Most of us have experienced or will experience anxiety at some point in the future. It’s normal to feel worried from time to time. Everyday stressors — such as finances, health and relationships — are common triggers for anxiety. In most cases, the anxiety is temporary and manageable.
However, for many people, anxiety can increase in intensity or progress to a chronic mental health condition, such as generalized anxiety disorder (GAD), in which anxiety symptoms last for months or longer. These chronic conditions are typically much more disruptive to daily life and may need careful management in collaboration with your healthcare professionals.
According to the National Institute of Mental Health (NIMH), anxiety disorders will affect about 31% of adults in the United States at least once in their lifetime. Anxiety symptoms of any degree can negatively impact your life and should not be ignored. If you are able to recognize the effects, there are a wide range of tools you can use to help alleviate them.
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Here, we’ll cover what anxiety is, its causes and risk factors, its symptoms, and the most common anxiety disorders.
What is Anxiety?
Anxiety is best described as a feeling similar to fear or worry in response to a perceived future threat that may or may not be real or rational. It varies in intensity between individuals and over time. It is often triggered by external causes that can have uncertain effects, such as a serious health issue or an upcoming exam.
Anxiety is distinct from the simple emotions of fear or worry because it is unusually intense, accompanied by heightened stress, and arises in response to an abstract future threat – real or imagined – rather than a clear and direct threat.
Sometimes anxiety has no obvious cause or occurs much more often than it should. This could be a sign that you have an anxiety disorder or that you could develop one if the problem is not resolved.
When the anxiety is constant or severe enough to make your daily life more difficult, the anxiety may have developed into a definite anxiety disorder.
Anxiety causes and risk factors
As noted above, anxiety can be triggered by a wide range of common everyday issues. Anxiety tends to appear before the triggering event occurs, when its outcome is still uncertain. However, not every stressful (or potentially stressful) event will trigger anxiety, or not consistently even when it did before.
There are many factors that can cause you to start experiencing anxiety or make the anxiety you already have worse. These include, but are not limited to:
Anxiety typically causes a mix of emotional, behavioral, and physical symptoms, and these can contribute to or worsen each other. For example, a racing heart can make a person intensely afraid of having a heart attack, even though this physical experience is temporary and does not indicate a health problem.
The type and intensity of these symptoms are variable and depend on the person, the situation, and whether and what type of anxiety disorder is present. According to the NIMH, the most common symptoms include:
- A fast heart rate
- Intense worry or fear
- Avoiding places, people, objects, behaviors, or situations that have caused anxiety in the past or that you fear will cause anxiety
- Difficulty concentrating
- sleep problems
- Unexplained aches and pains that can affect any part of your body – common areas include your head, chest and stomach
- A feeling of impending doom
- Numbness or tingling
- Sweat that is abnormal for the situation
There are treatments for anxiety. Your doctor may use a combination of medication and counseling or other behavioral interventions. The treatment(s) selected will depend on, among other factors:
- your diagnosis
- what have you tried before
- The severity of your symptoms
- Your preferences
- Your treatment goals
If your doctor determines that your anxiety is likely caused by another condition, treatment for that condition should improve your anxiety symptoms.
For anxiety unrelated to other conditions, the NIMH notes that these anxiety medications may be offered:
- Selective serotonin reuptake inhibitors (SSRIs). These are used to treat depression, anxiety, or a combination of depression and anxiety.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs). They are similar to SSRIs and are most often used to treat GAD.
- Benzodiazepines. These are only used for short term, occasional, severe symptoms as there is a high risk of addiction as well as tolerance (where you need to take an increased amount over time to have the same effect).
- Beta blockers. These are used off-label to help with the physical symptoms of anxiety such as a rapid pulse, sweating and nervousness.
Non-drug anxiety treatments
Some non-drug treatments available for a wide range of anxiety disorders include:
- Cognitive Behavioral Therapy (CBT)
- Acceptance and commitment therapy (ACT)
- psychodynamic therapy
- Exposure therapy (for phobias)
- Mindfulness-based stress reduction (MBSR) techniques, which may include meditation, deep breathing, guided imagery, tai chi, or yoga
- Art or music therapy
Anxiety disorders take many different forms. A person with one anxiety disorder may also have others at the same time. In general, women are more likely than men to experience any type of anxiety disorder.
Below are the diagnostic categories described in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Generalized Anxiety Disorder (GAD)
GAD is a chronic condition marked by persistent, low to moderate anxiety, typically nonspecific (i.e., not confined to a limited number of specific situations).
According to the American Psychiatric Association (APA), GAD affects about 2% of adults in the United States. It can last for months or years, and people with GAD tend to be aware that they worry too much or out of proportion to the perceived threat(s).
The most common treatment for GAD is a combination of psychotherapy and medication.
Panic disorder is a condition in which a person has multiple panic attacks.
The APA notes that it affects about 2% to 3% of adults in the United States.
These are usually short-term episodes where a person is very fearful and may have physical symptoms, including:
- Muscle pain
- Shortness of breathe
Psychotherapy is the first-line treatment for panic disorder as it can help a person recognize and manage their symptoms in order to prevent future panic attacks. Medications – such as SSRIs, benzodiazepines or beta-blockers – can be introduced if therapy does not provide enough relief.
Social anxiety disorder is a situational condition in which a person’s anxiety is largely triggered by social situations, such as meeting new people, social gatherings, or public speaking.
According to the APA, in the United States, social anxiety disorder affects about 7% of adults.
The most common treatment is specialized CBT along with exposure therapy, psychotherapy, and SSRIs.
A specific phobia is a long-lasting and intense fear of a usually harmless object, situation or activity that cannot be easily overcome, even if the person experiencing it knows that their reaction is excessive.
The APA notes that it is estimated that between 8% and 12% of adults in the United States have a specific phobia. The reaction is typically very stressful and will often cause the person to go to great lengths to avoid situations where it will be triggered.
- Heights (acrophobia)
- Spiders (arachnophobia)
- Tight spaces (claustrophobia)
Treatment for phobias is variable, but the most common ones include:
- exposed therapy
Agoraphobia is a severe and disproportionate fear of leaving the home or other safe location, especially to enter crowds or confined spaces such as elevators and movie theaters.
According to the APA, in the United States, it affects about 1% to 3% of adults.
Although related to other phobias, agoraphobia is distinct and disturbing enough to have its own category. It is usually treated with CBT and, in some cases, medications such as antidepressants.
Selective mutism is a rare anxiety disorder in which a person (usually a child) stops speaking altogether in certain situations when they would normally speak in others.
According to the American Speech-Language-Hearing Association (ASHA), it is difficult to find accurate numbers on the incidence of selective mutism, but some studies estimate that the disorder affects between 0.2% and 1.6% of children. It almost always starts in childhood and can continue into adulthood in some cases.
Many children simply outgrow selective mutism. For those who don’t, CBT is a common treatment, and SSRIs have also shown some success.
Substance/medication induced anxiety disorder
Substance/medication-induced anxiety disorder is anxiety that has a clear and specific cause: a drug (regulated or illicit) or alcohol. Side effects, effects of illicit use or misuse, and withdrawal can trigger this type of anxiety. Often the anxiety goes away with the effects of the substance or withdrawal.
Anxiety disorder due to another medical condition
Anxiety disorder due to another medical condition occurs when anxiety symptoms are secondary to another health condition (usually physical). In many cases, the anxiety will resolve once the underlying health condition is successfully managed.
National Institute of Mental Health (NIMH): Anxiety Disorders.
National Institute of Mental Health (NIMH): Any Anxiety Disorder.
American Psychiatric Association (APA): What are anxiety disorders?
American Psychological Association (APA): Anxiety.
US National Library of Medicine MedlinePlus: Anxiety.
Temple Health: Coping with COPD and Anxiety.
Current Middle Eastern Psychiatry: Depression and Anxiety Among Female Patients with Hyperthyroidism and Impact of Treatment.
Focus: Anxiety Disorders and General Medical Conditions.
Dialogues in Clinical Neuroscience: Treatment of Anxiety Disorders.
Frontiers of Psychology: The Effectiveness of Art Therapy for Anxiety in Adult Women.
JMIR Mental Health: Biofeedback-based connected mental health interventions for anxiety.
American Speech-Language-Hearing Association (ASHA): Selective Mutism.
European Child and Adolescent Psychiatry: Treatment of Selective Mutism.