Anxiety creates feelings of worry, fear, or dread, and it’s a common reaction to real or perceived threats. Everyone experiences anxiety from time to time — those butterflies before a job interview or worries about finances, for example. Even if your symptoms aren’t disruptive enough to be considered an anxiety disorder, it’s still common to go through periods of pronounced anxiety where you may want to discuss treatment options with a professional.
The specific effects of anxiety vary from person to person, but anxiety impacts the way we feel, think, and act. Anxiety may make a person feel fearful, tense, or jumpy. Cognitively, an intense fear may eclipse logic. For example, many people who have a phobia of flying know their thoughts are irrational but they can’t shake the idea that something bad will happen if they take the chance and get on that flight. Anxiety can influence behavior, too: Some people may avoid situations — such as public places or heights — that have triggered anxiety or panic in the past.
What causes anxiety?
Periods of heightened stress at work or school, strained relationships, financial issues, illness, and traumatic experiences like a car accident can all trigger anxiety. But the cause of anxiety isn’t always clear. Anxiety can be triggered by brain chemistry and it’s also genetic — so it may not be directly linked to a current life issue.
What are the symptoms of anxiety?
The symptoms of anxiety include feeling apprehensive and/or powerless, and having a sense of impending danger, panic or doom. Anxiety can cause physical symptoms as well, including heart palpitations, sweating, rapid heartbeat, difficulty breathing, body aches and pains, trembling, and fatigue.
Certain medications (such as codeine, ACE inhibitors, and statins) may have side effects that mimic the symptoms of anxiety, including dizziness, rapid heart rate, headaches, and restlessness.
When should I seek help?
If your anxiety is persistent, overwhelming, and seemly out of your control, you may have an anxiety disorder.
If the symptoms described above are impacting your work, relationships, sleep and/or appetite, you should seek help immediately, as anxiety disorders can be treated once you receive a diagnosis. Talk to your health care provider so she can assess your symptoms, rule out any underlying medical causes, and if necessary, provide a referral to a regarded mental health provider. Keeping your primary care provider in the know regarding your emotional health will give her the opportunity to check in with you periodically, ensuring you receive the care you need.
What are the types of anxiety disorders?
Anxiety disorders are categorized based on their symptoms.
People with generalized anxiety disorder (GAD) may feel intense worry about many different things and can’t identify one particular cause their anxiety. For example, they may ruminate over the safety of their children, decisions they need to make, and their own health issues. This worry is excessive and impacts their daily living.
Panic disorder causes feelings of terror that strike without warning and include physical symptoms such as palpitations, sweating and difficulty breathing (although each person’s experience may be different). Panic disorder can include agoraphobia, where the person may be so fearful of having an attack in public that he or she becomes afraid to leave home.
Phobias include strong irrational fears, such as a fear of flying or heights. Phobias cause people to go to great lengths to avoid particular situations, which can be quite disruptive to their lives. For example, someone with a phobia of flying may try to avoid seeing clients that are out of town or have to take more time for travel to drive long distances instead of flying.
People with obsessive-compulsive disorder (OCD) experience constant thoughts (obsessions) that cause them to perform rituals or routines (compulsions).
Post-traumatic stress disorder (PTSD) affects some people who have experienced a painful event. People with PTSD may have difficulty sleeping or suffer vivid nightmares in which they replay the event. PTSD is sometimes characterized by extreme anger or fear that affects a person’s work or relationships.
People who experience overwhelming worry that they are being judged by others or have an intense fear they will embarrass themselves in social situations may have social anxiety disorder (aka social phobia).
How are anxiety disorders treated?
Symptoms of anxiety can be manageable with the right treatment approach. Cognitive Behavioral Therapy (CBT) provides techniques to help you identify, understand, and change your thoughts and behavior patterns. Exposure therapy, one form of CBT, is a process of gradually reducing your anxiety response to a certain trigger. It works particularly well for phobias and PTSD. Traditional psychotherapy can be useful for addressing various issues that may be contributing to your anxiety. Lifestyle modifications such as eating a balanced diet, reducing alcohol and caffeine intake, incorporating exercise, and balancing work and personal life can make a dramatic difference in a person’s overall anxiety level. In addition, relaxation techniques such as yoga, guided imagery, acupuncture, and breathing exercises can also help to slow down your heart rate and thoughts and decrease anxiety.
If you’ve tried counseling, lifestyle changes, and relaxation techniques and you still feel anxious, it may be time to try medication. There are many types of medications that are effective in treating anxiety. These include traditional anti-anxiety drugs such as benzodiazepines and other options such as SSRIs (serotonin selective reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors) and tricyclic antidepressants. Certain herbal supplements such as kava and valerian may help to relieve symptoms of anxiety, as well, although they may cause drug interactions and other adverse effects, so they should only be taken under close supervision of a qualified practitioner. Consult with your PCP or a psychiatrist who can assess your symptoms and decide on the best line of treatment for you. Combined medication with counseling is recommended to address the underlying cause of your anxiety.
We can’t avoid stress and anxiety altogether—and we shouldn’t want to. “Good” stress can help us get things done quickly, meet deadlines, and warn us when there’s danger. But if stress and anxiety is impacting your daily life, then it’s worth paying closer attention to your symptoms, making appropriate lifestyle changes, and exploring treatment options.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, Portland, the San Francisco Bay Area, Seattle, and Washington, DC.
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