Anxiety

We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.

 

Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Meanwhile, approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21.

Symptoms

Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People typically experience one or more of the following symptoms:

Emotional symptoms:

  • Feelings of apprehension or dread

  • Feeling tense or jumpy

  • Restlessness or irritability

  • Anticipating the worst and being watchful for signs of danger

 

Physical symptoms:

  • Pounding or racing heart and shortness of breath

  • Sweating, tremors and twitches

  • Headaches, fatigue and insomnia

  • Upset stomach, frequent urination or diarrhea

 

Treatment

Different anxiety disorders have their own distinct sets of symptoms. This means that each type of anxiety disorder also has its own treatment plan. But there are common types of treatment that are used. 

 

Types of

Anxiety

There are many types of anxiety disorders, each with different symptoms. The most common types of anxiety disorders include:

 

Generalized Anxiety Disorder (GAD)

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

 

Social Anxiety Disorder

More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

 

Panic Disorder

This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.

 

Phobias

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

 

Other anxiety disorders include:

- Agoraphobia

- Selective mutism

- Separation anxiety disorder

- Substance/medication-induced anxiety disorder, involving intoxication or withdrawal or medication treatment

 

Co-Occurring

Mental Illness

A co-occurring disorder refers to when one person has two or more mental health disorders or medical illnesses. These co-occurring disorders may overlap and begin at the same time, or one may appear before or after the other.

Social anxiety & bipolar disorder 

 

Medication

Guide

(Prescription, Experimental, &

Natural Herbs and Medicines)

Some people find that medication is helpful in managing an anxiety disorder. Talk with your health care provider about the potential benefits, risks and side effects.

Traditional Prescriptions:

  • Anti-anxiety medications. Certain medications work solely to reduce the emotional and physical symptoms of anxiety. Benzodiazepines can be effective for short-term reduction of symptoms, but can create the risk of dependence when used for a long time. Be sure to review these potential risks if you select these medicines. Click here for more information on these medications.

  • Antidepressants. Many antidepressants may also be useful for treating anxiety. These can also be useful if your anxiety has a co-occurring depression. Be sure to check our Medication page for more information.

  • Pharmacologic interventions for anxiety include: 

    • Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs are used to treat anxiety, depression, panic disorder, fibromyalgia and back pain. They work by blocking or delaying the reuptake of serotonin and norepinephrine, which helps to improve your mood. Some SNRI brand names include Cymbalta, Pristiq, Effexor and Savella. Common side effects of these medications include dizziness, nausea, loss of appetite, sexual problems, constipation, weight loss, insomnia, headaches, dry mouth and agitation.

    • Selective serotonin reuptake inhibitors (SSRIs): SSRIs are used to correct low serotonin levels in the brain. SSRIs are used to treat anxiety disorders and depression. Some examples of commonly prescribed SSRIs include Lexapro, Prozac, Zoloft and Celexa. Possible side effects of these medications include drowsiness, nausea, diarrhea, headache, sexual problems, agitation, dizziness, dry mouth, insomnia and blurred vision. In fact, research shows that approximately 30–50 percent of patients on SSRIs experience these kind of mild side effects. (4)

    • Benzodiazepines: Benzodiazepines are used to enhance the effect of GABA, a neurotransmitter that reduces the activity of neurons that cause anxiety. Benzodiazepine drugs are used to treat anxiety, insomnia, alcohol withdrawal, pack attacks and seizures (due to their anticonvulsant properties). The most popular types of benzodiazepines include Xanax, Valium, Librium and Tranxene. These medications come with side effects like dizziness, headaches, blurred vision, sweating, trouble sleeping, impaired coordination, confusion and an increased risk of falling in elderly patients. (5) trad med for e.d.

Experimental

Although in the early stages of testing, experimental procedures and substances have shown promising results towards helping those with mental health. Please consult with your doctor before moving forward with any new or experimental medicine. 

  • Ketamine - A new study suggests that ketamine may not only be helpful for those with clinical depression, but also bipolar depression. Ketamine differs from traditional antidepressants in its mechanism of action – it affects different brain systems, neurotransmitters, and neural pathways.

  • Psychedelics -The psychedelic substance psilocybin may be more effective in patients who suffer from major depression than previously appreciated

Natural Herbs and Medicines:  

  • Ashwagandha  is used as a popular home remedy in India and it has shown promise in the reduction of anxiety

  • Ginko is one of the best researched medicinal plants has also been found effective in the treatment of anxiety

  • American skullcap is widely used for complaints involving an overactive nervous system such as insomnia, anxiety, and epilepsy.   

  • Lemon balm is mainly known as an anxiolytic (reduces anxiety), nootropic, anti-depressant, and carminative (reduces excess gas). Double-blind placebo-controlled human studies have shown positive results for lemon balm extracts in the improvement of mood, reduction of anxiety, and improvement of cognitive abilities.  

  • Minchex - It is said to help keep the nervous system healthy. The ingredients found in Min-Chex are said to induce a natural calming effect by exerting their individual influence on specific parts of the central nervous system.

 

Medical

Procedures

Vagus Nerve Stimulation (VNS)- VNS uses a pulse generator, about the size of a stopwatch, placed in the upper left side of the chest to stimulate the vagus nerve, which carries messages to parts of the brain that control mood and sleep, with electrical impulses. 

Electroconvulsive Therapy (ECT)- ECT is a procedure where controlled electric currents are passed through the brain while the person is under general anesthesia. This results in a brief, controlled seizure that affects neurons and chemicals in the brain. It is most often used to treat severe depression and depression with psychosis that has not responded to medications. 

 

Deep Brain Stimulus (DBS) -  Deep brain stimulation is currently being studied as treatment for Tourette’s syndrome and major depression. DBS involves two electrodes put surgically directly in the brain and a pulse generator put in a person’s chest.

 

Transcranial Magnetic Stimulation (TMS) - TMS is a procedure that creates magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS should not be used to treat anyone experiencing depression with psychosis or bipolar disorder or having a high risk of suicide. 

Systematic Treatment EnhancementThe NIMH-funded Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) is a long-term outpatient study designed to find out which treatments, or combinations of treatments, are most effective for treating episodes of depression and mania and for preventing recurrent episodes in people with bipolar disorder. 

 
 

Sleep, Diet and Exercise for Better Mental Health

 

Additional

Resources

Support Programs

Blogs

Videos

 

Books

Articles

Websites

  • Anxiety & Depression Association of America

  • Mental Health 101

  • HelpGuide - Trustworthy resources and content to help improve your mental health and make healthy changes.

  • Moodgym - An online self-help program designed to help users prevent and manage symptoms of depression and anxiety which teaches skills based on cognitive behavior therapy

  • Mental Health Online - Free self-help resources and therapist support

  • ThisWayUp - Offers self-paced online courses that teach clinically-proven strategies to help you improve the way you feel

  • myCompassA personalized self-help tool for your mental health

  • MindSpot - A digital mental health clinic

Podcasts

Handouts

Apps

  • MindDoc - Monitoring and self-management app for promoting emotional well-being and coping

  • Headspace - Guided meditations, animations, articles, and videos