WHAT WE TREAT

Anxiety

Feelings of anxiety and worry are common parts of everyday life, experienced by nearly everyone at some point in their lives.

These feelings are normal, and often are our body’s signal for anticipating difficulties or dangerous situations and preparing for them.

 

While these feelings are normal when experienced occasionally, anxiety symptoms can manifest into a chronic condition that interferes with daily life, activities, and responsibilities.

Anxiety disorders are the most common mental health concern in the United States. Most people with anxiety disorders develop symptoms of the condition by the age of 21. About 18% of the United States adult population, or about 40 million adults, and 8% of American children and teenagers suffer from an anxiety disorder that has had a negative impact on some aspect of their lives. Women are also 60% more at risk of suffering from an anxiety disorder than men.

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What is Anxiety?

Anxiety is a general term that characterizes several disorders that produce symptoms of nervousness, fear, apprehension, and worry. In addition to these emotional symptoms, anxiety can also manifest as several physical symptoms, such as feelings of discomfort, increased heartbeat, and sweating.

Feelings of anxiety prior to speaking in public, taking a challenging examination, having an interview, or going on a date are quite common; in fact, these feelings are normal, situational, and justifiable. Anxiety becomes a problem when the condition interferes with everyday life, such as a person’s ability to sleep or perform normal functions and responsibilities.

Anxiety disorders can be categorized into several specific conditions. These include:

 

  • Generalized Anxiety Disorder (GAD)

  • Panic Disorder

  • Phobias

  • Social Anxiety Disorder

  • Obsessive-Compulsive Disorder (OCD)

  • Post-Traumatic Stress Disorder (PTSD)

  • Separation Anxiety Disorder

 

While all anxiety disorders produce feelings of persistent, excessive fear or worry in situations that do not warrant such emotions, each anxiety disorder has unique symptoms that differentiate it from another.

 

Generalized anxiety disorder is often characterized as constant feelings of anxiousness and worrying, most often without any other problem that may be causing the condition. Symptoms persisting for 6 months or more are often diagnosed as GAD.

 

Panic disorders are usually identified by panic attacks, or sudden and intense episodes of anxiety, in addition to severe physical symptoms. These attacks often occur randomly, at any time, and often without warning.

Phobias involve certain places, events, or objects producing powerful and strong reactions of irrational fear. Patients with phobias often go to great lengths to avoid triggers that involve phobias.

Social anxiety disorder, or social phobia, causes people to become anxious or stressed out in social situations, often due to irrational feelings of embarrassment or fear of judgement.

Obsessive-compulsive disorder involves patients obsessing about particular thoughts or concerns, causing them to create certain rituals or routines to cope with such obsessions. This can be characterized by actions such as repetitive behavior, dressing in a certain way, touching or putting things away in a particular order, or other strict routines.

 

Post-traumatic stress disorder occurs in patients who have witnessed or experienced a traumatic event, such as war crimes, rape, car accidents, or natural disasters. This disorder is often characterized by flashbacks that frighten the patient, causing them to avoid certain people or situations.

Separation anxiety disorder occurs when patients experience high levels of anxiety when separated from a person or place that provides feelings of safety and security, leading to excessive or inappropriate panic.

Many patients with anxiety also suffer from depression at some point during their lives. It is important to be assessed and treated for both conditions simultaneously, as one often makes the other worse.

What Causes Anxiety?

While there may be different causes for anxiety depending on the person, the condition, and type of anxiety disorder, many experts believe that several factors combine to cause anxiety disorders.

A stressful or traumatic event can often be a trigger that leads to feelings of anxiety and the development of an anxiety disorder. Such events include the death of a loved one, abuse, violence, and prolonged illness.

Other environmental or external factors leading to anxiety include general stress and stressful situations, such as feelings of overwhelming stress regarding a personal relationship, work, school, finances, and money. High altitudes with a lack of oxygen can also lead to feelings of anxiety.

Anxiety disorders may also be caused by genetics. Patients with family members who suffer from anxiety are more likely to develop anxiety. Further, many families have a higher than average number of people suffering from issues related to anxiety, when compared to the general population.

Certain medical conditions are associated with anxiety, including anemia, asthma, infections, diabetes, thyroid problems, tumors, and heart conditions. Stress from the illness or from the side effects of a medication can also lead to anxiety. Symptoms from several conditions such as emphysema or a pulmonary embolism may cause a lack of oxygen, leading to feelings of anxiety as well.

Anxiety can also be caused by substance use and abuse, including use of alcohol, cocaine, heroin, prescription drugs, barbiturates, or benzodiazepines. Such anxiety is most often produced from intoxication or withdrawal.

Another cause of anxiety may be due to abnormalities in brain chemistry, such as abnormal levels of certain neurotransmitters. This may cause the brain to react in certain ways, leading to anxiety.

Signs and Symptoms of Anxiety

Symptoms of anxiety include both emotional and physical components. Such symptoms make the patient feel extremely uncomfortable, helpless, and out of control.

Common emotional symptoms of anxiety include:

 

  • Excessive fear

  • Excessive worrying

  • Feelings of apprehension or dread

  • Difficulty concentrating

  • Feelings of tension

  • Feeling jumpy

  • Anticipating the worst

  • Feelings of irritability

  • Restlessness

  • Anticipating danger, watching unnecessarily for signs of danger

  • Recurring intrusive thoughts or concerns

  • Feeling like your mind has gone blank

  • Poor memory

  • Feelings of confusion

  • Inability to relax

 

Physical symptoms of anxiety often involve the “fight or flight” response, and typically include:

 

  • Increased heartbeat, pounding heart, heart palpitations

  • Numbness or “pins and needles” in extremities (hands, legs, arms)

  • Sweating

  • Restlessness

  • Upset stomach

  • Stomach cramps

  • Dizziness

  • Frequent urination

  • Frequent diarrhea

  • Shortness of breath

  • Easily startled

  • Trembling

  • Tremors

  • Twitches

  • Muscle tension

  • Weakness

  • Headaches

  • Fatigue

  • Insomnia

 

Many symptoms of anxiety, particularly the physical symptoms, can be easily confused with other medical conditions, such as heart disease or hyperthyroidism. Anxiety is also similar to, or may be experienced in conjunction with, disorders such as depression, ADHD, eating disorders, insomnia, and substance abuse. It is important to be carefully evaluated by a medical professional prior to diagnosing and treating anxiety disorders.

Prevention of Anxiety

Although anxiety disorders cannot be completely prevented, there are certain measures and approaches patients can take to minimize the risk or reduce symptoms of anxiety related conditions.

Learn to manage stress in your life, such as life pressures and important deadlines, can help prevent anxiety, or the worsening of anxiety.

Be aware of particular triggers that may induce an anxiety attack can also be helpful in the management of this condition.

Maintain a healthy lifestyle, including a healthy diet and regular aerobic exercise can also help eliminate symptoms of anxiety, in addition to regularly getting a good night’s sleep. Low-intensity activities such as yoga or Tai Chi can also help relieve stress and anxiety-related symptoms.

Try to reduce the amount of caffeine, tea, coffee, and chocolate you consume on a regular basis.

Avoid drugs and alcohol can help prevent the onset of substance-related anxiety.

Consult with a medical expert or pharmacist regarding certain drugs or herbs you may be taking, to see if they contain chemicals that may contribute to anxiety is another helpful method in the prevention of this condition.

Finding support through family, friends, and support groups is a valuable outlet to share thoughts, feelings, fears, and questions. Leaning on support through such avenues is a helpful way to reduce and even prevent symptoms of anxiety. This is particularly important after experiencing a traumatic or disturbing event. Getting help early can help reduce the chances that your anxiety condition will worsen.

Treatment of Anxiety

Anxiety disorders are treatable. Depending on the type of anxiety disorder you have, your medical provider may recommend different treatments. The most common types of treatment for most anxiety disorders include psychotherapy and medication.

Psychotherapy includes treatments such as cognitive behavioral therapy (CBT). This type of treatment most often involves helping the patient develop a more constructive response to fear, experience less anxiety over time, and develop coping mechanisms when dealing with anxiety. Exposure therapy is another method that encourages patients to confront specific fears that induce anxiety in a safe, controlled environment. Through gradual, repeated exposures to the feared situation or object, exposure therapy allows a patient’s anxiety to gradually decrease.

Several medications can be prescribed by a medical professional, including anti-anxiety medications and antidepressants. Anti-anxiety medications include benzodiazepines, such as:

 

  • Alprazolam (Xanax, Niravam)

  • Chlordiazepoxide (Librium)

  • Diazepam (Valium)

  • Lorazepam (Ativan)

  • Clonazepam (Klonopin)

 

Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can be especially helpful when treating anxiety that is mixed with depression. Common SSRI antidepressants include:

  • Sertraline (Zoloft)

  • Paroxetine (Paxil, Pexeva)

  • Fluoxetine (Prozac, Sarafem)

  • Imipramine (Tofranil)

  • Escitalopram (Lexapro)

  • Citalopram (Celexa)

  • Venlafaxine (Effexor)

 

Other antidepressants used in the treatment of anxiety include tricyclic antidepressants, and include Imipramine (Tofranil) and Clomipramine (Anafranil). Additional medications that can be prescribed to treat anxiety include monoamine oxidase inhibitors (MAOIs), beta-blockers, and buspirone.

Complementary or alternative health approaches have also been useful in the treatment of anxiety, such as stress management or relaxation techniques. Breathing exercises, and other methods that can calm the mind and body, have been helpful in patients suffering from anxiety. Reducing the amount of negative “self-talk” can also help reduce anxiety. Replacing negative thoughts with positive affirmations can help patients cope with anxiety. Herbal remedies such as Kava, Valeria, Passionflower, and Theanine have been seen to help some patients cope with anxiety, however more research is needed to fully understand the risks and benefits of these treatments.

Yoga and other forms of physical exercise can also have a positive effect on your mental well-being and management of stress and anxiety.

When Should I Call a Doctor?

Consulting with a medical provider can help control symptoms of anxiety before they worsen. It is usually easier to treat anxiety with early treatment.

If your anxiety is causing you excessive worry, interfering with daily life, and hindering your social interactions and your ability to perform responsibilities, speaking with a medical professional can help control your symptoms.

If you are feeling depressed or upset due to your anxiety, consult a medical provider for management of your anxiety.

If your anxiety is caused by a physical condition, illness, or substance abuse, seek medical care.

If you have been diagnosed with anxiety and it is getting worse, a medical provider can help adjust your treatment plan to assist in the management of your condition.

Medical specialists such as a psychiatrists, clinical psychologists, or other mental health professionals can help diagnose anxiety and help you develop a treatment plan.

Emergency Warning Signs

If you, or someone you know, are experiencing any suicidal or homicidal thoughts or behaviors, immediately dial 911.

Signs that you need to dial 911 are: thoughts of harming yourself or others, and actions or behaviors relating to harming yourself or others. It is not up to you to determine whether or not these are serious or dangerous, the only person who can determine the severity of these thoughts or actions is a licensed medical provider or counselor.

This page offers general health information to facilitate discussion with your telehealth provider. You must not rely on the information on our website as an alternative to medical advice from your doctor or other professional healthcare provider.

MeMD is a convenient and secure way to receive medical care for conditions like anxiety online, over the phone, or by app 24/7/365.

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