Anxiety: Things you need to know

Anxiety is a normal emotion, and is often healthy. However, if a person feels disproportionate levels of anxiety on a regular basis, this could become a medical disorder.

Anxiety disorders form a group of conditions of mental health that lead to excessive nervousness, anxiety, anticipation, and worry These disorders change how a person experiences emotions and behaviors, and also cause physical symptoms.

Mild anxiety can be vague and unsettling while severe anxiety can seriously affect everyday life.

In the United States, 40 million people suffer from anxiety disorders. It is the country’s most common category of mental illnesses.

Furthermore, care is given to only 36.9 per cent of people with an anxiety disorder.

What is anxiety?

Disproportionate reactions of tension and worry characterize anxiety
Disproportionate reactions of tension and worry characterize anxiety

The American Psychological Association (APA) describes anxiety as “an emotion defined by feelings of stress, anxious thoughts, and physical changes such as increased blood pressure.”

Knowing the difference between normal anxiety symptoms and a medical attention-requiring anxiety disorder may help a person recognize and manage the condition.

In this article we look at the distinctions between anxiety and anxiety disorder, the various types of anxiety and the treatment options available.

When does anxiety need treatment?

It is not always a medical condition, but anxiety can cause distress.

Anxiety

Anxiety feelings are not only normal but necessary for survival when an person experiences potentially harmful or disturbing stimuli.

The arrival of threats and emerging threat has been setting off alarms in the body since humanity’s earliest days and allows for evasive action. Such warnings become evident in the form of accelerated breathing, sweating, and increased ambient sensitivity.

The danger induces an adrenaline rush, a hormone and chemical messenger in the brain, which in turn activates such nervous reactions in a process called the “fight-or-flight” response, which trains humans to physically encounter or escape any potential safety threats.

Running from larger animals and potential risk is a less pressing concern for many people than it would have been for early humans. Anxieties now revolve around work, finances, family life, health, and other critical issues that require the attention of a person without actually needing the reaction of’ fight-or-flight.’

The anxious feeling that is a natural echo of the original’ fight-or-flight’ reaction before an important life event or during a difficult situation. Survival can still be important– fear about being hit by a car, for example while crossing the street, means a person would instinctively look both ways to avoid danger.

Anxiety disorder

Sometimes the duration or severity of an anxious feeling may be out of proportion to the initial stimulus, or the stressor. Physical symptoms can also occur, such as increased blood pressure, and nausea. Those reactions turn into an anxiety disorder beyond fear.

The APA describes a person with anxiety disorder as having “recurring intrusive thoughts or concerns.” It can interfere with daily function once anxiety reaches the stage of a disorder.

Symptoms

Although a number of different conditions are anxiety disorders, the symptoms of a generalized anxiety disorder (GAD) will often include:

  • restlessness, and a feeling of being “on-edge”
  • uncontrollable feelings of worry
  • increased irritability
  • concentration difficulties
  • sleep difficulties, such as problems in falling or staying asleep

Though these symptoms may be normal in everyday life, people with GAD will experience them at persistent or extreme levels. GAD may present a vague, unsettling worry or a more serious anxiety that disrupts everyday life.

For information about the symptoms of other diagnoses under the anxiety disorder umbrella, please follow the links below in the “Types” section.

Types

One type of anxiety disorder is panic disorder.
One type of anxiety disorder is panic disorder.

The Mental Health Conditions Diagnostic and Statistical Manual: Fifth Edition (DSM-V) classifies anxiety disorders into a number of key categories.

Anxiety disorders in earlier editions of DSM included obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), as well as acute stress disorder. Today, however, the manual does not group these mental health problems under stress any more.

Subsequent treatments now include anxiety disorders.

Generalized anxiety disorder: This is a persistent condition that causes severe long-lasting anxiety and worries about non-specific life events, things, and circumstances. GAD is the most common anxiety disorder, and the cause of their anxiety is not always known by people with the disorder.

Panic disorder: The panic disorder is characterized by short or unexpected episodes of extreme fear and anxiety. These attacks can cause shaking, confusion, dizziness, nausea and difficulties in breathing. Panic attacks tend to take place and intensify quickly, peaking in 10 minutes. A panic attack could last for hours though.

Panic symptoms usually occur after traumatic events or excessive stress, but without a cause can also occur. An person who has a panic attack may view it as a life-threatening disorder, and may make drastic behavioral changes to avoid future attacks.

Specific phobia: This is an irrational fear and avoidance of an object or a particular situation. Phobias aren’t like other anxiety disorders, because they relate to a particular cause.

A person with a phobia may recognize anxiety as illogical or extreme but may not be able to control feelings of anxiety around the trigger. The triggers for a phobia range from everyday objects to situations and animals.

Agoraphobia: This is a fear and avoidance of locations, things, or circumstances from which it can be difficult to escape or where help would not be available if a person is stuck in.

People sometimes misinterpret it disorder as a phobia of outdoor and open spaces, but it isn’t that easy. A person suffering from agoraphobia may be afraid to leave home or use elevators and public transport.

Selective mutism: This is a type of anxiety exhibited by some children, in which they can not communicate in certain locations or situations, such as school, even though they may have outstanding verbal communication skills with familiar people. It could be a form of extreme social phobia.

Social anxiety disorder, or social phobia: This is a fear of other people’s negative opinion in social situations or public embarrassment. Social anxiety disorder includes a variety of emotions, such as scenario terror, trust panic, and anxiety about embarrassment and rejection.

This disorder can result in people avoiding public situations and human contact to the point where everyday life becomes extremely difficult.

Separation anxiety disorder: High levels of anxiety characterize separation anxiety disorder after separation from a person or place which provides feelings of security or protection.

Causes

There are complicated causes of anxiety disorders. Many may occur at once, some may lead to others, and some may not give rise to an anxiety disorder unless there is another.

Potential causes include:

  • environmental stressors, such as difficulties at work, relationship problems, or family issues
  • genetics, as people who have family members with an anxiety disorder are more likely to experience one themselves
  • medical factors, such as the symptoms of a different disease, the effects of a medication, or the stress of an intensive surgery or prolonged recovery
  • brain chemistry, as psychologists define many anxiety disorders as misalignments of hormones and electrical signals in the brain
  • withdrawal from an illicit substance, the effects of which might intensify the impact of other possible causes

Treatment

Treatments will be a mix of psychotherapy, behavioral therapy, and medications.

Dependence on alcohol, depression, or other factors can sometimes have such a strong effect on mental well-being that the treatment of an anxiety disorder must wait until any underlying conditions are managed.

Self-treatment

In some cases, without professional supervision, a person may treat an anxiety disorder at home. This may however not be effective for serious or long-term anxiety disorders.

There are several activities and behaviors to help a person deal with anxiety disorders that are milder, more concentrated, or shorter-term.

  • Stress management: Stress management skills can help limit potential triggers. Organize any demands and deadlines to come, prepare lists to make stressful things more manageable and commit to taking time off study or work.
  • Relaxation methods: Simple activities can help to calm the mental and physical anxiety signs. Such techniques include meditation, deep breathing exercises, long baths, dark sleeping, and yoga.
  • Exercises to replace negative thoughts with positive ones: list the negative thoughts that may be cycling as a result of anxiety, and write a list next to it that contains positive, believable thoughts to replace them. Having a mental image of facing a particular fear effectively and overcoming it can also bring benefits if the symptoms of anxiety relate to a specific cause, such as in a phobia.
  • Social network: Talk to may supporting individuals, such as a family member or friend. Support group services can also be accessed on-line and in the local area.
  • Exercise: Physical exertion will boost the self-image and release into the brain chemicals that cause positive feelings.

Counseling

Psychological therapy is a common form of managing anxiety. That may include cognitive-behavioral therapy (CBT), psychotherapy, or a therapy combination.

CBT

It method of psychotherapy aims at identifying and modifying negative patterns of thought that form the basis of nervous and upsetting feelings. In the process, CBT practitioners hope to limit distorted thinking and change the way people react to anxiety-triggering objects or situations.

A psychotherapist who provides CBT for panic disorder, for example, will try to reinforce the fact that panic attacks are not really heart attacks. CBT may be a result of exposure to fears and causes. This allows people to face their anxieties and helps to reduce sensitivity to their normal anxiety causes.

Medications

A person should support multiple types of medication to relieve anxiety.

Antidepressants, benzodiazepines, tricyclics, and beta-blockers are medications that might regulate some of the physical and mental symptoms.

Benzodiazepines: These can be prescribed by a doctor for certain nervous people but they can be extremely addictive. Except for drowsiness and possible dependence, they drugs tend to have few side effects. A commonly prescribed example of benzodiazepine is diazepam, or Valium.

Antidepressants: These are widely used to aid with anxiety, although they also target for depression. People frequently use serotonin reuptake inhibitors (SSRIs), which have fewer side effects than older antidepressants but are likely to cause jitters, nausea and sexual dysfunction when therapy starts.

Other drugs include fluoxetine, or Prozac, and or Celexa, or citalopram.

Tricyclics: This is a class of older drugs than SSRIs which provide benefits for most other anxiety disorders than OCD. Such medications may cause side effects, including dizziness, drowsiness, dry mouth and gain in weight. Two examples of tricyclics are imipramine and clomipramine.

Additional medications that a person may use to treat anxiety include:

  • monoamine oxidase inhibitors (MAOIs)
  • beta-blockers
  • buspirone

If the adverse effects of any prescription drugs are serious, seek medical advice.

Prevention

There are ways of reducing the risk of symptoms of anxiety. Recall that nervous emotions are a common occurrence in everyday life, and having them does not always suggest a mental health disorder.

To help moderate nervous feelings, take the steps below:

  • Reduce intake of caffeine, tea, cola, and chocolate.
  • Before using over-the-counter (OTC) or herbal remedies, check with a doctor or pharmacist for any chemicals that may make anxiety symptoms worse.
  • Maintain a healthy diet.
  • Keep a regular sleep pattern.
  • Avoid alcohol, cannabis, and other recreational drugs.

Takeaway

Anxiety itself is not a medical condition but a natural emotion necessary to survival when an person is in danger.

When that reaction is amplified or out of proportion to the stimuli that causes it, an anxiety disorder occurs. There are several forms of anxiety disorder, including fear, phobia, and social anxiety disorder.

Treatment involves, along with self-help steps, a combination of different types of therapy, medicine and counseling.

An active lifestyle with a healthy diet can help to reduce anxiety within safe limits.

Q:

How do I know when my nervous emotions start to take place out of proportion to their trigger?

A:

The clearest indication of anxiety becoming problematic can be that it is becoming increasingly difficult to do things that the person used to do relatively easily.

This can mean talking to a group of people, going to the grocery store, being separated from a loved one or caregiver, or riding in an elevator. If anxiety is beginning to get in the way, then it is definitely time to reach out.

__Dillon Browne, PhD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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