Anxiety happens as a normal part of life. It can even be useful when it alerts you to danger. But for some people, anxiety persistently interferes with daily activities such as work, school or sleep. This type of anxiety can disrupt relationships and enjoyment of life, and over time it can lead to health concerns and other problems.
In some cases, anxiety is a mental health condition that requires treatment. Generalized anxiety disorder, for example, is characterized by persistent worry about major or minor concerns. Other anxiety disorders — such as panic disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) — have more-specific triggers and symptoms. Sometimes, anxiety results from a medical condition that needs treatment.
Whatever form of anxiety you have, lifestyle changes, counseling or medications — or a combination of these approaches — can help.
Common anxiety signs and symptoms include:
Having a sense of impending danger, panic or doom
Having an increased heart rate
Breathing rapidly (hyperventilation)
Feeling weak or tired
Several types of anxiety disorders exist:
Panic attacks can start suddenly and cause apprehension, fear or terror. You may have feelings of impending doom, shortness of breath, heart palpitations or chest pain. You may feel as if you're choking, being smothered or that you're "going crazy."
Agoraphobia is anxiety about, or avoidance of, places or situations where you might feel trapped or helpless if you start to feel panicky.
Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
Social phobias are characterized by major anxiety provoked by exposure to certain types of social or performance situations and a desire to avoid them.
Obsessive-compulsive disorder (OCD) includes persistent, recurring thoughts, images or impulses (obsessions) or an irresistible desire to perform irrational or seemingly purposeless acts or rituals (compulsions). Often it involves both obsessive and compulsive behavior.
Post-traumatic stress disorder (PTSD) includes the feeling that you're re-experiencing an extremely traumatic event. It causes intense emotions and physical reactions along with a desire to avoid anything that might remind you of the event.
Acute stress disorder includes symptoms similar to those of PTSD that occur immediately after an extremely traumatic event.
Generalized anxiety disorder includes at least six months of persistent and excessive anxiety and worry about small or large concerns. This type of anxiety disorder often begins at an early age. It frequently occurs along with other anxiety disorders or depression.
Anxiety disorder due to a medical condition includes prominent symptoms of anxiety that are directly caused by a physical health problem.
Substance-induced anxiety disorder is characterized by prominent symptoms of anxiety that are a direct result of abusing drugs, taking medications or being exposed to a toxic substance.
When to see a doctor
See your doctor if:
You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life
You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety
You think your anxiety could be linked to a physical health problem
You have suicidal thoughts or behaviors (seek emergency treatment immediately)
Your worries may not go away on their own, and they may actually get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It may be easier to treat if you address it early.
As with many mental health conditions, the exact cause of anxiety disorders isn't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to becoming anxious. Inherited traits also are a factor.
For some people, anxiety is linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators that you have a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order lab tests and other tests to look for signs of a problem.
Physical problems that can be linked to anxiety include:
Thyroid problems (such as hypothyroidism or hyperthyroidism)
Withdrawal from anti-anxiety medications (benzodiazepines)
Rare tumors that produce certain "fight-or-flight" hormones
Muscle cramps or spasms
Tingling, burning or prickling sensations that may have no apparent cause
It's more likely that your anxiety may be due to an underlying medical condition if:
Your anxiety symptoms started after age 35
You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder
You didn't have an anxiety disorder as a child
You don't avoid certain things or situations because of anxiety
No events have occurred in your life that were triggered by significant anxiety
Medications used to treat feelings of panic don't ease your anxiety symptoms
Treatment & Drugs
When anxiety is severe, disrupts your day-to-day life, causes panic attacks or doesn't get better over time, you may have a disorder that needs to be diagnosed and treated.
The two main treatments for anxiety disorders are behavior therapy (psychotherapy) and medications. You may benefit most from a combination of the two. It may take some trial and error to discover exactly what treatments work best for you.
Also known as behavior or talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.
Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to gradually return to the activities you have avoided because of anxiety. Through this process, your symptoms improve as you build upon your initial success.
Several different types of medications are used to treat anxiety disorders, including those below. Talk with your doctor about benefits, risks and possible side effects.
Antidepressants. These medications influence the activity of brain chemicals (neurotransmitters) thought to play a role in anxiety disorders. Examples of antidepressants used to treat anxiety disorders include fluoxetine (Prozac), imipramine (Tofranil), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and venlafaxine (Effexor XR). Citalopram (Celexa) and escitalopram (Lexapro) also can be effective, but dosages of about 40 milligrams (mg) a day of citalopram or 20 mg a day of escitalopram warrant discussion of risks versus benefits.
Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
Benzodiazepines. In limited circumstances your doctor may prescribe one of these sedatives for relief of anxiety symptoms. Examples include alprazolam (Niravam, Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan). Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you've had problems with alcohol or drug abuse.
Lifestyle & Home Remedies
While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:
Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It can improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
Avoid alcohol and other sedatives. These substances can worsen anxiety.
Quit smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety.
Use relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
Make sleep a priority. Do what you can to make sure you're getting enough quality sleep. If you aren't sleeping well, see your doctor.
Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed. Avoid fried, fatty, sugary and processed foods.