Anxiety Symptoms, Treatments, Diagnosis and More
Medically Reviewed by Madeline Hubbard, RN, BSN
Anxiety Symptoms, Treatments, Diagnosis and More
Anxiety is a psychological and physiological state that causes temporary feelings of fear and worry. For the most part, feeling anxious is a normal response to stressful or tense situations. Anxiety can help motivate us to anticipate challenges, plan ahead and push through tough times. However, when feelings of anxiety are excessive or constant and disrupt daily life, it can become a mental health disorder. Many people with anxiety disorders perceive threats that are not grounded in reality, and this interferes with their ability to live comfortably.
Anxiety disorders impact people of all ages and genders, and approximately 31% of adults in the United States will experience an anxiety disorder at some point in their lifetimes. These commonly experienced disorders can be managed with appropriate supportive treatment.
Causes and Warning Signs of Anxiety
Many situations in life can cause us to feel temporarily anxious, especially leading up to or during an experience that we're worried about the outcome of. Here are some common examples:
- Tests or competitions
- Public speaking
- Social interactions
- Difficult decisions
- Financial stressors
- Health concerns
- Safety threats
When feelings of anxiety persist beyond a particular stressor or get worse over time, this chronic worry can begin to interfere with activities like work or sleep. When this happens, it may be a sign of a mood or anxiety disorder. There's no specific cause of anxiety disorders, but some risk factors that can increase the likelihood of experiencing an anxiety disorder include:
- Living through a traumatic event
- Feeling chronic life stress
- Having another mental health diagnosis, such as depression or obsessive compulsive disorder
- Having a family history of anxiety or other mood disorders
- Misusing substances like drugs or alcohol
What Does Anxiety Feel Like?
When your brain perceives a threat, this activates your sympathetic nervous system. This leads to physical changes in your body that originally evolved to benefit its performance during a dangerous situation. For example, if a person was to come upon a bear in the woods, their heart would need to beat faster in order to circulate blood to their body as they ran away from the bear. During periods of anxiety, regardless of the reason, your body goes into a similar state. The specific sensations anxiety causes often vary from person to person and may include:
- Uncontrollable worry or a sense of danger
- Restlessness or trembling
- Increased heart rate
- Faster breathing
- Blurred vision
- Muscle tension
- Difficulty concentrating
- Trouble sleeping
- Weakness or fatigue
- Nausea or upset stomach
It's important to keep in mind that these symptoms of anxiety are sometimes not related to a mood disorder but can be attributed to other underlying causes, such as:
- A medical condition like asthma, anemia, infection or low oxygen levels
- Medication side effects
- Substance use (nicotine, alcohol, caffeine)
- Substance withdrawal
Testing and Diagnosis for Anxiety
No specific laboratory test is available to diagnose anxiety. Instead, a healthcare provider or mental health specialist can diagnose anxiety disorders using questionnaires and psychological assessments. Blood or other laboratory tests might be ordered to help identify or rule out other conditions with similar symptoms like high blood pressure, heart palpitations, thyroid conditions or diabetes.
To assess anxiety symptoms, your healthcare provider will ask questions about your medical and mental health history, family medical history, recent mood and behavior changes. These questions might be difficult to answer, and it's important to let the provider know if you're feeling uncomfortable for any reason.
A mental health professional, like a psychologist or psychiatrist, can diagnose an anxiety disorder when symptoms fit criteria listed in the Diagnostic and Statistical Manual of Mental Disorders. This is a handbook that helps healthcare professionals diagnose mental health conditions. There are several different anxiety disorders that may be diagnosed, including:
- Generalized anxiety disorder (GAD): Excessive uncontrollable worry occurs most days for at least six consecutive months and interferes with areas of daily life like sleep, work and relationships. Mood shifts can also include symptoms of depression.
- Panic disorder: Periods of sudden fear called panic attacks are experienced either without identifiable causes or in response to a specific situation or trigger. Individuals with panic disorder typically worry about when the next panic attack will occur, and the combined fear can cause significant disruption to their lives.
- Social anxiety disorder: This condition involves an intense fear of public situations. Individuals with this disorder experience symptoms of anxiety in everyday social situations and might fear ridicule or feel afraid to talk to or eat in front of others.
- Separation anxiety disorder: Anxiety symptoms occur when a person is separated from a specific person or people to whom they feel attached.
- Phobia: This describes an intense fear related to interacting with a specific object or context, such as heights, confined spaces, spiders or needles.
- Agoraphobia: This anxiety involves an intense fear of public spaces, crowds or being outside of the home.
Treatment for Anxiety
Anxiety affects people differently, so strategies for prevention and treatment will vary depending on you as an individual, your source of anxiety and the coping mechanisms you have available. People with GAD will likely have already been able to identify triggers of stress, nervousness, worry or fear. There are many lifestyle modifications you can make to alleviate anxiety that don’t require you to see a healthcare professional.
Often, voicing your feelings of anxiety to a healthcare professional, family member or friend can in itself be helpful. It's tough to acknowledge that you have a problem that you don't feel in control of. However, sharing your thoughts with another can help you rationalize and decide if you need further help. Friends and family can also create an excellent support system while you seek professional help from a healthcare provider.
Getting Active and Relaxing Right
A regular fitness and exercise routine can help prevent stress. Exercise is known to release endorphins — chemicals that promote feelings of wellbeing and freedom from tension. During periods of intense activity, you can overcome thoughts of stressful situations with a focus on the activity at hand. Because stress and anxiety can often manifest as physical tension in your muscles, incorporating a stretching routine can aid in relief of stress-related muscle tension.
Exercise doesn't have to be particularly strenuous, and you don't have to do it every single day for it to have an effect on feelings of anxiety. A quick walk outside may be enough to make you feel significantly better. After a stressful day, spending a few minutes doing some aerobic exercise such as walking, running, cycling, swimming or using an exercise machine can release anxieties. Exercise works best when you do it frequently, even on days when stress and anxiety seem like less of an issue. Finding an activity that you enjoy is important so your exercise doesn't become an activity that provokes dread or anxiety itself.
Practicing meditation or mindfulness has been shown to be incredibly useful in the management of anxiety. In acute attacks of anxiety, techniques such as breathing exercises or distraction activities can alleviate a pending anxiety attack before symptoms even appear.
Good sleep hygiene is imperative to reducing anxiety, too. It's recommended to create a fairly constant sleep schedule and to incorporate a "winding down" period before bed that includes reducing your screen time and practicing relaxation techniques.
Managing Alcohol and Tobacco Use
Consumption of tobacco and nicotine can contribute to anxiety and make symptoms worse. If you have anxiety, you should avoid smoking, chewing or consuming products that contain tobacco. Nicotine is the active stimulant ingredient in these products. It causes chemical effects on your brain and can affect your mood, awareness and emotions. Nicotine products also have an effect on your cardiovascular system, increasing your heart rate and blood pressure, which may contribute to physical symptoms such as palpitations. Therefore, smoking cessation is beneficial for people with symptoms of anxiety.
When stopping your intake of nicotine products, you may go through a period of withdrawal. This period can bring about increased feelings of restlessness and anxiety. This adjustment period can continue for several weeks. During this time, you may feel irritable, upset and angry. There are many methods of nicotine cessation, including pharmacological methods. It may be useful to speak to your healthcare provider before considering quitting to get advice on alleviating withdrawal symptoms.
People with anxiety often use alcohol to cope, as it can promote feelings of relaxation. However, users often report feeling much worse the next day after drinking. In addition, relying on alcohol as a relaxant can cause you to develop a dependency. Alcohol dependency can not only cause long-term physical damage to your body, but it's also associated with a greater risk of developing other psychological conditions such as depression.
Counseling and Psychotherapy
If you feel that your anxiety is persisting and starting to grow out of control, you should see a healthcare professional. These experts can help you gain control over your emotions and thoughts in order to prevent the condition from worsening. They can direct you to sources of support or prescribe pharmacological therapies if required. Also, keep in mind that there are many different types of counseling, and you might find that the first method you try doesn't work for you. It's important to be open to other methods to find what works best for you.
Cognitive-behavioral therapy (CBT) is a specialized form of counseling that helps people to restructure the thoughts and thought patterns that occur in response to anxiety. Through CBT, you can learn to correct these harmful thoughts and associated behaviors. Treatment typically takes several months or years to fully correct anxiety, as the thoughts and feelings have likely been ingrained for years. CBT is generally delivered in person by a qualified therapist; however, new methods of internet- or phone-based CBT are emerging.
Prolonged exposure therapy (PE) is a specific type of therapy that aims to slowly introduce images or situations that would normally provoke anxiety, but in a safe and controlled way. It's conducted by a licensed therapist and is often useful for people with phobias or traumatic memories.
In some cases, anxiety may be treated with medication. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), function to prevent serotonin from being reabsorbed. Serotonin is a hormone that promotes feelings of wellbeing, so having more of this around can alleviate your anxiety. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are similar.
Benzodiazepines such as alprazolam, clonazepam, diazepam and lorazepam are useful in the short-term management of anxiety or as an add-on therapy. These are quick-acting and short-lived and function to reduce activity in your nervous system while promoting feelings of calmness. Beta blocker therapy is helpful for short-term use in people who experience physical symptoms of palpitations and high blood pressure as a result of their anxiety.
Sometimes, anxiety and medical treatments can exacerbate other heart or blood pressure conditions. If you have any other medical conditions and are considering medical therapy, it's important to tell your healthcare professional about these co-existing conditions.
Your Next Steps
While fleeting moments of anxiety are normal, it's important to talk with a healthcare professional if your anxiety symptoms are causing issues in or interfering with your daily life. If you've been living with constant feelings of stress or worry, or are drinking more or using drugs to feel relief, consult with a healthcare professional as soon as possible.
You can also search for local resources or support groups through the Substance Abuse and Mental Health Services Administration national helpline.