What You Need To Know About Anxiety

What is anxiety?

Anxiety is a stress reaction. It's normal and, in some situations, beneficial. It alerts you to potential dangers, helping you to prepare and pay attention. But, what are anxiety disorders?

An anxiety disorder is different from normal feelings of anxiousness or nervousness. It involves the experience of excessive anxiety or fear. Anxiety disorders affect approximately 30% of adults at some point in their lives and are the most common mental disorders.

People with anxiety disorders often have excessive, intense, and persistent fear and worry about everyday situations. Frequently, people with anxiety experience panic attacks, which are repeated events of sudden feelings of extreme fear and anxiety or terror that peak within minutes.

Panic attacks are out of proportion to the danger presented, are hard to control, interfere with day-to-day activities, and can last a long time.

There are many types of anxiety disorders, including:

  • Generalized anxiety disorder

  • Panic disorder

  • Separation anxiety disorder

  • Social anxiety disorder

  • Specific phobias

  • Post-traumatic stress disorder (PTSD)

Generalized anxiety disorder

This includes excessive and persistent worry and anxiety about events or activities — even routine, ordinary issues. The worry you feel is out of proportion to the circumstances being presented. It can affect how you feel physically and is hard to control.

Learn more about generalized anxiety disorder.

Panic disorder

This involves repeated events of sudden feelings of extreme fear, terror, and anxiety that reach their peak within minutes. These events are known as panic attacks. You might experience shortness of breath, feelings of impending doom, a pounding or rapid, fluttering heart (heart palpitations), or chest pain.

Understand panic disorder symptoms and treatment methods.

Separation anxiety disorder

Separation anxiety disorder is a childhood disorder marked by anxiety that's excessive for the level of the child's development and related to being separated from their parents or individuals who have parental roles.

Social anxiety

Also referred to as social phobia, this involves extreme levels of anxiety, avoidance, and fear of social situations because of feelings of self-consciousness, embarrassment, and concern about being viewed negatively or judged by others.

Learn more about social anxiety and coping techniques.

Specific phobias

A specific phobia is a persistent and excessive fear of a certain situation, object, or activity that's typically not harmful. Individuals know their fear is extreme and excessive, but it's difficult for them to overcome it. Some people experience such distress that they go to great lengths to avoid the thing they fear.

Post-traumatic stress disorder (PTSD)

This is a potentially debilitating and serious condition that can occur in individuals who have witnessed or experienced a serious accident, natural disaster, sudden death of someone they love, violent personal assault like rape, terrorist incident, or another life-threatening event.

Symptoms

What are signs of anxiety you can look for? Symptoms may vary depending on what type of anxiety disorder you're struggling with. General symptoms and signs of an anxiety disorder include the following:

Physical symptoms

Mental symptoms

  • Nightmares

  • Worry

  • Feeling fear, panic, and uneasiness

  • Obsessive, uncontrollable thoughts

  • Repeated flashbacks or thoughts of traumatic experiences

Behavioral symptoms

  • Trouble sleeping

  • Inability to be calm and still

  • Ritualistic behaviors like repeatedly washing hands

  • Avoidance of people, places, or things

Not everyone will experience anxiety in the same way. Some people may avoid situations or places in an attempt to prevent anxiety or other negative feelings. Others will experience full-blown panic attacks, which are a common symptom of anxiety.

During a panic attack, you experience an intense wave of fear marked by its debilitating, unexpected, and immobilizing intensity. Your heart will pound, you'll have shortness of breath, and you may feel as if you're going crazy or dying.

Panic attacks frequently hit suddenly, without warning, and sometimes without any clear trigger. They might be a one-time occurrence or occur in repeated episodes.

Find more information on panic attack triggers, prevention, and coping techniques.

Causes

A lot of research is being conducted into the causes of anxiety disorders, and experts feel there is a combination of factors involved, including diet, genes, and stress.

According to the National Institute of Mental Health¹, researchers agree that it could be a combination of environmental and genetic factors that play a role. Brain chemistry is also being researched as a possible cause, and the brain areas that control your response to fear might be involved.

Anxiety disorders often occur alongside other mental health conditions like depression or substance abuse. Some people try easing their symptoms by using drugs or alcohol. These substances may offer temporary relief but could make your anxiety disorder worse.

While there aren't any clear causes of anxiety disorders, there are some identified risk factors. For instance, you may have a higher risk of developing an anxiety disorder if you have:

  • A history of substance abuse

  • Depression

  • Another anxiety disorder

  • Irritable bowel syndrome

Other factors that could increase your chances of developing an anxiety disorder are:

Stress

All people encounter stress, but unresolved or excessive stress could increase your risk of developing chronic anxiety.

See seven techniques that can help you cope with stress and anxiety.

Personality type

Certain individuals are more susceptible to anxiety. Highly-strung, busy individuals with type A personalities have a higher risk of developing an anxiety disorder.

Genetics

If you have a family member who has an anxiety disorder, it increases your risk of developing one as well. If one of your parents suffers from anxiety, your risk is particularly high.

Research of twins suggests that genetics could play a role. One study² suggests the RBFOX1 gene might play a role in the development of an anxiety-related condition, like generalized anxiety disorder. The study's authors feel that both non-genetic and genetic factors play a role.

Trauma

Severe trauma like military combat or child abuse can increase your risk of developing an anxiety disorder. This could include being a trauma victim, being close to a person who's a trauma victim, or witnessing a traumatic event.

Gender 

Women are almost twice as likely as men³ to experience generalized anxiety disorder or another related condition.

Diagnosis

You might start by setting up an appointment with your primary care doctor to see if your anxiety is related to your physical health. They'll look for any signs of an underlying medical ailment that might require treatment.

To make an anxiety disorder diagnosis, a mental health provider might:

Provide you with a psychological evaluation

This will typically involve talking about your feelings, thoughts, and behavior to help come up with a diagnosis and look for any related complications.

Often, anxiety disorders occur alongside other mental health issues like substance misuse or depression, which can make it more challenging for doctors to come up with a diagnosis.

Compare the symptoms you're experiencing to the DSM-5 criteria

The American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make an anxiety disorder diagnosis, which many health care providers use.

You might have to set up an appointment with a mental health specialist if you're experiencing severe anxiety. This might be a psychologist or a psychiatrist.

A psychologist is a specific mental health professional who can provide you with an anxiety disorder diagnosis and counseling (psychotherapy). A psychiatrist specializes in not just diagnosing mental health conditions but also in treating them.

Treatments

There are two main anxiety disorder treatments: psychotherapy and medication. It might take a little experimenting to determine which treatment option works best for you. You might benefit most from combining them.

Psychotherapy

Psychotherapy is a form of counseling. It helps you deal and cope with the emotional response you have to your condition. A mental health expert will explain strategies designed to help you better manage and understand your disorder.

A couple of approaches are:

Cognitive behavioral therapy (CBT):

This is the most common form of psychotherapy used for anxiety disorders. It teaches you how to recognize certain behaviors and thought patterns that can lead to troublesome feelings that you'll then work on changing.

Exposure therapy

This helps you deal with the fears behind your anxiety disorder. It helps you start engaging in situations or activities you might be avoiding. The health provider might also use imagery and relaxation exercises with exposure therapy.

Medication

Several types of medication are used for relieving anxiety symptoms, depending on which anxiety disorder you're struggling with and if you have other physical or mental health problems. Some types of medication that may be used are:

Sedatives or anti-anxiety medications

Anti-anxiety medicine can help decrease symptoms of anxiety, extreme worry, fear, and panic attacks. Benzodiazepines are the most common type of anti-anxiety medication used. They help ease your anxiety by enhancing your brain's neurotransmitter activity and producing a sedative effect.

Antidepressants

While antidepressants are typically used for treating depression, they're also useful as an anxiety disorder treatment. They might help enhance how your brain uses specific chemicals that control stress and mood.

Beta-blockers

While beta-blockers are most frequently used for treating high blood pressure, they're often helpful for relieving the physical symptoms that come with anxiety, like:

  • Shaking

  • Rapid heartbeat

  • Blushing

  • Trembling

Selecting the right medicine, dose, and treatment plan should be done under your healthcare provider's care and based on your specific medical situation and needs. Your doctor might try a few medications before finding the right one for you.

You should never stop taking any medication without first speaking with your doctor and always follow the instructions provided to you.

Lifestyle and home remedies

While most individuals with an anxiety disorder require medication or psychotherapy to get their anxiety under control, certain lifestyle changes could make a difference. For instance, you can:

  • Quit smoking if you smoke

  • Avoid recreational drugs and alcohol

  • Keep physically active

  • Quit or cut back on drinking caffeinated drinks

  • Make sleep a priority

  • Use stress management and relaxation techniques (yoga, meditation)

  • Eat healthily

Along with adhering to healthy guidelines like drinking plenty of water to stay hydrated, eating a balanced diet, and avoiding or limiting caffeine and alcohol, other dietary considerations could help ease anxiety.

For instance, some studies suggest certain foods could improve anxiety. One study shows a link between lowered social anxiety and probiotic foods¹. Eating probiotic-rich foods like sauerkraut, kefir, and pickles were associated with fewer symptoms.

Learn more with our comprehensive guide to treating anxiety.

Prevention

You can't prevent an anxiety disorder. However, you can take steps to reduce or manage your symptoms. These steps may include:

  • Research medication: Speak with your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Some may contain chemicals that might make your symptoms of anxiety worse.

  • Limit your caffeine intake: Limit or stop your caffeine consumption, including coffee, tea, chocolate, and soda.

  • Seek help: Get support and counseling if you've experienced a disturbing or traumatic event. This could help prevent anxiety and other unpleasant feelings from disrupting your life.

  • Live a healthy lifestyle: Eat a healthy, balanced diet and exercise regularly.

If you're experiencing anxiety, it's essential that you decrease the stress in your life as much as possible. Find different ways to relax. Exercise is an ideal way of relieving stress. There are several ways you can incorporate exercise into your day-to-day routine, such as:

  • Joining the gym or an exercise class

  • Taking walks regularly

  • Practicing yoga

Along with exercise, you may wish to plan a vacation or take breaks from your routine. If you have a certain hobby you enjoy, make time for it. You should be making time for things that make you feel better and more relaxed.

Statistics

The U.S. Centers for Disease Control and Prevention (CDC) and the Census Bureau conducted a survey that found an increase in how many adults experienced anxiety and depression. The survey found the percentage of adults experiencing anxiety or depressive disorder symptoms increased from 36.4% to 41.5%¹ from Aug 2020 to Feb 2021.

Prevalence

Anxiety disorders are the most common type of mental illness in the United States, impacting 40 million adults in the U.S.² who are 18 years old and older each year. This is 18.1% of the population.

Statistics by type² include:

  • Generalized anxiety disorder (GAD) affects 3.1% (6.8 million adults) of the U.S. population. Women have twice the risk as men of being affected. GAD frequently co-occurs with major depression.

  • Social anxiety disorder affects 6.8% (15 million adults) of the U.S. population. It's equally common among women and men and usually starts around age 13.

  • Panic disorder affects 2.7% (6 million adults) of the U.S. population. Women have twice the risk as men of being affected.

  • Post-traumatic Stress Disorder (PTSD) affects 3.5% (7.7 million adults) of the U.S. population. Women have twice the risk as men of being affected.

  • Specific phobias affect 8.7% (19 million adults) of the U.S. population. Women have twice the risk as men of being affected.

Anxiety is just as common in older adults as it is in the young. The most common of all anxiety disorders among older adults is generalized anxiety disorder, though anxiety disorders are often linked with traumatic events like acute illness or a fall.

See even more anxiety statistics here.

Doctors & specialists

If you're struggling with anxiety, there are a few different types of doctors who can help.

Primary care doctor (general practitioner)

Your primary care doctor will provide you with a complete physical exam to see if another condition is causing your symptoms. Anxiety symptoms might be due to:

  • Certain illnesses

  • Hormone imbalance

  • Medication side effects

  • Other conditions

Your doctor might provide you with an anxiety disorder diagnosis if they rule out other conditions. At that point, they might give you a referral to a mental health professional like a psychologist or psychiatrist, depending on the severity of your anxiety disorder or if your anxiety disorder co-occurs with another mental health condition like depression.

Psychologist

Psychologists can offer psychotherapy, also referred to as counseling or talk therapy. They can help you get down to the root of your anxiety. They can also assist you with making behavioral changes.

Depending on where you live, they might prescribe you medicine if you're also struggling with depression. The only states that allow psychologists to prescribe medication are Louisiana, Illinois, and New Mexico. In other states, it would need to be prescribed by a psychiatrist.

The treatment you receive from a psychologist will usually be combined with the ongoing treatment you're receiving from your primary doctor.

Psychiatrist

Psychiatrists are medical doctors with specialized training in mental illness diagnosis and treatment. They can offer both medication and psychotherapy to help treat your anxiety disorder.

What to do if you're having panic attacks

If you're experiencing panic attacks or recently had your first panic attack, you might be wondering if you should go to the emergency room. Panic attacks aren't dangerous, but their symptoms can mimic those of a heart attack or other health issues that do require emergency care and treatment.

If you've never experienced a panic attack before and you're experiencing chest pain, go to the emergency room immediately. A doctor should check you out and ensure you're not suffering from a serious medical issue like a heart attack, a collapsed lung, or a blood clot in your lungs.

If you've experienced panic attacks before and have gone to the emergency room, chances are you were provided with a series of tests, like bloodwork and an electrocardiogram (EKG). The results from these tests help determine if your symptoms are caused by a panic attack or something more severe like a heart problem.

If the doctors didn't identify a health problem then and you're experiencing the same symptoms now, chances are you're just experiencing another panic attack. However, if you're not sure, it's always best to seek medical treatment right away. Most panic attacks, however, pass within 30 minutes.

Often, anxiety disorders go undiagnosed and untreated. This is unfortunate because the right treatment can improve your mood, productivity, relationships, and quality of life. It can also help support your general well-being.

Get information and advice that can help you find the right doctor to help treat your anxiety.


Clinical trials for anxiety

Actively recruiting
Sleep and Emotional Memory in Peripubertal Anxiety
FL (US)
Actively recruiting
Efficacy Trial of the CALM Intervention
CT, MD (US)
Actively recruiting
Trial With the Treatment of Sertraline in Youth With Generalized, Separation and/or Social Anxiety Disorders.
NY, OH (US)