Anxiety, Generalized Anxiety Disorder & Panic Disorder
What Is Anxiety?
Everyone worries from time to time. Occasional anxiety can be caused by worries about finances, employment, health concerns, relationship issues, or other major life events. These feelings are normal and temporary – as the situation changes, the anxiety lessens.
Anxiety can be helpful as a protective response to stress and threats. Anxiety is a normal response to things that are terrifying, threatening our safety, well-being, or the safety and well-being of others. Having times of heightened worry, physical feelings of anxiety, or even a panic attack is a common, normal part of the human experience. It is not a disorder to just experience anxiety feelings. But when those worries persist or become uncontrollable, you may be experiencing anxiety disorder.
What is an Anxiety Disorder?
Anxiety disorders are defined as excessive anxiety symptoms out of proportion to the situation, that cause significant functional impairment for a prolonged length of time. Depending on the type of anxiety disorder, for 6 months or longer.
Anxiety is an excessive and persistent fear or worry about common situations. It can often be accompanied by sudden, intense episodes of high levels of fear, worry, or terror that are uncontrollable, known as panic attacks. Often anxiety disorders involve an element of fear about anxiety, or fear of having anxiety.
Anxiety may fixate on a specific situation or person, or it may be generalized to a broad category of situations, such as taking public transportation. While it is normal to be concerned about a loved one dealing with a health issue, for example, a person experiencing anxiety elevates that concern far out of proportion to the severity of the health issue, often escalating to worst case scenarios and then fixating on those scenarios and constantly replaying them over and over.
Anxiety disorders are the most common mental health conditions in the U.S. They affect about 40 million people, and it is estimated that nearly 30 percent of adults will experience an anxiety disorder at some point. Source
What Causes Anxiety?
We have much to learn about anxiety. We still don’t know the exact cause of anxiety disorders, but researchers suspect a combination of factors are involved. Those factors include genetic, environmental, psychological and developmental causes. Source
Anxiety disorders do tend to run in families, so there is a hereditary predisposition for anxiety. It is possible that the genetic tendency is present as an inherited trait but requires a second contributing factor to activate.
Experiencing trauma, either directly or being a witness to a traumatic event, can trigger anxiety disorders. Other environmental factors include our workplace, housing, surrounding community, and support systems.
Severe or long-lasting stress can lead to the development of anxiety disorders, depression, or other mental health problems.
Our upbringing, family structure, and relationships can all contribute to developing anxiety disorders. Unhealthy relationships can be the cause of several mental health issues, including anxiety.
Types of Anxiety
Generalized anxiety disorder
Generalized anxiety disorder (GAD) is a persistent feeling of anxiety, excessive worry, or dread. What distinguishes GAD from normal worry is that the level of worry is greatly exaggerated relative to the cause for concern. GAD is also characterized by the length of time it persists. People dealing with GAD experience excessive anxiety for many months, if not years.
Symptoms of GAD:
- Feeling restless, wound-up, or on-edge
- Fatigue and exhaustion caused by the excessive mental strain of constant worry
- Difficulty concentrating
- Headaches, muscle aches, stomach aches, or other unexplained pains
- Persistent feelings of worry
Panic disorder is responsible for frequent and unexpected panic attacks. The attacks can appear out of nowhere, even when there is no clear danger or trigger. Panic attacks bring sudden, intense feelings of fear, discomfort, unease, or a sense of being out of control.
Symptoms of a panic attack:
- Pounding or racing heart
- Feelings of impending doom
- Feelings of being out of control
- Chest pain
People with panic disorder typically worry about a panic attack hitting during an embarrassing moment, such as at work or when out in public. They may actively try to prevent future attacks by avoiding places, situations, or behaviors they believe could trigger a panic attack. This avoidance behavior can cause social isolation, prevent career advancement, and inhibit the person’s overall quality of life.
Social anxiety disorder
Social anxiety disorder is an intense, persistent fear of being watched and judged by others. For people experiencing social anxiety disorder, social situations may be unbearable due to the uncomfortable feeling of constantly being watched.
People with social anxiety disorder may also worry that any unusual actions or behaviors associated with their anxiety will be harshly judged by others, causing them to feel even more embarrassed, watched, and judged by others. This persistent worry often causes people with social anxiety to avoid social situations altogether. This avoidance behavior can have a negative impact on interpersonal relationships, work situations, career advancement, or educational opportunities.
Symptoms of social anxiety disorder:
- Feelings of self-consciousness or fear that people will judge them negatively
- Difficulty making eye contact or being around people they don’t know
- Intense dislike of social gatherings
- Blushing, sweating, or trembling
- Pounding or racing heart
- Rigid body posture or speaking with an overly soft voice
How Anxiety Interferes With Life
People experiencing anxiety disorders of all types suffer serious, negative impact from their disorder. These negative impacts can damage relationships, harm careers, and reduce the person’s own feelings of self-worth. Common impacts include:
Avoidance behavior – The desire to avoid public places, social events, or other situations that may trigger a panic attack or induce social anxiety disorder. Even gatherings of close friends or family members could potentially trigger an episode, so the person tends to withdraw socially and professionally from such events.
Social awkwardness – If avoidance is not possible (a mandatory work event, for example), the person may demonstrate social awkwardness, causing other people to form a negative impression of the person’s social skills, intelligence, or suitability for promotion within a company.
Embarrassment – A person dealing with anxiety disorders may experience intense embarrassment as a result of a panic attack that happens in a public situation. The person often relives the embarrassment over and over, further adding to their panic disorder.
Inability to take positive action – Anxiety disorders can prevent people from taking positive actions in life, such as moving to a new city for career advancement, starting a new relationship, or asking for a raise or job promotion. Avoidance of social situations can also result in the loss of opportunities that would otherwise be available if the person were able to attend.
Treatments for Anxiety
Treatment of anxiety disorders should include evidence-based psychotherapy such as Cognitive Behavioral Therapy, Acceptance and Commitment therapy or trauma-informed therapies for trauma-based anxiety disorders. A key component of all of these therapies in psychoeducation about the natural anxiety response and an element of gradual exposure to the feared stimuli (if safe), with support of how to use coping skills to manage stress. Increasing a person’s knowledge of their own physical response to anxiety, and what helps to increase relaxation, take hold of one’s attention and change what you are focusing on, are all helpful tools to managing anxiety symptoms.
A psychiatrist can prescribe antidepressant medication, which also help alleviate anxiety by increasing the levels of serotonin in the brain, which regulates anxiety. A psychiatrist or psychiatric mental health nurse practitioner at Ampelis Health can identify the best medication to treat your anxiety.
TMS, or Transcranial Magnetic Stimulation, treats anxiety by improving the function of neural pathways in the brain. TMS is a safe, effective treatment delivered in a psychiatrist’s office and is used to treat mental disorders like depression and anxiety. Although TMS has shown impressive results with anxiety, TMS has not yet been cleared by the FDA for treating anxiety as a primary diagnosis, which limits its coverage by insurance. You can still receive TMS therapy for anxiety on a cash pay basis, or you may be approved for insurance coverage of TMS if you also suffer from an approved primary diagnosis, such as depression, anxious depression, or OCD.
Fear and worry are two of the persistent hallmarks of anxiety. Through personalized coaching, patients suffering from anxiety learn how to overcome fear through healthy habits, mindfulness, and new ways of addressing situations.
While coaching is not a treatment for anxiety disorders, it can be a helpful tool to make behavior changes and form habits that promote a healthy lifestyle. Ampelis Coaching helps extend the benefit of psychiatric treatments, such as TMS, into a continuous, lifelong pattern of growth and healing.
Which Treatment is Best for Anxiety?
The best treatment for anxiety will depend on the type of anxiety disorder you have, and what treatments will fit best for your personal situation. Visiting with a psychiatrist or psychiatric mental health nurse practitioner at Ampelis Health is the best way to receive a complete and accurate diagnosis and to develop a treatment plan that will work best for you.