Anxiety: What it is, what to do

Francesca Coltrera

Senior Content Writer, Harvard Health Publishing

While anxiety symptoms vary widely, odds are good that at some point you’ve experienced occasional physical and emotional distress signals such as panicky breathing, your heart pounding in your chest, trouble sleeping, feelings of dread, or even loops of worry. That’s normal.

By itself, anxiety isn’t a problem. It anchors the protective biological response to danger that boosts heartbeat and breathing, pumping oxygenated blood to your muscles as your body prepares to fight or flee. A dollop of healthy anxiety can persuade you to get to work on time, push you to study hard for an exam, or discourage you from wandering dark streets alone.

“Experiencing anxiety is normal,” says Dr. Gene Beresin, executive director of the Clay Center for Healthy Young Minds at Massachusetts General Hospital. “A certain amount of anxiety can even be helpful. The problem is that sometimes the systems underlying our anxiety responses get dysregulated, so that we overreact or react to the wrong situations.”

What is an anxiety disorder?

Severity of symptoms and a person’s ability to cope separate everyday worries or anxious moments from anxiety disorders. National surveys estimate nearly one in five Americans over 18, and one in three teens ages 13 to 18, had an anxiety disorder during the past year.

If anxiety is persistent, excessive, or routinely triggered by situations that aren’t an actual threat, tell your doctor, who can discuss treatment options or refer you to an experienced mental health professional.

What kind of anxiety disorder do you have?

As with every health issue, an accurate diagnosis is essential. A few common anxiety disorders include:

  • Generalized anxiety disorder: A pattern of excessive worry about a variety of issues on most days for at least six months, often accompanied by physical symptoms, such as muscle tension, a hammering heart, or dizziness.
  • Social anxiety disorder: Feeling significant anxiety in social situations or when called on to perform in front of others, such as in public speaking.
  • Phobias: A particular animal, insect, object, or situation causes substantial anxiety.
  • Panic disorder: Panic attacks are sudden, intense episodes of heart-banging fear, breathlessness, and dread. “It’s the feeling you’d have if you just missed being hit by a Mack truck — but for people with panic disorder there is no Mack truck,” says Dr. Beresin.

The costs of anxiety

Constant anxiety levies a toll on health. For example, anxiety increases levels of the stress hormone cortisol, raising blood pressure, which contributes over time to heart problems, stroke, kidney disease, and sexual dysfunction. And a 2017 Lancet study using brain scans measured activity in an area called the amygdala, which mounts split-second responses to danger and encodes memories of frightening events. Greater activity in the amygdala correlated with higher risk for heart disease and stroke, possibly, the researchers speculated, by triggering immune system production of extra white cells to fight perceived threats. In people struggling with emotional stress, this might drive inflammation and plaque formation that leads to heart attacks and strokes.

Quality of life suffers, too. Intrusive thoughts, dread of panic attacks, intense self-consciousness and fear of rejection, and other hallmarks of anxiety disorders compel people to avoid anxiety-provoking situations. This interferes with relationships, work, school, and activities as people isolate themselves, turn down opportunities, and forgo possible joys in life.

There are effective treatments for anxiety

Treatment is tailored to the diagnosis. Effective options include:

  • Lifestyle changes, such as skipping caffeine, exercising regularly, and avoiding medicines or substances that might cause anxiety symptoms.
  • Mind-body approaches, such as deep breathing, meditation, mindfulness, and techniques to ease muscle tension and promote calm.
  • Psychotherapy, such as cognitive behavioral therapy (CBT) and exposure therapy. CBT teaches people to challenge and reframe distorted or unhelpful anxious thinking, because thoughts influence feelings and actions. Exposure therapy helps people tolerate and calm anxiety by gradually exposing a person to feared situations or objects under guidance from a therapist.
  • Medicines, such as short-acting drugs called benzodiazepines, which are taken as needed when anxiety spikes. Low doses of some antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), help relieve anxiety when taken daily.

Often, a combination of approaches is best. Relieving anxiety with medicine while using CBT or exposure therapy to strengthen coping skills and help retrain the brain can do much to make anxiety manageable.

Related Information: Anxiety and Stress Disorders

Comments:

  1. Sari

    Here are two research-based interventions for anxiety not mentioned in this article:

    Alpha Stim
    https://www.alpha-stim.com/alpha-stim-technology/anxiety/ – prescribed by physician, mental health clinician…

    CART( Capnometry-Assisted Respiratory Training) breathing – Respiratory Therapist referral from MD
    https://www.eurekalert.org/multimedia/pub/28252.php

  2. edwin van vliet

    Hey there,

    I love your article!!. I can relate to this and it’s comforting too.

    I’m a bit confused these days. I’m trying to get help for my social anxiety and see if there’re proper treatments for this.

    I see this video on youtube: https://youtu.be/axQx6JI9mjU

    And i was wondering if you could make an assessment if it’s any good? The site and video looks legit, but I’m a bit sceptical too.

    Would you do this for me. I’m a bit desperate if i didnt gave it away allready 😓

    Waiting for your reply. Thanks in advance.

    Edwin

  3. Joshua Miller

    I believe in meditation that can improve such kind of situation. I have read an article entitled “Meditation for Anxiety, Depression and ADD” at zovon.

  4. Joshua Miller

    I believe that meditation is one of the best way to overcome the anxiety. It promotes the calmness in the mind and relaxes the brain cells. Get more info at https://goo.gl/VDpxDf

  5. Gerardo Ruiz

    In your location there must be an expert in mindfulness. If not try the videos on you tube.

  6. Bob

    I am not sure if this is helpful but you kind of want to be a detective and try to figure out what may be causing the anxiety. If there is no emotional reason or event that seems to be the cause and it seems like a mystery you may want to look at diet https://www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441.. Lack of Vitamin D can be an issue and a GP can give you a blood test for that. Magnesium is considered to be very important and the amount you need various from person to person. A good magnesium supplement that I know does work quite well is Remag but it is not inexpensive but they do give helpful on-line support to people. They say that the gut is the “second brain” meaning that important brain chemicals that make you feel good are made here and so probiotics in the form of food eg. sauerkraut and natto and more expensive probiotic supplements may be beneficial. Anxiety can also be linked to the thyroid which a GP can check out and I would not underestimate exercise as it is key to most ailments and you can get good recommendations from Harvard on exercises.

    If it is caused by emotions or an event you could probably talk to someone or help groups who deal with this area and have expertise. As I understand it emotional issues are best dealt with by insight, thoughts and emotions. Much like a sore foot is not healed by eating chocolate or drinking beer though both may act as comfort and reduce the stress.

  7. Donna

    I suffer with anxiety, I take lorazepam for it.The er nurse put me on it after I had an anxiety attack and thought I was dying.After about One week of taking it I felt like I couldn’t catch my breath until I took a pill. I dont like having to take them but I also don’t want to wake up all of a sudden at 2am and can’t breathe, hence this is why I have been on them for six years.If you guys can come up with something that can help people like myself get off of these without having the scary withdrawals or even after stopping them getting the side effects also please let me know.I also take thyroid pills for hypothyroid which my doctor said the lorezepam caused.I would greatly appreciate any suggestions or anything new you all come out with. Thank you!

  8. cathy

    I have severe anxiety and depression, tried several meds nothing helps, tried cbd doesn’t help, tried medical marahuana it made anxiety worse, please help I feel like this is slowly killing me, I can’t sleep,can’t drive, I am embarrassed of myself, I had to give up a 69,000 a year job please someone help

  9. Linda D Everett

    This is all well and good. I was terrified of my ex he tried to kill me once and I was afraid of that. I couldn’t sleep or even function for about 2 years. . He then moved to another city. I was hooked on drugs and stayed that way for 30 years. No one noticed including the Drs. Prescribing them. Now at 70 I am off the drugs in therapy with a trauma therapist. Anxiety can really take away your life if you unaware.

  10. Bob

    What message you tell yourself is more powerful than what others tell you. The message can be repeated in your head many many times and faster than the spoken word. This kind of programming has to affect a person. But if fear is all it is, a shadow that follows you. But a shadow has no substance and has no life unless you give it some by encouraging it. Sometimes I think of fear as a bully and I hate bullies and won’t put up with them. We need to say “enough is enough” and not let fear bully us around. It’s advice to give and also to take. Life is for living not fearing and in the end we do the best we can as people and no more.

  11. Bella Dushner

    I have a depressive disorder for many years now. It started when my mom and dad got a divorce. And i am the only child so it’s really hard for me to accept it. Everyday i wake up i don’t know what will i do or should i continue my life. Luckily i have this friend who introduce me the CBD at first i don’t know what will be the effect of this. But i tried taking it and it really helps me a lot. I’m taking 100mg of CBD as well same as yours. So now i believe that CBD is the best solution.

  12. Betty

    I have suffered anxiety since I was a child! Fear of dying
    and self diagnosing myself with the worst diseases even to this age of 69! I can make myself so anxious that I cannot stay asleep at night! I wake up several times a night with the same lingering thought!
    Don’t want to take meds! How do you handle this type of anxiety?

  13. Beth Gomez

    Anxiety has been with me for many years i take duloxTine and do yoga and other exercise meditate last ar i nearly had a stroke now blood pressure tablets exercise diet meditation laughing help can it be partly genetic

  14. Connie b.

    I sure do wish I had a different body system – would love to have positive results from marijuana – but I end up with hallucinations, visual disturbances etc – not for me, sadly…..

  15. margaret alkire

    I’ve had “white coat syndrome” for a number of years and dread going to any doctor’s office with the exception, strangely, of my opthalmologist.
    I’ve tried everything mentioned in the blog post without success. I’m very afraid that if this continues, I will end up with multi-infarct dementia or worse. My blood pressure goes up in the range of 200/120, but comes down to 180/80 if I stay in the office long enough. My usual B/P at home (always taken with a cuff) is in the range of 110/60 to 120/78. My heart rate at home is 60 to 68. A holter monitor recently reported the same heart rate and was considered within normal limits. An echocardiogram revealed an aortic valve stenosis. The cardiologist diagnosed this as mild to below moderate and chose to monitor the condition. I’ve had a functional heart murmur since childhood. I suppose my question is: could this be an anxiety disorder or even an adrenal problem. I’m 73 and in otherwise good health. Thank you.

  16. Morton D Hurt

    I am 72 years old. Obviously my story is too long to tell. What I can say is that I have had a lifetime of suffering from anxiety. Yet, I have found a way over those 72 years to enjoy a rich and rewarding life. Two recent medical events have played major rolls in my success. Some 3 years ago I began taking Zoloft. Then in late 2017 I had a pacemaker implanted. The addition of the pacemaker has provided me for the first time a real life. As I say it’s amazing the positive effects blood and oxygen have on the functioning of ones brain not to mention all the other functions of the body. I’d be happy to share my story with anyone at Harvard Medical so perhaps others might benefit.

    I want to add when I had the pacemaker implanted the cardiologist noted I had a PFO. Looks like as luck would have it I am one of the few to have such feature.

  17. WFV

    My daughter, 14, has a nightly fear of death. It leads to anxiety and difficulty sleeping. I believe this is a common fear among teens, but I would like to kn ow how others have handled this anxiety.

  18. Geoff Stuart

    Where’s the fifth bullet under Treatments for Medical Marijuana? It would be courageous and quite helpful if you delved into the research on CBD usage in legal states. I don’t understand why you don’t even mention it as a possibility. Five years hence it will be standard at the pace things are going now. It can be an extremely helpful treatment, from my personal experience. In states where is has been legalized (NJ in my case), a patient must be under the care of a practitioner who has been licensed, and there are hundreds of them state-wide, before any product can be purchased.

  19. Roy Parker

    Learned a lot of important things

  20. Hung Luong

    In life, I often encounter this problem, I am often psychologically and anxious by the pressure of work as well as related issues make me tired. I am a business person with a quality that makes me feel anxious.

    Through this article I have learned a lot to minimize this situation. Thank you!

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