Anxiety Disorders – Symptoms, Diagnosis, Treatment

Anxiety: Symptoms, Diagnosis, and Treatment

Anxiety is a experience that many people have and is, in many ways, a fairly normal human emotion. We experience anxiety when something uncertain is happening, when we’re waiting for an anticipated outcome, or when we’re in an unfamiliar environment. The problem comes when this normal anxiety becomes intense and debilitating, resulting in an interference with our ability to function in our activities of daily life.

Symptoms of Anxiety

There are many common symptoms that accompany anxiety which can help you identify your struggles as anxiety-related. Here they are:

  • Feeling nervous, tense, or unsettled
  • Rapid heart rate
  • Shallow and rapid breathing
  • Shaking or trembling
  • Sweating
  • Difficulty focusing / easily distracted
  • Sleep problems (trouble falling asleep or staying asleep)
  • Stomach pain / gastrointestinal (GI) problems
  • Avoidance of things that trigger anxiety
  • Unable to manage the anxiety
  • Panic/anxiety attacks

Common Anxiety Disorders

Generalized Anxiety Disorder (GAD)

Just like it sounds, GAD is a non-specific worry that you are unable to manage which causes significant distress and impairs your functioning to some extent. The anxiety of GAD can be about anything and is usually disproportionate to the event or cause of the anxiety. For example, if you feel physically sick when your annual review at work comes around despite being an adequately performing employee, you might be experiencing Generalized Anxiety Disorder.

Social Anxiety

People with social anxiety feel insecure, fearful, and anxious in situations around other people. Social situations can include going to work, having dinner at a restaurant, going out with friends, going to church, and many others. Often, people with social anxiety avoid these situations and tend to become isolated, having few friends as a result.

Agoraphobia

Sometimes social anxiety can become so severe that you avoid leaving your home altogether due to excessive and unmanageable fear or worry – this is called agoraphobia. Agoraphobics tend to avoid places (such as bridges, freeways, or going downtown) and situations for fear of having panic attacks or feeling trapped.

Panic Disorder

Recurring experiences of sudden, intense fear or terror that result in panic attacks are called Panic Disorder. These attacks last a few minutes and involve feelings of impending doom, rapid heart rate, shortness of breath, chest pain, and belief that you are having a heart attack or are going to die. People with panic attacks often go to the emergency room only to hear these attacks are not medically-related but are the result of anxiety.

Phobias

Anxiety that is related to specific objects or situations, which is usually avoided, is called a Phobia. Common phobias include heights (acrophobia), spiders (arachnophobia), snakes (ophidiophobia), germs (mysophobia), and dogs (cynophobia).

Obsessive-Compulsive Disorder (OCD)

When anxiety produces chronic reoccurring thoughts (obsessions) and behaviors (compulsions) that you feel you must repeat, this is called obsessive-compulsive disorder. Common obsessive thoughts include avoiding germs, symmetry and organization, and unwanted taboo or forbidden thoughts involving sex, religion, and harm. Common compulsive behaviors in response to obsessive thoughts include excessive cleaning, ordering things in a particular way, repeated checking on things (such as locks and lights), and counting.

Anxiety and Sleep

Many people have difficulty with sleep, including issues of insomnia. Stress and sleep can often have mutual impacts; anxiety can impair sleep, and poor sleep can increase anxiety. Stress can make it difficult to relax enough to fall asleep, or if you wake up in the middle of the night it can be difficult to go back to sleep once your mind starts going. Likewise, when you are tired you can be more susceptible to feeling stressed or worried. If you are struggling to sleep well at night, you can also become anxious about being able to sleep which makes the issue worse.

The good news is that there are many things you can do to improve the quality of your sleep and reduce your anxiety. Sleep habits are an important aspect to evaluate to ensure you are cultivating healthy patterns to promote good sleep. Here are some habits to practice that will improve your sleep and have a positive impact on your anxiety:

  • Establish a regular, consistent bedtime and routine
  • Avoid stimulating activities at least 60 minutes before you would like to fall asleep
  • Do not use electronic devices and screens for at least 60 minutes before bedtime
  • Avoid coffee, soda, sugary foods, alcohol, and nicotine for several hours prior to your bedtime
  • Make sure your room is cool, dark, and quiet
  • Keep your bedroom only for sleep or relaxing activities; do not use it for stressful activities
  • Exercise regularly, but not too close to bedtime
  • Take naps earlier in the day (if you must) so you are tired at bedtime
  • Do not look at the clock
  • Block out sufficient time for 7-8 hours of sleep
  • Only get into bed when you are tired

Treatment for Anxiety

There are many different approaches that can be effective for anxiety, and each person will respond differently to each approach. However, there are several common and most effective approaches that most professionals use. Cognitive-behavioral therapy (CBT) looks at your thinking and behavior patterns that may be causing anxiety, and seeks to challenge and change these. This is effective because anxiety involves perceiving events and interpreting them with distorted meaning which CBT can target and change to become more accurate, realistic, and less negative. CBT is arguably one of the most common and effective treatment modalities for anxiety.

Exposure therapy is another approach that seeks to reduce your fear and anxiety gradually over time by exposing you to the feared situation or object and helping you (usually through CBT) learn to become less anxiety and afraid. Exposure therapy is common and effective for obsessive-compulsive disorders as well as phobias.

Experiential techniques can also be helpful for anxiety. Exercises such as progressive muscle relaxation, deep breathing, mindfulness, and visualization can be helpful in alleviating the somatic symptoms of anxiety. These interventions focus on controlling and relaxing the mind and body, which are major contributing factors that produce anxiety, and can enable restoration of functioning with daily activities.

Acceptance and Behavior Therapy (ACT) is somewhat of a combination of CBT, exposure, and experiential techniques. ACT facilitates a process of allowing yourself to feel and accept discomfort without judgment, change your perspective on it that better aligns with your personal values, and uses skills to cope with the discomfort in a way that is committed to your desired behavioral change.

Eye Movement Desensitization and Reprocessing (EMDR) is a more recent but clinically proven and powerful tool for anxiety, particularly post-traumatic stress disorder (PTSD), panic attacks, and phobias. EMDR enables you to fully process distressing material (such as an event or series of events) through alternating (left-right, also called bilateral) auditory, tactile, or visual stimulation. EMDR requires special training but effective EMDR therapists can treat anxiety issues much more rapidly and permanently with it than with traditional talk therapy.

Medication for Anxiety

While anxiety can often be treated effectively with psychotherapy approaches such as those listed above, there are many cases where medication is an appropriate solution. Some people have biological tendencies or genetic predispositions that make anxiety much more difficult to manage, so medication is an excellent option in these cases. Psychotropic medications can help to reduce the symptoms of anxiety in order to improve functioning, as well as to boost the effectiveness of psychotherapy since the symptoms become more manageable.

It’s important to understand that while medications can be helpful, they only treat the symptoms. Underlying causes of anxiety, such as distorted belief patterns or a traumatic experience in childhood, are not changed by medication so these would still need to be addressed in order to achieve long-term relief and more permanent improvement.

Keep in mind that psychotropic medications can also have unwanted side effects. You should explore the possible side effects of medications with your prescribing doctor prior to taking them, and keep a track of things such as your mood, behavior, sleep, and weight as these may change as a result of the medication. Each person responds differently to medications, so you will need to determine if the benefits outweigh the negatives.

Resources

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