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Everything You Need to Know About Anxiety

In this article I will be discussing everything you need to know about anxiety, how it’s diagnosed, what are the risk factors and how is it treated.

This article is available in form of a short and digestible podcast. Tap the “Play” button below or listen to my Anxiety podcast episode.

Anxiety Diagnosis, Risk Factors and Treatment, Arsen The Science Guy Podcast
  1. Panic attacks or feelings of terror. Except for feeling dizzy or the sensation of being overwhelmed, panic attacks aren’t dangerous. The term “panic attack” refers to a sudden attack of intense fear that can affect you in your heart and lungs, even though you’re not actually in danger.
  2. Extreme anxiety about potential future events (e.g., public speaking, driving). You need to get treatment for your anxiety or it will get worse.
  3. Feeling shaky, sweaty, shaky, having chills or hot flashes. When talking about physical symptoms of anxiety, many people mention shaky hands or feeling shaky in general. This is a common symptom of anxiety.
  4. Irritability. Irritability is associated with anxiety disorders and takes the form of anger, hostility or aggression either expressed verbally toward others or “internally” felt toward yourself.

Symptoms of anxiety

The symptoms of anxiety can be caused by a variety of factors. Some people have anxiety because of a chemical imbalance in the brain, but there are also physical causes. For example, someone with an overactive thyroid gland (hyperthyroidism) could experience increased heart rate and increased sensitivity to stress (e.g., feeling nervous when you give a presentation in front of the entire class). Migraine headaches could also trigger bouts of anxiety.

The physical symptoms of anxiety could be from a number of other health conditions as well, so you must have a complete exam performed by a doctor to rule out other medical issues.

Symptoms include the following:

  • trembling or muscle twitching
  • weakness and lethargy
  • difficulty focusing or thinking clearly about anything other than the thing you’re worried about
  • insomnia
  • digestive or gastrointestinal problems, such as gas, constipation, or diarrhea
  • a strong desire to avoid the things that trigger your anxiety
  • obsessions about certain ideas, a sign of obsessive-compulsive disorder (OCD)
  • performing certain behaviors over and over again
  • anxiety surrounding a particular life event or experience that has occurred in the past, especially indicative of post-traumatic stress disorder (PTSD)

Panic attack

A panic attack is a sudden onset of fear or distress that peaks in minutes and involves experiencing at least four of the following symptoms.

  • Palpitations
  • Sweating
  • Trembling or shaking of hands or feet
  • Shortness of breath
  • Chest pain or discomfort
  • Nausea or abdominal distress

These symptoms are so intense that it might seem like someone else is doing them to you. They can feel like they’re happening for no reason, but the more you understand about panic attacks, the more it will help bring some relief.
A panic attack is different from having a heart attack. People who have had one panic attack will often worry that they’re about to have another one, which leads them to avoid situations in which they fear another attack might happen.- The material below was created in partnership with the Anxiety and Depression Association of America (ADAA) in order to provide the public with free, accessible information about anxiety disorders. We encourage you to visit their website at adaa.org for more information.

While anticipation is a part of everyone’s life, the anticipatory anxiety associated with an important event (like a job interview, wedding, or school play) can sometimes feel more intense than others. This type of anxiety is often what brings on the panic attack symptoms that can be so frightening. Learning how to prepare in advance and calm yourself down before a situation becomes overwhelming can help you prevent an attack when it does happen.
A panic attack usually comes on suddenly, with symptoms peaking within 10 minutes.

Types of anxiety disorders

There are several types of anxiety disorders, these include:

Agoraphobia

People who have agoraphobia have a fear of certain places or situations that make them feel trapped. These may include crowded public places, bridges, or being in an elevated place.

Social Anxiety Disorder

If you have Social Anxiety Disorder, you are afraid of social interactions with other people and it is difficult for you to function in these types of situations. Symptoms include blushing, trembling, rapid heartbeat, nausea and hot flashes. One can also get panic attacks which are intense feelings of fear usually accompanied by physical symptoms like heart pounding or chest pain.

Specific Phobia

Individuals with specific phobias have an unreasonably strong fear or response to a particular object or situation. Common triggers include animals, blood, flying, insects, heights and injections.

Panic Disorder

If you suffer from Panic Disorder, you feel sudden feelings of terror that happen repeatedly and without warning. These are not the same as panic attacks that are present in people who have anxiety disorders. People with panic disorder tend to have recurring spontaneous panic attacks that last at least 10 minutes. Panic can manifest as a full-blown panic attack or as a more mild panic attack that may go away without treatment. Panic disorder can have symptoms that occur in both children and adults, but their symptoms may vary from one age to another.

Generalized Anxiety Disorder (GAD)

People with generalized anxiety disorder have an excessive fear of everyday things associated with unknown or unpredictable threats. These may include public speaking, public transport, health issues and others. The person may feel restless, tired, irritable or nauseated.

Posttraumatic Stress Disorder (PTSD)

People who have Posttraumatic Stress Disorder develop symptoms following a terrifying experience or ordeal in which they felt helpless to stop the danger. This anxiety disorder includes flashbacks of the traumatic event and avoidance of anything associated with it. Symptoms may appear within 3 months after the trauma occurs but it may take years for them to develop. PTSD also affects approximately 3% of adults in the U.S.

Anxiety diagnosis

The first step in diagnosing anxiety is to rule out medical conditions that look similar or that cause similar types of symptoms. You must have a complete physical exam performed by a doctor to rule out other medical issues before making the diagnosis of anxiety. However, there are differentiating features between depression and anxiety disorders.

Depression symptoms include:

  • Depressed mood or sadness, as well as loss of interest or pleasure in normal activities
  • Decreased energy and weight loss or eating too much
  • Changes in sleep patterns (e.g., sleeping too much) and physical symptoms such as fatigue, restlessness, difficulty concentrating
  • Making suicidal comments and thoughts (e.g. “I wish I were dead”)
  • Loss of concentration, indecisiveness and memory problems
  • Thoughts that are often repeated, such as “I can’t do anything right” or “No one cares about me”
  • Thoughts of death, suicide or self-mutilation (i.e., cutting)
  • A feeling of worthlessness or hopelessness, along with guilt over things you have done or not done in your past. You feel like life is futile.
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Anxiety attack

Anxiety attack can feel like a warm wave, a sense of panic, a pressing tightness in your chest. You might feel hot and flushed with the skin on your face burning, or you may even experience nausea. You may also have trouble breathing and find yourself gasping for air.

But what is an anxiety attack? It is a feeling of intense discomfort often accompanied by physical symptoms such as chest pain or difficulty breathing. An anxiety attack can be an unexpected response to a stressful situation or event. There is no single cause of anxiety attacks. They are often the result of a complex mix of factors, including genetics, personality, and life experiences.

The following are some common causes of anxiety attacks:

  • Stressful life events. An anxiety attack can be the result of a stressful event or situation that causes you to feel anxious or on edge. Maybe you were involved in a car accident and had to readjust to day-to-day life. Maybe you had a family emergency and your stress levels became unmanageable.
  • Panic disorder
  • Situational anxiety
  • Depression
  • Major life changes, such as a death or a job loss
  • There are also some other causes that can cause anxiety attacks. These include: chronically worrying about things without good reason, being trapped in a place with no escape, feeling threatened by remote events, and feeling overwhelmed by the number of choices available to you. Sometimes anxiety attacks caused by other factors may manifest themselves through physical symptoms such as shortness of breath or chest pain.

Anxiety medications

Anxiety medications are drugs that are prescribed to patients who experience clinical anxiety. These drugs can be given in pill form, taken through an intravenous line within a hospital setting, or even by injection. This drug class is commonly used to reduce the physical symptoms of anxiety including shakiness, high heart rate, and shortness of breath that the brain experiences when it’s in overdrive mode.

Examples of these drugs are listed below.

  • Benzodiazepines are antiepileptic medications that have been used to treat anxiety for nearly three decades. They are most commonly used in the treatment of panic attacks, social phobia, and general anxiety disorders. Benzodiazepines are also used to treat alcohol withdrawal symptoms, tension, and sleep difficulties.

    Some people believe that benzodiazepines may be an effective treatment for the social anxiety disorder, especially when used as a maintenance treatment. A study conducted by J. R. Weaver and colleagues showed that benzo users experienced a reduction in social anxiety as well as significant effects on quality of life and mental health compared to those who did not use benzodiazepines.

    Benzodiazepines include: Alprazolam (Xanax), Clonazepam (Klonopin), Lorazepam (Ativan), Mellaril, and Diazepam (Valium).

    This drug class can be given as an injection or infusion.
  • The tricyclic antidepressants are quite effective at reducing anxiety symptoms and also control depression symptoms. The most commonly prescribed tricyclic antidepressant for anxiety disorders is the TCA drug clomipramine (Anafranil), which is also very effective at treating obsessive compulsive disorder. Some common side effects of the tricyclics include: dry mouth, sedation, and weight gain. The side effect profile includes potential side effects like blurred vision, shaking, and sexual dysfunction.

    The cyclic antidepressants are antidepressive drugs that are used to treat depression. They are also given to patients with anxiety disorders, especially in the class of the heterocyclic antidepressants. The most common side effects include headaches, nervousness, and insomnia. Less common side effects include weight gain and dry mouth.
  • Monoamine oxidase inhibitors (MAOIs) are used for depression but may also be prescribed for anxiety disorders. They affect serotonin levels in the brain which leads to an increase in serotonin activity. MAOIs have been found to be particularly effective at treating panic disorders. MAOIs have a long list of side effects including: insomnia, sexual dysfunction, weight gain, and anxiety.
  • The less commonly prescribed drug class is called benzodiazepine receptor agonists or more commonly called the thienobenzodiazepines. These drugs are used to target the benzodiazepine receptor in the central nervous system. The most common pharmaceuticals used in this class are: clorazepate (Tranxene), diazepam (Valium), and alprazolam (Xanax). They are not often prescribed for anxiety but are often prescribed for sleep disorders.
  • The drug class is also called beta blockers which are used to treat anxiety-related breathing problems.
  • Buspirone is a serotonergic drug that has been studied in numerous clinical trials. Results have shown that some patients have experienced significant improvements in anxiety symptoms while others have not shown any change. Studies have suggested that buspirone may be most effective for generalized anxiety disorder, although it has also been shown to help treat social phobia. Buspirone can be used alone or in combination with other drugs for panic disorder or obsessive compulsive disorder. Common side effects include fatigue, headache, dizziness, nausea, and diarrhea.
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At-home anxiety treatments

More and more people are recognizing that their anxiety can’t be cured by a quick fix. In fact, many mental health professionals agree that the traditional approach to treating anxiety at home just isn’t cutting it anymore. As one therapist from Manhattan put it, “Not only is medication not a long-term solution for most patients, but it can lead to dependence and addiction. There’s a different way of addressing the needs of those with chronic anxiety – namely by figuring out what’s making them anxious in the first place.”

If you’re suffering from anxiety, then traditional home remedies aren’t doing the trick. You might try to meditate, or force yourself into relaxing situations, but it’s likely that your efforts are falling short. If you’re ready to get real about your anxiety, then start by taking these 3 steps toward eliminating it once and for all…

  1. Figure out what’s making you anxious. As mentioned above, many people are unaware of what’s causing their chronic anxiety. If you find that you can’t get your anxiety under control, then it’s time to examine what’s really happening. Are you stuck in a rut? Are your everyday experiences triggering your anxiety? Are certain people making you anxious, like family members or coworkers? You need to pinpoint the source of your stress.
  2. Start figuring out ways to relax. You need a plan for calming down once you’ve identified the problem. For example, sure, one strategy might be to say no to parties, but if you’re overweight and health-conscious, then perhaps it’s time to cut back on your junk food consumption. In any case, it’s important that you have a plan in place before engaging in anxiety-provoking activities.
  3. Stop being attached to your feelings of anxiety. Remember that anxiety isn’t necessarily a problem – it’s an emotion, plain and simple. The real issue is when people live their lives in fear of anxiety. Practicing mindfulness techniques can help you to detach from your feelings of anxiety, which will lead to greater peace of mind.

As you can see, there are several different approaches to fixing your home-based anxiety treatment. Remember that the first step is always the hardest. You’ve got this!

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Here are some at-home anxiety treatments:

  1. Get lots of rest. We’ll start with some basic advice: sleep well. The more you sleep, the better you’ll feel during the day. Plus, it’s been proven that those with anxiety-related disorders can often benefit from a good night’s rest. Don’t forget to follow through on the first step (see below) if you really want to see some improvements!
  2. Reduce your caffeine intake. Although coffee can have some health benefits, it’s important to keep in mind that it can cause anxiety in some people. You might want to cut back for a couple of weeks before you take any other steps (see below).
  3. Start and stay active. Aerobic exercise has been proven to help improve mental health and reduce stress. The key is to start moving and not quitting. If you suffer from anxiety, then you know that the symptoms are often debilitating. Not only will you feel your heart racing, but you might also feel sick to your stomach or like the world is closing in around you. Treating anxiety at home isn’t easy – here’s what worked for us.
  4. Start exercising more. Our bodies were built to move; it’s what they do best. If you need help, then try to get in at least 30 minutes of exercise three times per week.
  5. Take a nap every day. Naps are especially great when you’re feeling anxious because they can really help restore your energy and mind. Plus, many benefits have been attributed to naps so it’s easy to see why they can do so much for your anxiety.
  6. Calm down in the evenings. One of the hardest things to do when you have anxiety is to calm down at the end of the day. Some people prefer a relaxing bath while others might need a nice, long walk. Whatever your favorite self-soothing techniques are, try to start using them regularly.
  7. Practice deep breathing exercises. Another simple relaxation technique is learning how to properly breathe. You can do this anywhere and it only takes a few minutes (and you’re guaranteed to feel better afterward).
  8. Meditate daily. This is yet another great way to reduce your anxiety levels. It can be as easy as sitting still for a few minutes, breathing deeply and focusing on the present. Meditation can really help you become more aware of your surroundings and yourself.

Commonly asked questions about anxiety

What is anxiety?

Anxiety is a psychiatric disorder and has the following categories: Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder (SAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and Acute Stress Reaction.

Why does someone have anxiety?

Anxiety disorders are caused by the interaction of natural, biological factors with life events. The combination of these can change how an individual reacts to stressful situations.

What are the symptoms of anxiety?

Symptoms can be divided into four categories: Physical, Emotional, Cognitive and Behavioral. Symptoms include: Restlessness or increased energy; Muscle tension; Difficulty sleeping; Irritability; Anxiety about performing in public; Not wanting to go out; Feeling tense and jittery. Some people who experience intense and prolonged bouts of intense fear and anxiety may experience paralysis, usually referred to as a panic attack.

What causes anxiety?

Although no one knows exactly what causes anxiety disorders, research suggests that early life trauma, genetics, biology, personality, alcohol/substance abuse, neurochemistry and environment can contribute to the development of anxiety.

How is anxiety treated?

Medications such as antidepressants and anti-anxiety medication can be effective in treating anxiety. The most common classes of medications used to treat GAD include: SSRIs, SNRIs and benzodiazepines. Many people with GAD may also benefit from cognitive-behavioral therapy (CBT) and relaxation training. The first treatment for social anxiety disorder is usually medication, such as antidepressants and beta blockers. However, psychotherapy may help those who do not respond to medications alone. Exposure therapy is also a common psychotherapy used to treat anxiety.

How can anxiety be prevented?

Social support is an essential protective factor in preventing and treating anxiety. Good social supports can help prevent the onset of mental health disorders such as anxiety.

How to deal with anxiety?

  1. Identify and record your physical feelings. Anxiety has many physical symptoms such as nausea, an irregular heartbeat, and elevated blood pressure. Recording these can help you better understand whether or not your anxiety is real.
  2. Relaxation exercises such as deep breathing combined with visualization can be a great way to get back on track when you feel like your imagination is racing out of control in worrying about potential outcomes of certain decision-making scenarios.
  3. Over time, you will learn to identify what thoughts lead to where. By keeping a thought journal , you can get a sense of your triggers. If your anxiety is coming from an unrealistic fear about what others think your new haircut looks like, you can then begin to challenge that assumption with the knowledge that it is okay for people not to like it.
  4. Take control of situations by doing . When faced with challenges, do not be afraid to get involved and figure things out for yourself. The more you push past your fear of failure, the greater your chances of success.
  5. Remember that you will be fine. Anxiety causes us to see things differently than how they actually are. By writing out a list of all of the things that may happen and then crossing off the ones that do not occur, you can begin to overcome your fear and see possibilities instead of threats.
  6. Create a plan for what you will do if bad things happen and record it on paper so that it becomes more tangible and less scary . For example, if you are in an airplane and it crashes, your plan should include the steps that would lead to safety in the event of crashing.
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How to calm anxiety?

  1. Learn to breathe consciously.
  2. Learn how to move your body in the opposite direction of the anxiety-producing stimuli.
  3. Check whether your fear is real or not- perhaps there’s just something you’re uncomfortable with?
  4. Stop freaking out.
  5. Take note of the uniqueities of the situation, the people involved- how do they seem to you?
  6. Learn to name your discomforts, fears, and other ‘negative’ emotions.
  7. Develop an emotional vocabulary- list these emotions that bother you, or that trigger anxiety symptoms in different situations or contexts (e.g., anger vs. sadness).
  8. Learn to identify the precursors of your anxiety- it’s easier to be aware of what triggers your anxiety then.
  9. Identify how you’d like to feel instead (e.g., happy, relaxed, etc.).
  10. Rank your discomfort/anxiety on a scale from 1 – 10 (1 – not uncomfortable; 10 – really freaking out).
  11. Develop coping strategies for how to deal with the unpleasant sensations (e.g., breathing exercises, deep-breathing, etc.).
  12. Practice your coping strategy in situations that aren’t directly linked to your anxiety (e.g., when you’re done with work, or when you’ll be able to distract yourself at home).
  13. Focus on present moment experience; maybe this particular situation is quite mundane in the grand scheme of things?
  14. Practice saying to yourself “I am okay” or “my mind/body are okay”
  15. Allow yourself to be okay sometimes.
  16. Sit with uncomfortable sensations, unpleasant thoughts, bodily sensations or aches and pains, without judging or trying to change them (e.g., this is okay; this is not okay).

What causes anxiety?

Social anxiety disorder is a mental health condition that makes it hard to function in everyday life. People with social anxiety disorder worry about how they come off to others and what others think of them.

They often avoid social situations, which can lead to depression and problems at work or school.

This is how you can overcome it:
There are several ways of improving your symptoms of social anxiety disorder, which include cognitive-behavioral therapy, breathing exercises, meditation, or just trying new things. There is no cure for social anxiety disorder, but it can be controlled with medication.

Anyone can have this, not just people with social anxiety disorder:
Social anxiety disorder affects an estimated 6.7 percent of the U.S population.

This is how people may hide their social anxiety:
People with social anxiety disorder often avoid situations that are uncomfortable or uncomfortable to others, which can get in the way of their personal relationships and their job performance. Symptoms of social anxiety disorder can also include blushing, trembling, having a shaky voice, nausea, diarrhea, and an upset stomach.

This is what you can do if you think you may have it:
The first step in overcoming social anxiety disorder is to talk with your doctor about your symptoms. If they are severe enough that they are affecting your daily life, then your doctor may prescribe medication or refer you to a therapist for cognitive-behavioral therapy (CBT).

What does anxiety feels like?

Anxiety feels like the room suddenly getting too hot, the pressure in your chest suddenly feels like it’s crushing you, suddenly you’re fighting an invisible demon. This is just a short list of some of the symptoms that anxiety can cause in someone who is experiencing it. However, not all anxious people experience all these symptoms but many still feel a bit anxious in a day to day life and can be somewhat aware that they are feeling anxious or nervous in a situation or have been told they have anxiety disorder by their doctor. This is of course a misconception of anxiety disorder, but anxiety can still feel a bit scary and has a tendency of making people avoid situations that give them a feeling of nervousness or discomfort.

That feeling of nervousness or discomfort is the cause of the fight or flight response. Basically this means that there are two main modes of action when dealing with danger: fight and flight. These are actually hard wired into our brains and bodies. They were necessary in ancient times when we were very likely to be attacked by a close-by predator such as a wolf for example, and we were just as likely to have to outrun an oncoming mammoth to survive. This all being said, it can be easy to see why these feelings seem so natural, and why people tend to experience these symptoms in certain situations that provoke anxiety or nervousness.

There is great variability in anxiety symptoms from person to person.

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