What is anxiety? Are you anxious? Maybe you’re feeling worried about a problem at work with your boss. Maybe you have butterflies in your stomach while waiting for the results of a medical test. Maybe you get nervous when driving home in rush-hour traffic as cars speed by and weave between lanes. In life, everyone experiences anxiety from time to time. This includes both adults and children. For most people, feelings of anxiety come and go, only lasting a short time. Some moments of anxiety are more brief than others, lasting anywhere from a few minutes to a few days. But for some people, these feelings of anxiety are more than just passing worries or a stressful day at work. Your anxiety may not go away for many weeks, months, or years. It can worsen over time, sometimes becoming so severe that it interferes with your daily life. When this happens, it’s said that you have an anxiety disorder. What are the symptoms of anxiety? While anxiety symptoms vary from person to person, in general the body reacts in a very specific way to anxiety. When you feel anxious, your body goes on high alert, looking for possible danger and activating your fight or flight responses. As a result, some common symptoms of anxiety include: nervousness, restlessness, or being tensefeelings of danger, panic, or dreadrapid heart raterapid breathing, or hyperventilationincreased or heavy sweatingtrembling or muscle twitchingweakness and lethargydifficulty focusing or thinking clearly about anything other than the thing you’re worried aboutinsomniadigestive or gastrointestinal problems, such as gas, constipation, or diarrheaa strong desire to avoid the things that trigger your anxietyobsessions about certain ideas, a sign of obsessive-compulsive disorder (OCD)performing certain behaviors over and over againanxiety surrounding a particular life event or experience that has occurred in the past, especially indicative of post-traumatic stress disorder (PTSD) Panic attacks A panic attack is a sudden onset of fear or distress that peaks in minutes and involves experiencing at least four of the following symptoms: palpitationssweatingshaking or tremblingfeeling shortness of breath or smotheringsensation of chokingchest pains or tightnessnausea or gastrointestinal problemsdizziness, light-headedness, or feeling faintfeeling hot or coldnumbness or tingling sensations (paresthesia)feeling detached from oneself or reality, known as depersonalization and derealizationfear of “going crazy” or losing controlfear of dying There are some symptoms of anxiety that can happen in conditions other than anxiety disorders. This is usually the case with panic attacks. The symptoms of panic attacks are similar to those of heart disease, thyroid problems, breathing disorders, and other illnesses. As a result, people with panic disorder may make frequent trips to emergency rooms or doctor’s offices. They may believe they are experiencing life-threatening health conditions other than anxiety. Types of anxiety disorders There are several types of anxiety disorders, these include: Agoraphobia People who have agoraphobia have a fear of certain places or situations that make them feel trapped, powerless, or embarrassed. These feelings lead to panic attacks. People with agoraphobia may try to avoid these places and situations to prevent panic attacks. Generalized anxiety disorder (GAD) People with GAD experience constant anxiety and worry about activities or events, even those that are ordinary or routine. The worry is greater than it should be given the reality of the situation. The worry causes physical symptoms in the body, such as headaches, stomach upset, or trouble sleeping. Obsessive-compulsive disorder (OCD) OCD is the continual experience of unwanted or intrusive thoughts and worries that cause anxiety. A person may know these thoughts are trivial, but they will try to relieve their anxiety by performing certain rituals or behaviors. This may include hand washing, counting, or checking on things such as whether or not they’ve locked their house. Panic disorder Panic disorder causes sudden and repeated bouts of severe anxiety, fear, or terror that peak in a matter of minutes. This is known as a panic attack. Those experiencing a panic attack may experience: feelings of looming dangershortness of breathchest pain rapid or irregular heartbeat that feels like fluttering or pounding (palpitations) Panic attacks may cause one to worry about them occurring again or try to avoid situations in which they’ve previously occurred. Post-traumatic stress disorder (PTSD) PTSD occurs after a person experiences a traumatic event such as: warassault natural disaster accident Symptoms include trouble relaxing, disturbing dreams, or flashbacks of the traumatic event or situation. People with PTSD may also avoid things related to the trauma. Selective mutism This is an ongoing inability of a child to talk in specific situations or places. For example, a child may refuse to talk at school, even when they can speak in other situations or places, such as at home. Selective mutism can interfere with everyday life and activities, such as school, work, and a social life. Separation anxiety disorder This is a childhood condition marked by anxiety when a child is separated from their parents or guardians. Separation anxiety is a normal part of childhood development. Most children outgrow it around 18 months. However, some children experience versions of this disorder that disrupt their daily activities. Specific phobias This is a fear of a specific object, event, or situation that results in severe anxiety when you’re exposed to that thing. It’s accompanied by a powerful desire to avoid it. Phobias, such as arachnophobia (fear of spiders) or claustrophobia (fear of small spaces), may cause you to experience panic attacks when exposed to the thing you fear. What causes anxiety? Doctors don’t completely understand what causes anxiety disorders. It’s currently believed certain traumatic experiences can trigger anxiety in people who are prone to it. Genetics may also play a role in anxiety. In some cases, anxiety may be caused by an underlying health issue and could be the first signs of a physical, rather than mental, illness. A person may experience one or more anxiety disorder at the same time. It may also accompany other mental health conditions such as depression or bipolar disorder. This is especially true of generalized anxiety disorder, which most commonly accompanies another anxiety or mental condition. When to see a doctor It’s not always easy to tell when anxiety is a serious medical problem versus a bad day causing you to feel upset or worried. Without treatment, your anxiety may not go away and could worsen over time. Treating anxiety and other mental health conditions is easier early on rather than when symptoms worsen. You should visit your doctor if: you feel as though you’re worrying so much that it’s interfering with your daily life (including hygiene, school or work, and your social life)your anxiety, fear, or worry is distressing to you and hard for you to controlyou feel depressed, are using alcohol or drugs to cope, or have other mental health concerns besides anxietyyou have the feeling your anxiety is caused by an underlying mental health problemyou are experiencing suicidal thoughts or are performing suicidal behaviors (if so, seek immediate medical assistance by calling 911) Next steps If you’ve decided you need help with your anxiety, the first step is to see your primary care doctor. They can determine if your anxiety is related to an underlying physical health condition. If they find an underlying condition, they can provide you with an appropriate treatment plan to help alleviate your anxiety. Your doctor will refer you to a mental health specialist if they determine your anxiety is not the result of any underlying health condition. The mental health specialists you will be referred to include a psychiatrist and a psychologist. A psychiatrist is a licensed doctor who is trained to diagnose and treat mental health conditions, and can prescribe medications, among other treatments. A psychologist is a mental health professional who can diagnose and treat mental health conditions through counseling only, not medication. Ask your doctor for the names of several mental health providers covered by your insurance plan. It’s important to find a mental health provider you like and trust. It may take meeting with a few for you to find the provider that’s right for you. To help diagnose an anxiety disorder, your mental healthcare provider will give you a psychological evaluation during your first therapy session. This involves sitting down one-on-one with your mental healthcare provider. They will ask you to describe your thoughts, behaviors, and feelings. They may also compare your symptoms to the criteria for anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) to help arrive at a diagnosis. Finding the right mental healthcare provider You’ll know your mental healthcare provider is right for you if you feel comfortable talking with them about your anxiety. You’ll need to see a psychiatrist if it’s determined that you need medication to help control your anxiety. It’s sufficient for you to see a psychologist if your mental healthcare provider determines your anxiety is treatable with talk therapy alone. Remember that it takes time to start seeing results of treatment for anxiety. Be patient and follow the directions of your mental healthcare provider for the best outcome. But also know that if you feel uneasy with your mental healthcare provider or don’t think you’re making enough progress, you can always seek treatment elsewhere. Ask your primary care doctor to give you referrals to other mental healthcare providers in your area. At-home anxiety treatments While taking medication and talking with a therapist can help treat anxiety, coping with anxiety is a 24–7 task. Luckily there are many simple lifestyle changes you can make at home to help further alleviate your anxiety. Get exercise. Setting up an exercise routine to follow most or all days of the week can help reduce your stress and anxiety. If you are normally sedentary, start off with just a few activities and continue adding more over time. Avoid alcohol and recreational drugs. Using alcohol or drugs can cause or increase your anxiety. If you have trouble quitting, see your doctor or look to a support group for help. Stop smoking and reduce or stop consuming caffeinated drinks. Nicotine in cigarettes and caffeinated beverages such as coffee, tea, and energy drinks can make anxiety worse. Try relaxation and stress management techniques. Taking meditation, repeating a mantra, practicing visualization techniques, and doing yoga can all promote relaxation and reduce anxiety. Get enough sleep. A lack of sleep can increase feelings of restlessness and anxiety. If you have trouble sleeping, see your doctor for help. Stick to a healthy diet. Eat plenty of fruits, vegetables, whole grains, and lean protein such as chicken and fish. Coping and support Coping with an anxiety disorder can be a challenge. Here are some things you can do to make it easier:Be knowledgeable. Learn as much as you can about your condition and what treatments are available to you so you can make appropriate decisions about your treatment. Be consistent. Follow the treatment plan your mental healthcare provider gives you, taking your medication as directed and attending all of your therapy appointments. This will help keep your anxiety disorder symptoms away. Know yourself. Figure out what triggers your anxiety and practice the coping strategies you created with your mental healthcare provider so you can best deal with your anxiety when it’s triggered. Write it down. Keeping a journal of your feelings and experiences can help your mental healthcare provider determine the most appropriate treatment plan for you. Get support. Consider joining a support group where you can share your experiences and hear from others who deal with anxiety disorders. Associations such as the National Alliance on Mental Illness or the Anxiety and Depression Association of America can help you find an appropriate support group near you. Manage your time intelligently. This can help reduce your anxiety and help you make the most of your treatment. Be social. Isolating yourself from friends and family can actually make your anxiety worse. Make plans with people you like spending time with. Shake things up. Don’t let your anxiety take control of your life. If you feel overwhelmed, break up your day by taking a walk or doing something that will direct your mind away from your worries or fears.