Your life shouldn’t be run by worry and fear. Knowing what causes anxiety disorders, how they show up, and how to treat them can help you get in charge.
Everyone gets worried at times. It’s just a part of being human. Speaking in front of a big group, driving during a storm, or having a work deadline coming up can all make you feel worried, scared, and dreadful.
But anxiety that comes and goes because of a specific cause is different from a feeling that won’t go away. If your anxiety doesn’t go away or makes your daily life hard, you might have an anxiety disorder.
The National Institute of Mental Health says that more than 30% of adults will have an anxiety disorder at some point in their lives. The National Alliance on Mental Illness says that each year, about 7% of kids have problems with anxiety. A lot of people have anxiety. But that doesn’t mean you just have to take it.
By learning more about what anxiety is, what its symptoms are, and what treatments are available, you can stop it from taking over your life.
What exactly is anxiety?
Anxiety is simply a feeling of worry or dread about what’s going to happen. It could be a big meeting with your boss about a possible promotion. Or maybe you’ve been putting off a first date or a doctor’s appointment.
Any of these things, among many others, can keep you up at night and make your mind race. They can also make you feel sick:
- Your heart could be beating faster.
- Your palms might get wet.
- Your shoulders may tighten up so much that they almost touch your ears.
This is a totally normal response to both good and bad things that happen in life. Anxiety may seem pointless and bothersome, but it serves a purpose. Its purpose is to keep us safe and help us act quickly in dangerous situations. It’s sometimes called the “fight-or-flight” response.
How does it work? You meet a possible danger. Then your fight-or-flight response, which is controlled by your sympathetic nervous system, happens automatically. Stress hormones like adrenaline and cortisol are released in large amounts. These hormones make us more alert and speed up our heartbeat, which sends more blood to our muscles.
The brain gets more fresh oxygen because the person breathes faster. Also, our pupils get bigger to help us see better. All of this (and more) is done to train our bodies to move quickly and keep us safe.
This response is very helpful when facing a dangerous animal or a car coming at you at 70 miles per hour. It can also help in less scary situations, like when you need to stay awake and meet a deadline quickly.
The most important thing to know is that normal anxiety, which everyone feels sometimes, doesn’t last forever. Once the stressful event is over, the feelings of fear and worry and any other symptoms that come with them go away. You might feel relieved or even silly for having been so worried about it in the first place.
But it’s a different story for people with anxiety disorders.
What is the difference between normal worry and an anxiety disorder?
For people with anxiety disorders, the nervousness, worry, or fear is constant and can sometimes be too much to handle. It’s not always caused by a specific stressor. That means it doesn’t go away when you meet the deadline or avoid a close call while driving.
This kind of anxiety can make it hard to do your job or do other things in your day-to-day life. Even though persistence is the main difference, there are other signs you might be dealing with an anxiety disorder, such as:
- You may worry about the same things that other people do, but you take your worries to a whole new level. If you text a friend and they don’t respond right away, you think you did something wrong and the friendship is over.
- People with anxiety disorders often worry about things that might happen in the future (job loss or a house fire). Normal anxiety usually centers on something you know is going to happen (a scheduled surgery or cross-country flight).
This is why the term “imagined threat” is sometimes used to describe what people with anxiety feel. The fear is about something you think or imagine might happen, even if there’s little to no proof that it will.
What are the signs of an anxiety disorder?
Anxiety disorders can be put into 3 main groups: generalized anxiety disorder (GAD), phobia disorders, and panic disorder.
That is important to know. The symptoms of each anxiety disorder can be different. The symptoms also vary from person to person. And they can change even in the same person from day to day.
One thing that all anxiety disorders have in common is that the symptoms are both mental and physical. You can blame the mixed messages anxiety sends to the body for that. Here’s a breakdown of how each type of anxiety disorder might affect you:
Generalized anxiety disorder (GAD) signs
The Anxiety and Depression Association of America says that GAD is the most common anxiety disorder and that 6.8 million adults, or 3.1% of the U.S. population, have it. GAD is marked by a feeling of dread or excessive worry most days for at least 6 months.
This worry can be about anything, from your job to your social life to your health. It can also affect your relationships and make it hard to handle work, school, or even simple everyday tasks.
People with GAD may feel on edge or “keyed up” most of the time. Other common emotional and physical signs include:
-Trouble focusing and concentrating
-Feeling like you can’t control your worry
-Sleep problems, such as trouble falling asleep or staying asleep, restlessness, or an unsatisfying sleep,
-üfeeling tired for no clear reason
-Rapid heartbeats or heart palpitations
-Tense muscles, often in the neck and shoulders
-Lightheadedness, wooziness, or shakiness
-Stomach pain, sickness, or diarrhea
-increase in sweating
Types of phobia disorders and their signs
Simply put, a phobia is an extreme fear. Like most things that cause anxiety, this fear is out of proportion to the actual threat. Still, a person with a phobia may be so afraid of a certain object or situation that they try very hard to avoid it. If they can’t avoid it, they feel a lot of anxiety.
There are many types of phobia disorders, including:
- Specific phobias: As you might have guessed, this is when a specific thing or activity causes a lot of fear and anxiety. Common phobias include fear of spiders, heights, flying, and blood.
- Social anxiety disorder (SAD) or social phobia: This is a strong fear or anxiety about being in a group, which often makes people avoid going to social events altogether.
- Agoraphobia: This type focuses on specific situations or places that you may not be able to get out of.
People with agoraphobia may be afraid of:
-Standing in line
-Getting in a crowd
-Being in a closed space like an elevator
-Only leaving the house alone
-Taking public transportation
Separation anxiety disorder: As the name suggests, this is anxiety caused by being away from a person you care about. Often, a person with separation anxiety disorder worries that something bad will happen to that person while they are away.
The mental and physical symptoms of a phobia disorder are similar to those of generalized anxiety disorder. The main difference is that they’re brought on by that specific thing or event that is feared.
Because of this, people with phobias tend to put a lot of effort into avoiding whatever they’re afraid of. The avoidance can even take over their lives and keep them from doing normal things like socializing or leaving the house.
One unique sign of separation anxiety is that people may have nightmares about being separated from the person they’re close to. They may even get sick (nausea, headaches, quick breathing) when they are separated or when they are expecting to be separated.
Panic disorder is defined by panic attacks. These sudden, overwhelming periods of intense fear often come out of the blue and get worse quickly. Some people with panic disorder know the things that set off these attacks. Others can’t quite figure out what sets off an episode.
Not surprisingly, many people who have panic attacks live in fear of having more attacks. This waiting can really mess up a person’s life. It makes them avoid a lot of situations, just in case an attack might happen.
Symptoms of a panic attack are:
-Chest pain, heart palpitations, a pounding heartbeat, or a faster heart rate can be signs of heart disease.
-Trembling or shaking
-Shortness of breath or a feeling of suffocating or choking
-Feelings of impending death or thoughts that you may be dying
-Feeling like you’re not in control
Another thing about panic attacks is that they feel like they go on forever. They actually only last about 10 minutes. But it is also possible to have panic attacks in waves, so that you continue to feel anxious for a long time.
Other kinds of anxiety disorders
There are a few other kinds of anxiety disorders that don’t fit neatly into either GAD, phobia disorder, or panic disorder. This includes:
Selective mutes. People with selective mutism seem to be unable to speak in certain social situations, like at work or school. But they may talk a lot at home or with people they are comfortable with. This usually happens to young children (before age 5) and often happens along with other anxiety disorders.
Substance or medication-induced anxiety disorder. Anxiety disorders can sometimes be caused by using drugs, going through withdrawal from drugs, or taking certain medications.
Anxiety disorder caused by another medical condition. Some medical problems can cause the classic physical symptoms of anxiety. For example, menopause and hyperthyroidism can affect the body’s hormones. These changes can cause anxiety symptoms such as a racing heart, sweating, irritability, or trouble sleeping.
In these cases, treating the other medical condition is a key part of reducing the anxiety.
Eco-anxiety. Climate change has direct and indirect effects that are making more adults and children feel stressed and worried.
What causes the anxiety disorders?
That’s the million-dollar question. Researchers don’t know what exactly causes anxiety disorders. If we did, we’d be much better at preventing them and even curing them. What we do know is that anxiety disorders are probably caused by a mix of genetic and environmental factors, along with a few other things that can make them more likely (but don’t guarantee it).
Here is a closer look:
Like heart disease or diabetes, anxiety disorders are known to run in families. If someone in your biological family has a history of anxiety or another mental illness, you are more likely to develop anxiety at some point in your life.
Life can be stressful. Some situations, especially those involving family, work, or your social life, can make it more likely for people who are prone to anxiety disorders to get one. For instance, during the COVID-19 pandemic, life as we knew it changed almost overnight. Fear and uncertainty about the dangerous new coronavirus made a lot of people feel like they didn’t have much control over their lives anymore.
That kind of stressful situation is enough to give anyone anxiety. And it could be especially hard for someone with an anxiety disorder.
Going through a traumatic event as a child or as an adult makes you more likely to develop an anxiety disorder. This could mean growing up in an abusive or violent home, losing a loved one, or dealing with a long illness.
Some traits in children, like shyness and behavioral inhibition (being shy or wary of new people and situations), are also linked to a higher risk of developing an anxiety disorder.
When do I need to talk to someone about my anxiety?
The right time to ask for help with anxiety is when it starts to get in the way of your daily life. It’s time to see a doctor if your anxiety is making it hard for you to focus and get your work done, hurting your relationships, or affecting your ability to feel joy or pleasure.
How is anxiety figured out?
Primary care providers (PCPs) see anxiety disorders every single day in their offices. The National Alliance on Mental Illness says that more than 40 million Americans have them, so that makes sense. Usually, your primary care doctor is the first person to notice them, whether you see him or her in person or online. When you make an appointment, you can expect the following:
Comprehensive medical history. If you go to your doctor’s office, he or she will probably start by checking your body. The doctor will want to know about your symptoms and any regular medicines or supplements you take.
The goal is to make sure you don’t have any other health problems and to find out if you’re taking anything that has side effects that look like anxiety. As part of the process, the doctor might also order blood tests.
Screening for mental health. If your PCP can’t find a clear physical cause for your symptoms, he or she will ask you some questions to learn more about your anxiety symptoms and how they affect your life. The doctor will also want to know if your parents, grandparents, or siblings have ever had problems with their mental health.
If everything points to anxiety, your doctor may talk with you about how to treat it. Those will probably include psychotherapy (talk therapy) and medication, or they may refer you to a mental health specialist. Some health care offices even have a clinical social worker or counselor on site who can work with you more closely right away.
Referral to a professional in mental health (if needed). Mental health professionals use standard screening tools to figure out if your symptoms fit the criteria for an anxiety disorder.
Your family doctor (GP) might also be able to do this. But not all GPs are trained to fully diagnose mental health problems, which is why they sometimes send you to a specialist after ruling out other possible conditions.
Since there is a range of anxiety disorders, you might have several symptoms but not meet the criteria for a specific diagnosis. That doesn’t mean your symptoms aren’t real and need to be taken care of. In this case, your doctor or therapist will help you make a personal plan to deal with your anxiety.
Remember that you don’t have to ignore how you feel.
Is there a way to treat anxiety?
The American Psychological Association says that there are many ways to treat anxiety disorders. You probably won’t be able to get rid of anxiety completely, but you can get rid of a lot of its symptoms and loosen its hold on you. With the right combination of treatments, you’ll feel better. No longer will anxiety get in the way of you living your life.
What are the most effective treatments for anxiety disorders?
The best treatment for you will depend on your specific diagnosis. In general, anxiety disorders are treated with psychotherapy, medication, or a combination of both. Other tools, such as exercise and mindfulness meditation, can be used along with traditional treatments.
Psychotherapy. Psychotherapy is an umbrella term for different kinds of talk therapy, like cognitive-behavioral therapy (CBT), exposure therapy, and more. All of them try to give you the tools you need to deal with anxiety and make sure you know how to use them.
CBT stands for cognitive-behavioral therapy (CBT). CBT is a popular way to treat anxiety. It helps you recognize the negative things you say to yourself, like “No one will even notice if I don’t go to the party.” You’ll also learn to recognize any unhealthy patterns of behavior (never leaving the house because of fear that something bad might happen).
Then you are taught how to challenge them. This helps you realize that you’re in charge. You have the power to change your thoughts and actions, which is the key to stopping anxiety from messing up your life.
A lot of research shows that CBT can help with a wide range of mental health problems, including anxiety disorders, depression, and eating disorders. And you don’t have to meet with a therapist in person to get help.
A 2018 study in the Journal of Anxiety Disorders found that online cognitive behavioral therapy was just as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.
This is called exposure therapy. Exposure therapy is a type of CBT that helps you get over fears and worries by breaking the pattern of avoiding the thing or situation that scares you. Therapists often use it to treat phobias like social anxiety disorder or specific phobias. It works by gradually exposing you to what scares you in a safe environment.
For example, if you’re scared of spiders, the therapist might start by having you look at pictures of spiders. In the next meeting, they might bring in a live spider in a closed container. Eventually, they might make you hold a spider.
Other therapies and ways of living. Your doctor may teach you other therapy techniques, like visualizing or deep breathing exercises, that you can use in addition to psychotherapy. These techniques can help when you need a little something extra to get through a particularly stressful time.
Even though exercise isn’t exactly a treatment, it can make a big difference in dealing with anxiety. And you don’t have to commit to an hour of sweating every day. Research published in the Expert Review of Neurotherapeutics suggests that just 30 minutes of exercise 3 or 4 times a week can be enough to reduce anxiety.
How will I know that my treatment for anxiety is working?
The easy answer is that you’ll feel better. Depending on your treatment, it may take a while before you notice that your symptoms are getting less bad and happening less often. You may be sleeping better or realize that things that used to bother you don’t bother you as much as they used to. And hopefully, you’ll also start to enjoy your favorite activities and hobbies again.
There are also scales that your doctor can use to figure out how much anxiety you have. These are two examples:
- Generalized anxiety disorder is measured by the GAD-7.
- The Social Phobia Inventory (SPIN) is used to measure social phobias in adults. Rating your symptoms before and during treatment makes it easy for you and your doctor to see how well your treatment is working and whether anything needs to be changed.
It’s also helpful to keep track of your own symptoms. If you aren’t feeling better after 8 to 10 weeks, you should talk to your doctor or another provider (e.g., a psychotherapist). To make sure you’re making progress and feeling your best, they may want to give you a higher dose or a different medication, or add another type of treatment (like combining psychotherapy and medication).