What Is Anxiety?
Liam had always looked out for his younger brother Sam. But
whenever Sam took the late bus after soccer practice, Liam worried
about him so much he couldn't concentrate on his homework. Liam
watched the clock, worrying and imagining the worst - picturing bus
accidents and fearing, for no particular reason, that Sam might be
injured or dead. Only when Sam arrived home safe could Liam finally
It's completely normal to worry when things get hectic and
complicated. But if worries become overwhelming, you may feel that
they're running your life. If you spend an excessive amount of
time feeling worried or nervous, or you have difficulty sleeping
because of your anxiety, pay attention to your thoughts and
feelings. They may be symptoms of an anxiety problem or
Anxiety is a natural human reaction that involves mind and body.
It serves an important basic survival function: Anxiety is an alarm
system that is activated whenever a person perceives danger or
When the body and mind react to danger or threat, a person feels
physical sensations of anxiety - things like a faster heartbeat and
breathing, tense muscles, sweaty palms, a queasy stomach, and
trembling hands or legs. These sensations are part of the
body's fight-flight response. They are caused by a rush of
adrenaline and other chemicals that prepare the body to make a
quick getaway from danger. They can be mild or extreme.
The fight-flight response happens instantly when a person senses
a threat. It takes a few seconds longer for the thinking part of
the brain (the
) to process the situation and evaluate whether the threat is real,
and if so, how to handle it. If the cortex sends the all-clear
signal, the fight-flight response is deactivated and the nervous
system can relax.
If the mind reasons that a threat might last, feelings of
anxiety might linger, keeping the person alert. Physical sensations
such as rapid, shallow breathing; a pounding heart; tense muscles;
and sweaty palms might continue, too.
Everyone experiences feelings of anxiety from time to time.
Anxiety can be described as a sense of uneasiness, nervousness,
worry, fear, or dread of what's about to happen or what might
happen. While fear is the emotion we feel in the presence of
threat, anxiety is a sense of anticipated danger, trouble, or
Feelings of anxiety can be mild or intense (or anywhere in
between), depending on the person and the situation. Mild anxiety
can feel like a sense of uneasiness or nervousness. More intense
anxiety can feel like fear, dread, or panic. Worrying and feelings
of tension and stress are forms of anxiety. So are stage fright and
the shyness that can come with meeting new people.
It's natural for new, unfamiliar, or challenging situations
to prompt feelings of anxiety or nervousness. Facing an important
test, a big date, or a major class presentation can trigger normal
anxiety. Although these situations don't actually threaten a
person's safety, they can cause someone to feel
"threatened" by potential embarrassment, worry about
making a mistake, fitting in, stumbling over words, being accepted
or rejected, or losing pride. Physical sensations - such as a
pounding heart, sweaty hands, or a nervous stomach - can be part of
normal anxiety, too.
Because anxiety makes a person alert, focused, and ready to head
off potential problems, a little anxiety can help us do our best in
situations that involve performance. But anxiety that's too
strong can interfere with doing our best. Too much anxiety can
cause a person to feel overwhelmed, tongue-tied, or unable to do
what they need to do.
Anxiety disorders are mental health conditions that involve
excessive amounts of anxiety, fear, nervousness, worry, or dread.
Anxiety that is too constant or too intense can cause a person to
feel preoccupied, distracted, tense, and always on alert.
Anxiety disorders are among the most common mental health
conditions. They affect people of all ages - including adults,
children, and people in their teens. There are many different types
of anxiety disorders, with different symptoms. They all have one
thing in common, though: Anxiety occurs too often, is too strong,
is out of proportion to the present situation, and affects a
person's daily life and happiness.
Symptoms of an anxiety disorder can come on suddenly, or
they can build gradually and linger until a person begins to
realize that something is wrong. Sometimes anxiety creates a sense
of doom and foreboding that seems to come out of nowhere. It's
common for those with an anxiety disorder to not know what's
causing the emotions, worries, and sensations they have.
Different anxiety disorders are named to reflect their specific
With this common anxiety disorder, a person worries excessively
about many things. Someone with generalized anxiety may worry
excessively about school, the health or safety of family members,
and the future. They may always think of the worst that could
Along with the worry and dread, people with generalized anxiety
have physical symptoms, such as chest pain, headache, tiredness,
tight muscles, stomachaches, or vomiting. Generalized anxiety can
lead a person to miss school or avoid social activities. With
generalized anxiety, worries can feel like a burden, making life
feel overwhelming or out of control.
Obsessive compulsive disorder (OCD).
For a person with OCD, anxiety takes the form of obsessions (bad
thoughts) and compulsions (actions that try to relieve
These are intense fears of specific situations or things
that are not actually dangerous, such as heights, dogs, or flying
in an airplane. Phobias usually cause people to avoid the things
they are afraid of.
Social phobia (social anxiety).
This intense anxiety is triggered by social situations or
speaking in front of others. An extreme form called
causes some kids and teens to be too fearful to talk at all in
These episodes of anxiety can occur for no apparent reason. With
a panic attack, a person has sudden and intense physical symptoms
that can include a pounding heart, shortness of breath,
dizziness, numbness, or tingling feelings causes by overactivity
of the body's normal fear response.
is an intense fear of panic attacks that causes a person to avoid
going anywhere a panic attack could possibly occur.
Posttraumatic stress disorder (PTSD).
This type of anxiety disorder results from a traumatic or
terrifying past experience. Symptoms include flashbacks,
nightmares, or constant fear after the fact.
How Anxiety Disorders Affect People
For people dealing with anxiety disorders, symptoms can feel
strange and confusing at first. For some, the physical sensations
can be strong and upsetting. For others, feelings of doom or fear
that can happen for no apparent reason can make them feel scared,
unprotected, and on guard. Constant worries can make a person feel
overwhelmed by every little thing. All this can affect
someone's concentration, confidence, sleep, appetite, and
People with anxiety disorders might avoid talking about their
worries, thinking that others might not understand. They may fear
being unfairly judged, or considered weak or scared. Although
anxiety disorders are common, people who have them may feel
misunderstood or alone.
Some people with anxiety disorders might blame themselves. They
may feel embarrassed or ashamed, or mistakenly think that anxiety
is a weakness or a personal failing. Anxiety can keep people from
going places or doing things they enjoy.
The good news is, doctors today understand anxiety disorders
better than ever before and, with treatment, a person can feel
What Causes Anxiety Disorders?
Experts don't know exactly what causes anxiety disorders.
Several things seem to play a role, including genetics, brain
biochemistry, an overactive fight-flight response, stressful life
circumstances, and learned behavior.
Someone with a family member who has an anxiety disorder has a
greater chance of developing one, too. This may be related to
that can affect brain chemistry and the regulation of chemicals
called neurotransmitters. But not everyone with a family member who
has an anxiety disorder will develop problems with anxiety.
Things that happen in a person's life can also set the stage
for anxiety disorders. Frightening traumatic events that can lead
to PTSD are a good example.
Growing up in a family where others are fearful or anxious can
"teach" a child to view the world as a dangerous place.
Likewise, if a person grows up in an environment that is actually
dangerous (if there is violence in the child's family or
community, for example), he or she may learn to be fearful or
expect the worst.
Although everyone experiences normal anxiety in certain
situations, most people - even those who experience traumatic
situations - don't develop anxiety disorders. And people who
develop anxiety disorders can get relief with proper treatment and
care. They can learn ways to manage anxiety and to feel more
relaxed and at peace.
How Are Anxiety Disorders Treated?
Anxiety disorders can be treated by mental health professionals,
or therapists. A therapist can look at the symptoms someone is
dealing with, diagnose the specific anxiety disorder, and create a
plan to help the person get relief.
A particular type of talk therapy called cognitive-behavior
therapy (CBT) is often used. In CBT, a person learns new ways to
think and act in situations that can cause anxiety, and to manage
and deal with stress. The therapist provides support and guidance
and teaches new coping skills, such as relaxation techniques or
breathing exercises. Sometimes, but not always, medication is used
as part of the treatment for anxiety.
What to Do
Getting the problem treated can help a person feel like himself
or herself again - relaxed and ready for the good things in life.
Someone who might be dealing with an anxiety disorder should:
Tell a parent or other adult about physical sensations,
worries, or fears.
Because anxiety disorders don't go away unless they are
treated, it's important to tell someone who can help. If a
parent doesn't seem to understand right away, talk to a
school counselor, religious leader, or other trusted adult.
Get a checkup.
See a doctor to make sure there are no physical conditions that
could be causing symptoms.
Work with a mental health professional.
Ask a doctor, nurse, or school counselor for a referral to
someone who treats anxiety problems. Finding out what's
causing the symptoms can be a great relief.
Get regular exercise, good nutrition, and sleep.
These provide your body and brain with the right fuel and time to
Try to stay patient and positive. It can take time to feel
better, and courage to face fears. But letting go of worry allows
space for more happiness and fun.
D'Arcy Lyness, PhD
Date reviewed: November 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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