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Anxiety

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. A person can have more than one anxiety disorder.

Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety you have, treatment can help.

Symptoms Causes Risk factors Complications Prevention

Common anxiety signs and symptoms include:

  • Feeling nervous
  • Feeling powerless
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly (hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Trouble concentrating or thinking about anything other than the present worry

Several types of anxiety disorders exist:

  • Separation anxiety disorder is a childhood disorder characterized by anxiety that is excessive for the developmental level and related to separation from parents or others who have parental roles.
  • Selective mutism is a consistent failure to speak in certain situations, such as school, even when you can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
  • Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
  • Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
  • Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, heart palpitations or chest pain.
  • Agoraphobia is anxiety about, and often avoidance of, places or situations where you might feel trapped or helpless if you start to feel panicky or experience embarrassing symptoms, such as losing control.
  • Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is usually out of proportion to the actual circumstance, is difficult to control and interferes with your ability to focus on current tasks. It often occurs along with other anxiety disorders or depression.
  • Substance-induced anxiety disorder is characterized by prominent symptoms of anxiety or panic that are a direct result of abusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
  • Anxiety disorder due to a medical condition includes prominent symptoms of anxiety or panic that are directly caused by a physical health problem.
  • Specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

When to see a doctor

See your doctor if:

  • You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life
  • Your fear, worry or anxiety is upsetting to you
  • You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety
  • You think your anxiety could be linked to a physical health problem
  • You have suicidal thoughts or behaviors — seek emergency treatment immediately

Your worries may not go away on their own, and they may actually get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It may be easier to treat if you get help early.

As with many mental health conditions, the exact cause of anxiety disorders isn't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to becoming anxious. Inherited traits also can be a factor.

Medical causes

For some people, anxiety is linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order lab tests and other tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

  • Heart disease
  • Diabetes
  • Thyroid problems, such as hypothyroidism or hyperthyroidism
  • Asthma
  • Drug abuse or withdrawal
  • Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
  • Irritable bowel syndrome
  • Rare tumors that produce certain "fight-or-flight" hormones
  • Premenstrual syndrome

Sometimes anxiety can be a side effect of certain medications.

It's more likely that your anxiety may be due to an underlying medical condition if:

  • You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder
  • You didn't have an anxiety disorder as a child
  • You don't avoid certain things or situations because of anxiety
  • You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety

These factors may increase your risk of developing an anxiety disorder:

  • Being female. Women are more likely than men to be diagnosed with an anxiety disorder.
  • Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.
  • Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.
  • Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family or ongoing worry about finances.
  • Personality. People with certain personality types are more prone to anxiety disorders than are others.
  • Other mental health disorders. People with other mental health disorders, such as depression, often experience anxiety disorder as well.
  • Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
  • Drugs or alcohol. Drug or alcohol use or abuse or withdrawal can cause or worsen anxiety.

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical health conditions, such as:

  • Depression (which often occurs with anxiety disorder)
  • Substance abuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Headaches
  • Suicide
  • Poor quality of life

There's no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:

  • Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Stay active. Continue to participate in activities that you enjoy and that make you feel good about yourself. Avoiding activities because you're nervous can make anxiety worse.
  • Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
  • Avoid unhealthy alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.
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