What Is Anxiety? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Anxiety is a feeling of nervousness, unease, or worry that typically occurs in the absence of an imminent threat. It differs from fear, which is the body’s natural response to immediate danger.
Anxiety is part of the body’s natural reaction to?stress, so it can be helpful at times, making you more alert and ready for action.
Anxiety disorders and normal feelings of anxiousness are two different things.?Many of us get anxious when faced with particular situations we find stressful, but if those feelings don’t subside, the anxiety could be more chronic. When feelings of fear or nervousness become excessive?or difficult to control, or interfere with daily life, an anxiety disorder may be present. Anxiety disorders are among the most common psychiatric conditions in the United States.
It’s common to think about anxiety in a way that may hinder our ability to overcome it. “The biggest misconception about anxiety is that it’s to be feared and avoided at all costs,” says?Noah?Clyman, the director of?NYC?Cognitive Therapy, a private psychotherapy practice in New York City.
“I teach my clients that negative emotions, such as sadness, anger, and fear,?are important to our survival, and emotional discomfort is a very normal, universal human experience,” he says.
Self-Care Tips for Anxiety
Signs and Symptoms of Anxiety Disorders
Your heart beats fast, and your breathing speeds up. Your chest may feel tight, and you might start to sweat. If you’ve ever felt it, you know that anxiety is just as much a physical state as a mental state. That’s because there’s a very strong biological chain reaction that occurs when we encounter a?stressful event?or begin to worry about potential?stressors or dangers in the future. Other physical symptoms include headaches and?insomnia. Psychological symptoms may include feeling restless or tense, having a feeling of dread, or experiencing ruminative or obsessive thoughts.
Some of the most common?symptoms of anxiety?disorders include:
- Feelings of apprehension
- Anticipating the worst
- Irritability
- Tremors or twitches
- Frequent urination?or diarrhea
- Nausea or?upset stomach
When Should I Seek Treatment?
When the symptoms of anxiety and the associated behaviors are having a detrimental impact on your well-being and day-to-day functioning, it’s important to get help.
Suma?Chand, PhD, the director of the cognitive behavioral therapy program at St. Louis University School of Medicine in Missouri, says a person who has?panic disorder?is “very avoidant of many situations that could trigger [their] panic symptoms,” and the panic disorder is?likely impacting their ability to go to work regularly, go shopping, attend church, and the like. The ability to function while in these situations is negatively impacted as well. If you’re avoiding situations that trigger your anxiety, or you experience tremendous discomfort and can’t function effectively when you’re in those situations, it’s probably a good time to seek treatment.
Causes and Risk Factors of Anxiety Disorders
Researchers think that various factors may contribute to anxiety.?The more risk factors an individual has, the greater the likelihood that they’ll develop an anxiety disorder, notes Dr. Chand.
- Family history?Having a family member with anxiety increases the likelihood of developing an anxiety disorder. Although this may suggest genetic transmission, Chand explains that “there is also the possibility of learning anxious responses from family members with anxiety.”
- Temperaments of behavioral inhibition, negative affectivity, and anxiety sensitivity?Starting in infancy, according to Chand, people with a temperament of behavioral inhibition have heightened reactions to new and different situations and stimuli. This tendency may lead them to withdraw from new or unfamiliar social situations as they grow older. Negative affectivity is the tendency to experience negative emotions, while anxiety sensitivity means you’re inclined to believe that symptoms of anxiety are harmful.
- Traumatic events?Children who have endured abuse (physical, emotional, or sexual) or other traumatic experiences are more likely to develop anxiety disorders. Adults exposed to traumatic experiences can also develop overwhelming anxiety.
- Stress?can be associated with the development of anxiety, whether it’s a major stressor such as a serious illness or the ongoing stress caused by work issues, financial and family conflicts, and chronic health problems. Thyroid?problems or heart arrhythmias can produce or aggravate anxiety symptoms.
- Drug or alcohol?use, misuse, or withdrawal can cause anxiety.
- Brain structure?Changes in the areas that regulate?stress?and anxiety may contribute to the disorder.
An author of the study,?Koraly?Perez-Edgar, PhD, a professor of psychology at the Pennsylvania State University in University Park, says that this focus on threat may be one way that anxiety begins to take hold.
“Individuals who attend to aspects of the environment that they consider threatening can potentially create a cycle that strengthens biases toward threat, as well as toward the view that the environment is threatening, which can then lead to social withdrawal and anxiety,” she says.
“People can learn to be anxious in various situations,” says?Jonathan Abramowitz, PhD, a professor of psychology at the University of North Carolina in Chapel Hill.
“This can occur through experiences in which anxiety or fear becomes associated with a specific stimulus or?a stressful or traumatic event, by learning about something fearful, and through vicarious conditioning,” he says.
Vicarious conditioning, says Dr. Abramowitz, occurs when you watch someone else experience a stressful and traumatic event — like food poisoning or being bitten by a dog — and come to see certain situations as dangerous.
Learn More About Causes of Anxiety Disorders: Common Risk Factors, Genetics, and More
How Is Anxiety Diagnosed?
When you visit your healthcare provider, you can expect that your doctor or nurse will ask you about your symptoms, perform a physical exam, and order lab tests to rule out other health problems. If tests don’t reveal any other conditions, your doctor will likely refer you to a?psychiatrist?or psychologist to make a diagnosis.
A mental health professional will identify the specific type of anxiety disorder that’s causing your symptoms. They’ll also look for any other mental health conditions that you may be experiencing, including?depression.
The Different Types of Anxiety Disorders
What Is Agoraphobia?
Agoraphobia?is often comorbid?with panic disorder — meaning people often suffer from both conditions at the same time. It’s an intense fear of not being able to escape whatever place you’re in if you were to have a panic attack or an embarrassing experience such as incontinence, and it can often lead to an avoidance of leaving the house.?People with agoraphobia can fear situations where this anxiety might flare up and typically don’t feel comfortable or safe in public, crowded places.
What Are Some Other Phobia-Related Disorders?
What Is Generalized Anxiety Disorder (GAD)?
Generalized anxiety disorder?is a condition in which your worries about a wide range of things overwhelm you to the point where your daily routine may be difficult to carry out, and you have been worrying this way for at least six months. You may feel on edge and have difficulty focusing on tasks. There may be a tendency to fear and expect the worst; some call this catastrophic thinking. You may know that your worries are perhaps irrational, but you continue to worry.
Learn More About Generalized Anxiety Disorder
What Is Panic Disorder?
Everyone has probably experienced a feeling of panic, or something like it, at least once in their lifetime: on a disturbingly turbulent airplane, or before giving an important presentation, or after realizing you hit reply all when you really, really should not have. We all know the paralyzed feeling and the heightened physical sensations.?But?panic attacks?and panic disorder take a different shape.?Panic attacks?have many physical symptoms and tend to peak around 10 minutes and may last for 30 or more. Panic disorder is diagnosed by having?recurrent, unexpected panic frequency of these attacks, along with unhelpful changes in behavior and/or the fear of having them.
Learn More About Panic Disorder
What Is Social Anxiety Disorder?
Many of us may know what it feels like to be nervous before a party or when meeting new people or making an important phone call.?Those with?social anxiety disorder?have very intense versions of those fears?— intense fears of being judged by others that trigger intense distress and may cause them to avoid those kinds of situations. For most people, fears of social situations usually subside once the intimidating event has been faced. But in social anxiety disorder, these feelings are more pervasive and usually last for at least six months.
Duration of Anxiety
It is possible to manage anxiety with therapy or medication, or through a combination of therapy and medication. It may also be helpful to reexamine your relationship with your anxiety.
According to Clyman,?“You might start to consider your emotions as changing experiences that are always fluctuating. When we feel distressed, it can seem like the distress is going to go on and on forever until we emotionally?combust. But instead, emotions act more like a wave, at times increasing and becoming more intense. Inevitably, they’ll reach a plateau, subsiding and finally passing.”
Treatment and Medication Options for Anxiety
Anxiety disorders are?treated through medication and therapy. You might feel embarrassed talking about the things you are feeling and thinking, but talking about it, say experts, is the best treatment.
A particular form of therapy has the most research support: cognitive behavioral therapy, or?CBT?for short, which offers patients strategies to help change the negative thought patterns that have reinforced their anxiety.
The?types of medication most frequently used to?treat depression?are the drugs that also work best for anxiety disorders.?Anti-anxiety medications?are also used.
What Are the Most Common Types of Treatment for Anxiety?
There’s no one-size-fits-all approach in?treating anxiety, but the most common methods are a combination of medication and psychotherapy (talk therapy).
Medication Options
There are dozens of drugs that can be prescribed to?treat anxiety. Since each person responds to medication differently, there’s no one drug that works perfectly for everyone. You may have to work with a psychiatrist to find the medication, or the combination of medicines, that’s most beneficial to you.?The drugs that are used to treat anxiety over a long period of time are?antidepressants, which affect?serotonin,?norepinephrine, and other?neurotransmitters?in the brain.
What Are Some Anxiety-Relieving Techniques?
What Are Some Anxiety-Relieving Techniques?
In addition to medication and therapy, exercise can be helpful.?Aerobic exercise?“has been found to improve mood and anxiety by releasing?endorphins?and neurotransmitters such as?dopamine?and serotonin,” says Chand, adding that “regular moderate exercise also helps with sleep, which in turn has a beneficial impact on anxiety.”
Research suggests that yoga, meditation, and acupuncture may also reduce anxiety symptoms by?reducing stress. Anecdotal evidence, notes Chand, indicates that massage therapy may be helpful in improving a sense of overall well-being.
More scientific evidence is needed to support treating anxiety disorders with aromatherapy and essential plant oils, such as?lavender, but some people find they have a calming effect. Chand points out that certain scents work better for some people than others, so it’s good to try a variety.
Learn More About Treatment for?Anxiety: Medication, Therapy, and Complementary Techniques
Prevention of Anxiety
According to Chand, here are some important ways to prevent the development of an anxiety disorder:
- Build a repertoire of stress management strategies, such as: break tasks down into manageable steps, plan and schedule tasks and activities in a flexible manner, and delegate and share responsibilities instead of taking on everything yourself. Routinely incorporate meditation and relaxation practices into your life to keep stress at bay.
- Good relationships and a social support system act as a protective force. Build interpersonal and communication skills to reduce stress associated with social interactions, which can sometimes be challenging.
- Create a healthy lifestyle with good?sleep hygiene, healthy nutrition, regular exercise, and self-care.
- Develop coping skills geared toward facing rather than avoiding stressful problems. Use of problem-solving coping skills has been found to be helpful in reducing stress and anxiety.
- A more optimistic outlook can be achieved consciously by recognizing skewed negative thinking and establishing a more balanced perspective. The earlier this is done, the more likely it will help with prevention of anxiety disorders.
Good mental health education is also vital, says Chand. “While several steps can be taken to prevent mental health problems, people often feel helpless when they’re not armed with information. Mental health education paves the way for a society that is more mentally healthy. Early mental health education starting in schools would be ideal,” she says, adding that the initiation of such programs has yielded positive?results.
Can My Diet Affect Anxiety?
Dietary changes are no substitute for treatment, but what you eat can indeed have an effect on your anxiety levels.
Limit or avoid caffeine and alcohol, as they can worsen feelings of anxiety.
Complications of Prolonged Anxiety
Research and Statistics: How Many People Have Anxiety Disorders and When Do Symptoms Tend to Start?
Many people first develop?symptoms of an anxiety disorder?during childhood. Some anxiety disorders, such as specific phobias and?social anxiety disorder, are more likely to develop in childhood or the teenage years, while others, such as?generalized anxiety disorder, are more likely to start in young adulthood.
Are Anxiety Disorders More Common in Women?
What is known for sure, says?Beth Salcedo, MD, a past board president of the Anxiety and Depression Association of American (ADAA), “is that more often than not, women definitely experience an uptick in anxiety before?menstruation, around?perimenopause, and after giving birth.”
How Common Are Anxiety Disorders in Children and Teens?
Anxiety Disorders and Black and Asian Americans
Conditions Related to Anxiety
Anxiety often coexists with other chronic health conditions, including:
Depression and How It Relates to Anxiety
Depression and anxiety?are different disorders, but it’s very common for someone with an anxiety disorder to suffer from depression, too.
If you have both anxiety and depression, you may experience the following symptoms:
- Problems sleeping
- Decreased energy and increased fatigue
- Difficulty concentrating
- Rumination
- Apprehension
- Worry
Obsessive-Compulsive Disorder and Anxiety
While obsessive-compulsive disorder is no longer officially classified by the American Psychological Association as an anxiety disorder, it shares many traits with common anxiety disorders, such as generalized anxiety disorder. In both conditions, you may know that your thoughts are irrational, but you feel unable to stop thinking them.?Often, but not always, these thoughts may concern cleanliness,?sex, religion, or a fear of causing harm.
With obsessive-compulsive disorder, you may also think you need to carry out certain actions in order to relieve anxiety or prevent something bad from happening. For instance, you might not be able to leave the house without locking all the doors and checking all the appliances — multiple times. And the compulsion to carry out those actions may make it difficult to get through your day.
Common Questions & Answers
The Takeaway
Anxiety is often a natural stress response that keeps you alert and ready to respond, but when these feelings become excessive or interfere with your daily life, you might have an anxiety disorder like panic disorder, social anxiety disorder, generalized anxiety disorder, or agoraphobia. Common symptoms include a rapid heartbeat and breathing, chest tightness, sweating, tremors, nausea, diarrhea, and frequent urination, as well as feelings of irritability, apprehension, dread, and obsession.
Anxiety disorders may develop due to stress, brain structure, alcohol and drug use, trauma, and family history. Reaching out for support when anxiety symptoms start to disrupt your day can help you manage symptoms effectively, and treatment might include talk therapy, medications, and learning self-management methods that include exercise, meditation, and yoga.
Resources We Trust
- Mayo Clinic:?Mayo Clinic Q and A: Understanding High-Functioning Anxiety
- Cleveland Clinic:?Generalized Anxiety Disorder (GAD)
- American Psychiatric Association: Anxiety Disorders
- National Institute of Mental Health: Generalized Anxiety Disorder: When Worry Gets Out of Control
- Anxiety & Depression Association of America:?Managing Stress and Anxiety
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Sources
- Anxiety Disorders. National Institute of Mental Health.
- Maternal Anxiety Predicts Attentional Bias Towards Threat in Infancy. Emotion.
- Anxious Moms May Give Clues About How Anxiety Develops. Penn State.
- What Are Anxiety Disorders? American Psychiatric Association.
- Specific Phobias. Anxiety and Depression Association of America.
- Anxiety Disorders: Symptoms and Causes. Mayo Clinic.
- Anxiety Disorders. Cleveland Clinic.
- Coping With Anxiety: Can Diet Make a Difference? Mayo Clinic.
- Nutritional Strategies to Ease Anxiety. Harvard Health Publishing.
- Pain, Anxiety, and Depression. Harvard Health Publishing.
- Depression and Other Common Mental Disorders: Global Health Estimates. World Health Organization.
- Statistics: Any Anxiety Disorder. National Institute of Mental Health.
- A Systematic Review of Reviews on the Prevalence of Anxiety Disorders in Adult Populations. Brain and Behavior.
- A Systematic Review of Reviews on the Prevalence of Anxiety Disorders in Adult Populations. Brain and Behavior.
- Anxiety Disorders. U.S. Department of Health and Human Services Office on Women’s Health.
- Sex Differences in the Persistence of the Amygdala Response to Negative Material. Social Cognitive and Affective Neuroscience.
- Progesterone Selectively Increases Amygdala Reactivity in Women. Molecular Psychiatry.
- Nervous Nellies. Slate.
- Unequal Depression for Equal Work? How the Wage Gap Explains Gendered Disparities in Mood Disorders. Social Science & Medicine.
- Anxiety Disorders. Boston Children’s Hospital.
- Generalized Anxiety Disorder (GAD) in Children and Teens. Stanford Medicine Children’s Health.
- Childhood Anxiety Disorders. Anxiety and Depression Association of America.
- Beyond Symptoms: Race and Gender Predict Anxiety Disorder Diagnosis. Society and Mental Health.
- Identity and Cultural Dimensions: Black/African American. National Alliance on Mental Illness.
- Identity and Cultural Dimensions: Asian American and Pacific Islander. National Alliance on Mental Illness.
- Anxiety Disorders — Facts and Statistics. Anxiety and Depression Association of America.
- What Characteristics of Primary Anxiety Disorders Predict Subsequent Major Depressive Disorder? The Journal of Clinical Psychiatry.
- Comorbidity Patterns of Anxiety and Depressive Disorders in a Large Cohort Study: The Netherlands Study of Depression and Anxiety (NESDA). The Journal of Clinical Psychiatry.
- Secondary Depression in Severe Anxiety Disorders: A Population-Based Cohort Study in Denmark. The Lancet Psychiatry.
Resources
- Anxiety Disorders.?National Institute of Mental Health.?April 2023.
- Morales S, Brown KM, Taber-Thomas BC, et al. Maternal Anxiety Predicts Attentional Bias Towards Threat in Infancy.?Emotion. August 2017.
- Anxious Moms May Give Clues About How Anxiety Develops.?Penn State. September 27, 2017.
- What Are Anxiety Disorders??American Psychiatric Association. June 2021.
- Specific Phobias.?Anxiety and Depression Association of America. March 6, 2023.
- Anxiety Disorders: Symptoms and Causes.?Mayo Clinic.?May 4, 2018.
- Anxiety Disorders.?Cleveland Clinic.?December 17, 2020.
- Coping With Anxiety: Can Diet Make a Difference??Mayo Clinic.?May 24, 2017.
- Nutritional Strategies to Ease Anxiety.?Harvard Health Publishing. August 28, 2019.
- Pain, Anxiety, and Depression. Harvard Health Publishing. September 16, 2021.
- Depression and Other Common Mental Disorders: Global Health Estimates [PDF].?World Health Organization. 2017.
- Statistics:?Any Anxiety Disorder.?National Institute of Mental Health.
- Remes?O, Brayne?C, van der Linde R, Lafortune L. A Systematic Review of Reviews on the Prevalence of Anxiety Disorders in Adult Populations.?Brain and Behavior. July 2016.
- Anxiety Disorders.?U.S. Department of Health and Human Services Office?on Women’s Health. February 17, 2021.
- Andreano JM, Dickerson BC, Barrett LF. Sex Differences in the Persistence of the Amygdala Response to Negative Material.?Social Cognitive and Affective Neuroscience. September 2014.
- Van Wingen GA, van Broekhoven F, Verkes RJ, et al. Progesterone Selectively Increases Amygdala Reactivity in Women.?Molecular Psychiatry. March 2008.
- Clark T. Nervous Nellies.?Slate. April 20, 2011.
- Platt J, Prins S, Bates L, Keyes, K. Unequal Depression for Equal Work??How the Wage Gap Explains Gendered Disparities in Mood Disorders.?Social Science & Medicine.?January 2016.
- Anxiety Disorders.?Boston Children’s Hospital.
- Generalized Anxiety Disorder (GAD) in Children and Teens.?Stanford Medicine Children’s Health.
- Childhood Anxiety Disorders.?Anxiety and Depression Association of America. September 2015.
- Identity and Cultural Dimensions: Black/African American. National Alliance on Mental Illness.
- Identity and Cultural Dimensions: Asian American and Pacific Islander. National Alliance on Mental Illness.
- Vanderminden J, Esala JJ. Beyond Symptoms: Race and Gender Predict Anxiety Disorder Diagnosis. Society and Mental Health. March 2019.
- Anxiety Disorders —?Facts and Statistics.?Anxiety and Depression Association of America. October 28, 2022.
- Bittner A, Goodwin RD, Wittchen H-U, et al. What Characteristics of Primary Anxiety Disorders Predict Subsequent Major Depressive Disorder??The Journal of Clinical Psychiatry. May 2004.
- Lamers F, van Oppen P, Comijs HC, et al. Comorbidity Patterns of Anxiety and Depressive Disorders in a Large Cohort Study: The Netherlands Study of Depression and Anxiety (NESDA). The Journal of Clinical Psychiatry. March 2011.
- Meier SM, Petersen L, Mattheisen M, et al. Secondary Depression in Severe Anxiety Disorders: A Population-Based Cohort Study in Denmark. The Lancet Psychiatry. June 2015.
- Anxiety Disorders.?National Alliance on Mental Illness. December 2017.
Seth Gillihan, PhD
Medical Reviewer
Lindsey Konkel
Author
Lindsey Konkel is an award-winning freelance journalist with more than 10 years of experience covering health, science, and the environment. Her work has appeared online and in print for Newsweek, National Geographic, Huffington Post, Consumer Reports, Everyday Health, Science, Environmental Health Perspectives, UCSF Magazine, American Association for Cancer Research, and others.
She previously worked as an editor and staff writer at Environmental Health News. She holds a master’s degree in journalism from NYU’s Science, Health and Environmental Reporting Program and a bachelor’s degree in biology from College of the Holy Cross.
Konkel lives in Haddon Township, New Jersey, with her husband, daughter, three cats, and dog. When she isn't writing, she handles social media and content marketing for a small veterinary clinic she started with her husband, Neabore Veterinary Clinic.