Common Symptoms of Anxiety

More than 20 million Americans suffer from anxiety disorders.They are tormented by panic attacks, obsessive thoughts, flashbacks, nightmares, or countless frightening physical symptoms.

Anxiety disorders are the most common of all the mental disorders. At the The National Institute of Mental Health (NIMH), the Federal agency that conducts and supports research related to mental disorders, mental health, and the brain, scientists are learning more and more about the nature of anxiety disorders, their causes, and how to alleviate them. NIMH also conducts educational outreach activities about anxiety disorders and other mental illnesses.

Anxiety is a feeling of apprehension, uncertainty, and fear in anticipation of or in response to some real or perceived danger. Mild forms of anxiety caused by emotional conflict or life stress are fairly common and are not usually a clinical problem. Exaggerated fear may lead to an anxiety attack.

Anxiety disorders are often related to the biological makeup and life experiences of the individual, and they frequently run in families. There are several types of anxiety disorders, each with its own distinct features.

  • Generalized Anxiety Disorder - Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.
  • Panic Disorder - People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can't predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.

When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you're having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during nondream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.

  • Post-Traumatic Stress Disorder - Persistent symptoms that occur after experiencing a traumatic event such as rape or other criminal assault, war, child abuse, natural disasters, or crashes. Nightmares, flashbacks, numbing of emotions, depression, and feeling angry, irritable or distracted and being easily startled are common.
  • Phobias - Phobias occur in several forms. A specific phobia is a fear of a particular object or situation. Social phobia is a fear of being painfully embarrassed in a social setting. And agoraphobia, which often accompanies panic disorder, is a fear of being in any situation that might provoke a panic attack, or from which escape might be difficult if one occurred.

In many cases, anxiety associated with recent stress is time limited. If it persists, brief, supportive counseling and/or short-term use of medication may be helpful. Chronic, generalized anxiety can usually be treated through psychotherapy and relaxation techniques. Medication, for example, minor tranquilizers, may help control the symptoms of anxiety. If medication is used, it should be used along with and not as a substitute for any appropriate therapy or relaxation techniques. If troublesome anxiety attacks, phobias, or obsessions are present, psychiatric intervention combining medication and behavioral techniques is usually necessary. The newer serotonin-specific reuptake inhibitors can also be effective. A thorough evaluation should be done to rule out other emotional problems, such as depression, as well as medical disorders, such as thyroid dysfunction, that can cause anxiety.

Two clinically-proven effective forms of psychotherapy used to treat anxiety disorders are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy focuses on changing specific actions and uses several techniques to stop unwanted behaviors. In addition to the behavioral therapy techniques, cognitive-behavioral therapy teaches patients to understand and change their thinking patterns so they can react differently to the situations that cause them anxiety.

It is common for an anxiety disorder to accompany depression, eating disorders, substance abuse, or another anxiety disorder. Anxiety disorders can also co-exist with physical disorders. In such instances, the accompanying disorders will also need to be treated. Before beginning any treatment, however, it is important to have a thorough medical examination to rule out other possible causes of symptoms.

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Publications and other information about Anxiety Disorders are available from the NIMH Anxiety Disorders website at http://www.nimh.nih.gov/ or by calling toll-free 1-88-88-ANXIETY (1-888-826-9438).