5th Edition, text revision (DSM-5-TR) includes several distinct anxiety disorders.

In previous editions of the DSM-5-TR, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and acute stress disorder also fell into this category. However, as of 2013, the manual no longer groups these diagnoses together.

The anxiety disorders are as follows:

Generalized anxiety disorder (GAD)

People with GAD have persistent, pervasive feelings of anxiety or dread that do not have a specific focus. It is not a response to a stressful situation that then goes away once it is over, but a general feeling of worry that may affect many aspects of everyday life.

A person with GAD may worry about lots of things, and find it difficult to relax or get to sleep.

Panic disorder

People with panic disorder experience frequent and unexpected panic attacks. A person may have specific triggers, or they may not know the cause.

Specific phobia

Specific phobias are a fear of a particular object or situation, such as heights or spiders. Unlike other anxiety disorders, phobias focus on one specific trigger.

A person with a phobia might know their fear is illogical or extreme, but remain unable to control it when they encounter the trigger.

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 or the outdoors, but this is not the case. Some common situations a person with agoraphobia may be scared of include:

• using elevators
• using public transport
• leaving home, in some cases

Social anxiety disorder

Social anxiety is a fear of negative judgment from others. A person with social anxiety may feel others are evaluating everything they do, or that they will be embarrassed or humiliated if they interact with people.

This can cause a person to avoid social interaction, or only certain types of interaction, such as talking with strangers.

Additional signs of social anxiety can include:

• intense self-consciousness
• finding it difficult to make eye contact
• speaking in a quiet or soft voice
• feeling as though the mind has “gone blank” in social situations

Separation anxiety disorder

Separation anxiety is when a person feels anxious after separating from a place or person that makes them feel safe, such as a parent.

Separation anxiety is most common in young children but can affect people of all ages.

Selective mutism

Some children experience this form of anxiety, in which they cannot speak in certain places or contexts, even though they have the ability to do so.

Occasional anxiety is often a response to uncertainty about the future or worry about something that happened in the past.

For example, a person may feel anxious about taking a test, or worry they have made a decision they might regret.

The causes of anxiety disorder are more complex and can involve several factors. The United Kingdom charity, Mind, lists several psychological factors:

• Current situation: Life events that cause ongoing stress may contribute to the development of an anxiety disorder. Examples of these include financial struggles, being under pressure at work, or experiencing discrimination.
• Past trauma: Traumatic events are incidents that cause an actual or perceived threat to a person’s safety. Even if these events happened a long time ago, they can still affect people years later.
• Substance use: Some substances, such as stimulant drugs, can cause anxiety. Other substances may cause anxiety when a person experiences withdrawal.

Some physical factors include:

• Brain structure or function: People with anxiety disorders may have a heightened amygdala response. The amygdala is part of the brain that responds to danger.
• Genetics: Some people may have a genetic predisposition toward anxiety.
• Medical factors: Sometimes, anxiety is the product of a physical illness, such as a neurological disorder or hormonal imbalance. It can also be a side effect of some medications, or a result of experiencing long-term pain or other symptoms.

Sometimes other conditions, such as PTSD or substance use disorders, may require treatment before the anxiety can be addressed.

Self-care

Sometimes, a person can ease anxiety at home without clinical supervision. Things that may help a person cope include:

• relaxation techniques
• physical exercise
• getting enough sleep
• reducing the use of caffeine or other stimulants
• talking with a trusted loved one

However, this may only be effective for mild or short-term anxiety. Those with more severe or ongoing anxiety may benefit from combining these strategies with therapy or medication.

Psychotherapy

A first-line treatment for anxiety is psychotherapy, or talk therapy.

There are many types of talk therapy. Each one aims to help a person understand the thoughts, beliefs, or experiences that may be contributing to persistent anxiety, and ways of changing or coping with them.

Some examples include:

• cognitive behavioral therapy
• acceptance and commitment therapy
• exposure therapy
• psychodynamic therapy

There are also distinct forms of therapy that can help children, people who have a history of trauma, or people with specific types of anxiety disorder.

Medications

Some medications can reduce the symptoms of anxiety, making the condition more manageable. Some people take medications to make it easier to begin therapy, while others may take them on an ongoing basis.

Some examples of medications a doctor may suggest include:

• Antidepressants: Some antidepressants can help with anxiety, even though they also target depression. Serotonin reuptake inhibitors, fluoxetine, and citalopram are examples. They take several weeks to begin working.
• Beta-blockers: These drugs do not stop anxiety, but they do reduce the physical symptoms associated with it, such as a rapid heartbeat. People can take them over a short period of time, or only occasionally for anxiety-inducing situations.
• Benzodiazepines: These drugs act immediately to reduce anxiety, but they can quickly cause dependence or addiction. As a result, doctors only prescribe them for short-term use. Diazepam, or Valium, is a common benzodiazepine.

Some drugs work better for certain types of anxiety than others, so people should work with a knowledgeable mental health professional to find what works for them.

It is important to note that some of these drugs can cause side effects, including a worsening of anxiety, when a person starts taking them. It may take several months for this to subside.

Seek medical advice if the adverse effects of any prescribed medications become severe.

It is not always possible to prevent anxiety entirely. Many people experience anxiety when they are going through a challenging time.

However, researchers have suggested that building resilience to stress may reduce the likelihood of anxiety disorders. A 2020 review of past research highlighted several strategies that may help to reduce the risk by affecting a person’s gene activity, such as:

• getting regular exercise
• practicing mindfulness
• having a supportive family environment

This research is still in its early stages, though. Other strategies that may help include:

• reducing caffeine intake
• maintaining a balanced, nutritious diet
• keeping a regular sleep pattern
• avoiding alcohol, cannabis, and other recreational drugs
• checking with a health professional before using over-the-counter medicines or herbal remedies

Below are some commonly asked questions about anxiety.

What coping skills help with anxiety?

Some short-term coping skills that can help with anxiety include breathing techniques and grounding techniques.

Breathing techniques involve slowing breathing down to help calm the nervous system. Grounding techniques involve focusing on things that remind a person of the present moment. Mindfulness has a similar approach.

How do you calm down anxiety?

Breathing techniques and grounding techniques can calm anxiety. People can also use exercises from CBT to challenge or diffuse anxious thoughts.

Other ideas include:

• writing anxious thoughts down, then ripping them up or throwing them away
• going for a run to use up nervous energy
• trying yoga or meditation

What makes anxiety worse?

Stress, lack of sleep, caffeine, and alcohol may worsen anxiety.

Should I see a psychologist or psychiatrist?

Generally speaking, if a person has mild to moderate anxiety, they can often get effective treatment from their primary care doctor. For talk therapy, a doctor may refer someone to a psychologist.

Psychiatrists can also provide talk therapy, but unlike psychologists, they can also prescribe medications.

Anxiety is a natural emotion that many people experience. An anxiety disorder develops when this emotion becomes exaggerated or out-of-proportion to the trigger that causes it.

There are several types of anxiety disorders, including panic disorder, GAD, and social anxiety. Treatment can involve therapy or medication alongside self-help measures.