Anxiety is a normal part of life. It is a psychological and biological response to stress and has several different components: somatic (related to the body), emotional (related to mood), cognitive (related to thinking), and behavioral (related to actions). It is our body’s way of letting us know that something isn’t quite right. It often helps us keep out of harm’s way or helps us prepare to respond when faced with danger or other concerns. In this way, anxiety can actually be beneficial since it helps us stay alive and well in critical situations.
There are times, however, when anxiety can overwhelm us and remain long after dangerous situations have been resolved. Whenever we have trouble controlling the anxiety, or when it interferes with our activities of daily living, it is a good idea to look at the possibility of an anxiety disorder. There are many different kinds of anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorders, and phobias.
Anxiety disorders are among the most common of psychiatric illnesses affecting an estimated 40 million adults (18% of the population). Despite the fact that people with anxiety disorders are three to five times more likely to see a doctor and six times more likely to be hospitalized for psychiatric disorders than those who do not have anxiety, only about one-third of those afflicted seek treatment. Often the reason for the doctor visits, have to do with physical symptoms that are associated with physical ailments, such as chest pain, shortness of breath, or insomnia. And yet, anxiety disorders are highly treatable conditions and people with anxiety often respond well to treatment.
Symptoms of Anxiety
Symptoms of anxiety can take on many different forms and often mimic actual physical conditions. Among these physical symptoms are heart palpitations, chest pain, nausea, shortness of breath, stomach aches, headaches, fatigue, back or neck pain, sleeping disturbances, dizziness, muscle weakness, nail biting, twitching, sweating, numbness, and even excess energy, to name a few.
Emotional symptoms of anxiety are just as diverse. Among these symptoms are mood swings, irritability, confusion, feeling jumpy, fear, dread, and panic. Cognitive symptoms can include obsessions, trouble concentrating, having your mind go blank, anticipating the worst, fear of dying, a sense of déjà vu, or short term memory loss. And behavioral symptoms can be broad as well: nail biting, foot tapping, excessive talking, frequent urination, hair pulling, weight loss or weight gain, difficulty swallowing, or even vomiting. There are also other symptoms that can be unique to each individual.
Anxiety Disorders
- Obsessive-Compulsive Disorder (OCD):is characterized by persistent and recurring thoughts or images (obsessions) and an irresistible urge to engage in rituals or repetitive behaviors (compulsions) in order to reduce distress; These thoughts and urges are often intrusive, time-consuming, and excessive or unreasonable. About 2.2 million people suffer from the condition and it is found equally in men and women.
- Panic Disorder:is a condition of repeated panic attacks, which consist of episodes of intense fear or terror, with no warning preceding these symptoms. The episodes are usually accompanied by physical symptoms such as a pounding heart, sweatiness, smothering sensations, or a fear of losing control. Approximately 6 million or 2.7% of the population are afflicted with this condition, with women twice as likely to be affected than men. Major depression is often present with this disorder.
- Post Traumatic Stress Disorder (PTSD):develops as a result of experiencing a traumatic event in which serious harm occurs or is threatened. Intense fear and/or helplessness usually accompany the event. PTSD is diagnosed when this experience is relived in disturbing memories, flashbacks, or recurring nightmares. Most of these symptoms develop within three months of the event, but in some cases can develop even years later. PTSD has a lifetime prevalence of 7% – 30%, with about 5.2 million people suffering from the condition in a given year. As many as 30% – 60% of children who have survived disasters develop PTSD and up to 100% of children who have seen a parent killed or who have experienced a sexual assault or abuse, will develop PTSD. Ethnic minorities and females have a greater likelihood of developing this condition than do Caucasians or males.
- Phobias: are intense and often unreasonable fears involving an object or situation that disrupt the ability to function normally with daily activities. There are three major types of phobias: social phobias (fear of social situations); agoraphobia (fear of the outside or open spaces); and specific phobias: (fear of particular items or situations). The average age in which phobias begin is about age 10, with approximately 6 million people afflicted in the United States. Women, it seems, are about twice as likely to develop a phobia as compared to men.
- Generalized Anxiety Disorder (GAD): is characterized by excessive worry or tension even when the situation does not warrant such concern. The symptoms are present for a minimum of six months and are often accompanied by physical symptoms of anxiety: headaches, twitching, muscle aches and pains, fatigue, sweating, irritability, restlessness, sleeping difficulties, and even nausea or diarrhea. GAD can develop at any point during the lifetime, but the years of greatest risk are between childhood and middle age. Symptoms of GAD are often accompanied by other disorders, primarily depression, substance abuse, or other anxiety conditions. GAD affects about 6.8 million people, with women experiencing this disorder about twice as often as men.
Anxiety in…
Children and Teens: Anxiety is a normal part of growing up. Most worry and nervousness that children and teens experience is temporary, and an important means to learning about themselves. But in some cases, even when reassured about an event or experience, the nervousness or worry can become excessive and children will start to avoid places and activities because of their anxiety. Different kinds of anxiety disorders affect approximately one in eight children and are often accompanied by other disorders such as depression, eating disorders, and attention deficit/hyperactivity disorder (ADHD). Researchers agree that there seems to be a genetic link with anxiety disorders, but there is no consensus in terms of how important that role actually is. It is imperative, however, that children with intense anxiety get treatment for it, as untreated children are at a much higher risk to miss out on important social experiences, perform poorly in school, and engage in substance abuse.
College Students: There are many stressors that college students face that are unique to this situation. Many become anxious in dealing with tests and deadlines, work and money issues, and making the transition to dealing with roommates and experiencing different cultures and ways of thinking. While many anxiety disorders develop or have their roots in childhood, the unique pressures that college presents often leads to episodes of anxiety. In fact, most people diagnosed with an anxiety disorder will have their first episode by age 22. It is critical that students receive treatment during this time, as they may be at risk for dropping out of school or developing secondary conditions. At the very least, anxiety may be a contributing factor in making poor lifestyle choices. According to the National Center on Addiction and Substance Abuse, about 45 percent of college students binge drink and nearly 21 percent abuse prescription or illegal drugs. Research has also shown that anxiety disorders may be a risk factor for attempting suicide.
Women: Women are diagnosed with anxiety disorders about twice as often as are men. There may be a variety of reasons for this, including physiological causes. Hormone imbalances or hormone changes are often cited as a reason for increases in anxiety. This would include such conditions as pregnancy, post-partum depression, menopause, and pre-menstrual syndrome (PMS) or pre-menstrual dysphoric disorder (PMDD). Other physical causes can include digestive issues, thyroid problems, and adrenal imbalances. There are also other non-physical contributing factors with women and anxiety. A genetic predisposition can influence anxiety, as well as traumatic experiences, whether they have occurred recently or in the distant past. In addition, women who have anxiety conditions are more likely to develop other related anxiety issues.
Older Adults: About 10-20% of the older adult population suffers from some sort of anxiety disorder. The most common diagnosed conditions are phobias and Generalized Anxiety Disorder. But diagnosing anxiety in the aging population has often been challenging. As people age, different medical conditions become more prevalent. Distinguishing between the medical condition and the potential anxious condition can be tricky, particularly when prescription medications are being used, which can have different side effects. Plus, older adults are usually more in tune with their physical ailments and either ignore, or are not aware of, anxiety symptoms. Others, who have had anxiety for much of their lives, believe that their symptoms are a normal part of daily living and nothing to worry about. In other cases, when dementia may be present, it can be difficult to tease out the anxiety symptoms from agitation associated with the dementia. It can also be difficult to distinguish between realistic fears and excessive or phobic reactions. Sometimes the people best able to understand the symptoms are the people closest to the older person. They are in a position to see the differences in behavior and can interpret the events in that person’s life that may be contributing to the anxiety symptoms.
Military Members: Military personnel can be exposed to situations that are not usually present in everyday life. For this reason, they are particularly vulnerable to acute stress and reactions to severe trauma. In fact, according to the Department of Defense statistics, since 2003 approximately 40,000 returning troops from Iraq or Afghanistan have been diagnosed with PTSD. The rate of PTSD is actually three times higher in men and women exposed to combat, as compared to nondeployed military members. In addition, many soldiers have had various traumatic brain injuries or concussions from exposure to explosive devices. These can also lead to mental health issues ranging from anxiety to depression. And it is not only the soldiers themselves that are impacted by war. Families of combat personnel have also been shown to suffer from the effects. There is the hardship of being separated from loved ones, raising children alone, multiple deployments, and the fear that the service member may be injured or even die. According to an American Psychiatric Association survey, military members self report a 38% rate of anxiety, and the spouses report a 39% rate. This is a serious issue that must be addressed.
Managing Anxiety
Anxiety disorders are highly treatable conditions. Depending on the individual and the nature of the anxiety, treatment can relieve symptoms within a few weeks or months. With some more complex conditions, treatment may need to be extended for up to a year. But getting professional help can greatly reduce anxiety and enable individuals to function well in society.
In addition to professional help, there are many things that each person can do on their own, to help reduce the intensity of the symptoms. Among these are the following:
- Exercise: Physical activity helps your body help your mind. It doesn’t matter what kind of activity you choose to engage in. What matters is that you move. Of course, if you have fun, this will reduce your stress and anxiety even more!
- Good nutrition:Eat a balanced diet with plenty of fruits and vegetables. Don’t skip meals. Instead, eat at regular times. And stay away from caffeinated beverages, which have been known to trigger panic attacks.
- Alcohol and drugs: Limit or eliminate alcohol and stay away from all illegal drugs. Alcohol and drugs can intensify anxiety symptoms and trigger panic attacks as well.
- Sleep: Most people require 7-8 hours of quality sleep per night. This helps reduce overall stress and enables one to think more clearly about what might be helpful in the face of anxiety.
- Relaxation: When you notice your stress building, take a time out, count to ten, listen to music, or in some way remove yourself from the stress. On a regular basis, try yoga or relaxation exercises, meditation, or massages.
- Support Group: Many organizations have support groups for various conditions. Find one that supports people with anxiety. When we feel supported and understood our anxiety is often reduced.
- Journal: Take notes on what triggers your anxiety in different situations. After a while you may be able to detect patterns and work on prevention.
- Talk to yourself: Think rationally about your situation. Put things into perspective. Ask yourself if things are really as bad as you think they are. It may be possible that the fear may be worse than the situation actually warrants.
- Go outside: Fresh air and sunshine are wonderfully restorative. In fact, 20 minutes a day in the sun has been proven to reduce blood pressure. Allow nature to do some healing work.
Research suggests that people with anxiety disorders run a higher risk of developing physical health problems. When you learn to manage your anxiety, you are also caring for yourself physically and reducing the possibility of other complications.
