Anxiety: Overview, symptoms, causes, and treatments

Anxiety is a perfectly normal human reaction and is an instinct necessary for survival.

The “fight or flight” instinct acts as an alarm and protective mechanism to alert humans that they are in danger. Some of the signals of the body in such situations include a racing heartbeat, increased sensitivity, sweating and others.

Anxiety can have the same symptoms, but it usually occurs when there is no actual danger but rather, the person believes that there is a hazard.

When the levels of anxiety are too high and are persistent, this may be a symptom of a health problem or an anxiety disorder.

Today, more than 40 million people in the US only are affected by anxiety disorders, making them the most common type of mental disorders in the country.

Shockingly, less than 40% of those affected seek and receive treatment for their anxiety.

It is normal to be anxious before a public speech, an important test at school, or before a job interview. But when an anxiety attack takes control over most of the other emotions and dictates one’s life, it can take a toll on one’s everyday life, relationships and work.

There are several types of anxiety disorders, which can lead to excessive apprehension, worry, nervousness and fear.

While the symptoms of such a disorder may vary from one person to another, in some cases, when they are severe, they can severely disrupt day-to-day life.

Read on to find out more about the different types of anxiety disorders, their symptoms, causes, risk, diagnosis, and treatment. You can also find some useful tips on preventing and controlling your anxiety.

What is the definition of anxiety?

According to the American Psychological Association, anxiety is “an emotion characterized by feelings of tension, worried thoughts and physical changes, such as increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns.”

It is essential to recognize the difference between normal anxiety, which almost everyone feels, and the feelings associated with anxiety disorders so that you can get timely and proper treatment if necessary.

Types of anxiety disorders

You may be suffering from an anxiety disorder if you have anxious feelings and physical symptoms which are disproportionate to the actual stressor or trigger.

Some common symptoms of this type of disorders include nausea and increased blood pressure. Also, when the constant worrying and nervousness or fear begins to interfere with daily life and functioning, then it is probably an anxiety disorder of some type.

Here are the main types of anxiety disorders:

Generalized anxiety disorder (GAD)

GAD is a chronic anxiety disorder that causes persistent and excessive anxieties and worries about non-specific situations, objects or life events. It is the most common type of anxiety disorder, and often the people affected by it cannot pinpoint the actual cause of their excessive anxiety.

In general, the people affected by GAD display a disproportionate amount of anxiety almost every day for six months or more.

This hyperbolized fear and worrying can seriously interfere with their relationships, social lives, work, school, and everyday lives.

Here are the symptoms of Generalized Anxiety Disorder:

• Feeling “on-edge” and restlessness
• Uncontrollable worrying
• Difficulty concentrating
• Increased irritability
• Insomnia, or problems falling asleep
• Nervousness without an apparent reason
• Muscle tension
• A non-realistic perception of problems
• Sweating
• Fatigue and tiredness
• Headaches
• Frequent need for going to the bathroom
• Trembling
• Being startled easily

All of these symptoms are perfectly normal when they occur occasionally. But for people with GAD, they are persistent and extreme and may prevent them from functioning and living normally.

Panic disorder

People who have panic disorder suffer from reoccurring panic attacks. A panic attack can be a genuinely terrifying experience, and escalates quickly, lasting for 10 to 30 minutes or more.

Panic attacks can occur without an obvious trigger and can happen anywhere and at any time.

The symptoms of a panic attack are similar to that of a heart attack, which is why so many people end up in the emergency room after such an occurrence.

The fact is, panic attacks are not life-threatening, but their symptoms – physical and mental are so intense that they can cause a lasting mark on a person’s psyche.

The most common symptoms of a panic attack include:

• A racing or a pounding heart
• Hyperventilation and difficulty breathing
• Sweating
• Discomfort or pain in the chest
• A tight throat
• Chills or hot waves
• Tremor and shaking
• Dizziness and light-headedness
• A feeling of impending doom and death
• Loss of touch with reality

Since the experience can be very frightening, it can cause the person affected to feel a constant fear of the panic attack reoccurring and start avoiding places, settings, situations and objects which may trigger it.

People who have panic disorder have unexpected and frequent panic attacks.

The “fear of fear” can cause them to make drastic changes to their lifestyles, and can seriously interfere with their relationships, social life, school, work, and everyday life. In some extreme cases, this can lead to debilitating agoraphobia.

This is why, even if you have experienced a single panic attack, it is advisable to seek timely treatment, to prevent such complications.

Plus, in some cases, the symptoms of panic attacks can be similar to symptoms of other serious medical conditions or can be caused by underlying causes, which should be diagnosed and treated too.

Specific phobia

This type of anxiety disorder causes the person affected to feel an irrational fear and aversion of a particular object or situation and to avoid it at all costs.

Even though some people with specific phobias may realize that their fear is extreme or out of proportion, they can still find it difficult to control their anxiety when in contact with the triggers.

There are various types of specific phobias, including fear of animals, heights, flying, blood, injections, specific objects and many others.

The main symptoms of specific phobias include:

• Taking all kinds of active steps to avoid the trigger
• Excessive and irrational worrying about coming into contact with the feared situation or object
• Intense anxiety when having to endure unavoidable triggers

Agoraphobia

Agoraphobia is an anxiety disorder that causes the affected person to fear and thus avoid certain situations, places and events which are hard to get out of and escape or where there will be no help if one gets trapped.

Although some people think that agoraphobia is the fear of being outdoors, it can be a fear of leaving home, being in an elevator, in a bus, in a crowded space, being alone and more. Any one of these fears will most likely cause the person to prefer to stay at home, where it is safe.

The most common triggers causing anxiety and fear in people with agoraphobia include:

• Enclosed spaces
• Open spaces
• Using public transportation
• Being in a crowd, on the street or standing in line
• Leaving home alone

Commonly, people with agoraphobia will do anything possible to avoid the situations they fear. Often, this is due to their fear of experiencing panic attacks, and of embarrassing themselves, as well as the irrational fear of not being able to get out or be saved if trapped.

People suffering from severe cases of agoraphobia often reach to extremes and become housebound.

In some cases, people who have untreated panic disorder can develop agoraphobia.

Selective mutism

Selective mutism is a relatively rare anxiety disorder that affects children. These children are unable to speak in certain situations and places, even though they can otherwise speak and communicate perfectly.

It usually occurs up to the age of 5 years. Often selective mutism is associated with fear of public embarrassment, disproportional shyness, clinging behavior, compulsive traits, temper tantrums and others.

This can also be an extreme form of another anxiety disorder – social phobia.

Social anxiety disorder, social phobia

Social anxiety disorder is an irrational fear of public embarrassment or negative judgment from other people. It can be a fear of intimacy, fear of rejection and humiliation, stage fright or other.

This is another anxiety disorder which may cause the people affected to avoid any public situations, or even human contact, which obviously can seriously disrupt one’s daily life, work, and wellbeing.

Separation anxiety disorder

Separation anxiety disorder can, in some cases, result in panic attacks. It is an irrational level of anxiety and fear when separated from a specific person or people.

Even though it is more likely for children to have separation anxiety when parted from their parents at an early age, some adults too can suffer from this disorder.

Adults who suffer from a separation anxiety disorder often feel constant fear and dread that something will happen to their attachment figure while they are gone or separated.

This type of extreme fear may lead them to avoid separation altogether, as well as having nightmares and actual physical symptoms when separated from the particular person..

Other types of anxiety disorders

Some other types of anxiety disorders can occur due to a specific physical problem or medical condition or can be induced by substance abuse and withdrawal.

Post-traumatic stress disorder (PTSD) is an extreme anxiety disorder resulting from a life-threatening event or trauma. Today, PTSD is not part of the list of anxiety disorders and is now classified as a separate condition by the American Psychiatric Association.

Causes of anxiety disorders

The actual causes of the different types of anxiety disorders are not completely clear or understood. It is known that traumatic events can trigger such anxieties in people who are prone to them. Genetics and stress can also be factors, as well as certain medical and other underlying conditions.

Medical causes for anxiety disorders

In many cases, there could be underlying medical conditions that cause the signs and symptoms of anxiety. Some of the common health conditions which may trigger anxiety disabilities include:

• Thyroid problems – overactive or underactive thyroid
• Post-traumatic stress disorder (PTSD) or obsessive-compulsive disorder (OCD)
• Heart disease, such as arrhythmia
• Diabetes
• COPD, asthma or other respiratory diseases
• IBS
• Chronic pain
• Rare tumors which produce hormones triggering the “fight or flight” reaction
• Anti-anxiety, or opiate medication withdrawal

Non-medical causes for anxiety disorders

Outside of the medical ones, the other main possible causes for developing an anxiety disorder include:

• Specific stressors in one’s life including – problems at work, problems in a relationship, family problems, and others
• Trauma – experienced in childhood or as an adult
• Genetics – it is found that people who have other close relatives suffering from anxiety disorders are more prone to developing one themselves
• Bereavement, divorce, separation
• Marriage, having a new baby, starting a new job
• Changes in brain chemistry – in some cases, hormonal imbalances or misaligned electrical signals can cause changes in brain chemistry, which can lead to extreme anxiety
• Withdrawal from alcohol, benzodiazepines, other medications or illicit substances can cause unexplained anxiety and sometimes panic
• Caffeine (coffee, energy drinks, chocolate)
• Some medications or supplements
• Overall stress due to serious illness including worrying about the treatment and the future

Possible complications

Suffering from an anxiety disorder is not only bothersome because of the extreme worrying  and fear, but it if left untreated, it can get worse, and lead to more serious conditions including:

Prevention of anxiety disorders

Although there is no way to prevent or predict the development of an anxiety disorder completely, there are some ways to minimize the risk and reduce the symptoms of anxiety before they get stronger and more overpowering.

Here are the steps to control and to decrease the symptoms of anxiety disorders:

When is it time to see a doctor?

You should make an appointment with a doctor if:

Even if you think that you can manage your anxiety by yourself, keep in mind that if left untreated, it can get worse over time, so getting timely treatment is vital if you want to be healthy and go on with your life.

Treatment of anxiety disorders

Anxiety disorders are treatable, but the exact treatment depends on your specific case.

In most cases, the treatment includes psychotherapy or behavioral therapy, sometimes in combination with medication.

If your anxiety is due to underlying medical conditions, or alcohol or drug abuse, then the primary issues must be treated first, before the anxiety itself can be addressed.

Here are the treatments for anxiety disorders:

Psychotherapy

Therapy can help people suffering from anxiety disorders. The therapy treatment should be tailored and directed to address your specific anxieties and your situation.

Cognitive Behavioral Therapy (CBT)

CBT is highly effective in treating anxiety disorders. It is a type of psychotherapy in which the therapist will teach you how to understand, react, behave and think when put in anxiety-inducing conditions or situations.

CBT will also help people with anxiety practice their social skills, which is essential for returning to leading a normal life.

Your therapist may assign you homework or exercises for home practice during the sessions.

Cognitive therapy is focused on pinpointing, recognizing, challenging and eventually neutralizing the distorted thoughts underlying the anxiety disorder.

If you suffer from panic disorder, the therapist will emphasize on teaching you to accept the fact that panic attacks are not heart attacks, and how to recognize, accept and control the symptoms.

CBT can be performed in groups or individually.

Exposure therapy

This type of therapy focuses on confronting a person with a phobia or another anxiety disorder confronting his or her fears to help relieve or eliminate the anxiety symptoms. Successful exposure therapy will teach people with anxiety disorders to stop avoiding the setting and activities which they have been avoiding. This type of therapy is commonly combined with learning and practicing relaxation imagery techniques and relaxation exercises.

Psychotherapy is extremely efficient for treating anxiety disorders, especially when it is done early on with the onset of the symptoms.

Medication

Although medication cannot cure an anxiety disorder, in some cases, it can help relieve its symptoms and help control them.

Anxiety medications must be prescribed by a doctor, such as your primary care provider or a psychiatrist. In some cases, the drug can be prescribed by a psychologist who has the training and permission to do so.

The most commonly used medications for treating and controlling anxiety disorders are anti-anxiety drugs, antidepressants, or beta-blockers.

Anti-anxiety medications – benzodiazepines

These medicaments can help reduce the symptoms of extreme anxiety, fear, worrying and panic attacks.

The most commonly used anti-anxiety medications are benzodiazepines.

They are highly efficient and quick-acting medications for alleviating the symptoms of anxiety disorders, but they have their pros and cons.

Since they are highly addictive, they should be taken with extra caution and only with a doctor’s prescription.

They have few side effects, aside from possible addiction and drowsiness, and are relatively safe as compared to the older drugs used to treat anxiety such as barbiturates, glutethimides and meprobamates.

Some of the most commonly prescribed benzodiazepines include Valium, Librium, Xanax, Klonopin, Dalmane, Ativan, Restoril, Halcion, and others.

Most of them can alleviate extreme anxiety very quickly, and can be taken as soon as one feels an onset of a panic attack, or is about to go into surgery or on a plane and feels uncontrollable fear and panic.

The drawbacks include the fact that some people can develop a tolerance to them, and will need higher and higher doses every time, as well as their addictiveness.

This is why doctors usually prescribe these types of medications for use for a short time, or to use only as a last resort in extreme cases of anxiety.

In some cases, people can experience withdrawal symptoms when they stop taking the benzodiazepines abruptly.

You should follow your doctor’s advice for tapering the medication off slowly, instead of stopping it suddenly.

Buspirone is another type of anti-anxiety medication which is a non-benzodiazepine, used for the treatment of chronic anxiety, but it is helpful only for some people and cases.

Antidepressants

These medications are used for treating depression, but in many cases can help treat anxiety disorders as well. Antidepressants can help the brain improve its use of the chemicals which control the mood or stress levels.

In most cases, the patient will have to try more than one antidepressant so that the best one which manages to improve the anxiety symptoms is identified.

If a close relative has taken a specific antidepressant that has helped them, it is highly likely that it will work for you too, so always tell your doctor about people in your family with anxiety or other mental health issues.

Unlike benzodiazepines, antidepressants need some time to build up in the body and start to work. So it may take days or weeks before the medication has an effect.

It is essential to follow the doctors’ orders when stopping your antidepressant medication to do so safely and to avoid the unpleasant withdrawal symptoms.

One of the most commonly used antidepressants are selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Some of the most commonly prescribed SSRIs for anxiety disorder include Prozac, Zoloft, Paxil, Celexa, and Lexapro.

You should only take such medications with a prescription from your doctor.

They have fewer side effects as compared to older antidepressant medications but still may cause nausea, jitters, sexual dysfunction, and others.

Tricyclics are an older class of antidepressant drugs than the SSRIs. They, too, can be used for treating many anxiety disorders but are likely to cause side effects such as drowsiness, dizziness, a dry mouth or weight gain. Some of the most common tricyclics are imipramine and clomipramine.

Monoamine Oxidase inhibitors (MAOIs) are another older class of antidepressants that are sometimes used for treating anxiety.

In any case, especially when children, teenagers, and young adults start taking antidepressants, it is essential that they are monitored closely during the first few weeks, or every time the dose is changed. This is because they can experience severe side effects like suicidal thoughts and behavior.

Beta-Blockers

Beta-blockers are high blood pressure medicaments, but in some cases that can be prescribed to reduce the physical symptoms of anxiety, including a rapid heart rate, trembling, shaking, or blushing.

When taken over a short period of time, beta-blockers can help the person keep these physical symptoms under control.

In some cases, they can help as preventative medications for predictable anxieties, such as stage fright, airplane flying, and others.

How to choose the best medication for you

While some medications may work perfectly for some types of anxiety disorders and for some people, they may not be suitable for others.

This is why you should work closely with your doctor when testing and identifying the best medication which can actually help you.

Also, keep in mind that some OTC medications, caffeine, herbal supplements, and illicit drugs can interfere with the prescribed medication for anxiety. This is why you should always discuss which other drugs, supplements and substances are safe and which are not during your treatment.

In order to pinpoint the best medication for your anxiety, you can expect that you and your doctor will discuss the following:

• The benefits and the side effects of each drug
• The risk of side effects for your specific case
• The need for lifestyle changes
• The cost

But as mentioned before, the medications can help control and alleviate the symptoms, but cannot cure an anxiety disorder, which is why they are usually prescribed alongside therapy and other treatments.

Support Groups

Some people suffering from anxiety disorder find it very useful to join support groups with people who share common disorders and problems. There are also online support groups, forums and chat rooms which can be useful too. But any advice received online by a person you don’t know should be treated with caution.

Even if you have found what seems like a great treatment, medication or supplement online, always discuss it with your doctor first, even if it is a completely natural, herbal or a vitamin supplement. The reason is that some of these supplements can interfere with your prescription medication.

Stress Management Techniques

Learning and practicing stress management techniques is also very helpful for dealing with an anxiety disorder. Meditation, aerobic exercise, yoga, tai chi, or other stress management techniques can be used to enhance the effects of the medication or therapy, but not as the only treatment plan.

Self-treatment and self-help for anxiety

Although there are some home remedies and self-treatments that can help manage, control and alleviate the symptoms of anxiety, they should not serve as the only long-term treatment for anxiety disorders, especially for severe cases.

Here are some of the common self-treatment methods for helping deal with mild or short-term anxiety:

• Stress management – learning and practicing how stress management can help reduce and even eliminate future triggers of anxiety. Stress management can include learning how to organize your work and deadlines, in a way which makes them more manageable and less daunting
• Relaxation techniques – there are some simple activities that can help alleviate the physical and mental symptoms of anxiety disorders, such as panic disorders
• Learning deep breathing exercises, meditation, mindfulness, yoga, resting and long baths can help you control the symptoms when you feel them coming
• Breathing exercises – learning how to control your breathing and being mindful of it can be extremely helpful if you tend to get panic attacks or hyperventilation when feeling anxious. Put your hand on your belly, and practice taking slow deep breaths through the nose while counting to four. Hold the breath for a second, and then gently and slowly exhale through the mouth while counting to four again. This can help you get your breathing under control in situations when it seems like the panic is about to take over
• Exercising the replacement of negative thoughts with positive ones – it helps to write down all of the negative thoughts which cycle through your brain and which make you anxious. Next to the list write another one with believable positive thoughts that can replace the negative ones. This exercise can be beneficial if you have a phobia or a problem with a specific fear of a particular event or situation
• A support network – create or join a support network of people like friends, relatives or new friends which are available and supportive when you need them in the cases when anxiety strikes and you are panicking or afraid
• Physical exercise – aerobic exercise like walking, running, cycling, or swimming helps boost the release of endorphins and other chemicals in the brain which trigger positive thoughts and feelings and improve the mood. Make sure you engage in some kind of physical activity or exercise for at least 30 minutes on a daily basis. If you work on a desk, try taking short breaks every 30 minutes for some quick and simple exercises or to take a brief walk
• Find time for relaxing – no matter how well you have learned to manage the stress in your work, school or life, you need to find the time and ways to relax
• Recognizing and acknowledging the anxiety symptoms – you should learn the signs that you may be heading for a panic attack or a worsening of your anxiety in order to take timely precautions and possibly avoid or at least manage the symptoms when they come
• Recognize the triggers of your anxiety – in some cases, the trigger of anxiety is obvious (like with a specific phobia) but in others, it isn’t. It is important to pinpoint your triggers so that you can seek timely help or take timely actions (some triggers can include stress, alcohol of coffee intake, and others)
• A healthy diet – eating a balanced and healthy diet instead of fast food or processed food can help keep your body healthy, and the chemical balance in the brain healthy too
• Aromatherapy – some essential smells and aromas like lavender and chamomile can help soothe the symptoms of anxiety and can help you relax and sleep
• A new hobby – you can find a new activity which helps you relax and take your mind off of your worries, fears, and other anxiety symptoms. Join a pottery class, engage in gardening, painting, dancing, choir or anything which will help you focus on something you enjoy and thus alleviate your anxiety
• Stay social – even if you don’t feel like leaving your home or meeting other people, it is crucial to be social, in order to prevent the worsening of your anxiety symptoms. You should make sure that you see family members, friends, find new friends, or join a support group where you can share common feelings and concerns with others affected by your condition. Loneliness and social isolation can trigger and often will worsen anxiety disorders.
• Set goals – if you are overly anxious because of too much work, financial problems, or others, it is a good idea to take the time to create a plan with your goals. Set short term targets and priorities and then check them off when you reach them. This will help you manage stress, your time, and have a clearer picture of the future without the anxiety and worries involved
• Get restful and sufficient sleep – sleep is essential for human health and can help relieve anxiety symptoms such as worrying thoughts and feelings. It also helps the body relax and recuperate for the next day, so try to get 7 to 9 hours of sleep per night
• Cut down or quit alcohol, caffeine, and nicotine – all of these are substances that can trigger anxiety symptoms, so consider cutting down their intake, or quitting completely. Keep in mind that if you have problems with alcohol abuse, the withdrawal can enhance the anxiety symptoms, so if you are planning on quitting, ask your doctor for guidance and help to help reduce these symptoms
• Tell yourself to stop worrying – worrying is a habit that you can learn how to recognize and break. Try using strategies such as challenging any anxious thoughts, creating a set worry period, as well as learning how to accept the uncertainty of certain situations, in order to help curb and control the worrying and the anxious thoughts and feelings. Setting up a “worry time” can help direct the anxiety to just the set 30 minutes per day to dwell on any problems, worries or anxious thoughts
• Turn the “what ifs” into “so whats” – if you are persistently haunted by thoughts about something which you want to avoid happening, then sit down and write down these “what ifs,” and next to them turn them into “so whats” instead. By visualizing these often irrational fears and anxieties you can help train your brain to resist these triggers and may learn how to start going to places or getting into situations which you normally would avoid

Final words

Although anxiety is a normal and useful human survival instinct, excessive anxiety can seriously disrupt one’s life and can lead to more serious medical conditions.

An anxiety disorder develops when anxiety, worrying and fear are blown out of proportion especially as compared to the actual trigger causing them.

There are different types of anxiety disorders which are all treatable.

Treatment can include psychotherapy, as well as medication, combined with joining a support group, learning stress management techniques, and making lifestyle changes.

People who are at risk of developing anxiety disorders, or those already affected by one or more of these disorders must seek treatment.

Treating anxiety is possible, and is relatively easy when the right treatment is prescribed.

Make sure that you seek medical or expert care if you are feeling the onset of panic disorder, a phobia, agoraphobia, social phobia, separation anxiety, or other conditions which are getting in the way of your everyday life, your school, your work, your relationships and others.

With the help of an expert and a few lifestyle changes, even the most severe cases of anxiety disorders can be successfully managed and even eliminated.