Anxiety
Topic OverviewAnxietyFeeling worried or nervous is a normal part of everyday
life. Everyone frets or feels anxious from time to time. Mild to moderate
anxiety can help you focus your attention, energy, and motivation. If anxiety
is severe, you may have feelings of helplessness, confusion, and extreme worry
that are out of proportion with the actual seriousness or likelihood of the
feared event. Overwhelming anxiety that interferes with daily life is not
normal. This type of anxiety may be a symptom of an anxiety disorder, or it may be a symptom of another problem, such as
depression. Anxiety can cause physical and
emotional symptoms. A specific situation or fear can cause some or all of these
symptoms for a short time. When the situation passes, the symptoms usually go
away. Physical symptoms of anxiety include: - Trembling, twitching, or
shaking.
- Feeling of fullness in the throat or
chest.
- Breathlessness or rapid heartbeat.
- Lightheadedness or
dizziness.
- Sweating or cold, clammy
hands.
- Feeling jumpy.
- Muscle tension, aches, or
soreness (myalgias).
- Extreme tiredness.
- Sleep problems,
such as the inability to fall asleep or stay asleep, early waking, or
restlessness (not feeling rested when you wake up).
Anxiety affects the part of the brain that helps control how
you communicate. This makes it harder to express yourself creatively or
function effectively in relationships. Emotional symptoms of anxiety
include: - Restlessness, irritability, or feeling on edge
or keyed up.
- Worrying too much.
- Fearing that something
bad is going to happen; feeling doomed.
- Inability to concentrate;
feeling like your mind goes blank.
Anxiety disordersAnxiety disorders occur when people
have both physical and emotional symptoms. Anxiety disorders interfere with how
a person gets along with others and affect daily activities. Women are twice as
likely as men to have problems with anxiety disorders. Examples of anxiety
disorders include panic attacks, phobias,
and generalized anxiety disorder. Often the cause of anxiety disorders is not known. Many people with an
anxiety disorder say they have felt nervous and anxious all their lives. This
problem can occur at any age. Children who have at least one parent with the
diagnosis of depression are more than twice as likely to have an anxiety
disorder than other children. Anxiety disorders often occur with
other problems, such as: - Mental health problems, such as depression.
- Substance use problems.
- A physical problem, such
as heart or lung disease. A complete medical examination may be needed before
an anxiety disorder can be diagnosed.
Panic attacks A
panic attack is a sudden feeling of extreme anxiety or
intense fear without a clear cause or when there is no danger. Panic attacks
are common. They sometimes occur in otherwise healthy people. Panic attacks usually last
only a few minutes, but an attack may last longer. And for some people, the anxiety can get worse quickly during the attack.
Symptoms include feelings of
dying or losing control of yourself, rapid breathing (hyperventilation), numbness or tingling of the hands or lips, and a racing heart. You may feel
dizzy, sweaty, or shaky. Other symptoms include trouble breathing, chest pain
or tightness, and an irregular heartbeat. These symptoms come on suddenly and
without warning. Sometimes symptoms of a panic attack are so
intense that the person fears he or she is having a
heart attack. Many of the symptoms of a panic attack
can occur with other illnesses, such as
hyperthyroidism,
coronary artery disease, or
chronic obstructive pulmonary disease (COPD). A
complete medical examination may be needed before an anxiety disorder can be
diagnosed. People who have repeated unexpected panic attacks and
worry about the attacks are said to have a
panic disorder. PhobiasPhobias are
extreme and irrational fears that interfere with daily life. People with phobias have fears that are out of proportion to real danger, and they are not able to control them. Phobias are common and are sometimes present with
other conditions, such as panic disorder or
Tourette's disorder. Most people deal with phobias by
avoiding the situation or object that causes them to feel panic (avoidance
behavior). A phobic disorder occurs when the avoidance behavior
becomes so extreme that it interferes with your ability to participate in your
daily activities. There are three main types of phobic disorders: - Fear of being alone or in public places where
help might not be available or escape is impossible (agoraphobia).
- Fear of situations where the individual might be exposed to
criticism by others (social phobia).
- Fear of specific things (specific phobia).
Phobias can be treated to help reduce feelings of fear and anxiety. Check your symptoms to decide if and when
you should see a doctor. Check Your SymptomsAre you having a problem with anxiety? This also could include concerns about panic attacks, fear, or obsessive or compulsive behaviors. Yes Anxiety or anxiety-related concern No Anxiety or anxiety-related concern How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Anxiety and stress can cause symptoms similar to those of a heart attack. Yes Symptoms of heart attack No Symptoms of heart attack Are you thinking seriously of committing suicide or harming someone else right now? Yes Thinking seriously of committing suicide or harming someone else No Thinking seriously of committing suicide or harming someone else Are you thinking about suicide but do not have a plan? Yes Considering suicide but does not have a plan No Considering suicide but does not have a plan Is a concern about abuse causing feelings of anxiety or depression? Yes Concern about abuse causing feelings of anxiety or depression No Concern about abuse causing feelings of anxiety or depression Are you concerned about self-harm? It can include acts like cutting, burning, or choking yourself on purpose, or pushing objects under your skin (like pieces of metal, glass, or wood). People doing these acts usually are not trying to kill themselves, but the results can still be dangerous. Yes Concerns about self-harm No Concerns about self-harm Do you think that a medicine may be causing the anxiety? Think about whether the anxiety started soon after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing anxiety No Medicine may be causing anxiety Does anxiety, fear, or obsessive or compulsive behavior interfere with your daily activities at work, school, or home? Yes Anxiety interferes with daily activities No Anxiety interferes with daily activities Are you able to do your daily activities at all? Yes Able to perform daily activities No Not able to perform daily activities Do you have sudden, severe attacks of fear or anxiety when there is no clear reason to be afraid? Yes Sudden, severe attacks of fear or anxiety No Sudden, severe attacks of fear or anxiety Do you often have nightmares or have flashbacks to a traumatic event? The event could have been something that happened to you directly or something that you saw or heard about. Yes Frequent nightmares or flashbacks to traumatic events No Frequent nightmares or flashbacks to traumatic events Have you had severe anxiety for more than a week? Yes Severe anxiety for more than 1 week No Severe anxiety for more than 1 week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
A few examples of obsessive or compulsive behaviors that can interfere with your daily activities include: - Frequently washing your hands, showering, or
brushing your teeth.
- Constantly cleaning, straightening, and
ordering certain objects.
- Checking lights, appliances, or doors
again and again to be sure they are turned off or closed.
- Repeating
certain physical activities, such as sitting down and getting up from a chair,
or saying the same thing over and over.
- Hoarding objects, such as
newspapers.
- Avoiding public places or taking extreme measures to
prevent harm or embarrassment to yourself or others.
The risk of a suicide attempt is
highest if: - You have the means to kill yourself, such as a
weapon or medicines.
- You have set a time and place to do
it.
- You think there is no other way to solve the problem or end the
pain.
Many prescription and nonprescription medicines can cause
anxiety. A few examples are: - Decongestants.
- Diet
pills.
- Steroid medicines.
- Thyroid medicines.
Some illegal drugs, such as cocaine, crack, and speed
(amphetamines), also can cause anxiety. Symptoms of a heart attack may
include: - Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of
breath.
- Nausea or vomiting.
- Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself. Home TreatmentHome treatment, combined with
professional treatment, can help relieve
anxiety. - Recognize and accept your anxiety about specific
fears or situations, and then make a plan for dealing with it. For example,
if you are constantly worrying about finances, set up a budget or savings
plan.
- Don't dwell on past problems. Change what you can to help you
feel more comfortable with present concerns, but let go of past problems or
things you cannot change.
- Be kind to your body:
- Relieve tension with exercise or
massage.
- Try stress-relief techniques that focus on relaxing your mind and your body. For more information, see
the topic
Stress Management.
- Get enough rest. If you
have trouble sleeping, see the topic
Sleep Problems, Age 12 and Older.
- Practice healthy thinking and stop negative thoughts.
- Avoid
alcohol, caffeine, chocolate, and nicotine. They may increase your anxiety
level. Some illegal drugs, such as cocaine, crack, and speed (amphetamines), also can cause anxiety.
- Engage your mind:
- Get out and do something you enjoy, such as
going to a funny movie or taking a walk or hike.
- Plan your day.
Having too much or too little to do can make you more anxious.
- Keep
a
diary of your symptoms(What is a PDF document?). Discuss your fears with a good friend. Confiding in others
sometimes relieves stress.
- Get involved in social groups, or volunteer to help
others. Being alone can make things seem worse than they are.
- Learn
about resources available in your community:
- Talk with your human resources officer about
counseling benefits that may be available through your employee assistance
program.
- Check with your insurance company to see what mental
health benefits are available.
- Contact your public health
department for information on community mental health programs.
Symptoms to watch for during home treatmentCall your doctor if symptoms become more frequent or severe during home
treatment. PreventionYou can help prevent
anxiety attacks: - Avoid caffeine, especially in coffees, teas, colas, energy drinks, and chocolate. Caffeine can keep you in a tense, aroused condition. For more information, see the topic
Healthy Eating.
- Do not smoke or use
smokeless (spit) tobacco products. Nicotine stimulates many physical and
psychological processes, causes your blood vessels to constrict, and makes your
heart work harder. For more information, see the topic
Quitting Smoking.
- Exercise during the day.
Even a brisk walk around the block may help you stay calm. For more
information, see the topic
Fitness.
Talk with your doctor about your symptoms
of anxiety or panic. A licensed counselor or other health professional can help you find ways to reduce your symptoms with techniques such as biofeedback, hypnosis, or cognitive-behavioral therapy. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What is your major symptom?
- How long
have you had your symptoms? Do they come and go, or are they always
present?
- What triggers the onset of your symptoms?
- What
makes your symptoms better or worse?
- Do you have other symptoms
that may be related to your major symptom? These other symptoms may include:
- Rapid or irregular
heartbeat.
- Nausea or vomiting.
- Numbness or
weakness.
- Excessive sweating.
- Feeling that you are not
able to get enough air (air hunger).
- Restlessness, irritability, or
feeling on edge.
- Feeling depressed.
- Have you ever had a similar problem in the past? If
so, how was it treated?
- Has anyone else in your family ever been
diagnosed with an
anxiety disorder, depression, or another mental
illness?
- Has anyone in your family tried suicide or died by suicide?
- What home treatment measures have you tried? Did
they help?
- What prescription or nonprescription medicines are you
currently using?
- What herbal supplements are you
taking?
- Are you using alcohol or illegal drugs, such as marijuana
or cocaine, to manage your symptoms?
- Do you smoke or use other
tobacco products?
- Do you have any
health risks?
While waiting for your appointment, it may be helpful to keep
a
diary of your symptoms(What is a PDF document?). CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerDavid Messenger, MD Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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