Definition

Anxiety is a normal state of dread, tension, and unease. It is considered a normal response to stress or uncertain situations. Prolonged or intense periods of anxiety may suggest an anxiety disorder. A disorder may also be indicated if anxiety:

  • Occurs without an external threat (“free-floating” anxiety)
  • Impairs daily functioning

The most common types of anxiety disorders are:

  • Phobias
  • Post-traumatic stress disorder (PTSD)
  • Panic disorder
  • Obsessive-compulsive disorder
  • Social anxiety disorder
  • Generalized anxiety disorder

Anxiety is often complicated by the presence of alcohol or drug abuse and depression.

Causes

Anxiety may result from many factors including:

  • Appropriate response under stressful circumstances
  • Drugs that affect the nervous system, such as:
    • Caffeine
    • Alcohol
    • Cocaine
    • Nicotine
    • Amphetamines (eg, “crystal meth”)
    • Some herbal medications
  • Biological factors:
    • Brain chemistry imbalances (eg, serotonin and norepinephrine)
    • Personality traits
  • Faulty perceptions and irrational beliefs (eg, phobias)
  • Unresolved emotional conflicts

Risk Factors

A risk factor increases your chance of getting a disease or condition. Risk factors for anxiety include:

  • Sex: female
  • Family member with anxiety disorders
  • Stressful life events
  • Ineffective coping strategies
  • History of physical or psychological trauma

Symptoms

Psychological symptoms may include:

  • Worry or dread
  • Obsessive or intrusive thoughts
  • Sense of imminent danger or catastrophe
  • Fear or panic
  • Restlessness
  • Irritability
  • Impatience
  • Ambivalence
  • Trouble concentrating

Physical symptoms may include:

  • Rapid or irregular heartbeat
  • Sweating, especially the palms
  • Dry mouth
  • Flushing or blushing
  • Muscle tension
  • Shortness of breath
  • Lightheadedness or faintness
  • Difficulty sleeping
  • Shaking
  • Choking sensation
  • Frequent urination
  • Nausea or vomiting
  • Diarrhea
  • Constipation
  • Feeling of “butterflies” in the stomach
  • Sexual difficulties
  • Tingling sensations
  • Nail biting or other habitual behavior

Diagnosis

Your doctor will ask about your symptoms and medical history. A psychiatric evaluation will be done. Your doctor may also perform a physical exam and diagnostic tests. Usually the results of these tests are normal. You may be referred to a psychotherapist for further evaluation.

Treatment

Effective treatment usually involves a combination of interventions, including:

Lifestyle Changes

  • Get sufficient rest and sleep.
  • If you smoke, quit.
  • Reduce or eliminate caffeinated beverages.
  • Drink alcohol in moderation.
  • Avoid illicit drugs.
  • Reduce exposure to stressful environments.
  • Exercise regularly.

Relaxation Techniques

  • Deep breathing
  • Meditation
  • Deep muscle relaxation
  • Massage
  • Engaging in pleasurable activities
  • Yoga

Social Support

  • Strong support system of family and friends
  • Counseling to improve coping skills
  • Support groups

Psychotherapy

This therapy addresses thoughts, feelings, and behaviors that play a role in anxiety. It helps you work through traumas and conflicts.

Cognitive-behavioral therapy can help you identify negative thought patterns and behaviors. Over time, you can learn to retrain your thinking. This will help you choose better options in response to stress and anxiety.

Medication

For severe anxiety or anxiety disorder, medicines may include:

  • Benzodiazepines
  • Buspirone
  • Antidepressants (eg, tricyclic antidepressants, selective serotonin reuptake inhibitors [SSRIs])

If you are diagnosed with an anxiety disorder, follow your doctor’s instructions .

Prevention

To help prevent anxiety, consider taking the following steps:

  • Avoid situations, occupations, and people that cause you stress.
  • If unavoidable, confront and overcome situations that provoke anxiety.
  • Find a relaxation technique that works for you. Use it regularly.
  • Develop and maintain a strong social support system.
  • Express your emotions when they happen.
  • Challenge irrational beliefs and counterproductive thoughts.
  • Correct misperceptions. Ask others for their views.
  • Work with a therapist.
  • Avoid using nicotine or other drugs. Drink alcohol in moderation

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