Topic Overview

 

Anxiety

 

Feeling worried or nervous is a normal part of everyday life.  Everyone frets or feels anxious from time to time.  However, anxiety that becomes overwhelming and interferes with daily life is not normal.  This type of anxiety may be a symptom of another problem, such as depression.

 

Anxiety can cause physical and emotional symptoms.  A specific situation of fear can cause some or all of these symptoms for a short time.  When the situation passes, the symptoms usually go away.

 

Physical symptoms of anxiety include:

 

• Trembling, twitching or shaking.
• Feeling of fullness in the throat or chest.
• Breathlessness or rapid heartbeat.
• Lightheartedness or dizziness.
• Sweating or cold, clammy hands.
• Excessive startle reflex.
• Muscle tension, aches, or soreness (myalgias).
• Fatigue.
• Sleep problems, such as the inability to fall asleep or stay asleep, early waking, or restless unsatisfying sleep.

 

Anxiety affects the part of the brain that helps control creative expression and complex communication.  This makes that more difficult to express yourself creatively or function effectively in relationships.  Emotional symptoms of anxiety include:

 

• Restlessness, irritability, feeling on edge.
• Excessive worrying.
• Fearing that something bad is going to happen; sense of impending doom.
• Inability to concentrate, “blanking out.”
• Constant feelings of sadness.

 

Anxiety disorders

 

Anxiety disorders occur when people have a mixture of physical and emotional symptoms.  Many people, including children and teens, develop anxiety disorders in which many of these symptoms occur when there is no identifiable cause.  Anxiety disorders interfere with personal relationships with others and affect daily activities.

 

Women have anxiety disorders twice as often as men.  Many people with an anxiety disorder say they have felt nervous and anxious all their lives.  This problem can occur at any age.  Children who have at least one parent with the diagnosis of depression at 60% more likely to have an anxiety disorder than children with nondepressed parents.

 

Generalized anxiety disorders often occur with other problems, such as depression, substance abuse, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).  It also can be caused by a physical problem, such as heart or lung disease.  A complete medical examination may be needed before an anxiety disorder can be diagnosed.

 

Phobias

 

Phobias are irrational, involuntary fears of specific places, objects, activities, or situations.  Most people deal with phobias by avoiding the situation or object that causes them to feel panic (avoidance behavior).  Phobias are a common anxiety-related disorder.

 

A phobic disorder occurs when the avoidance behavior becomes so extreme that it interferes with everyday life.  There are three main types of phobic disorders:

 

• Fear of being alone or in public places where help might not be available (agoraphobia).
• Fear of situations where the individual might be exposed to criticism by others (social phobia)
• Fear of specific things (specific phobia)

 

Panic attacks

 

Panic attacks occur when a person has distinct periods of intense fear and anxiety when there is no clear cause or danger.  These symptoms come on suddenly and without warning.  Panic attacks are a common anxiety-related disorder.  Panic attacks can sometimes occur in otherwise normal, healthy people and will usually last for several minutes.

 

Physical symptoms that can occur during a panic attack include feelings of choking or suffocating, chest pain, nausea, shaking, sweating, pounding of the heart, and feeling dizzy or faint.  Sometimes these symptoms are so intense that the person fears he or she is having a heart attack.  Many of the symptoms of a panic attack can occur with other illnesses, such as hyperthyroidism, coronary artery disease, or chronic obstructive pulmonary disease (COPD).  A complete medical examination may be needed before an anxiety disorder can be diagnosed.

 

People who have repeated unexpected panic attacks and worry about the attacks are said to have a panic disorder.

 

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

 

Emergencies

 

Do you have any of the following symptoms that require emergency treatment?  Call your doctor or other emergency services immediately.

 

• Chest pain that is crushing, squeezing, or feels like a heavy weight on the chest or that occurs with any other symptoms of a heart attack
• Seriously considering harming yourself or someone else with a plan that includes:
  • Having the means, such as weapons or medications, available to commit suicide or do harm to another person
  • Having to set a time and place to commit suicide
  • Thinking there is no other way to solve your problem or end your plan

 

Check Your Symptoms

 

If you answer yes to any of the following questions, click on the “Yes” in front of the question for information about how soon to see a health professional.

 

Review health risks that may increase the seriousness of your symptoms.

 

• Does anxiety interfere with your daily activities?
• Do you have sudden, severe attacks of fear or anxiety when there is no apparent reason to be afraid?
• Do you think your anxiety may be caused or made worse by medication?
• Do you suffer from recurrent nightmares or flashbacks of traumatic events?

 

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

 

Home Treatment

 

Home treatment, combined with professional treatment, can help relieve anxiety.

 

• Recognize and accept your anxiety about specific fears or situations, and then make a plan for dealing with them.  For example, if you are constantly worrying about finances, set up a budget or savings plan.
• Don’t dwell on past problems.  Change what you can to help you feel more comfortable with present concerns, but let go of past problems or things you cannot change.
• Be kind to your body:
  • Relieve tension with vigorous exercise or massage.
  • Practice relaxation techniques.  Read the section Relieving Symptoms of Stress in the topic Stress Management.
  • Get enough rest.  If you have trouble sleeping, see the topic Sleep Problems, Age 12 and Older.
  • Avoid alcohol, caffeine, chocolate, and nicotine.  They may increase your anxiety level.

 

• Engage your mind:
  • Get out and do something you enjoy, such as going to a funny movie or taking a walk or hike.
  • Plan your day.  Having too much or too little to do can make you more anxious.
  • Keep a record of your symptoms.  Discuss your fears with a good friend.  Confiding in others sometimes relieves stress.

 

• Get involved in social groups or volunteer to help others.  Being alone can make things seem worse than they are.
• Learn about resources available in your community:

o       Talk with your human resource officer about counseling benefits that may be available through your Employee Assistance Program.

o       Check with your insurance company to see what mental health benefits are available.

o       Contact your public health department for information on community mental health programs.

 

Symptoms to Watch For During Home Treatment

 

Use the Check Your Symptoms section to evaluate your symptoms if symptoms become more frequent or severe during home treatment.

 

Prevention

 

You can help prevent anxiety attacks.

 

• Avoid caffeine, such as coffee, tea, Mountain Dew, colas, and chocolate.  Caffeine can keep you in a tense, aroused condition.
• Do not smoke or use smokeless (spit) tobacco products.  Nicotine stimulates many physical and psychological processes, causes your blood vessels to constrict, and makes your heart work harder.
• Exercise during the day.  Even a brisk walk around the block may help you stay calm.
• Monitor your eating habits:
  • Do not eat too fast or eat on the run.
  • Try to chew your food at least 15 to 20 times per mouthful.
  • Do not drink too much fluid with your meal.  One glass of fluids is enough.
  • Eliminate as much sugar from your diet as you can.  Do not snack on candy, ice cream, or soft drinks.  Substitute fruit when you feel like having something sweet.

 

Cognitive-behavioral therapy can help prevent additional attacks of anxiety or panic.

 

Preparing For Your Appointment

 

Making the most of your doctor visit

 

You can help your health professional diagnose and treat your anxiety if you come prepared with the following information:

 

• What is your major symptom?
• How long have you had your symptoms?  Do they come and go, or are they always present?
• What triggers the onset of your symptoms?
• What makes your symptoms better or worse?
• Do you have other symptoms that may be related to your major symptoms?  Symptoms may include:
  • Rapid or irregular heartbeat.
  • Nausea or vomiting.
  • Numbness or weakness.
  • Excessive sweating.
  • Feeling that you are not able to get enough air (air hunger).
  • Restlessness, irritability, or feeling on edge.
  • Feeling depressed.

• Have you ever had a similar problem in the past?  If so, how was it treated?
• Has anyone else in your family ever been diagnosed with an anxiety disorder or depression?
• What prescription or nonprescription medications are you currently using?
• What herbal supplements are you taking?
• Are you using alcohol or illegal drugs, such as marijuana or cocaine, to manage your symptoms?
• Do you smoke or use other tobacco products?
• Do you have any health risks?

 

While waiting for your appointment, it may be helpful to keep a diary of your symptoms.

 

Related Information

 

• Depression
• Feeling Depressed
• Fitness
• Mental Health Problems and Mind-Body Wellness
• Obsessive Compulsive Disorder (OCD)
• Post –Traumatic Stress Disorder
• Sleep Problems, Age 12 and Older
• Stress Management