Anxiety is a feeling of uneasiness and apprehension over normal life stressors, like beginning a new job or taking a test. When anxiety becomes overwhelming, it can interfere with a person’s physical and mental health and is then referred to as an anxiety disorder.
Anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior. Anxiety is the most common mental-health disorder in the United States, affecting nearly one-third of both adolescents and adults, according to the National Institute of Mental Health. But unlike depression, with which it routinely occurs, anxiety is often seen as a less serious problem. But sometimes there are good reasons to feel anxious. For many young people, particularly those raised in abusive families or who live in neighborhoods besieged by poverty or violence, anxiety is a rational reaction to unstable, dangerous circumstances.
Fear is an emotional response to an immediate threat and is more associated with a fight or flight reaction – either staying to fight or leaving to escape danger.
Anxiety disorders may involve frequent episodes of sudden feelings of intense anxiety and fear that can peak within minutes (anxiety attack or panic attack). The anxiety is out of proportion to the stressful situation or happens when there is no real danger. These episodes can interfere with daily activities and often are difficult to control.
Types of Disorders
Anxiety disorder is an umbrella term that includes different conditions:
Panic disorder: You feel terror that strikes at random. During a panic attack, you may also sweat, have chest pain, and feel palpitations(unusually strong or irregular heartbeats). Sometimes you may feel like you’re choking or having a heart attack.
Social anxiety disorder: Also called social phobia, this is when you feel overwhelming worry and self-consciousness about everyday social situations. You fixate about others judging you or on being embarrassed or ridiculed. A person with social anxiety disorder has significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions. People with this disorder will try to avoid the situation or endure it with great anxiety. Common examples are extreme fear of public speaking, meeting new people or eating/drinking in public. The fear or anxiety causes problems with daily functioning and lasts at least six months.
Specific phobias: You feel intense fear of a specific object or situation, such as heights, spiders, lizards, or flying. The fear goes beyond what’s appropriate and may cause you to avoid ordinary situations. A specific phobia is excessive and persistent fear of a specific object, situation or activity that is generally not harmful. Patients know their fear is excessive, but they can’t overcome it. These fears cause such distress that some people go to extreme lengths to avoid what they fear.
Generalized anxiety disorder: You feel excessive, unrealistic worry and tension with little or no reason. Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.
Separation anxiety disorder: A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person’s age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.
Agoraphobia: Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning.
Generalized Anxiety Disorder
People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms.
Generalized anxiety disorder symptoms include:
Restlessness or feeling wound-up or on edge
Being easily fatigued
Difficulty concentrating or having their minds go blank
Difficulty controlling the worry
Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)
People withpanic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.
Panic disorder symptoms include:
Sudden and repeated attacks of intense fear
Feelings of being out of control during a panic attack
Intense worries about when the next attack will happen
Fear or avoidance of places where panic attacks have occurred in the past
Social Anxiety Disorder
People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.
Social anxiety disorder symptoms include:
Feeling highly anxious about being with other people and having a hard time talking to them
Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
Being very afraid that other people will judge them
Worrying for days or weeks before an event where other people will be
Staying away from places where there are other people
Having a hard time making friends and keeping friends
Blushing, sweating, or trembling around other people
Feeling nauseous or sick to your stomach when other people are around
A person with agoraphobia experiences this fear in two or more of the following situations:
Using public transportation
Being in open spaces
Being in enclosed places
Standing in line or being in a crowd
Being outside the home alone
The individual actively avoids the situation, requires a companion or endures with intense fear or anxiety. Untreated agoraphobia can become so serious that a person may be unable to leave the house. A person can only be diagnosed with agoraphobia if the fear is intensely upsetting, or if it significantly interferes with normal daily activities.
People with chronic (long-term) anxiety have a higher risk of physical and mental health problems because of how anxiety activates the body’s stress response. The body’s cells, tissues and organs go on high alert, resulting in a general “wearing down” of the body. Physical complaints such as a headache or racing heart may actually be symptoms related to anxiety.
Causes and Risk Factors
The causes of anxiety disorders are currently unknown but likely involve a combination of factors including genetic, environmental, psychological and developmental. Anxiety disorders can run in families, suggesting that a combination of genes and environmental stresses can produce the disorders. Researchers are finding that genetic and environmental factors, frequently in interaction with one another, are risk factors for anxiety disorders. Specific factors include:
Shyness, or behavioral inhibition, in childhood
Having few economic resources
Being divorced or widowed
Exposure to stressful life events in childhood and adulthood
Anxiety disorders in close biological relatives
Parental history of mental disorders
Elevated afternoon cortisol levels in the saliva (specifically for social anxiety disorder)
Any form of complain of anxiety must never be left unattended. Whether you or your loved one needs help.