- Anxiety Disorders and Anxiety Attacks
- Do you struggle with anxiety? Here’s how to recognize the signs, symptoms, and different types of anxiety—and find the relief you need.
- Signs and symptoms of anxiety disorders
- What is an anxiety attack?
- Types of anxiety disorders and their symptoms
- Self-help for anxiety
- When to seek professional help for anxiety symptoms
- Treatment for anxiety disorders
- What does anxiety feel like and how does it affect the body?
- Anxiety and physical illness
- Understanding and treating anxiety can often improve the outcome of chronic disease, such as GI tract problems and heart disease.
- Anxiety and gastrointestinal disorders
- Chronic respiratory disorders and anxiety
- Anxiety and heart disease
- Physical benefits of treating anxiety
- Drug therapy to treat anxiety
- Seeking help for anxiety
- Top 10 List of
- 10. Blushing (Face Turns Red)
- 8. Swallowing / Lump in Throat
- 4. Facial Tics/Neck, Mouth
- Panic Attack Symptoms
- What Are Common Symptoms of Anxiety Disorders?
- What Are the Symptoms of Anxiety Disorders?
- What Are the Symptoms of Anxiety or Panic Attacks?
- When Are Anxiety Symptoms Not a Sign of Anxiety?
- How Is Anxiety Disorder Diagnosed?
- What Makes Anxiety Symptoms Worse?
- Signs & Symptoms of Anxiety
- Learn About Anxiety
Anxiety Disorders and Anxiety Attacks
Do you struggle with anxiety? Here’s how to recognize the signs, symptoms, and different types of anxiety—and find the relief you need.
Anxiety is a normal reaction to danger, the body’s automatic fight-or-flight response that is triggered when you feel threatened, under pressure, or are facing a challenging situation, such as a job interview, exam, or first date. In moderation, anxiety isn’t necessarily a bad thing. It can help you to stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming—when worries and fears interfere with your relationships and daily life—you’ve likely crossed the line from normal anxiety into the territory of an anxiety disorder.
Since anxiety disorders are a group of related conditions rather than a single disorder, symptoms may vary from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything. But despite their different forms, all anxiety disorders illicit an intense fear or worry out of proportion to the situation at hand.
While having an anxiety disorder can be disabling, preventing you from living the life you want, it’s important to know that you’re not alone. Anxiety disorders are among the most common mental health issues—and are highly treatable. Once you understand your anxiety disorder, there are steps you can take to reduce the symptoms and regain control of your life.
Do I have an anxiety disorder?
If you identify with any of the following seven signs and symptoms, and they just won’t go away, you may be suffering from an anxiety disorder:
- Are you constantly tense, worried, or on edge?
- Does your anxiety interfere with your work, school, or family responsibilities?
- Are you plagued by fears that you know are irrational, but can’t shake?
- Do you believe that something bad will happen if certain things aren’t done a certain way?
- Do you avoid everyday situations or activities because they cause you anxiety?
- Do you experience sudden, unexpected attacks of heart-pounding panic?
- Do you feel like danger and catastrophe are around every corner?
Signs and symptoms of anxiety disorders
In addition to the primary symptom of excessive and irrational fear and worry, other common emotional symptoms of an anxiety disorder include:
- Feelings of apprehension or dread
- Watching for signs of danger
- Anticipating the worst
- Trouble concentrating
- Feeling tense and jumpy
- Feeling like your mind’s gone blank
But anxiety is more than just a feeling. As a product of the body’s fight-or-flight response, anxiety also involves a wide range of physical symptoms, including:
- Pounding heart
- Stomach upset
- Frequent urination or diarrhea
- Shortness of breath
- Muscle tension or twitches
- Shaking or trembling
Because of these physical symptoms, anxiety sufferers often mistake their disorder for a medical illness. They may visit many doctors and make numerous trips to the hospital before their anxiety disorder is finally recognized.
Many people with anxiety disorders also suffer from depression at some point. Anxiety and depression are believed to stem from the same biological vulnerability, which may explain why they so often go hand-in-hand. Since depression makes anxiety worse (and vice versa), it’s important to seek treatment for both conditions.
What is an anxiety attack?
Anxiety attacks, also known as panic attacks, are episodes of intense panic or fear. Anxiety attacks usually occur suddenly and without warning. Sometimes there’s an obvious trigger—getting stuck in an elevator, for example, or thinking about the big speech you have to give—but in other cases, the attacks come out of the blue.
Anxiety attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, you may experience terror so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people think they’re having a heart attack. After an anxiety attack is over, you may worry about having another one, particularly in a public place where help isn’t available or you can’t easily escape.
Symptoms of an anxiety attack include:
- Surge of overwhelming panic
- Feeling of losing control or going crazy
- Heart palpitations or chest pain
- Feeling like you’re going to pass out
- Trouble breathing or choking sensation
- Hot flashes or chills
- Trembling or shaking
- Nausea or stomach cramps
- Feeling detached or unreal
It’s important to seek help if you’re starting to avoid certain situations because you’re afraid of having a panic attack. The truth is that panic attacks are highly treatable. In fact, many people are panic free within just 5 to 8 treatment sessions.
Types of anxiety disorders and their symptoms
Anxiety disorders and conditions closely related to anxiety disorders include:
Generalized anxiety disorder (GAD)
If constant worries and fears distract you from your day-to-day activities, or you’re troubled by a persistent feeling that something bad is going to happen, you may be suffering from generalized anxiety disorder (GAD). People with GAD are chronic worrywarts who feel anxious nearly all of the time, though they may not even know why. Anxiety related to GAD often manifests in physical symptoms like insomnia, stomach upset, restlessness, and fatigue.
Panic attacks and panic disorder
Panic disorder is characterized by repeated, unexpected panic attacks, as well as fear of experiencing another episode. Agoraphobia, the fear of being somewhere where escape or help would be difficult in the event of a panic attack, may also accompany a panic disorder. If you have agoraphobia, you are likely to avoid public places such as shopping malls, or confined spaces such as an airplane.
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (OCD) is characterized by unwanted thoughts or behaviors that seem impossible to stop or control. If you have OCD, you may feel troubled by obsessions, such as a recurring worry that you forgot to turn off the oven or that you might hurt someone. You may also suffer from uncontrollable compulsions, such as washing your hands over and over.
Phobias and irrational fears
A phobia is an unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals (such as snakes and spiders), fear of flying, and fear of heights. In the case of a severe phobia, you might go to extreme lengths to avoid the object of your fear. Unfortunately, avoidance only strengthens the phobia.
Social anxiety disorder
If you have a debilitating fear of being viewed negatively by others and humiliated in public, you may have social anxiety disorder, also known as social phobia. Social anxiety disorder can be thought of as extreme shyness. In severe cases, social situations are avoided altogether. Performance anxiety (better known as stage fright) is the most common type of social phobia.
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD) is an extreme anxiety disorder that can occur in the aftermath of a traumatic or life-threatening event. PTSD can be thought of as a panic attack that rarely, if ever, lets up. Symptoms of PTSD include flashbacks or nightmares about the incident, hypervigilance, startling easily, withdrawing from others, and avoiding situations that remind you of the event.
Separation anxiety disorder
While separation anxiety is a normal stage of development, if anxieties intensify or are persistent enough to get in the way of school or other activities, your child may have separation anxiety disorder. Children with separation anxiety disorder may become agitated at just the thought of being away from mom or dad and complain of sickness to avoid playing with friends or going to school.
Self-help for anxiety
Not everyone who worries a lot has an anxiety disorder. You may feel anxious because of an overly demanding schedule, lack of exercise or sleep, pressure at home or work, or even from too much caffeine. The bottom line is that if your lifestyle is unhealthy and stressful, you’re more likely to feel anxious—whether or not you actually have an anxiety disorder. These tips can help to lower anxiety and manage symptoms of a disorder:
Connect with others. Loneliness and isolation can trigger or worsen anxiety, while talking about your worries face to face can often make them seem less overwhelming. Make it a point to regularly meet up with friends, join a self-help or support group, or share your worries and concerns with a trusted loved one. If you don’t have anyone you can reach out to, it’s never too late to build new friendships and a support network.
Manage stress. If your stress levels are through the roof, stress management can help. Look at your responsibilities and see if there are any you can give up, turn down, or delegate to others.
Practice relaxation techniques. When practiced regularly relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and deep breathing can reduce anxiety symptoms and increase feelings of relaxation and emotional well-being.
Exercise regularly. Exercise is a natural stress buster and anxiety reliever. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days (broken up into short periods if that’s easier). Rhythmic activities that require moving both your arms and legs are especially effective. Try walking, running, swimming, martial arts, or dancing.
Get enough sleep. A lack of sleep can exacerbate anxious thoughts and feelings, so try to get seven to nine hours of quality sleep a night.
Be smart about caffeine, alcohol, and nicotine. If you struggle with anxiety, you may want to consider reducing your caffeine intake, or cutting it out completely. Similarly alcohol can also make anxiety worse. And while it may seem like cigarettes are calming, nicotine is actually a powerful stimulant that leads to higher, not lower, levels of anxiety. For help kicking the habit, see How to Quit Smoking.
Put a stop to chronic worrying. Worrying is a mental habit you can learn how to break. Strategies such as creating a worry period, challenging anxious thoughts, and learning to accept uncertainty can significantly reduce worry and calm your anxious thoughts.
When to seek professional help for anxiety symptoms
While self-help coping strategies for anxiety can be very effective, if your worries, fears, or anxiety attacks have become so great that they’re causing extreme distress or disrupting your daily routine, it’s important to seek professional help.
If you’re experiencing a lot of physical anxiety symptoms, you should start by getting a medical checkup. Your doctor can check to make sure that your anxiety isn’t caused by a medical condition, such as a thyroid problem, hypoglycemia, or asthma. Since certain drugs and supplements can cause anxiety, your doctor will also want to know about any prescriptions, over-the-counter medications, herbal remedies, and recreational drugs you’re taking.
If your physician rules out a medical cause, the next step is to consult with a therapist who has experience treating anxiety disorders. The therapist will work with you to determine the cause and type of your anxiety disorder and devise a course of treatment.
Treatment for anxiety disorders
Anxiety disorders respond very well to therapy—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with therapy, medication, or some combination of the two. Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. They can help with issues such as panic attacks, generalized anxiety, and phobias.
Cognitive-behavior therapy helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety.
Exposure therapy encourages you to confront your fears and anxieties in a safe, controlled environment. Through gradual exposure to the feared object or situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety will diminish.
Medication for anxiety disorders
If you have anxiety that’s severe enough to interfere with your ability to function, medication may help relieve some anxiety symptoms. However, anxiety medications can be habit forming and cause unwanted or even dangerous side effects, so be sure to research your options carefully. Many people use anti-anxiety medication when therapy, exercise, or self-help strategies would work just as well or better—minus the side effects and safety concerns. It’s important to weigh the benefits and risks of anxiety medication so you can make an informed decision.
What does anxiety feel like and how does it affect the body?
Share on PinterestDizziness and lightheadedness are potential symptoms of anxiety.
Anxiety can have a significant effect on the body, and long-term anxiety increases the risk of developing chronic physical conditions.
The medical community suspects that anxiety develops in the amygdala, an area of the brain that manages emotional responses.
When a person becomes anxious, stressed, or frightened, the brain sends signals to other parts of the body. The signals communicate that the body should prepare to fight or flee.
The body responds, for example, by releasing adrenaline and cortisol, which many describe as stress hormones.
The fight or flight response is useful when confronting an aggressive person, but it is less helpful when going for a job interview or giving a presentation. Also, it is not healthy for this response to persist in the long term.
Some of the ways that anxiety affects the body include:
Breathing and respiratory changes
During periods of anxiety, a person’s breathing may become rapid and shallow, which is called hyperventilation.
Hyperventilation allows the lungs to take in more oxygen and transport it around the body quickly. Extra oxygen helps the body prepare to fight or flee.
Hyperventilation can make people feel like they are not getting enough oxygen and they may gasp for breath. This can worsen hyperventilation and its symptoms, which include:
- feeling faint
Cardiovascular system response
Anxiety can cause changes to the heart rate and the circulation of blood throughout the body.
A faster heart rate makes it easier to flee or fight, while increased blood flow brings fresh oxygen and nutrients to the muscles.
When blood vessels narrow, this is called vasoconstriction, and it can affect body temperature. People often experience hot flashes as a result of vasoconstriction.
In response, the body sweats to cool down. This can sometimes be too effective and make a person feel cold.
Long-term anxiety may not be good for the cardiovascular system and heart health. Some studies suggest that anxiety increases the risk of heart diseases in otherwise healthy people.
Impaired immune function
In the short-term, anxiety boosts the immune system’s responses. However, prolonged anxiety can have the opposite effect.
Cortisol prevents the release of substances that cause inflammation, and it turns off aspects of the immune system that fight infections, impairing the body’s natural immune response.
People with chronic anxiety disorders may be more likely to get the common cold, the flu, and other types of infection.
Changes in digestive function
Cortisol blocks processes that the body considers nonessential in a fight or flight situation.
One of these blocked processes is digestion. Also, adrenaline reduces blood flow and relaxes the stomach muscles.
As a result, a person with anxiety may experience nausea, diarrhea, and a feeling that the stomach is churning. They may also lose their appetite.
Some research suggests that stress and depression are linked to several digestive diseases, including irritable bowel syndrome (IBS).
One study, of outpatients at a gastroenterology clinic in Mumbai, reported that 30–40 percent of participants with IBS also had anxiety or depression.
Anxiety and stress can increase the need to urinate, and this reaction is more common in people with phobias.
The need to urinate or a loss of control over urination may have an evolutionary basis, as it is easier to flee with an empty bladder.
However, the link between anxiety and an increased urge to urinate remains unclear.
A panic attack is the abrupt onset of intense fear or discomfort that reaches a peak within minutes and includes at least four of the following symptoms:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, light-headed, or faint
- Chills or heat sensations
- Paresthesia (numbness or tingling sensations)
- Derealization (feelings of unreality) or depersonalization (being detached from oneself) Listen to this podcast.
- Fear of losing control or “going crazy”
- Fear of dying
Some people experience what is referred to as limited-symptom panic attacks, which are similar to full-blown panic attacks but consist of fewer than four symptoms.
Although anxiety is often accompanied by physical symptoms, such as a racing heart or knots in your stomach, what differentiates a panic attack from other anxiety symptoms is the intensity and duration of the symptoms. Panic attacks typically reach their peak level of intensity in 10 minutes or less and then begin to subside. Due to the intensity of the symptoms and their tendency to mimic those of heart disease, thyroid problems, breathing disorders, and other illnesses, people with panic disorder often make many visits to emergency rooms or doctors’ offices, convinced they have a life-threatening issue.
Panic attacks can occur unexpectedly during a calm state or in an anxious state. Although panic attacks are a defining characteristic of panic disorder, it is not uncommon for individuals to experience panic attacks in the context of other psychological disorders. For example, someone with social anxiety disorder might have a panic attack before giving a talk at a conference and someone with obsessive-compulsive disorder might have a panic attack when prevented from engaging in a ritual or compulsion.
Panic attacks are extremely unpleasant and can be very frightening. As a result, people who experience repeated panic attacks often become very worried about having another attack and may make changes to their lifestyle so as to avoid having panic attacks. For example, avoiding exercise so as to keep their heart rate low, or avoiding certain places.
In the past it might have taken months or years and lots of frustration before getting a proper diagnosis. Some people are afraid or embarrassed to tell anyone, including their doctors or loved ones about what they are experiencing for fear of being seen as a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful. Other people suffering from panic attacks don’t know they have a real and highly treatable disorder. It is our hope that through increased education, people will feel more empowered to discuss their symptoms with a healthcare professional and seek appropriate treatment.
ADAA members Stefan Hoffmann, PhD, Aleena Hay, PhD and their Boston University colleague Abigail Barthal, BA discusses panic attacks and panic disorder: symptoms, treatment, causes, and coping strategies in this in-depth Anxiety.org article.
Screen yourself or a family member for panic disorder.
Learn more about panic attacks and their symptoms at BetterHelp.com
Anxiety and physical illness
Understanding and treating anxiety can often improve the outcome of chronic disease, such as GI tract problems and heart disease.
Updated: May 9, 2018Published: July, 2008
With headlines warning us of international terrorism, global warming, and economic uncertainty, we’re all likely to be a little more anxious these days. As an everyday emotion, anxiety — the “fight or flight” response — can be a good thing, prompting us to take extra precautions. But when anxiety persists in the absence of a need to fight or flee, it can not only interfere with our daily lives but also undermine our physical health. Evidence suggests that people with anxiety disorders are at greater risk for developing a number of chronic medical conditions. They may also have more severe symptoms and a greater risk of death when they become ill.
The anatomy of anxiety
Anxiety is a reaction to stress that has both psychological and physical features. The feeling is thought to arise in the amygdala, a brain region that governs many intense emotional responses. As neurotransmitters carry the impulse to the sympathetic nervous system, heart and breathing rates increase, muscles tense, and blood flow is diverted from the abdominal organs to the brain. In the short term, anxiety prepares us to confront a crisis by putting the body on alert. But its physical effects can be counterproductive, causing light-headedness, nausea, diarrhea, and frequent urination. And when it persists, anxiety can take a toll on our mental and physical health.
Anxiety as illness
Research on the physiology of anxiety-related illness is still young, but there’s growing evidence of mutual influence between emotions and physical functioning. Yet anxiety often goes unidentified as a source of other disorders, such as substance abuse or physical addiction, that can result from attempts to quell feelings of anxiety. And it’s often overlooked in the myriad symptoms of chronic conditions like irritable bowel syndrome (IBS) or migraine headache.
Nearly two-thirds of the estimated 40 million adults with anxiety disorders are women. What people with these disorders have in common is unwarranted fear or distress that interferes with daily life (see chart). Anxiety also plays a role in somatic symptom disorder, which is characterized by physical symptoms such as pain, nausea, weakness, or dizziness that have no apparent physical cause.
Anxiety has been implicated in several chronic physical illnesses, including heart disease, chronic respiratory disorders, and gastrointestinal conditions. When people with these disorders have untreated anxiety, the disease itself is more difficult to treat, their physical symptoms often become worse, and in some cases they die sooner.
Anxiety disorders and their symptoms
Generalized anxiety disorder
Exaggerated worry about health, safety, money, and other aspects of daily life that lasts six months or more. Often accompanied by muscle pain, fatigue, headaches, nausea, breathlessness, and insomnia.
Irrational fear of specific things or situations, such as spiders (arachnophobia), being in crowds (agoraphobia), or being in enclosed spaces (claustrophobia).
Social anxiety disorder (social phobia)
Overwhelming self-consciousness in ordinary social encounters, heightened by a sense of being watched and judged by others and a fear of embarrassment.
Post-traumatic stress disorder (PTSD)
Reliving an intense physical or emotional threat or injury (for example, childhood abuse, combat, or an earthquake) in vivid dreams, flashbacks, or tormented memories. Other symptoms include difficulty sleeping or concentrating, angry outbursts, emotional withdrawal, and a heightened startle response.
Obsessive/compulsive disorder (OCD)
Obsessive thoughts, such as an irrational fear of contamination, accompanied by compulsive acts, such as repetitive hand washing, that are undertaken to alleviate the anxiety generated by the thoughts.
Recurrent episodes of unprovoked feelings of terror or impending doom, accompanied by rapid heartbeat, sweating, dizziness, or weakness.
Anxiety and gastrointestinal disorders
About 10% to 20% of Americans suffer from the two most common functional digestive disorders — IBS and functional dyspepsia (upset stomach). In these disorders, the nerves regulating digestion appear to be hypersensitive to stimulation. Because these conditions don’t produce lesions like ulcers or tumors, they aren’t considered life-threatening. But their symptoms — abdominal pain, bloating, and diarrhea or constipation in IBS; and pain, nausea, and vomiting in functional dyspepsia — can be chronic and difficult to tolerate.
There are no firm data on the prevalence of anxiety disorders in people with functional digestive disorders, but a 2007 New Zealand study of subjects with gastroenteritis (inflammation of the digestive tract) found an association between high anxiety levels and the development of IBS following a bowel infection.
Chronic respiratory disorders and anxiety
In asthma, inflamed airways constrict spasmodically, reducing the flow of air through the lungs. In chronic obstructive pulmonary disease (COPD), inflammation of the airways is exacerbated by a loss of elasticity in the lungs: not only is it more difficult for air to reach the lungs, but the lungs neither fill nor expel air completely.
Although results vary, most studies have found a high rate of anxiety symptoms and panic attacks in patients who have chronic respiratory disease, with women at greater risk than men. In several studies involving COPD patients, anxiety has been associated with more frequent hospitalization and with more severe distress at every level of lung function. So even if anxiety doesn’t affect the progress of the disease, it takes a substantial toll on quality of life.
Anxiety and heart disease
Anxiety disorders have also been linked to the development of heart disease and to coronary events in people who already have heart disease. In the Nurses’ Health Study, women with the highest levels of phobic anxiety were 59% more likely to have a heart attack, and 31% more likely to die from one, than women with the lowest anxiety levels. Data from 3,300 postmenopausal women in the Women’s Health Initiative showed that a history of full-blown panic attacks tripled the risk of a coronary event or stroke.
Two studies — one involving Harvard Medical School and the Lown Cardiovascular Research Institute; the other, several Canadian medical colleges — concluded that among both men and women with established heart disease, those suffering from an anxiety disorder were twice as likely to have a heart attack as those with no history of anxiety disorders.
Physical benefits of treating anxiety
Therapies that have been successful in treating anxiety disorders can ease the symptoms of chronic gastrointestinal and respiratory diseases. These therapies may have an important role in preventing and treating heart disease. These are the best-studied approaches:
Cognitive-behavioral therapy. The cognitive component helps people identify and avoid thoughts that generate anxiety, and the behavioral part helps them learn how to react differently to anxiety-provoking situations. The specifics of the treatment depend on the type of anxiety. For example, patients with generalized anxiety disorder or panic disorder may be asked to examine their lives for habits and patterns that foster a sense of dread. They may also be taught relaxation techniques to diminish anxiety. Patients with OCD characterized by excessive washing may be asked to dirty their hands and wait with a therapist for increasingly longer intervals before cleaning up.
Psychodynamic psychotherapy. Anxiety is often triggered by a deep-seated emotional conflict or a traumatic experience that can sometimes be explored and resolved through psychotherapy. In the first randomized controlled clinical trial comparing relaxation therapy to psychodynamic psychotherapy (focused talk therapy), clinician-researchers at Columbia University in New York found that panic-disorder patients treated with psychodynamic therapy had significantly fewer symptoms and functioned better socially than those who underwent relaxation therapy. Nearly three-quarters of the psychotherapy group responded to treatment compared with only 39% of the relaxation-therapy group.
Drug therapy to treat anxiety
Medications alone are less effective than psychotherapy over the long term. They may also have unpleasant side effects and interact with other medications. Still, they can be helpful when used in combination with psychotherapy. The most commonly used types of drugs include these:
Anti-anxiety drugs. Benzodiazepines — clonazepam (Klonopin) and alprazolam (Xanax) — were developed to relieve anxiety. They act rapidly and have few side effects except occasional drowsiness. But they’re not recommended for long-term use, because patients develop tolerance and require increasing doses. Buspirone (BuSpar) may be a preferred drug. It needs two weeks to take full effect but can be taken for longer periods than benzodiazepines.
Antidepressants. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft), have been replacing benzodiazepines in the long-term treatment of panic disorder and generalized anxiety. Antidepressants have the advantage of relieving depression as well as anxiety, and they are believed to create less risk of dependence and abuse.
Beta blockers. These drugs can help relieve the symptoms of acute anxiety by slowing the heart rate and reducing blood pressure. They are often used, for example, to treat stage fright.
Seeking help for anxiety
About 30% of people with anxiety disorders go through life untreated. If you think you might fall into this category — or if you have IBS, asthma, COPD, or heart disease and haven’t been evaluated for anxiety — discuss it with your primary care clinician. Also be open to considering anxiety as the root cause if you have unexplained physical symptoms. Keep in mind that all symptoms are real — and treatable — whether they originate in the body or the brain.
By the way, if you’re just feeling a little more stress and anxiety than you once did, try some relaxation techniques (for some examples, visit Six relaxation techniques to reduce stress).
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From the outside looking in, it can be difficult to spot the differences between stress and anxiety. Both can lead to sleepless nights, exhaustion, excessive worry, lack of focus, and irritability. Even physical symptoms – like rapid heart rate, muscle tension, and headaches – can impact both people experiencing stress and those diagnosed with an anxiety disorder. With symptoms that can appear interchangeable, it can be difficult to know when to work on deep breathing and when to seek professional help.
In short, stress is your body’s reaction to a trigger and is generally a short-term experience. Stress can be positive or negative. When stress kicks in and helps you pull off that deadline you thought was a lost cause, it’s positive. When stress results in insomnia, poor concentration, and impaired ability to do the things you normally do, it’s negative. Stress is a response to a threat in any given situation.
Anxiety, on the other hand, is a sustained mental health disorder that can be triggered by stress. Anxiety doesn’t fade into the distance once the threat is mediated. Anxiety hangs around for the long haul, and can cause significant impairment in social, occupational, and other important areas of functioning.
Symptoms of Stress
There are a number of emotional and physical disorders linked to stress, including depression, anxiety, heart attacks, strokes, gastrointestinal distress, obesity, and hypertension, to name a few. High levels of stress can wreak havoc on the mind and the body. While stress can manifest in many ways, it helps to know a few common symptoms:
- Frequent headaches
- Sleep disturbance
- Back and/or neck pain
- Feeling light-headed, faint, or dizzy
- Sweaty palms or feet
- Difficulty swallowing
- Frequent illness
- Gastrointestinal problems
- Excessive worry
- Rapid heart rate
- Muscle tension
- Feeling overwhelmed
- Having difficulty quieting the mind
- Poor concentration
- Low energy
- Loss of sexual desire
Symptoms of stress can vary and change over time. Cueing into your own responses to stress can help you increase awareness of how stress manifests for you. Knowing this vital information will help you learn to use stress reduction techniques at the first signs of stress to avoid long-term repercussions.
Coping with Stress
Learning to cope with stress can require some trial and error. What works for your best friend might not work for you. It’s important to build your own stress reduction toolkit so that you have more than one strategy to implement when stress kicks in.
- Relaxation breathing: The single best thing you can do when under stress is to engage in deep breathing. Practice this strategy when you’re calm so that you know how to use it when you’re under pressure. Inhale for a count of four, hold for four, and exhale for four. Repeat.
- Practice mindfulness: Sure, there’s an app for that, but the best way to practice mindfulness is to disconnect from your digital world and reconnect with your natural world for a specific period of time each day. Take a walk outside and use the opportunity to notice your surroundings using all of your senses.
- Get moving: Daily exercise releases feel-good chemicals in your brain. Making exercise a daily habit can buffer you from negative reactions to stressful events.
- Keep a journal: Writing down your best and worst of the day helps you sort through the obstacles and focus on what went right. It’s normal to experience ups and downs on any given day.
- Get creative: There’s a reason adult coloring books are so popular – they work. Whether you’re drawing, coloring, writing poetry, or throwing paint on a wall, engaging in a creative hobby gives your mind a chance to relax.
- Crank up the tunes: Listening to slow, relaxing music decreases your stress response (just as fast-paced music pumps you up for a run.)
When to Seek Help
If you have difficulty managing stress and it impedes your ability to carry out your normal daily activities (like getting to work on time), talk therapy can help. It’s important to learn to identify your triggers and responses and find strategies that work for you.
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Symptoms of Generalized Anxiety Disorder
The defining feature of generalized anxiety disorder is excessive anxiety and worry (about a number of events or activities) occurring more days than not for at least six months. The intensity of the anxiety or worry is out of proportion to the actual likelihood or impact of the anticipated event or events.
Other symptoms of generalized anxiety disorder include the following:
- Difficulty controlling worry
- Restlessness or feeling keyed up or on edge
- Easily fatigued
- Difficulty concentrating or mind going blank
- Muscle tension
- Sleep disturbance
- Exaggerated startle response
- Psychosomatic symptoms: Headaches, stomachaches, dizziness, pins and needles
- Physical symptoms: Shortness of breath, rapid heartbeat, excessive sweating, shortness of breath, chest pain
- The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning
Anxiety disorders are the most common mental health disorder in the United States, affecting 40 million adults (18% of the population).
Treatment of Anxiety Disorders
The two main treatments for anxiety are psychotherapy and medication, and many people benefit from a combination of the two.
- Psychotherapy: Talk therapy is effective in helping people identify, process, and cope with their triggers of anxiety. Cognitive Behavioral Therapy (CBT) is a highly effective, short-term treatment that helps people learn specific skills to target their specific triggers.
- Medication: Antidepressants generally have some mild side effects but help alleviate some symptoms of anxiety. Antidepressants can be used for an extended period of time. Buspirone is an anti-anxiety medication that can also be used on an ongoing basis. Benzodiazepines can be used on a limited basis to mitigate anxiety symptoms, but they can be habit-forming. All medications should be thoroughly discussed with your healthcare provider. Any side effects should be reported immediately. Never discontinue the use of these medications without supervision from your healthcare provider.
- Lifestyle changes: There are several changes you can make at home before you try medications. Daily exercise, good sleep hygiene, healthy eating, and avoiding caffeine and alcohol are all home remedies that can decrease symptoms of anxiety.
Everyone experiences periods of increased stress, and sometimes stress can feel overwhelming. It is important to learn how to manage your stress and when to seek help. When stress no longer feels manageable and symptoms of anxiety interfere with your daily living, it’s time to seek an evaluation from a licensed mental health practitioner.
Article Sources Last Updated: Mar 19, 2019
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Physiological symptoms are the physical symptoms that occur when you feel anxious or under display. These are bodily reactions, and may be apparent to other people. Note that they are always stronger and more apparent to the person exhibiting them than to the person displaying them.
Blushing, for example, is not perceived in a negative light by most people. In survey after survery, people report that blushing does not turn them off. If anything, it has the tendency to make people like the person who blushes better. People (with social anxiety) who blush rarely believe this, though, and it takes progress against social anxiety before blushing recedes. Overcoming social anxiety resolves all these problems.
10. Blushing (Face Turns Red)
8. Swallowing / Lump in Throat
4. Facial Tics/Neck, Mouth
Social anxiety can be overcome if it is done in the appropriate manner, and these symptoms dissipate along with it. Overcoming social anxiety isn’t possible unless all the symptoms are alleviated as well. Thousands of people have overcome social anxiety based on our online therapy series.
The good news is that all these conditions go away. The physiological symptoms go away relatively quickly as people work in a structured, systematic manner to overcome social anxiety disorder. The cognitive-behavioral therapy groups at the Social Anxiety Institute run continuously, all year long, with start dates in January, May, and September.
Join us and get over the symptoms that social anxiety causes. More importantly, overcome social anxiety altogether. That’s what the Social Anxiety Institute is all about.
Panic Attack Symptoms
Panic attacks involve sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. People experiencing a panic attack may believe they are having a heart attack or they are dying or going crazy. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms:
- “Racing” heart
- Feeling weak, faint, or dizzy
- Tingling or numbness in the hands and fingers
- Sense of terror, or impending doom or death
- Feeling sweaty or having chills
- Chest pains
- Breathing difficulties
- Feeling a loss of control
Panic attacks are generally brief, lasting less than 10 minutes, although some of the symptoms may persist for a longer time. People who have had one panic attack are at greater risk for having subsequent panic attacks than those who have never experienced a panic attack. When the attacks occur repeatedly, and there is worry about having more episodes, a person is considered to have a condition known as panic disorder.
People with panic disorder may be extremely anxious and fearful, since they are unable to predict when the next episode will occur. Panic disorder is fairly common and affects about 6 million adults in the U.S. Women are twice as likely as men to develop the condition, and its symptoms usually begin in early adulthood.
It is not clear what causes panic disorder. In many people who have the biological vulnerability to panic attacks, they may develop in association with major life changes (such as getting married, having a child, starting a first job, etc.) and major lifestyle stressors. There is also some evidence that suggests that the tendency to develop panic disorder may run in families. People who suffer from panic disorder are also more likely than others to suffer from depression, attempt suicide, or to abuse alcohol or drugs.
Fortunately, panic disorder is a treatable condition. Psychotherapy and medications have both been used, either singly or in combination, for successful treatment of panic disorder. If medication is necessary, your doctor may prescribe anti-anxiety medications, certain antidepressants or sometimes certain anticonvulsant drugs that also have anti-anxiety properties, or a class of heart medications known as beta-blockers to help prevent or control the episodes in panic disorder.
What Are Common Symptoms of Anxiety Disorders?
Know the signs and symptoms of different types of anxiety disorders.
Anxiety can affect you both physically and psychologically. Jamie Grill/Getty Images
Each anxiety disorder has unique symptoms. Anxiety disorders are typically diagnosed when fear of non-threatening situations, places, events, or objects becomes extreme and uncontrollable.
An anxiety disorder may also be diagnosed if you have general feelings of fear or worry that interfere with your daily life and have lasted at least six months.
Most people with an anxiety disorder have a combination of physical and psychological symptoms.
There is one symptom that all anxiety disorders have in common: near-constant fear or worry about things that may happen to you now or in the future. Read on to learn what the symptoms are and how to diagnose anxiety disorders.
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What Are the Symptoms of Anxiety Disorders?
Psychological symptoms may include:
- Feelings of apprehension or dread
- Feeling restless or irritable
- Feeling tense or jumpy
- Anticipating the worst
- Constantly watching for signs of danger
Physical symptoms may include:
- Rapid or pounding heartbeat
- Shortness of breath
- Excessive sweating
- Tremors or twitches
- Fatigue or weakness
- Nausea or upset stomach
- Frequent urination or diarrhea
What Are the Symptoms of Anxiety or Panic Attacks?
What we think of as anxiety attacks are actually panic attacks. A panic attack is the sudden onset of intense fear or discomfort that peaks after about ten minutes, and it typically lasts no longer than 30 minutes. (1, 2)
According to the Anxiety and Depression Association of America, (3) it also involves four or more of the following symptoms:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Chills or heat sensations
- Parasthesia (numbness or tingling sensations)
- Derealization (feelings of unreality) or depersonalization (being detached from oneself)
- Fear of losing control or “going crazy”
- Fear of dying
Researchers think that panic attacks come about because the brain is telling the body that the fight-or-flight response, which includes a rapid heartbeat and shallow breathing, should kick in, even though there may be no threat at all. Scientists also theorize that the amygdala, which is the brain’s fear processing hub, may also be activated during a panic attack. (4)
Panic attacks may come on because of a particular event, or they may come on for no reason at all. It’s been estimated that almost 23 percent of people will have at least one panic attack in their lifetime. (5)
If your panic attacks are recurring, you are likely to be diagnosed with panic disorder. Panic disorder is a type of anxiety disorder that’s characterized by persistent worry about future panic attacks or their consequences.
Noah Clyman, a licensed clinical social worker and director of NYC Cognitive Therapy, a private psychotherapy practice in Manhattan, New York, says that panic attacks do not have to be feared. “By learning to correctly interpret bodily sensations and not relate to them as dangerous,” he says, “your fear level can go down.”
RELATED: When Anxiety Becomes a Disorder
When Are Anxiety Symptoms Not a Sign of Anxiety?
Some of the physical symptoms of an anxiety disorder may be symptoms of other medical conditions, such as:
- Heart disease
- Lyme disease
- Alzheimer’s disease
- Parkinson’s disease
Anxiety often co-exists with other chronic health conditions, including:
- Hepatitis C
- Multiple sclerosis
- Rheumatoid arthritis
Researchers are not sure why anxiety and conditions like these occur together, but one explanation may be that the stress of dealing with a chronic illness could contribute to developing a mood disorder.
It could also be that anxiety is a precursor to the kind of cognitive decline at the center of Parkinson’s and Alzheimer’s diseases.
It’s been estimated that anxiety disorders are present in 5 to 21 percent of those with dementia (Alzheimer’s disease is the most common form of dementia). (6)
In a Swedish study of twins, which was published in April 2015 in Alzheimer’s and Dementia, researchers found that higher levels of anxiety was associated with an increased risk of developing dementia. (7)
A study of more than 12,000 adults published in October 2017 in Aging and Mental Health found that anxiety, along with depression and sleep disturbances, was associated with the development of Alzheimer’s disease. (8)
Researchers believe that the stress hormone cortisol may be at work in this connection. Whenever you become anxious or stressed, you induce a flood of the stress hormone cortisol, and it may be that a consistent presence of the hormone may damage parts of the brain that process memory and executive functioning.
It’s important to see your doctor if any changes in your mood or health are concerning you. Your doctor can help you determine what disorder or medical condition you may be suffering from, and what assistance you might need.
How Is Anxiety Disorder Diagnosed?
Here’s what you might be able to expect when you visit your doctor:
- Your doctor or nurse will ask you questions about your symptoms.
- Your doctor may perform a physical exam and order lab tests to rule out other health problems.
- If no other health problems are found, your doctor may refer you to a psychiatrist or psychologist to make a diagnosis.
- A psychiatrist or psychologist will identify the specific type of anxiety disorder that’s causing your symptoms.
- This doctor will also look for any other mental health conditions that you may be experiencing, including depression.
What Makes Anxiety Symptoms Worse?
Caffeine, alcohol, and some over-the-counter cold medicines — particularly decongestants — can amplify and aggravate anxiety symptoms.
Additional reporting by Carlene Bauer.
Signs & Symptoms of Anxiety
Learn About Anxiety
While some amount of anxiety is normal, for example when starting a new job or studying for a big exam, people who have anxiety disorders face an overwhelming amount of fears and worries that disrupt normal daily life. Anxiety disorders are a group of mental health disorders that cause some children, teens, adults, and older adults to feel very frightened, fearful, uneasy, and distressed in everyday situations which would not normally evoke an anxiety response. Untreated anxiety disorders can lead to extremely negative consequences that can impact a person’s entire daily life – they may not be able to work, go to school, or have normal social relationships. The most common anxiety disorders include:
Panic disorder involves feelings of intense terror that strike out of nowhere and occur repeatedly, without warning. People who have panic disorder may feel as though they’re suffocating, having a heart attack, and going crazy. In order to avoid these panic attacks, people with panic disorder may begin to avoid going out into crowds or places in which they do not feel safe.
Post-traumatic stress disorder (PTSD) is a disorder that develops after a person is exposed to a traumatic, terrifying event – such as a natural disaster or sexual assault – that leads to flashbacks, avoidance of reminders of the event, and emotional numbness.
Social anxiety disorder, also called social phobia, or social anxiety disorder involves overwhelming feelings of worry and self-consciousness about everyday social situations. These may include fears of being judged by others or that his or her actions may lead to ridicule, embarrassment, or negative judgment. People who have social phobia may have extreme dread and anxiety about activities of daily living such as going to school or work.
Specific phobias are severe fears of a specific situation or object like a fear of heights or a fear of spiders. The level of fear for people who have specific phobias are far stronger than those appropriate for the situation or object and may lead to an avoidance of everyday, common situations.
Generalized anxiety disorder (GAD) is characterized by extreme, unrealistic worries, tension, or dread often without a known stimulus. This worrying lasts at least six months, impairs the ability to concentrate, and makes living daily life challenging.
Fortunately, while anxiety disorders can lead to tremendous challenges in a person’s life, they are eminently treatable disorders. With proper care and therapies, children, teens, adults, and older adults who have anxiety disorders are able to lead productive, happy lives.