Anxiety
What is anxiety?
Anxiety is characterized by nervousness, worry and fear that is intense and ongoing, affecting a person’s functioning. Specifically, the fear is excessive and experienced as a person’s emotional response to a real or perceived threat. Such intense worry and fear has emotional, physical and behavioral consequences that can severely impact an individual’s life as well as the lives of their loved ones.
If you think you or someone in your life might be suffering from an anxiety disorder, you are not alone. Anxiety disorders are the most common mental illness in the United States. In fact, over 40 million people suffer from an anxiety disorder. At some point in their life, 40 percent of adults will experience an anxiety disorder.
One way to understand anxiety is to consider anxiety as a normal emotion. In fact, it is a normal response when someone is truly in danger. For instance, pausing before you cross the road is a good thing. That pause allows you to be wise in a dangerous situation. When we are in danger, our brains and bodies react in a fight, flight or freeze response. We either want to run, become aggressive, or freeze. These are survival responses when we are in true danger. Yet, anxiety causes people to be in this state of high alert a lot of the time. In this way, it is like a fire alarm is going off in your mind and yet often there is no real danger.
In discerning a possible anxiety disorder from normal anxiety, consider the source of the worry and fear, and then reflect on whether your response and experience is proportional to it. For instance, it is natural to have some degree of anxiety about snakes and spiders — but for some people, the anxiety assumes such a large role in their lives that they may never go outside again. Other times, discerning between a possible anxiety disorder and normal anxiety is more quiet and subtle. It can involve excessive fears and worry that play over and over again in your mind, yet those fears are less visible in terms of your behavior. In this way, it is possible to suffer from an anxiety disorder in silence, with no one even really knowing the degree to which it affects your life.
Symptoms of anxiety include emotional symptoms such as feeling tense, feelings of dread, irritability and restlessness, and being watchful for any signs of danger. Physical symptoms include shortness of breath, feeling your heart racing, sweating, trembling, headaches, fatigue, nausea, and an upset stomach. Other symptoms include having trouble concentrating or thinking about anything other than the impending worry, having trouble sleeping, and having the urge to avoid things that trigger anxiety.
What causes anxiety?
Anxiety is often caused by a multitude of factors. Many of these factors are interconnected, as our mind, emotions and body are all so integrally connected to one another. These factors include the following:
Environment: Stressful events, especially chronic stress or traumatic events, often lead to the development of an anxiety disorder. Unrelenting life stress activates stress hormones such as cortisol, leading to a state of high alert all the time. This high activation of stress hormones actually suppresses the immune system, which then can cause more stress and anxiety.
Brain chemistry: Many anxiety disorders involve disruptions to hormones and electrical signals in the brain. In addition, chronic stress and trauma alter brain structure and function in such a way that a person reacts strongly to various triggers that would not normally have caused anxiety.
Genetics: Studies support that anxiety may be more common in families when other relatives suffer from an anxiety disorder.
Medical factors: Other medical conditions may lead to the development of an anxiety disorder. This can be directly, for example through side effects of medication, or indirectly, through significant stress caused by a serious medical condition with significant pain and lifestyle adjustments.
Use of or withdrawal from an illicit substance: Substance use may trigger anxiety. Also, when someone is trying to quit using drugs or alcohol, they may find themselves experiencing a great deal of anxiety that might have been numbed and not felt as much while using substances.
What are the different types of anxiety?
The most common type of anxiety disorder is Generalized Anxiety Disorder (GAD) which causes chronic worry about everyday life. The worry is so significant that it may actually make it difficult for someone to concentrate and finish tasks. The worry is persistent and exhausting.
Several other types of adult anxiety disorders exist, including the following:
Social anxiety disorder: When someone is so consumed with fear about social interaction. Typically, the irrational fears are associated with embarrassment; the fear is so powerful that a person with social anxiety disorder may avoid as many social interactions as possible.
Agoraphobia: When an individual intensely fears and often avoids crowded places.
Panic disorder: Characterized by feelings of panic and terror that often strike repeatedly and without warning.
Specific phobias: Anxiety that is characterized by intense fear of specific things. It leads individuals to go to extremes to avoid all possible interactions with what they are afraid of.
Unspecified anxiety disorder: When other anxiety symptoms are present, but there are not enough exact symptoms to fit a more specific diagnosis.
Anxiety disorder due to a medical condition
Substance/medication induced anxiety disorder
Additional anxiety disorders for children include separation anxiety disorder and selective mutism, which causes a child to not talk.
What is a panic attack or anxiety attack? What are the symptoms?
Oftentimes the terms “panic attack” and “anxiety attack” might be used interchangeably. While many of the symptoms of panic attacks and anxiety overlap, there are differences.
Panic attacks typically occur in individuals with a diagnosable panic disorder. Panic attacks involve intense fear and terror that occurs suddenly and without warning. They do not have an identifiable trigger, except when it a known phobia. Panic attacks are so intense physically that many people in the throes of a panic attack visit the emergency room believing that they are dying. Even if they do not visit the hospital, a panic attack involves significantly disrupting a person’s day. Despite the disruption that they cause, panic attacks are short in duration, typically peak within 10 minutes and then subsiding.
An anxiety “attack” is actually better understood as anxiety manifesting itself in the whole body. Anxiety is experienced over longer periods of time, and as the worry and fear about a potential event or possible danger builds up, it may culminate in what is described often as an “attack.” In this way, anxiety involves some of the same symptoms of a panic attack, especially when experienced more intensely. In these instances, anxiety will be experienced in the body in a very tangible way involving symptoms such as shortness of breath, dizziness and an increased heart rate. These symptoms can feel scary and make a person feel less in control of themselves, which only intensifies the anxiety.
Do I have anxiety?
This is a screening measure to help you determine whether you might have anxiety that needs professional attention. This screening tool is not designed to make a diagnosis of anxiety but to be shared with your primary care physician or mental health professional to inform further conversations about diagnosis and treatment.
If you or someone you care about may be experiencing intense and pervasive anxiety that steals joy from your life, consider reaching out for support. As often is the case, a combination of supports may be most effective in treating anxiety. These supports include medication to help manage the most severe symptoms, psychotherapy with a trusted counselor who will support you in helping break the cycle of anxiety, and complementary health approaches focusing on stress and relaxation.
Schedule an evaluation at the Right Track Medical Group clinic nearest you.
Resources on Anxiety
Anxiety Attacks vs. Panic Attacks: https://www.verywellmind.com/anxiety-attacks-versus-panic-attacks-2584396
Learn more about the differences and similarities between anxiety and panic attacks as well as treatment options.
Anxiety Disorders: The Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
The Mayo Clinic is recognized as a leading worldwide nonprofit academic medical center based in Rochester, Minnesota, focused on integrated clinical practice, education, and research. It employs more than 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff. The Mayo Clinic guide on anxiety contains information on the symptoms of anxiety, types of anxiety, causes, risk factors, complications, prevention and also information on diagnosis and treatment.
Anxiety Guide: NAMI: https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders/Overview
Provided by the National Alliance on Mental Illness, this anxiety guide has helpful information the symptoms, causes, diagnosis and treatment of anxiety. They also have information available on how to provide support and resources for yourself, a family member or a friend who may be struggling with an anxiety disorder.
How do you know if you're having a panic or anxiety attack?: https://www.medicalnewstoday.com/articles/321798.php
Learn more about the signs and symptoms of anxiety and panic attacks as well as their causes and when you are more likely to experience an attack. Also, how to differentiate between an anxiety attack and a panic attack and what to do during an attack.
Screening for Generalized Anxiety Disorder (GAD): https://adaa.org/screening-generalized-anxiety-disorder-gad
Made available by the Anxiety and Depression Association of America (ADAA), the following is a screening measure to help you determine whether you might have anxiety that needs professional attention.
What causes anxiety?: https://www.medicalnewstoday.com/articles/323456.php
A range of factors can contribute to an anxiety disorder. Learn more about causes of anxiety in this article that highlights how understanding the causes of an anxiety disorder can be the key to successful treatment.
What is Anxiety?: https://www.anxiety.org/what-is-anxiety
Written by Sanne van Rooij, PhD, and Anaïs Stenson, PhD. Learn more about anxiety, types of anxiety disorders, causes and risk factors, impacts on physical health and treatment options. Also provided is information on how to prevent or cope with an anxiety disorder and information on how to recognize an anxiety disorder in others.
By Elizabeth Burton, LPC, EdS, NCC for Right Track Medical Group
This article is provided for information only and is not a substitute for diagnosis or treatment by a mental-health professional.