Anxiety

We all feel anxious, nervous, or stressed from time to time, but having an anxiety disorder takes these natural feelings and turns them into debilitating issues that can make it impossible for you to live your life. Anxiety disorders are “the most common mental disorders experienced by Americans” (NIMH).

Anxiety is a biological response which keeps you alert to possible dangers. In this sense, anxiety is not only normal but can also be helpful. Pathological anxiety deviates away from what could be considered normal or healthy; it causes such extreme unfounded anxiety that it inhibits your life.

There are many different types of anxiety disorders which can be caused by different issues, but they can all become extremely problematic and life-affecting. Getting treatment for your anxiety disorder is extremely important and can help you manage your symptoms more easily.

What are the Types of Anxiety Disorders?

There are several main types of anxiety disorders which can all be at different levels of severity and triggered by different things, depending on the individual. Learning about the specific types of anxiety disorders can help you analyze whether or not you may be experiencing the effects of one of them.

The main types of anxiety disorders are:

  • Generalized anxiety disorder (or GAD)
    • Individuals suffering from GAD are “extremely worried about” issues like health, finances, family and/or relationship problems, and other “things, even when there is little or no reason to worry about them” (NIMH).
  • Obsessive-compulsive disorder (or OCD)
    • Many people claim to have OCD if they happen to be extremely neat and tidy or picky about a certain thing. On the contrary, OCD can become a debilitating issue for many individuals, starting with an obsession like fear of death or sickness that manifests into a compulsion like constantly washing the hands, repeating small tasks an unnecessary number of times, or other issues that they cannot control.
  • Panic disorder
    • When someone has panic disorder, it means that they experience panic attacks often. These acts can make a person feel like they cannot breathe and they become weak, start to sweat, and experience a rapid heartbeat. According to the NLM, some people with panic disorder “live in fear of another attack” and sometimes come to a point where they avoid going anywhere they believe might cause them to have one.
  • Post-traumatic stress disorder (or PTSD)
    • Most people consider only returning soldiers to experience PTSD, but anyone who goes through a particularly traumatic experience, especially one with the threat of physical harm like rape or a car accident, can suffer from this disorder. The individual will not be able to stop thinking about the event, and it will become something they often cannot move forward from without treatment.
  • Social phobia (or social anxiety disorder)
    • Social phobia is similar to GAD, but individuals experience it mostly when they are in a situation where they must interact with other individuals. Parties and social gatherings in general make individuals with this disorder extremely uncomfortable. Their anxiety is often rooted in a fear of embarrassing themselves.

These five types of anxiety disorders can all reach high levels of intensity, especially if the individual goes for a long time without treatment. Recognizing that a person may have an anxiety disorder and discussing it calmly with respect and without judgment is the first step toward helping them.

What are the Signs of Anxiety Disorders?

Anxiety disorders often cause individuals to exhibit many obvious signs that friends, family members, and doctors can readily notice. Most of these signs are behavioral, but some might be physical. Anxiety disorders can often be noticed by the fact that their signs and symptoms last at least six months or longer.

The common signs of an anxiety disorder are:

Anxiety

Social withdrawal is common with anxiety disorders.

  • Physical tension of the body, muscles, etc. that is nearly constant
  • Irritability toward loved ones as a result of fear and/or not wanting to be looked at as if there is something wrong with them
  • Obvious signs of being uncomfortable like blushing, sweating, or trembling
    • These are especially common when a person with social phobia is around a lot of other individuals.
  • The inability to make friends or be close to others
    • Another common social phobia sign
  • Startling easily, if someone touches them or there is a loud noise
    • A common sign of GAD
  • Constant or unusual twitching that occurs all the time or in certain, high stress situations
  • Insomnia (GAD, PTSD)
  • Profuse sweating
  • Panic attacks (panic disorder) that include:
    • Sweating
    • Weakness or dizziness
    • Clutching the chest or stomach
    • Breathing problems
    • Extremely fast heartbeat
  • Constantly repeating activities or rituals like “relock[ing] their door many times before going to bed” or “wash[ing] their hands hundreds of times a day,” a sign of OCD (OWH)
  • Violent or angry outbursts toward others (PTSD)
  • Intense fear of something specific, as a sign of a phobia, such as:
    • Dogs
    • Blood
    • Flying
    • Water
    • Heights
    • Closed-in spaces
    • Balloons
    • Clowns
  • An “increase in avoidant behaviors, like drinking or drug use, or social withdrawal” (MOBAP)

Someone who experiences severe anxiety might turn to drugs or another dangerous method of coping with their disorder. According to the NIDA, “Many people who are addicted to drugs are also diagnosed with other mental disorders and vice versa.” This means that not only is drug abuse sometimes a sign of a deeper-lying mental disorder like an anxiety disorder, but drug abuse can even cause an anxiety disorder to manifest if the person is abusing drugs for long enough.

If you notice these signs in your loved one, talk to them about their feelings. Many people who suffer from anxiety disorders do so without telling anyone. Often, the pressure to be thought of as well both physically and mentally can be too much for an individual, and they might hide their problems as a result instead of looking for help. This is obviously extremely dangerous, and the best way you can help someone cope is by being understanding, caring, and by truly listening to their problems.

What are the Symptoms of Anxiety Disorders?

Experiencing a level of nervousness and/or anxiety that, for whatever reason it occurs, becomes unmanageable in your life is the strongest symptom of an anxiety disorder. Most people are able to shake their anxieties off after a while, to tell themselves that everything will be all right. It does not matter how many times a person with an anxiety disorder hears “Don’t worry!” or “It’ll be okay!” They will still feel the way that they do. This is why people with anxiety disorders need professional help to get better.

The NLM states, “Fear and anxiety are a part of life,” but they shouldn’t control your life. Consider what the last few months or years have been like for you and answer the questions below in order to find out if you may be suffering from an anxiety disorder too.

  • Do I constantly think about things something that scares me, including but not limited to:
    • Fear of death?
    • Fear of loneliness?
    • Fear of a specific object or situation?
    • Fear of being around other people or embarrassing myself?
  • Am I constantly worrying about the state of my life, others’ lives, or the world in general?
  • Do I always feel that I am forgetting something, missing something, or that something bad is right around the corner?
  • Am I unable to pull myself out of an anxiety slump, even when I know that there is nothing to be concerned about?
  • Have I experienced an event in the past that I still can’t move on from?
  • Have I ever experienced nightmares or flashbacks to that event?
  • Do I get panic attacks more than once a week?
  • Have I experienced so many panic attacks that I try to avoid places/things/people that might trigger one?
  • Do I feel unable to relax almost all the time because I am worried or anxious?
  • Are other people constantly telling me things like “Let it go,” “Get over it,” or “Calm down” even though I can’t?
  • Have I begun to keep these anxieties to myself as a result of the way people react to me?
  • Am I often startled by other people, loud noises, etc.?
  • Is it hard for me to be alone because I start thinking unpleasant or worrisome thoughts?
  • Do I have trouble sleeping at night because of these thoughts?
  • Do my muscles ache from being consistently tense all the time?
  • Do I sweat, tremble, shake, twitch, become nauseous, or otherwise exhibit physical symptoms of dread when I am feeling worried or anxious about something?
  • Do I feel that my worries, anxieties, and fears are keeping me from being happy in my life?

If you said yes to many of these questions, it is likely that you are experiencing a severe anxiety disorder and should seek professional treatment. With help, you can stop fighting with and especially hiding these symptoms and, instead, find ways to curb them, lessen them, and sometimes even erase them from your life.

Treatments for Anxiety Disorders

There are several well-accepted treatment methods for anxiety disorders and, like the treatment of mood and substance abuse disorders, therapy and medication used together are often considered the best methods for treating anxiety disorders. According to the NIH, “Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder together.”

Therapy

The psychological treatments used to help patients with anxiety disorders are all fairly similar to those used for individuals with other mental disorders. For example, one of the most commonly used psychotherapy methods for the treatment of all types of anxiety disorders is cognitive-behavioral therapy or CBT. This method helps people change the way they think and teaches them more effective coping skills.

“CBT can help people with panic disorder learn that their panic attacks are not really heart attacks and help people with social phobia learn how to overcome the belief that others are always watching and judging them” (NIMH 1).

Psychotherapy can also help a patient who is dealing with OCD by teaching them to wait between their fear and compulsion, like having them get their hands dirty and then asking them not to wash them for increasingly longer periods of time. This is called exposure therapy and it shows people with OCD that their fears are not as grounded as they feel they are. Therapy is highly beneficial toward the treatment of a patient with severe anxiety as it helps the individual to realize that they can change the way they feel, the way they react, and the way they think to fight the anxious feelings they experience.

Medication

Like during mood disorder treatment, medications are commonly prescribed to patients and the prescription drugs are usually similar. Antidepressants are extremely common and SSRIs are used much in the same way they are to treat depression, bipolar disorder, etc. They alter the levels of serotonin in the brain which helps the individual become calmer and less anxious, making it easier for them to focus on therapy as well as other aspects of life.

Tricyclics are also sometimes prescribed, especially for anxiety disorders other than OCD. MAOIs are given to patients with severe anxiety disorders as they can be extremely intense in the side effects they cause. Another common medication is clonazepam (brand name Klonopin) which is used to treat social phobia and GAD. Lorazepam (or Ativan) is used to treat panic disorder while alprazolam (or Xanax) is a common treatment for GAD and panic disorder.

Beta-blockers are sometimes used to treat the physical symptoms of anxiety disorders as they are helpful in treating heart conditions. With the help of these medications, patients can begin to feel less controlled by their anxieties.

Anxiety disorders can make it difficult for a person to enjoy life, as they are always worrying what might happen next. With the help of professional treatment involving therapy and medication, though, a person can learn to live with their anxiety disorder and control their symptoms much more easily.

The AWARE Strategy for Coping with Anxiety

Researchers Beck, Emery and Greenberg, authors of “Anxiety Disorders and Phobias: A Cognitive Perspective” explain the AWARE strategy, which can be very helpful for coping with anxiety disorders of all kinds:

  • Accept The Anxiety. Replace your hatred of it with acceptance. By resisting, you’re prolonging its unpleasantness. Instead, flow with it. Don’t make it responsible for how you think, feel, and act.
  • Watch Your Anxiety. Rate it on a 0-to-10 scale and be detached. Remember, you’re not your anxiety. The more you can separate yourself from the experience, the more you can just watch  it.
  • Act with the anxiety. Act as if you aren’t anxious. Slow down if you have to, but keep going. Breathe slowly and normally. If you run from the situation your anxiety will go down, but your fear will go up. If you stay, both your anxiety and your fear will go down.
  • Repeat the steps. Continue to accept your anxiety, watch it, and act with it until it goes down to a comfortable level. And it will. Just keep repeating these three steps:  accept, watch, and act with it.
  • Expect the best. What you fear the most rarely happens. Recognize that a certain amount of anxiety is normal. By expecting future anxiety, you’re putting yourself in a good position to accept it when it comes again.

There are also many other therapeutic methods which have proven effective for treating  anxiety disorders, with or without medications. A therapist can help you determine which approach will be most effective.

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