Anxiety Attacks and Anxiety Disorders
A Guide to the Signs, Symptoms, and Treatment Options
It’s normal to feel anxious when facing a challenging situation, such as a job interview, a tough exam, or a blind date. But if your worries and fears seem overwhelming and interfere with your daily life, you may be suffering from an anxiety disorder. There are many different types of anxiety disorders—and many effective treatments and self-help strategies. Once you understand your anxiety disorder, there are steps you can take to reduce your symptoms and regain control of your life.
Understanding anxiety disorders
Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened, under pressure, or are facing a stressful situation.
In moderation, anxiety isn’t always a bad thing. In fact, anxiety can help you stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming, when it interferes with your relationships and activities, it stops being functional—that’s when you’ve crossed the line from normal, productive anxiety into the territory of anxiety disorders.
Signs and symptoms of anxiety disorders
Because anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything.
Despite their different forms, all anxiety disorders share one major symptom: persistent or severe fear or worry in situations where most people wouldn’t feel threatened.
Emotional symptoms of anxiety
In addition to the primary symptoms of irrational and excessive fear and worry, other common emotional symptoms of anxiety include:
Physical symptoms of anxiety
Anxiety is more than just a feeling. As a product of the body’s fight-or-flight response, anxiety involves a wide range of physical symptoms. Because of the numerous physical symptoms, anxiety sufferers often mistake their disorder for a medical illness. They may visit many doctors and make numerous trips to the hospital before their anxiety disorder is discovered.
Common physical symptoms of anxiety include:
Anxiety attacks and their symptoms
Anxiety attacks, also known as panic attacks, are episodes of intense panic or fear. Anxiety attacks usually occur suddenly and without warning. Sometimes there’s an obvious trigger—getting stuck in an elevator, for example, or thinking about the big speech you have to give—but in other cases, the attacks come out of the blue.
Anxiety attacks usually peak within ten minutes, and they rarely last more than thirty minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape.
Symptoms of anxiety attacks include:
Types of anxiety disorders
There are six major types of anxiety disorders, each with their own distinct symptom profile: generalized anxiety disorder, obsessive-compulsive disorder, panic disorder (anxiety attacks), phobia, post-traumatic stress disorder, and social anxiety disorder.
Generalized anxiety disorder
If constant worries and fears distract you from your day-to-day activities or you’re troubled by a persistent feeling that something bad is going to happen, you may be suffering fromgeneralized anxiety disorder (GAD). People with GAD are chronic worrywarts who feel anxious nearly all of the time, though they may not even know why. Anxiety related to GAD often shows up as physical symptoms like insomnia, stomach upset, restlessness, and fatigue.
Anxiety attacks (Panic disorder)
Panic disorder is characterized by repeated, unexpected panic attacks, as well as fear of experiencing another episode. Panic disorder may also be accompanied by agoraphobia, which is a fear of being in places where escape or help would be difficult in the event of a panic attack. If you have agoraphobia, you are likely to avoid public places such as shopping malls or confined spaces such as an airplane.
Obsessive-compulsive disorder (OCD) is characterized by unwanted thoughts or behaviors that seem impossible to stop or control. If you have OCD, you may be troubled by obsessions, such as a recurring worry that you forgot to turn off the oven or that you might hurt someone. You may also suffer from uncontrollable compulsions, such as washing your hands over and over.
A phobia is an unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals such as snakes and spiders, fear of flying, and fear of heights. In the case of a severe phobia, you might go to extreme lengths to avoid the thing you fear. Unfortunately, avoidance only strengthens the phobia.
Social anxiety disorder
If you have a debilitating fear of being seen negatively by others and humiliated in public, you may have social anxiety disorder, also known as social phobia. Social anxiety disorder can be thought of as extreme shyness. In severe cases, social situations are avoided altogether. Performance anxiety (better known as stage fright) is the most common type of social phobia.
Post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is an extreme anxiety disorder that can occur in the aftermath of a traumatic or life-threatening event. PTSD can be thought of as a panic attack that rarely, if ever, lets up. Symptoms of PTSD include flashbacks or nightmares about what happened, hypervigilance, startling easily, withdrawing from others, and avoiding situations that remind you of the event.
Self-help for anxiety, anxiety attacks, and anxiety disorders
Not everyone who worries a lot has an anxiety disorder. You may be anxious because of an overly demanding schedule, lack of exercise or sleep, pressure at home or work, or even from too much coffee.
The bottom line is that if your lifestyle is unhealthy and stressful, you’re more likely to feel anxious—whether or not you have an anxiety disorder. So if you feel like you worry too much, take some time to evaluate how well you’re caring for yourself.
- Do you make time each day for relaxation and fun?
- Are you getting the emotional support you need?
- Are you taking care of your body?
- Are you overloaded with responsibilities?
- Do you ask for help when you need it?
If your stress levels are through the roof, think about how you can bring your life back into balance. There may be responsibilities you can give up, turn down, or delegate to others. If you’re feeling isolated or unsupported, find someone you trust to confide in. Just talking about your worries can make them seem less frightening.
Self-help for anxiety attacks and anxiety disorders #1: Challenge negative thoughts
- Write down your worries. Keep a pad and pencil on you, or type on a laptop, smartphone, or tablet. When you experience anxiety, write down your worries. Writing down is harder work than simply thinking them, so your negative thoughts are likely to disappear sooner.
- Create an anxiety worry period. Choose one or two 10 minute “worry periods” each day, time you can devote to anxiety. During your worry period, focus only on negative, anxious thoughts without trying to correct them. The rest of the day, however, is to be designated free of anxiety. When anxious thoughts come into your head during the day, write them down and “postpone” them to your worry period.
- Accept uncertainty. Unfortunately, worrying about all the things that could go wrong doesn’t make life any more predictable—it only keeps you from enjoying the good things happening in the present. Learn to accept uncertainty and not require immediate solutions to life’s problems.
Self-help for anxiety attacks and anxiety disorders #2: Take care of yourself
- Practice relaxation techniques. When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and deep breathing can reduce anxiety symptoms and increase feelings of relaxation and emotional well-being.
- Adopt healthy eating habits. Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more anxious.
- Reduce alcohol and nicotine. They lead to more anxiety, not less.
- Exercise regularly. Exercise is a natural stress buster and anxiety reliever. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days.
- Get enough sleep. A lack of sleep can exacerbate anxious thoughts and feelings, so try to get 7 to 9 hours of quality sleep a night.
When to seek professional help for anxiety disorders
While self-help coping strategies for anxiety can be very effective, if your worries, fears, or anxiety attacks have become so great that they’re causing extreme distress or disrupting your daily routine, it is important to seek professional help.
If you’re experiencing a lot of physical anxiety symptoms, consider getting a medical checkup. Your doctor can check to make sure that your anxiety isn’t caused by a medical condition, such as a thyroid problem, hypoglycemia, or asthma. Since certain drugs and supplements can cause anxiety, your doctor will also want to know about any prescriptions, over-the-counter medications, herbal remedies, and recreational drugs you’re taking.
If your physician rules out a medical cause, the next step is to consult with a therapist who has experience treating anxiety attacks and anxiety disorders. The therapist will work with you to determine the cause and type of your anxiety disorder and devise a course of treatment.
Treatment options for anxiety disorders
Anxiety disorders respond very well to treatment—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with behavioral therapy, medication, or some combination of the two. Sometimes complementary or alternative treatments may also be helpful.
Behavioral therapy for anxiety disorders
Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. Behavioral therapy for anxiety usually takes between 5 and 20 weekly sessions.
- Cognitive-behavior therapy focuses on thoughts—or cognitions—in addition to behaviors. In anxiety disorder treatment, cognitive-behavioral therapy helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety.
- Exposure therapy for anxiety disorder treatment encourages you to confront your fears in a safe, controlled environment. Through repeated exposures to the feared object or situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety gradually diminishes.
Medication for anxiety disorders
A variety of medications, including benzodiazepines and antidepressants, are used in the treatment of anxiety disorders. But medication is most effective when combined with behavioral therapy and anxiety self-help strategies. Medication may sometimes be used in the short-term to relieve severe anxiety symptoms so that other forms of therapy can be pursued.