Anxiety | Anxiety, Panic, Worry
What Is Anxiety?
Anxiety encompasses feelings of worry, nervousness, or
dread. Although unpleasant, occasional bouts of anxiety are natural and
sometimes even productive: By signaling that something isn’t quite
right, anxiety can help people both avoid danger and make important and
meaningful changes.
But persistent, pervasive anxiety that disrupts one’s daily life, whether at school, work, or with friends, can be the mark of an anxiety disorder. Nearly one-third of adults in the U.S. will grapple with one at some point in their lives, according to the National Institutes of Health, and the condition strikes more women than men.
Anxiety disorders manifest in different ways, and are often diagnostically distinct. Generalized anxiety disorder is a chronic state of severe worry and tension, often without provocation. Panic disorder refers to sudden and repeated panic attacks—episodes of intense fear and discomfort that peak within a few minutes. Obsessive-compulsive disorder is marked by intrusive thoughts or compulsions to carry out specific behaviors, such as handwashing. Post-traumatic stress disorder may develop after experiencing or witnessing a traumatic event.
Anxiety is often accompanied by depression, and the two share an underlying genetic architecture.
Beyond genetics, childhood experiences such as early trauma or parental overprotection can play a role in forming an anxious disposition. In people with anxiety disorders, the brain circuitry that controls the threat response seems to go awry: The amygdala, a structure that detects danger, can become overactive, triggering a threat where none really exists.
Anxiety is often treated successfully using therapy, medication or both. Cognitive behavioral therapy is one of the most effective options, in which patients learn to identify problematic thought patterns and change how they respond. Mindfulness meditation is another effective technique for some.
For more on causes, symptoms, and treatments of anxiety disorders, see our Diagnosis Dictionary.
But persistent, pervasive anxiety that disrupts one’s daily life, whether at school, work, or with friends, can be the mark of an anxiety disorder. Nearly one-third of adults in the U.S. will grapple with one at some point in their lives, according to the National Institutes of Health, and the condition strikes more women than men.
Anxiety disorders manifest in different ways, and are often diagnostically distinct. Generalized anxiety disorder is a chronic state of severe worry and tension, often without provocation. Panic disorder refers to sudden and repeated panic attacks—episodes of intense fear and discomfort that peak within a few minutes. Obsessive-compulsive disorder is marked by intrusive thoughts or compulsions to carry out specific behaviors, such as handwashing. Post-traumatic stress disorder may develop after experiencing or witnessing a traumatic event.
Anxiety is often accompanied by depression, and the two share an underlying genetic architecture.
Beyond genetics, childhood experiences such as early trauma or parental overprotection can play a role in forming an anxious disposition. In people with anxiety disorders, the brain circuitry that controls the threat response seems to go awry: The amygdala, a structure that detects danger, can become overactive, triggering a threat where none really exists.
Anxiety is often treated successfully using therapy, medication or both. Cognitive behavioral therapy is one of the most effective options, in which patients learn to identify problematic thought patterns and change how they respond. Mindfulness meditation is another effective technique for some.
For more on causes, symptoms, and treatments of anxiety disorders, see our Diagnosis Dictionary.
How to Recognize the Signs of Anxiety
Anxiety often involves worrying to an intense, excessive degree. Those worries can apply to any aspect of life, from social situations and family dynamics to physical health and professional concerns.
A person's angst or dread can be drastically out of proportion to the actual challenges he or she is facing. People may also irrationally believe that the worst-case scenario is inevitable.
How to Treat Anxiety
People may engage in talk therapy tailored to their specific anxieties. Cognitive behavioral therapy is one of the most effective options for anxiety disorders. The practice teaches patients to challenge distorted thought patterns to change how they respond. Social anxiety can be mitigated by exposure therapy, in which patients are safely and gradually exposed to their fears so they no longer avoid them.
Medication can help patients control their anxiety, but they cannot cure the underlying condition. Clinicians may prescribe fast-acting benzodiazepines for limited periods of time. Beta-blockers offer another short-term solution, as they can curb troubling symptoms such as racing heartbeat or trembling hands for a specific event. Antidepressants, such as selective serotonin re-uptake inhibitors (SSRIs)or less frequently tricyclics, are used as a longer-term treatment and can take a few weeks or months to work.
As with all medications, patients should consult a doctor to understand the side effects of a particular drug and to safely transition on and off of the medication.
Simple Strategies to Manage Anxiety
Increasingly, researchers argue that mindfulness meditation is a successful technique as well. Taking deep breaths, observing one’s thought without judgment, and acknowledging the limits of one’s control can reduce feelings of tension.
Identifying the circumstances that trigger one's anxiety, and then pushing back against anxious or irrational thoughts, can help to feel better prepared for the future.
Symptoms
GAD is characterized by the DSM-5 as six months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with this disorder usually experience symptoms including:
- -Inability to control excessive worrying
- -Difficulty falling or staying asleep
- -Irritability
- -Easily startled or scared
- -Difficulty concentrating or the mind goes blank
- -Headaches and fatigue
- -Muscle tension and aches
- -Having a hard time swallowing
- -Trembling or twitching
- -Sweating
- -Shaking
- -Rapid Heartbeat
- -Nausea
- -Light-headedness and tingling in the extremities.
- -Feeling out of breath
- -Having to go to the bathroom frequently
- -Hot flashes
Causes
Anxiety disorders are complex and result from a combination of genetic, behavioral, developmental, and other factors. Risk factors for GAD include a family history of anxiety and recent or extended periods of stress.
The brain circuitry involved in fear and anxiety is known to contribute to the experience of GAD, though the mechanism by which GAD is activated is unknown. Studies of twins and families suggest that genes play a role in the origin of anxiety disorders. Childhood adversity and parental overprotection have both been associated with the later development of GAD. It is important to rule out medical causes of anxiety, such as thyroid disorders, before a diagnosis is made.
