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

Samantha Hanratty, star of the Showtime series “Yellowjackets,” reveals how she copes with anxiety and prevents panic attacks: square breathing, Zoloft, and spending time outside.
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.

Learn More About Signs and Symptoms of Anxiety Disorders

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.
“There is a genetic component to anxiety disorders, no doubt,” says?Chand. “This tends to make the individual vulnerable to developing an anxiety disorder, rather than cause them to directly inherit one,” she says. Environmental factors, she adds, interact with genetic predispositions to trigger the onset of anxiety disorders. A study?published in 2017 may offer clues as to how both genes and environment combine to make anxiety take root.

When researchers showed babies pictures of angry, happy, and neutral faces, they found that the infants of anxious mothers took longer to look away from the angry faces, which suggested that the infants had a tendency to focus more on potential threats.

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.

Learn More About Agoraphobia

What Are Some Other Phobia-Related Disorders?

Phobias are a type of anxiety disorder. A specific phobia is an “excessive and persistent fear of a specific object, situation, or activity that is generally not harmful.”

?Examples include fear of flying, fear of heights, emetophobia (fear of vomiting) and arachnophobia (fear of spiders). People with specific phobias?often understand that their fear may be irrational, but they still experience intense anxiety, and their desire to avoid triggers may interfere with their daily routines. Even simply thinking about the situation or thing associated with the phobia can cause anxiety.

Specific phobias can develop in childhood, but they can also arise in adolescence or adulthood, often with a sudden onset, and are sometimes the result of a traumatic event or experience.

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.

Learn More About Social Anxiety Disorder

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.

Learn More About Medications for Treating Anxiety Disorders

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

There’s no way to know when or if someone will develop an anxiety disorder. But if you’re prone to being anxious, there are steps you can take that may help keep it in check. Seek treatment early, because anxiety can be harder to treat the longer you wait.

?Staying active and exercising regularly is important, as is avoiding drugs and alcohol, which might diminish anxiety in the short-term but increase it overall, and limiting your caffeine intake.

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.

Foods rich in?complex carbohydrates, such as whole grains, are thought to boost?serotonin levels?in the brain.

?Also, try not to skip meals. Doing so can affect your blood sugar levels throughout the day, which in turn can exacerbate underlying anxiety.

Limit or avoid caffeine and alcohol, as they can worsen feelings of anxiety.

Learn More About Anxiety and Diet

Complications of Prolonged Anxiety

Anxiety disorders can negatively affect both your physical and mental health, causing new concerns or exacerbating existing ones. As noted above, anxiety can lead to depression. It can also worsen insomnia, digestive troubles, headaches, and chronic pain.

?The emotional toll of excessive worrying and fear can contribute to substance misuse, increasing social isolation, and problems functioning at work. Suicidal thoughts are another complication of severe anxiety.
Untreated anxiety is also linked to?gastrointestinal?disorders, chronic respiratory disorders, and heart disease. Anxiety can make these conditions more difficult to treat, thereby worsening outcomes.

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.

An?estimated 3.6 percent of the world’s population?suffers from anxiety disorders.

The National Institute of Mental Health?reports?higher rates, noting that?19 percent of American adults?are affected by an anxiety disorder each year.

A?review of 48 studies published in 2016?noted that anxiety was more prevalent in women, in people under 35, and in those who live in North America or Western European countries.

The review?also found that people with chronic health conditions were more likely to experience anxiety.?According to the review, almost 11 percent of people with heart disease in Western countries reported having generalized anxiety disorder (GAD). In addition, 32 percent of those with?multiple sclerosis?had some kind of anxiety disorder.

Are Anxiety Disorders More Common in Women?

Women are?more than twice as likely as men to be diagnosed with an anxiety disorder.

?It’s not clear why this is the case, but researchers have theorized that it may be due to a combination of social and biological factors. Scientists are still investigating the complex role that gender plays in brain chemistry, but?some research suggests?that in women, the amygdala, which is the part of the brain responsible for processing potential threats, may be more sensitive to negative stimuli and may hold on to the memory of it longer.

Other?research suggests?that the hormone?progesterone?may act as a trigger for this amygdala response.

But some think that nature is less of an influence than nurture. Women, the theory goes, tend to be socialized in a way that gives them permission to openly discuss emotion. So women may feel more comfortable admitting to feelings than men, who tend to be socialized to keep their feelings to themselves. Women may therefore get diagnosed with anxiety disorders more often than men.

Other research suggests that social structures that contribute to inequality, such as lower wages, may play a part. In a?study published in 2016, epidemiologists reviewed data on wages and mood disorders, and noted that when a woman’s pay rose higher than a man’s, the odds of her having generalized anxiety disorder or major?depression decreased.

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?

Kids and teens often experience anxious feelings and worries, but when this apprehensiveness becomes so overwhelming or persistent that it interferes with daily functioning, they may have an anxiety disorder. Anxiety disorders are the most common childhood mental health problem, affecting up to 1 in 10 children and teens.

Generalized anxiety disorder in children and teens may manifest as excessive worry about performance in school or sports, or catastrophic events such as natural disasters. But children, unlike adults, may not understand that their anxiety is more extreme than any given situation typically warrants.

In addition to the specific types of anxiety disorders mentioned above, separation anxiety disorder can affect children. While young children frequently experience separation anxiety when they’re not in the same room as their parents, older kids who have intense fear when they’re apart from their caregivers may have separation anxiety disorder. This disorder affects 4 percent of children and is most common in children ages seven to nine.

Anxiety Disorders and Black and Asian Americans

Data suggests that anxiety disorders may be underdiagnosed in Black patients. A study published in 2019?examined the gap between prevalence of reported anxiety symptoms and diagnosis rates. Researchers found that Native American, white, and Hispanic/Latino Americans were more likely than Black respondents to receive an anxiety disorder diagnosis.

For Black Americans, barriers to care for mental health conditions include socioeconomic disparities, stigma within the community, and bias on the part of healthcare providers.

?Asian American and Pacific Islanders have the lowest help-seeking rate of any racial or ethnic group in the United States — with just over 23 percent of adults receiving treatment for mental health. Language barriers, cultural stigma around mental health, the “model minority” stereotype, and lack of insurance may all be contributing to treatment delays and disparities in AAPI populations.

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.

About half of all people diagnosed with depression also have an anxiety disorder.

Anxiety may trigger depression, or depression may trigger anxiety. Anxiety disorders?may be a predictor of a?major depressive episode, say researchers,

?and those who suffer from both anxiety and depression tend to have more severe?symptoms and earlier onset of symptoms of both.

In a large study published in 2015,?which followed participants for nearly 20 years,?researchers confirmed that having severe anxiety or several anxiety disorders is linked to recurrent depressive episodes.


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.

Learn More About Obsessive-Compulsive Disorder

Common Questions & Answers

What are the most common anxiety disorders?
The most common anxiety disorders are generalized anxiety disorder, panic disorder, social anxiety disorder, and phobias. Each has its own set of symptoms, but all are characterized by excessive fear or worry. Symptoms are usually both emotional and physical.
What causes anxiety and anxiety disorders?
The exact cause is not clear, but research shows there’s likely an interplay between biological factors, such as genetics and brain structure, and environmental factors, like lifetime adversity. Traumatic or stressful events, such as the death of a loved one, abuse, or prolonged illness, are often linked to the development of an anxiety disorder.
Is there a difference between feeling anxious and anxiety?
Yes. An anxiety disorder is a repetitive feeling of nervousness that causes serious distress and/or interferes with daily life. When someone has an anxiety disorder, they’re anxious so often that they may struggle to carry out day-to-day activities. Feelings of nervousness, unease, or worry that do not disrupt our everyday life or cause inordinate suffering are normal feelings of anxiousness and anxiety.
What is a panic attack?
A panic attack, sometimes called an anxiety attack, is a sudden and often unexpected onset of fear and discomfort that’s accompanied by intense symptoms, such as a racing heart rate, shortness of breath, sweating, trembling, chest pain or discomfort, and a sense of imminent doom. Panic attacks typically peak within 10 minutes of their onset and then begin to subside.
Is anxiety related to depression?
It’s very common for someone with an anxiety disorder to also suffer from depression, and about half of all people with depression also have an anxiety disorder. Either condition can trigger the other, and those who suffer from both tend to have more severe symptoms, as well as earlier onset of those symptoms.

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
Editorial Sources and Fact-Checking

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

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Seth Gillihan, PhD

Medical Reviewer
Seth Gillihan, PhD, is a licensed psychologist in private practice in Ardmore, Pennsylvania, who helps people find personal growth by making important changes in their thoughts and habits. His work includes books, podcasts, and one-on-one sessions. He is the the host of the Think Act Be podcast and author of multiple books on mindfulness and CBT, including Retrain Your Brain, Cognitive Behavioral Therapy Made Simple, and Mindful Cognitive Behavioral Therapy.

He completed a doctorate in psychology at the University of Pennsylvania where he continued as a full-time faculty member from 2008 to 2012. He has been in private practice since 2012.

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.

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