Anxiety Attack/Anxiety Disorder

Anxiety can occur when a person fears that something bad is going to happen. It is a non-medical term that refers to a feeling of fear or worry that often relates to a particular issue or concern.

Anxiety has been linked to stress. As well as feelings of fear and worry, it often involves physical symptoms, such as muscle tension.

However, if levels of stress and anxiety continue for a long time, further problems may develop.

Symptoms

Common anxiety signs and symptoms include:

  • Feeling nervous, restless or tense
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly (hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Trouble concentrating or thinking about anything other than the present worry
  • Having trouble sleeping
  • Experiencing gastrointestinal (GI) problems
  • Having difficulty controlling worry
  • Having the urge to avoid things that trigger anxiety

Several types of anxiety disorders exist:

  • Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
  • Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
  • Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
  • Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
  • Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
  • Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
  • Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
  • 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.
  • Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
  • Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

Can anxiety lead to panic?

A person who has panic disorder may experience anxiety that they are going to have a panic attack. The uncertainty about if or when an attack is going to happen can lead to anxiety between attacks.

How are anxiety disorders diagnosed?

If you have symptoms of an anxiety disorder, talk to your healthcare provider. They’ll start with a complete medical history and physical examination.

There are no lab tests or scans that can diagnose anxiety disorders. But your provider may run some of these tests to rule out physical conditions that may be causing symptoms.

Who can diagnose anxiety disorders?

If your provider finds no signs of physical illness, they may refer you to a psychiatrist or psychologist. These mental health professionals specialize in diagnosing and treating mental illnesses. They may use specially designed interview and assessment tools to figure out if you have an anxiety disorder. Typically, the provider bases a diagnosis on:

  • Your reported symptoms, including how intense they are and how long they last.
  • Discussion of how the symptoms interfere with your daily life.
  • The provider’s observation of your attitude and behavior.

Providers also consult the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The American Psychiatric Association publishes the DSM-5. It’s the standard reference manual for diagnosing mental illnesses.

How are anxiety disorders treated?

An anxiety disorder is like any other health problem that requires treatment. You can’t will it away. It’s not a matter of self-discipline or attitude. Researchers have made a lot of progress in the last few decades in treating mental health conditions. Your healthcare provider will tailor a treatment plan that works for you. Your plan may combine medication and psychotherapy.

How does medication treat anxiety disorders?

Medications can’t cure an anxiety disorder. But they can improve symptoms and help you function better. Medications for anxiety disorders often include:

  • Anti-anxiety medications, such as benzodiazepines, may decrease your anxiety, panic and worry. They work quickly, but you can build up a tolerance to them. That makes them less effective over time. Your healthcare provider may prescribe an anti-anxiety medication for the short-term, then taper you off or the provider may add an antidepressant to the mix.
  • Antidepressants can also help with anxiety disorders. They tweak how your brain uses certain chemicals to improve mood and reduce stress. Antidepressants may take some time to work, so be patient. If you feel like you’re ready to stop taking antidepressants, talk to your provider first.
  • Beta-blockers, usually used for high blood pressure, can help reduce some of the physical symptoms of anxiety disorders. They can relieve rapid heartbeat, shaking and trembling.

Your healthcare provider will work with you to find the right medication combination and dosage. Don’t change the dose without consulting your provider. They’ll monitor you to make sure the medicines are working without causing negative side effects.

How does psychotherapy treat anxiety disorders?

Psychotherapy, or counseling, helps you deal with your emotional response to the illness. A mental health provider talks through strategies to help you better understand and manage the disorder. Approaches include:

  • Cognitive behavioral therapy (CBT) is the most common type of psychotherapy used with anxiety disorders. CBT for anxiety teaches you to recognize thought patterns and behaviors that lead to troublesome feelings. You then work on changing them.
  • Exposure therapy focuses on dealing with the fears behind the anxiety disorder. It helps you engage with activities or situations you may have been avoiding. Your provider may also use relaxation exercises and imagery with exposure therapy.

What happens if I don’t get treatment for my child with an anxiety disorder?

Getting your child help for an anxiety disorder can improve their development and self-esteem. But untreated anxiety disorders can harm:

  • Family relationships.
  • School performance.
  • Social functioning.

Your child may also end up with more serious mental and physical health problems. Fortunately, there are several treatments for anxiety disorders. The right treatment can help your child manage their symptoms and feel their best.

PREVENTION

Can anxiety disorders be prevented?

You can’t prevent anxiety disorders. But you can take steps to control or reduce your symptoms:

  • Check out medications: Talk to a healthcare provider or pharmacist before taking over-the-counter medications or herbal remedies. Some of these contain chemicals that may make anxiety symptoms worse.
  • Limit caffeine: Stop or limit how much caffeine you consume, including coffee, tea, cola and chocolate.
  • Live a healthy lifestyle: Exercise regularly and eat a healthy, balanced diet.
  • Seek help: Get counseling and support if you experienced a traumatic or disturbing event. Doing so can help prevent anxiety and other unpleasant feelings from disrupting your life.

OUTLOOK / PROGNOSIS

What’s the outlook for people with anxiety disorders?

Anxiety disorders can often go undiagnosed and untreated. Fortunately, treatment can help. The right treatment can help improve your quality of life, relationships and productivity. It can also support your overall well-being.

You don’t need to live with constant worry and fear. If you notice symptoms of an anxiety disorder, talk to your healthcare provider. It’s best to get diagnosed and treated as soon as possible. Doing so can limit the problems that anxiety disorders can cause. Often, a combination of medications and counseling for anxiety can help you feel your best.

LIVING WITH ANXIETY

How can I best cope with an anxiety disorder?

There are several steps you can take to cope with anxiety disorder symptoms. These strategies can also make your treatment more effective:

  • Explore stress management: Learn ways to manage stress, such as through meditation.
  • Join support groups: These groups are available in-person and online. They encourage people with anxiety disorders to share their experiences and coping strategies.
  • Get educated: Learn about the specific type of anxiety disorder you have so you feel more in control. Help friends and loved ones understand the disorder as well so they can support you.
  • Limit or avoid caffeine: Many people with anxiety disorder find that caffeine can worsen their symptoms.
  • Talk to your healthcare provider: Your provider is your partner in your care. If you feel like treatment isn’t working or have questions about your medication, contact your provider. Together, you can figure out how to best move forward.

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