What is anxiety?

Anxiety is a feeling of fear, tension, or worry that occurs as a response to real or perceived threats.
When a person feels afraid, it triggers the body’s stress response, also known as fight, flight, or freeze. This can involveTrusted Source cognitive, physical, and behavioral changes, such as an increase in heart rate or breathing.
This response can help humans escape or avoid danger by supplying more oxygen and blood to the muscles. However, people can also feel anxiety about things that are not dangerous, such as:

Symptoms of anxiety

The main symptom of anxiety is a feeling of worry. Other symptoms can include:

Types of anxiety

The Diagnostic and Statistical Manual of Mental Health Disorders: 5th Edition, text revision (DSM-5-TR) includes several distinct anxiety disorders.
In previous editions of the DSM-5-TR, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and acute stress disorder also fell into this category. However, as of 2013Trusted Source, the manual no longer groups these diagnoses together.
The anxiety disorders are as follows:

• Generalized anxiety disorder (GAD) :
  People with GAD have persistent, pervasive feelings of anxiety or dread that do not have a specific focus. It is not a responseTrusted Source to a stressful situation that then goes away once it is over, but a general feeling of worry that may affect many aspects of everyday life.
  A person with GAD may worry about lots of things, and find it difficult to relax or get to sleep.
  
• Panic disorder
  People with panic disorder experience frequentTrusted Source and unexpected panic attacks. A person may have specific triggers, or they may not know the cause.
  
• Specific phobia
  Specific phobias are a fear of a particular object or situation, such as heights or spiders. Unlike other anxiety disorders, phobias focus on one specific trigger. A person with a phobia might know their fear is illogical or extreme, but remain unable to control it when they encounter the trigger.
  
• Agoraphobia
  This is a fear and avoidance of places, events, or situations from which it may be difficult to escape, or where help would not be available in emergencies. People often misunderstand this condition as a phobia of open spaces or the outdoors, but this is not the case. Some common situations a person with agoraphobia may be scared of include:
  using elevators
  using public transport
  leaving home, in some cases
  
• Social anxiety disorder
  Social anxiety is a fear of negative judgment from others. A person with social anxiety may feel others are evaluating everything they do, or that they will be embarrassed or humiliated if they interact with people. This can cause a person to avoid social interaction, or only certain types of interaction, such as talking with strangers. Additional signs of social anxiety can includeTrusted Source:
  intense self-consciousness
  finding it difficult to make eye contact
  speaking in a quiet or soft voice
  feeling as though the mind has “gone blank” in social situations
  
• Separation anxiety disorder
  Separation anxiety is when a person feels anxious after separating from a place or person that makes them feel safe, such as a parent. Separation anxiety is most commonTrusted Source in young children but can affect people of all ages.
  

Causes of anxiety

Occasional anxiety is often a response to uncertainty about the future or worry about something that happened in the past. For example, a person may feel anxious about taking a test, or worry they have made a decision they might regret. The causes of anxiety disorder are more complex and can involve several factors. The United Kingdom charity, Mind, lists several psychological factors:

• Current situation:
  Life events that cause ongoing stress may contribute to the development of an anxiety disorder. Examples of these include financial struggles, being under pressure at work, or experiencing discrimination.
• Past trauma:
  Traumatic events are incidents that cause an actual or perceived threat to a person’s safety. Even if these events happened a long time ago, they can still affect people years later.
• Substance use:
  Some substances, such as stimulant drugs, can cause anxiety. Other substances may cause anxiety when a person experiences withdrawal.
  

Some physical factors include:

• Brain structure or function:
  People with anxiety disorders may haveTrusted Source a heightened amygdala response. The amygdala is part of the brain that responds to danger.
• Genetics:
  Some people may have a genetic predisposition toward anxiety.
• Medical factors:
  Sometimes, anxiety is the product of a physical illness, such as a neurological disorder or hormonal imbalance. It can also be a side effect of some medications, or a result of experiencing long-term pain or other symptoms.

Treatment for anxiety

Treatment often consistsTrusted Source of psychotherapy, medication, or a combination of both. Sometimes other conditions, such as PTSD or substance use disorders, may require treatment before the anxiety can be addressed.

• Self-careSometimes, a person can ease anxiety at home without clinical supervision. Things that may help a person cope include:
  
  relaxation techniques
  physical exercise
  getting enough sleep
  reducing the use of caffeine or other stimulants
  talking with a trusted loved one
However, this may only be effective for mild or short-term anxiety. Those with more severe or ongoing anxiety may benefit from combining these strategies with therapy or medication.
• PsychotherapyA first-line treatment for anxiety is psychotherapy, or talk therapy. There are many types of talk therapy. Each one aims to help a person understand the thoughts, beliefs, or experiences that may be contributing to persistent anxiety, and ways of changing or coping with them. Some examples include:
  cognitive behavioral therapy
  acceptance and commitment therapy
  exposure therapy
  psychodynamic therapy
  There are also distinct forms of therapy that can help children, people who have a history of trauma, or people with specific types of anxiety disorder.
• Medications
  Some medications can reduce the symptoms of anxiety, making the condition more manageable. Some people take medications to make it easier to begin therapy, while others may take them on an ongoing basis. Some examples of medications a doctor may suggest include:
  Antidepressants:
  Some antidepressants can help with anxiety, even though they also target depression. Serotonin reuptake inhibitors, fluoxetine, and citalopram are examples. They take several weeksTrusted Source to begin working.
  Beta-blockers:
  These drugs do not stop anxiety, but they do reduce the physical symptoms associated with it, such as a rapid heartbeat. People can take them over a short period of time, or only occasionally for anxiety-inducing situations.
  Benzodiazepines:
  These drugs act immediately to reduce anxiety, but they can quickly cause dependence or addiction. As a result, doctors only prescribe them for short-term use. Diazepam, or Valium, is a common benzodiazepine.
  Some drugs work better for certain types of anxiety than others, so people should work with a knowledgeable mental health professional to find what works for them. It is important to note that some of these drugs can cause side effects, including a worsening of anxiety, when a person starts taking them. It may take several months for this to subside. Seek medical advice if the adverse effects of any prescribed medications become severe.

Preventing anxiety

• It is not always possible to prevent anxiety entirely. Many people experience anxiety when they are going through a challenging time. However, researchers have suggested that building resilience to stress may reduce the likelihood of anxiety disorders. A 2020 review of past research highlighted several strategies that may help to reduce the risk by affecting a person’s gene activity, such as:
• getting regular exercise
• practicing mindfulness
• having a supportive family environment
This research is still in its early stages, though. Other strategies that may help include:

• reducing caffeine intake
• maintaining a balanced, nutritious diet
• keeping a regular sleep pattern
• avoiding alcohol, cannabis, and other recreational drugs
• checking with a health professional before using
• over-the-counter medicines or herbal remedies

Symptoms and Causes of Stress

How does stress affect the body?
Your body’s autonomic nervous system controls your heart rate, breathing, vision changes and more. Its built-in stress response — the “fight-or-flight response” — helps your body face stressful situations. When you have long-term (chronic) stress, continued activation of the stress response causes wear and tear on your body. You may develop stress symptoms that are physical, psychological or behavioral.

• Physical symptoms
• Aches and pains.
• Chest pain or a feeling like your heart is racing.
• Exhaustion or trouble sleeping.
• Headaches, dizziness or shaking.
• High blood pressure (hypertension).
• Muscle tension or jaw clenching.
• Stomach or digestive problems.
• Psychological symptoms
• Anxiety or irritability.
• Depression.
• Panic attacks.
• Sadness.
• Behavioral symptoms
• Alcohol use disorder.
• Gambling disorder.
• Overeating or developing an eating disorder.
• Participating compulsively in sex, shopping or internet browsing.
• Smoking.
• Substance use disorder.

What causes stress?

Stress is how your body reacts to a change or challenge, and many different things can lead to it. Stressors can also be positive or negative. For instance, getting a new job or losing a job can both cause stress. Other causes of stress include:

• An illness or death of a loved one.
• Marriage, separation or divorce.
• Financial issues.
• Moving to a new house.
• Going on vacation.
• Having a baby.
• Retiring.

• Getting ready for a work presentation.
• aving an argument with a friend or loved one.
• Needing to get a lot completed in a short amount of time.
• Experiencing many small problems all at once, like getting in a traffic jam, spilling coffee all over yourself and running late.

Management and Treatment

How can I relieve stress?
You can’t avoid stress. But you can stop it from becoming overwhelming by practicing some daily stress relief strategies:

• Stress management starts with feeling good physically. Try getting some form of physical activity when you feel symptoms of stress coming on. Even a short walk can boost your mood.
• At the end of each day, take a moment to think about what you’ve accomplished — not what you didn’t get done.
• Set goals for your day, week and month. Narrowing your view can help you feel more in control of the moment and long-term tasks.
• Consider talking to a therapist or a healthcare provider about your worries.

Prevention Stress

How can I prevent or reduce stress?

• Try relaxation activities, like meditation, yoga, tai chi, breathing exercises and muscle relaxation. Programs are available online, in smartphone apps, and at many gyms and community centers.
• Take good care of your body each day. Eating right, participating in physical activity and getting enough sleep can help your body handle stress much better..
• Stay positive and practice gratitude, acknowledging the good parts of your day or life.
• Accept that you can’t control everything. Find ways to let go of worry about situations you can’t change.
• Learn to say “no” to additional responsibilities when you’re too busy or stressed.
• Stay connected with people who keep you calm, make you happy, provide emotional support and help you with practical things. A friend, family member or neighbor can become a good listener or share responsibilities so stress doesn’t become overwhelming.

A note from Health Ed Pro

It’s natural to have stress sometimes. You slept in, your shirt’s wrinkly and you’re going to be late for that job interview — now, you feel stressed. But long-term stress can cause physical, emotional and behavioral symptoms. It’s important to get control over your chronic stress because it can lead to other health issues. If symptoms of stress aren’t going away with stress relief techniques and if you’re feeling overwhelmed, talk to a healthcare provider.