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Definition

Anxiety is a feeling of dread, tension, and unease. An anxiety disorder is when these feelings are more intense than they should be or last for long periods of time. It may also happen even if there is no specific cause. An anxiety disorder also cause problems in day to day life and relationships.

The most common types of anxiety disorders are:

Anxiety may occur with other conditions such as alcohol use disorder, drug abuse, or depression.

Causes

The cause of anxiety is not clear. Trauma, regular stress, or genetics may all play a role. They may cause a change in how the brain reacts to stress. Other medical issues and medicine may also play a role.

Risk Factors

Women are more likely to report an anxiety disorders than men. Other things that may increase the risk of an anxiety disorders are:

  • Family member with anxiety disorders
  • Stressful life events
  • Not having good habits to manage stress or harmful habits to deal with stress
  • History of trauma emotional or physical
  • Long term medical illness or treatment
  • Substance abuse
  • History of self-harm as a teenager

Symptoms

An anxiety disorder can cause:

  • Worry or dread
  • Intrusive or ruminative thoughts
  • Sense of imminent danger or catastrophe
  • Fear or panic
  • Restlessness
  • Irritability
  • Impatience
  • Uncertainty
  • Trouble concentrating

It can also cause physical problems such as:

  • Headache
  • Fatigue
  • Chest pain
  • Rapid heartbeat
  • Sweating (especially the palms)
  • Dry mouth
  • Flushing or blushing
  • Muscle tension
  • Shortness of breath
  • Feeling lightheaded or fainting
  • Difficulty sleeping
  • Shaking
  • Choking sensation
  • Abdominal discomfort
  • Nausea or vomiting
  • Diarrhea
  • Feeling of "butterflies" in the stomach
  • Sexual problems
  • Tingling sensations
  • Nail biting or other habitual behavior

Symptoms of Anxiety
Physiological effects of anxiety

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Diagnosis

The doctor will ask about symptoms and past health. A physical and exam will be done. The doctor will also ask questions about emotional health. It is important to be honest and open with the doctor. Many mental health disorders go untreated because people do not ask for help. An anxiety disorder may be suspected based on answers to these questions.

Other tests may be done if there could be another cause of anxiety. A referral may be made to a mental health professional. They can help to diagnose anxiety disorder or other mental health issues.

Treatment

Anxiety disorders can be managed. Treatment can help to lower the effect on day to day life. The goal is to reduce stress and improve the reaction to it. A treatment plan may include a mix of the following:

Lifestyle Changes

Physical health can play an important role. Good overall health can improve mood. This may include getting enough sleep, choosing healthy foods, and exercise. Social support also plays an important role.

Food or drink with caffeine, drugs, and alcohol can also make anxiety worse.

Stress Management

When possible stress should be avoided. Other steps can help to decrease the response to stress. Steps may include:

  • Deep breathing and meditation
  • Progressive muscle relaxation.
  • Massage therapy
  • Yoga

Psychotherapy

Therapy will address thoughts, feelings, and behaviors and better understand how it affects day to day life. It can also help you work through traumas and conflicts. There are different types of therapy. A care team will help to find which type is best for each persons needs. Therapy may change over time.

Cognitive-behavioral therapy (CBT) is one type of therapy. It focuses on negative thought patterns and behaviors. Practice will help to retrain thinking to decrease reaction to stress and anxiety. CBT has been very effective in children and teens.

Medication

Medicine may help those with severe anxiety. Some medicines that are used for anxiety are:

  • Antidepressants
  • Buspirone
  • Benzodiazepines

Prevention

The cause of anxiety disorders is not clear, so prevention is not know. To decrease the risk of an episode of anxiety:

  • Be aware of situations, occupations, and people that cause you stress. Avoid them if you can.
  • Find a relaxation technique that works for you. Practice it often.
  • Grow and keep a strong social support system.
  • Express your emotions when they happen.
  • Challenge beliefs and thoughts that are not helpful to you.
  • Correct misperceptions. Ask others for their points of view.
  • Work with a therapist.
  • Avoid nicotine or other drugs. If you drink alcohol, drink only in moderation. Moderation is 1 drink or less per day for women and 2 drinks or less per day for men.
RESOURCES:

Anxiety and Depression Association of America
https://adaa.org

Mental Health America
http://www.mentalhealthamerica.net

CANADIAN RESOURCES:

Canadian Psychiatric Association
https://www.cpa-apc.org

Canadian Psychological Association
https://cpa.ca

REFERENCES:

Antidepressant efficacy in generalized anxiety disorder. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/antidepressant-efficacy-in-generalized-anxiety-disorder. Accessed January 31, 2020.

Anxiety disorders. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed January 31, 2020.

Generalized anxiety disorder. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/generalized-anxiety-disorder. Accessed January 31, 2020.

Javnbakht M, Hejazi Kenari R, Ghasemi M. Effects of yoga on depression and anxiety of women. Complement Ther Clin Pract. 2009;15(2):102-104.

Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.

11/6/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder: Mars B, Heron J, Crane C, et al. Clinical and social outcomes of adolescent self harm: Population based birth cohort study. BMJ. 2014;349:g5954.

Last reviewed January 2020 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 8/12/2020