Anxiety

Although anxiety is quite common, that doesn’t make experiencing it any less challenging. Anxiety can disrupt your social life, as well as your work life, and make it difficult to function in almost any situation.

Symptoms can be emotional and physical, with some individuals experiencing both, and including challenges such as: excessive worry, racing thoughts, but also chest pain, rapid heartbeat, stomach upset, dizziness, trembling, and shortness of breath are common. There are also several subtypes of anxiety disorder, including general anxiety, PTSD, panic disorder, social anxiety disorder, specific phobias, and OCD.

Anxiety is a common and natural human reaction that people experience both in their everyday lives, and at particular moments of heightened experience. Some levels of anxiety can be healthy and provide motivation to help with problem solving around concerning issues. When anxiety takes control over one’s day-to-day experience and causes significant disruption in one’s daily life, however, it may require the attention of a mental health professional.

Those with anxiety disorders may experience disruption in their social lives, family life, or employment.

Anxiety disorders, however, are some of the most common mental health diagnoses around the world. In the United States, about 18% of the population lives with an anxiety disorder within a 12 month period.

Symptoms of Anxiety Disorders

Anxiety disorders are often characterized by an ongoing, disruptive pattern of thinking about certain ideas, topics, or experiences.

Many people with anxiety disorders may experience the following:

• Excessive rumination or worry
• Difficulty stopping undesired thoughts
• A desire to avoid certain anxiety inducing situations, people, or things
• Chest pain or other discomfort
• Stomach pain or intestinal distress
• Feeling dizzy and/or fainting
• Trembling or shaking
• Shortness of breath

Although this list is not exhaustive, these symptoms can indicate anxiety in those experiencing them.

Subtle Indications of Anxiety Disorders

Although the criteria for diagnosis rests more squarely on the symptoms above, there are other additional, understated signs of anxiety disorders, including the following:

• You’re a perfectionist
• You’re easily startled or jumpy
• Everyone seems to be getting on your nerves
• You’re struggling to make decisions
• You keep getting sick, or having stomach aches
• Trouble sleeping, or weird dreams
• Sore neck or shoulder muscles
• Lack of appetite
• A rigid daily routine

While these habits and characteristics don’t indicate proof positive of the presence of an anxiety disorder, they can be sneaky signs that you’re struggling with the condition.

Treatments for Anxiety Disorders

In practice, many therapists use a range of techniques, approaches, and strategies to treat anxiety. Some of the most common and recommended sources of treatment include cognitive behavioral therapy (CBT), interpersonal (or relational) therapy, and mindfulness-based therapy, also known as mindfulness-based cognitive behavioral therapy (MBCBT)

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, or CBT, is the most common and recommended course of treatment for anxiety disorders. Treatment may include help in identifying, labeling and altering thought patterns, exposure and desensitization, and engaging in healthier coping strategies to lessen the overall negative impact of anxiety.

Interpersonal Psychotherapy

Interpersonal or relationally focused therapy can also be helpful for those living with anxiety disorders, in particular when the root causes are centered around interactions with others. Treatment may include an exploration of ways in which the person interacts with others and helpful recommendations for new ways to engage.

Mindfulness-based Cognitive Behavioral Therapy

Mindfulness-based therapy is a subset of CBT that incorporates the body as a tool for intervention and an instrument for change. MBCBT strategies or its techniques may include mindful breathing, meditation, guided visualization, and more.

Causes of Anxiety

Physiological

The disruption of basic physical habits can cause an increase in anxiety, routines like not getting enough sleep and exercise, not eating a balanced diet, and a lack of social support. Other common habits — like drinking caffeine and consuming alcohol — often also contribute to anxiety.

Common physiological causes of anxiety are often brought on or exacerbated by both prescription and illicit drug use. Anxiety is a common side effect of medications prescribed for a wide range of other conditions — if you believe you might be experiencing anxiety as a side effect of a medication, be sure to speak with your doctor. Anxiety can also be due to a lack of oxygen due to emphysema, pulmonary embolism, or even high altitude sickness.

Genetic

While the causes of anxiety aren’t completely scientifically settled, the National Institute of Mental Health notes that you’re at a higher risk for developing an anxiety disorder if your biological relatives have anxiety disorders or other mental illnesses.

Environmental

Environmental causes, such as stress, can contribute greatly to one’s anxiety. Whether it’s stress at work, school, or stress in a relationship — all of these issues can induce anxiety. Other stressors that can cause anxiety include: financial stress, traumatic stress, or stress over a medical illness. Traumatic life experiences in particular, are shown to increase the risk of developing an anxiety disorder.

Comorbidity (Anxiety + Depression)

Comorbidity is the presence of more than one distinct condition in an individual. Comorbidity is fairly common with anxiety. Depressive disorders and other anxiety disorders — especially panic disorder — are the most commonly co-occuring.

Types of Anxiety Disorders

Anxiety disorders cover a wide range of concerns — anxiety is an umbrella condition that includes diagnoses such as generalized anxiety disorder, panic disorder, agoraphobia, and others.

Generalized Anxiety Disorder

Generalized anxiety disorder is most often characterized by ongoing worry, rumination, or preoccupied thoughts. This can be related to general feelings of unease and can also be specific to concerns about health, interpersonal relationships, and job or school performance.

Panic Disorder

Panic disorder can be a debilitating condition that is defined as an experience of an “abrupt surge of intense fear,” which commonly manifests and is referred to as panic attacks. Those suffering from panic disorder often describe feeling intense, unexpected moments of panic initiating both from an anxious or relaxed state. Common symptoms include:

• Trembling
• Shaking
• Heart palpitations
• Sweating
• Fear of choking
• Pain or other discomfort
• Feeling dizzy
• Feeling a sudden loss of control

It should also be noted that those without a diagnosis of panic disorder may also experience panic attacks.

Social Anxiety Disorder

Social Anxiety Disorder is an internal emotional experience of heightened anxiety and/or panic when in, or when thinking about, social settings. Some who experience social anxiety may find themselves isolating or avoiding desired social interaction due to feelings of being negatively judged or criticized.

Agoraphobia

People with agoraphobia tend to experience an intense fear of public spaces, which can lead to significant and persistent isolation and deterioration of social relationships. Symptoms may include intense anxiety or fear of using public transportation, being in small enclosed spaces, being in wide open spaces, waiting in lines, or fear of leaving the home.

Demographics

Although anxiety can make you feel isolated and alone, it is actually one of the most common mental health disorders. In fact, according to the Anxiety and Depression Association of America, anxiety is the most widely experienced mental illness in the U.S., with 40 million adults (18.1% of the population) battling anxiety each year.

Unfortunately, only 36.9% of people with the disorder seek help. Cognitive behavioral therapy (CBT), interpersonal (or relational) therapy, and mindfulness therapy, however, are all effective evidence-based means of treating anxiety, and can be combined with medication in some cases.

Often, anxiety itself is what deters people from seeking treatment, but it’s important to know that compassionate, non-judgmental, effective treatment is readily available for anxiety sufferers.

Testing for Anxiety

There are several assessments that therapists use to make a diagnosis of generalized anxiety disorder.

GAD-7

One of the most common is the GAD-7, which is used by both primary care and by licensed therapists and psychiatrists. It’s an important tool when screening for symptoms and to assess the severity of common anxiety disorders, which include: generalized anxiety disorder, post-traumatic stress disorder, social phobia, and panic disorder. Research has shown the test to have a sensitivity of between 70-90% and to be specific across disorders by a measure of 80-90%.

The higher the score on a GAD-7 test, the more severe your anxiety. The test is brief and you can even take it online as a preliminary screening (just for personal use, not as a diagnosis) before seeking help from a therapist or psychiatrist, who will be able to make an accurate diagnosis and get the help you need to feel better.

DSM-5

In addition to using the GAD-7, clinical professionals often look for the following symptoms, as classified by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders:

• Excessive worry
  You may experience excessive worry and anxiety over all kinds of activities, topics, or events. Often the worry is excessive, lasts for more than 6 months, and you are worried more often than you are not.
• Difficulty controlling worry
  The worry is difficult to control and it may shift from one topic straight into another.
• Physical symptoms
  There are physical or cognitive symptoms that accompany your worry, including:
  • Restlessness or edginess
  • More fatigued than is typical; getting tired easily
  • Feeling as though your mind goes blank or you have trouble concentrating
  • Feeling irritable, and not necessarily in a way that others notice
  • An increase in soreness or muscle aches
  • Difficulty sleeping including unsatisfying sleep, trouble staying asleep, or falling asleep

If you think you are suffering from anxiety, it’s important not to delay seeking help — the earlier you receive help, the sooner you can start feeling better. And, of course, the uncertainty of wondering whether you have the condition can further exacerbate your anxiety.

Anxiety in Pop Culture

Over the past few years, depictions of anxiety have grown in pop culture. Whether it’s a speech at the Oscars about someone’s struggles with panic disorder, a song by a popstar revealing their challenges with social anxiety or PTSD, or captivating television series like This Is Us and Euphoria — depicting one’s daily anxiety is less stigmatized than at any time previous. In fact, sharing your anxiety issues is increasingly seen as brave and a show of strength. Both This Is Us and Euphoria have received praise for their accuracy in depicting mental health struggles, in ways unlike those we’ve seen in the past. Many albums and popular songs also now allude to overwhelming thoughts, overthinking, and symptoms of anxiety.

And, while our changing attitudes about mental health are showing up in art and pop culture, those depictions also influence our mental health care systems and people’s willingness to search for help. The next time you’re enjoying a new show or a movie, try to note how mental health is being discussed — you may be surprised by how the issue is treated when you pay attention.

Therapeutic Note

Remember a therapist will be there to help you figure out the best way to address your concerns. Therapy works best when it is a collaboration between you and your therapist. If you choose to work with a therapist, it is important to be open, honest, and an active participant in this process. Talk to your therapist about your goals for therapy so that together you can come up with the best plan to achieve your goals.

Questions You Might Have For Your Talkspace Therapist

• What caused my anxiety in the first place?
• How do I know what kind of anxiety disorder I have?
• Is this curable or will I always feel this way?
• How can I tell the difference between a panic attack and anxiety?