Anxiety is a natural feeling of fear or worry. It is normal to experience anxiety in your daily life. However, normal anxiety can become an anxiety disorder and take a toll on your mental wellbeing.

Anxiety disorders are one of the most common mental illnesses. In a single year, more than 18% of people in the US are affected by an anxiety disorder.

Anxiety disorders are very treatable. People who have anxiety can reduce or eliminate symptoms through one of the many treatment options.

What is Anxiety

Anxiety is a normal reaction to different situations or experiences in our lives. Everyone will experience some anxiety throughout their daily life. Most will be able to overcome the anxious thoughts and get back to their normal routine.

However, Normal Anxiety becomes an Anxiety Disorder when it is:

• constant and persistent worrying

• uncontrollable and overwhelming emotions that come out of nowhere

• excessive and irrational fear of situations or objects that pose no actual threat of danger

• disabling and interferes with daily activities

• avoidance of situations due to fear of being judged, embarrassed, or humiliated

What Does Anxiety Look Like

Anxiety can be defined by three parts: thoughts, feelings, and actions.

1. Thoughts: “I’m afraid something bad is going to happen”

   When anxiety occurs, you start thinking of negative thoughts. One negative thought can lead to another, and another, and then suddenly your thoughts start to spiral out of control and become irrational.

2. Feelings: “I feel overwhelmed and my hands are shaking”

   Feelings can consist of emotions and body sensations. These signs are a warning that your body is unable to cope with the anxiety and it wants you to take action so you can relieve that anxiety.

3. Actions: Runs away from the situation

When the anxiety becomes too much to cope with your body will respond in one of three ways: fight, flight, or freeze. This response will occur until the anxiety is relieved and the threat is no longer present.

Anxiety is different based on their personal experiences. This can make it difficult for you to describe your anxiety to others. Find out what’s the best way to describe your anxiety to someone who doesn’t have it.

Who is Affected

Anxiety disorders are the most common mental disorders and can affect anyone. Anxiety does not discriminate against age, gender, or race so everyone can be at risk of anxiety disorders.

More than 18% of the population is affected by anxiety disorders every year in the US. However, only 37% of those suffering receive any treatment. Nearly one-third of adolescents (aged 13-18) are affected by an anxiety disorder.

Overall health consists of physical, mental, and social health. All three are interlinked and when one state is out of balance, the other two states can be impacted.

Everyone has mental health, therefore, everyone is at risk of being affected by a mental illness. Someone with a physical illness is more likely to develop a mental illness such as an anxiety disorder.

Types of Anxiety Disorders

Generalized Anxiety Disorder (GAD): Excessive anxiety and worry about several events or activities (school or work performance).

Social Anxiety Disorder: Fear or anxiety about social situations where you are exposed to judgment or scrutiny to others (having a conversation, meeting unfamiliar people, being observed, or performing in front of others).

Specific Phobia: Fear or anxiety about a specific object or situation (flying, heights, or animals).

Panic Disorder: An abrupt surge of intense fear or discomfort that is unexpected and recurrent.

Agoraphobia: Fear or anxiety of being in a place that seems hard to escape (public transportation, in open spaces, in enclosed spaces, standing in line, in a crowd, or outside your home alone).

How Common are Anxiety Disorders

In any given year the estimated percent of US adults with various anxiety disorders are:

What Causes Anxiety

Researchers are not completely sure of the exact cause of anxiety disorders. Many factors could be linked to developing anxiety.

These factors can play a significant role and have the most impact during your childhood when cognitive development is at its peak.

For some, an anxiety disorder could be linked to an underlying physical health issue. It is not uncommon to see those with physical illnesses develop mental health issues like anxiety.

Risk Factors of Anxiety Disorders

Some common factors that may increase the risk of developing an anxiety disorder include:

• Environmental: Difficulties in school, work, relationship problems, or family issues

• Genetics: Family members with an anxiety disorder are more likely to experience one themselves

• Trauma: Abuse or traumatic events may trigger anxiety in the future

• Physical Illness: Physical conditions or medication can produce or aggravate anxiety symptoms

• Stress: A single event or a buildup of smaller stressful situations may trigger excessive anxiety

• Psychological Development: Exposure to stressful or negative life experiences in early childhood can influence your core beliefs

• Other Mental Health Disorder: People with other mental illnesses such as depression are more likely to have an anxiety disorder

• Drug or Alcohol Abuse: Withdrawal might intensify the impact of other possible causes

Diagnosis

If you think you may have an anxiety disorder, you can talk to your doctor about it. Share with them any symptoms you have been experiencing and for how long.

The doctor will perform a physical examination and be able to diagnose your anxiety. This will help rule out other illnesses that may be causing your symptoms.

If you are diagnosed with an anxiety disorder, a mental health professional can work with you on the best treatment.

Anxiety Tests

Although there are tests and scales to measure your level of anxiety, this is not a diagnosis. Some of the common tests available are:

• Hamilton Anxiety Rating Scale (HAM-A): First rating scale for anxiety; rates moods, fears, and tension

• Beck Anxiety Inventory (BAI): Measures the severity of your anxiety by rating symptoms

• Social Phobia Inventory (SPIN): Measures your social phobia by rating various social situations

• Penn State Worry Questionnaire: Measures your worries and distinguishes between social anxiety disorder and generalized anxiety disorder

When to See a Doctor

You should consider getting help for your anxiety and seeing a doctor if:

• your worries or fears interferes with daily activities

• your thoughts and emotions are intense, upsetting, and difficult to control

• you are avoiding activities you would normally engage in

• you worry about everything and the worries don’t go away after some time

Signs & Symptoms

Everyone reacts differently to their own anxiety experiences. Anxiety symptoms can range from just butterflies in your stomach to a racing heart rate.

Symptoms can include fight, flight, freeze responses when you leave your window of tolerance. Identify your symptoms with this worksheet here.

Common Symptoms of General Anxiety Include:

Mental Symptoms

• uncontrollable feelings of worry

• nervous, restless, feeling on-edge

• irritability

• sense of terror

• trouble concentrating

Physical Symptoms

• sweating or chills

• shortness of breath

• shaking or trembling

• fatigue

• stomach pain

• difficulty sleeping

• loss of appetite

What is an Anxiety Attack

An anxiety attack is a gradual buildup of an intense episode of fear and apprehension. These attacks could be caused by a specific trigger or occur for no apparent reason.

“Anxiety Attack” is not a recognized clinical term. Instead, it is often used to describe intense feelings of fear or worry. Some common signs of an anxiety attack include:

• apprehension

• difficulty sleeping

• irritability

• lightheadedness or headaches

• racing heart rate

• shaking

• sweating

• tightness in the chest and throat

Anxiety attacks are not the same as panic attacks. Panic attacks are abrupt surges of intense fear or discomfort whereas anxiety attacks gradually buildup in intensity.

“Panic Attack” is a term clinically defined to describe the features associated with the condition of a panic disorder. Although, it is possible to have a panic attack without the disorder.

While many of the symptoms of a panic attack are similar to an anxiety attack, the main differences of a panic attack are:

• feelings of unreality

• feeling detached from oneself

• fear of losing control

• fear of dying

Treatment

There are two main types of treatment options for anxiety disorders: psychotherapy and medication.

Psychotherapy

Psychotherapy is any form of psychological technique used to change harmful thoughts and behaviors. It is commonly known as talking therapy and is used to facilitate positive change.

There are different types of psychotherapy and based on your symptoms you may be treated with some of the common ones:

Cognitive Behavioral Therapy (CBT): CBT is the most widely used treatment for anxiety because of its effectiveness. It focuses on recognizing and reframing negative thoughts and behaviors. Requires active participation and teaches you to be your own therapist.

Dialectical Behavior Therapy (DBT): Teaches you to live in the moment, develop healthy coping strategies, regulate emotions, and improve relationships with others.

Acceptance and Commitment Therapy (ACT): This approach teaches you mindfulness skills and encourages you to accept and embrace the feelings rather than fighting them. 

Exposure Therapy: This treatment introduces you to anxiety-inducing objects or situations. It is effective for specific phobias, social anxiety, and PTSD.

Interpersonal Therapy (IPT): Focuses on social roles and relationships. It helps identify interpersonal issues and teaches you to express emotions and improve your communication with others.

Medication

Medication is generally given when psychotherapy doesn’t help or could be used in combination with psychotherapy.

Depending on your type of anxiety disorder and the symptoms you may experience, medication may be used to treat your physical symptoms as well as psychological ones.

There are some factors you will have to consider when treating your anxiety disorder with medication:

• different type of medication

• length of treatment

• side effects and possible interactions with other medicines

Self-Help and Prevention

There are many indirect ways to reduce anxiety, build resilience, and alleviate stress. As discussed earlier, there are three interlinked aspects of health: physical, mental, and social health.

By practicing self-care of the other two aspects you can also improve your mental health. Some simple things you can do to maintain a balanced health triangle are:

Physical Health

• exercise regularly

• eating a healthy diet

• get enough sleep each night

Social Health

• build a support network

• bond over a common interest or hobby

• volunteer in your community