What Is Anxiety?

Anxiety is an unpleasant emotion that people have when something feels risky, frightening or worrying. Everyone experiences mild anxiety when faced with stressful situations. This kind of anxiety is normal and is our body's way of preparing us to respond to difficult situations. However, people with anxiety disorders experience a state of uneasiness that is excessive or chronic and can be accompanied by compulsive behavior or panic attacks. 

Symptoms Of Anxiety

The most common physical symptoms of anxiety include increased heart rate, shortness of breath, muscle tension, sweating and shaking. People with anxiety disorders might also experience:

• Difficulty concentrating

• Restlessness and irritability

• Fatigue

• Insomnia

• Paranoia

• Social withdrawal

Many people with anxiety disorders may also experience symptoms of depression and addiction. 

Panic Attacks. Panic attacks can accompany anxiety disorders. During a panic attack, an individual experiences an anxious episode that usually includes many of the physical symptoms (i.e. shortness of breath, rapid heartbeat, etc.) listed above. Panic attacks are usually short – about 10 minutes – and are frightening and intense. Though an individual experiencing a panic attack might feel as though they are having a heart attack or an asthma attack, panic attacks almost never have long-term physical repercussions. 

Video on panic attacks: https://www.youtube.com/watch?v=uPlhgtQqA6c

Types Of Anxiety Disorders

Anxiety conditions are classified into different disorders. Below are descriptions of the most common anxiety disorders.

Generalized Anxiety Disorder. A condition that includes excessive worry. GAD can cause an individual to feel out of control, extremely tense and/or chronically nervous. 

Social Anxiety Disorder. A marked fear of social or performance situations in which an individual expects to feel embarrassed, judged, rejected, or is fearful of offending others. The most common symptom of social anxiety disorder is extreme social withdrawal. 

Panic Disorder. A condition characterized by chronic panic attacks. 

Specific Phobias. Intense fear of a particular situation or object (like small spaces or spiders).  Symptoms include extreme paranoia and social withdrawal in order to avoid triggers. 

Obsessive-Compulsive Disorder. Characterized by an extreme, uncontrollable urge to perform an action in a specific way, or to repeat a certain action repetitively. Compulsions are behaviors that individuals feel they must carry out over and over; obsessions are thoughts, images, or ideas that won’t go away, are unwanted and cause extreme distress. 

Helping Someone With Anxiety

A person with anxiety needs understanding and support. Anxiety disorders can often interfere with a person's ability to live a full life, so it is crucial to get help as soon as possible. Do your best to encourage the person to seek help (talk therapy, psychiatric evaluation etc.) if necessary. Take the person’s anxiety seriously. Telling them to ‘calm down’ is not enough and can often be counterproductive. If they are experiencing a panic attack, remind them that their symptoms will pass and that they won’t be physically harmed as a result of the episode. Be patient, listen and spend time with them. 

Treatments And Therapies

Anxiety disorders are generally treated with psychotherapy, medication (usually benzodiazepines like Xanax or Klonopin or anti-depressants), or a combination of the two.

Psychotherapy

Psychotherapy or “talk therapy” can help people with anxiety disorders.  In psychotherapy, an individual discusses their specific anxieties and works with a professional to discuss coping mechanisms. A typical “side effect” of psychotherapy is temporary discomfort involved with thinking about confronting feared situations.

Cognitive Behavioral Therapy. 

CBT is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to anxiety-inducing and fearful situations. 

Two specific components of CBT used to treat social anxiety disorder are cognitive therapy and exposure therapy. Cognitive therapy focuses on identifying, challenging, and neutralizing toxic thoughts underlying anxiety disorders. Exposure therapy focuses on direct confrontation with an individual’s phobias. Individuals undergoing exposure therapy are often taught relaxation and visualization exercises to help them cope with their anxiety. 

CBT may be conducted individually or with a group of people who have similar problems. Group therapy is particularly effective for social anxiety disorder. Often “homework” is assigned for participants to complete between sessions. 

Self-Help or Support Groups

Some people with anxiety disorders may benefit from joining a self-help or support group where they share their problems and achievements with others. Internet chat rooms can be useful, but any advice received over the Internet should be used with caution. Talking with a trusted friend or mentor can also provide support for individuals with anxiety, but this is not necessarily a sufficient alternative to care from an expert clinician.

Stress Management Techniques 

Stress management techniques and meditation can help people with anxiety disorders calm themselves, enhancing the effects of therapy. While there is evidence that aerobic exercise has calming effects, scientific evidence is not strong enough to support its use as treatment. Individuals with anxiety should avoid caffeine, certain illicit drugs, and even some over-the-counter cold medications that can aggravate the symptoms of anxiety disorders.

Medication

Medication does not cure anxiety disorders, but often relieves symptoms. Medication can only be prescribed by a medical doctor (such as a psychiatrist or a primary care provider), but a few states allow psychologists to prescribe psychiatric medications.

Medications can be used as an initial treatment of an anxiety disorder, or if there is insufficient response to a course of psychotherapy. In research studies, it is common for patients treated with a combination of psychotherapy and medication to have better outcomes than those treated with only one or the other.

The most common classes of medications used to combat anxiety disorders are antidepressants, anti-anxiety drugs, and beta-blockers (visit Mental Health Medications). Be aware that some medications are only effective if they are taken regularly, and that symptoms may recur if the medication is stopped.

Sources: Headspace, Paradigm Malibu, NIMH