Anxiety

Feeling anxious is a normal part of being human. It’s designed to protect us. In some cases, our internal alarm system is completely appropriate and can even be helpful, allowing us to act cautiously or fuel our performance on an exam or work project.

However, when anxiety is amped up too high, for too long, and prevents you from enjoying life, it’s no longer serving you. Frequent unease and nervousness in anticipation of something in the future is debilitating.

When anxiety gets in the way of daily life, talk to your provider to see if you meet the criteria for an anxiety-related mental health diagnosis.

What Causes Anxiety?

Anxiety is caused by biological, environmental and social factors. Here’s an explanation of each.

Biological Risk Factors

One biological reason for anxiety comes from interactions in various areas of the brain and the way neurotransmitters, like serotonin and dopamine, are disrupted. Here’s what else is happening when you feel anxious:

• When your amygdala, the part of your brain that processes emotions, thinks you’re in danger, it becomes activated and triggers a stress response. This stress response is known as “fight or flight.” When you’re in this state, your body releases the hormones cortisol and adrenaline to prepare you to deal with the danger.
• When the prefrontal cortex, the part of your brain that manages critical thinking, isn’t working properly, it can have trouble taming the amygdala’s response. This leads to ongoing and excessive worry.

Environmental Risk Factors

Negative life events are the primary environmental factors linked to anxiety. This includes — but is certainly not limited to — having traumatic experiences like going through a divorce, losing a loved one, being a victim to domestic violence, car accidents, a life-changing health diagnosis, financial strain or stress from work, school or community engagements. Learning how to recognize your body’s stress response and ways to cope with stress and anxiety may help build resilience and improve symptoms. 

Social and Cultural Risk Factors

Individuals who identify as LGBTQ+, are twice as likely (than heterosexual individuals) to experience a mental health condition. This is largely due to experiences of discrimination, harassment or rejection.

Trying to maintain a certain social status or image can also create a cycle of anxiety. As people become hyper focused on how others perceive them, anxiety grows. Social comparison also impacts self-esteem, emotional well-being and the ability to form genuine relationships.

Not having access to mental health resources and support also fuels anxiety. Barriers might include wait lists to see a mental health provider, not having transportation, language barriers, differing education levels and discrimination.

Certain medications, alcohol or drugs can cause a substance-induced anxiety order. It happens when you're intoxicated or withdrawing from alcohol or legal (prescribed medication, alcohol, caffeine) or illicit drugs (cannabis, hallucinogens, opioids or stimulants obtained illegally).

Signs and Symptoms of Anxiety

What does anxiety feel like? The way anxiety feels varies by person and often includes more than one symptom from the list below. Symptoms can be both mental and physical, such as:

Mental Symptoms

• Avoiding situations
• Excessive worry
• Feeling on edge
• Hypervigilance (being extremely alert)
• Irritability
• Restlessness
• Trouble focusing

Physical Symptoms

• Chest tightness or pain
• Dizziness
• Digestive distress, such as stomach pain, nausea or diarrhea
• Fatigue
• Heart palpitations
  
• Shortness of breath
  
• Sudden sweating
• Trouble sleeping
• Tense muscles (back, neck and shoulders are common)
• Twitching in the legs, arms or eyes

Can Anxiety Make You Sick?

Yes, anxiety that’s untreated can make existing physical conditions feel worse. Our autonomic nervous system regulates our heart rate, breathing, blood pressure, digestion and more. It's also designed to respond when our body goes into fight or flight mode. If you have ongoing anxiety, too many stress hormones are released and that can negatively impact your health.

Types of Anxiety Disorders

There’s no one-diagnosis-fits-all approach to anxiety. It can manifest in different ways. These are the most common types of anxiety disorders:

• Generalized anxiety disorder is consistent and uncontrollable worry that's disproportionate to the situation at hand. It’s triggered by issues like health, work or family.
• Separation anxiety disorder is most common in children who excessively worry about being away from a loved one or familiar environment.
• Social anxiety disorder is having an intense fear of social situations. People are typically extremely self-conscious and worried about feeling embarrassed.
• Panic disorder is characterized by reoccurring and unexpected episodes of intense fear. Physical symptoms, such as a rapid heartbeat and trouble breathing, are also commonly present during a panic attack.

Anxiety can be chronic or situational. Someone who experiences situational anxiety feels anxious about a specific event. It’s short-lived and goes away once the situation passes — like interviewing for a job or giving a presentation. Chronic anxiety is long-lasting and more relentless. People who have on-going anxiety feel persistent dread and concern.

Anxiety Attack vs Panic Attack

An anxiety attack and panic attack share many overlapping symptoms — such as a racing heart or chest pain. The difference is the symptoms of an anxiety attack usually build up rather than appearing suddenly. They’re triggered by a stressful situation or perceived threat. How long an anxiety attack lasts is different for everyone. It can be minutes to hours.

A panic attack doesn’t always have a trigger and may be unexpected. The onset is sudden, and they peak quickly — lasting about 10 minutes but sometimes longer. Panic attacks feel like an impending sense of doom and loss of control. There’s an overwhelming urge to escape or avoid a situation. The symptoms of a panic attack are more severe than what’s experienced during an anxiety attack, including choking sensations and dizziness.

While both attacks are stressful, they’re not physically harmful. It’s normal to feel the emotional and physical impact of the attack after it’s passed.

Anxiety Diagnosis and Treatment

How do you know if you have anxiety? An anxiety disorder often occurs with other mental health conditions, such as depression or post-traumatic stress disorder. If you feel like anxiety is a barrier in your life, a great first step is to talk with your primary care provider. From there, your provider will likely suggest psychotherapy, medications or a combination of the two.

In psychotherapy, a licensed mental health professional uses different techniques to help you identify, understand and better manage anxious thoughts and behaviors. Cognitive behavioral therapy (CBT), for instance, is an evidence-based and effective therapy for anxiety disorders.

In addition to your primary care physician, a psychiatrist can also prescribe medications to treat anxiety. Your psychiatrist works closely with you and your therapist to ensure you receive the best care possible and your unique health goals are met.

Better understanding the risk factors, symptoms and treatments for anxiety can help with healing. It’s important to then consult with a medical and/or mental health professional in addition to educating yourself on the condition.