Anxiety
We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.
Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Meanwhile, approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21.
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Symptoms
Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People typically experience one or more of the following symptoms:
Emotional symptoms:
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Feelings of apprehension or dread
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Feeling tense or jumpy
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Restlessness or irritability
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Anticipating the worst and being watchful for signs of danger
Physical symptoms:
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Pounding or racing heart and shortness of breath
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Sweating, tremors and twitches
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Headaches, fatigue and insomnia
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Upset stomach, frequent urination or diarrhea
Treatment
Different anxiety disorders have their own distinct sets of symptoms. This means that each type of anxiety disorder also has its own treatment plan. But there are common types of treatment that are used.
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Psychotherapy, including cognitive behavioral therapy
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Medications, including anti-anxiety medications and antidepressants
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Complementary health approaches, including stress and relaxation techniques
Types of
Anxiety
There are many types of anxiety disorders, each with different symptoms. The most common types of anxiety disorders include:
Generalized Anxiety Disorder (GAD)
GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.
Social Anxiety Disorder
More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.
Panic Disorder
This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.
Phobias
We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.
Other anxiety disorders include:
- Agoraphobia
- Selective mutism
- Separation anxiety disorder
- Substance/medication-induced anxiety disorder, involving intoxication or withdrawal or medication treatment
Co-Occurring
Mental Illness
A co-occurring disorder refers to when one person has two or more mental health disorders or medical illnesses. These co-occurring disorders may overlap and begin at the same time, or one may appear before or after the other.
Medication
Guide
(Prescription, Experimental, &
Natural Herbs and Medicines)
Some people find that medication is helpful in managing an anxiety disorder. Talk with your health care provider about the potential benefits, risks and side effects.
Traditional Prescriptions:
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Anti-anxiety medications. Certain medications work solely to reduce the emotional and physical symptoms of anxiety. Benzodiazepines can be effective for short-term reduction of symptoms, but can create the risk of dependence when used for a long time. Be sure to review these potential risks if you select these medicines. Click here for more information on these medications.
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Antidepressants. Many antidepressants may also be useful for treating anxiety. These can also be useful if your anxiety has a co-occurring depression. Be sure to check our Medication page for more information.
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Pharmacologic interventions for anxiety include:
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Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs are used to treat anxiety, depression, panic disorder, fibromyalgia and back pain. They work by blocking or delaying the reuptake of serotonin and norepinephrine, which helps to improve your mood. Some SNRI brand names include Cymbalta, Pristiq, Effexor and Savella. Common side effects of these medications include dizziness, nausea, loss of appetite, sexual problems, constipation, weight loss, insomnia, headaches, dry mouth and agitation.
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Selective serotonin reuptake inhibitors (SSRIs): SSRIs are used to correct low serotonin levels in the brain. SSRIs are used to treat anxiety disorders and depression. Some examples of commonly prescribed SSRIs include Lexapro, Prozac, Zoloft and Celexa. Possible side effects of these medications include drowsiness, nausea, diarrhea, headache, sexual problems, agitation, dizziness, dry mouth, insomnia and blurred vision. In fact, research shows that approximately 30–50 percent of patients on SSRIs experience these kind of mild side effects. (4)
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Benzodiazepines: Benzodiazepines are used to enhance the effect of GABA, a neurotransmitter that reduces the activity of neurons that cause anxiety. Benzodiazepine drugs are used to treat anxiety, insomnia, alcohol withdrawal, pack attacks and seizures (due to their anticonvulsant properties). The most popular types of benzodiazepines include Xanax, Valium, Librium and Tranxene. These medications come with side effects like dizziness, headaches, blurred vision, sweating, trouble sleeping, impaired coordination, confusion and an increased risk of falling in elderly patients. (5) trad med for e.d.
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Hallucinogenic Therapy:
Several recent studies have shown strong evidence that natural and man-made hallucinogenics can be helpful in treating people with acute depression, PTSD and substance and alcohol dpendence. May studies have also shown that many forms of hallucingens, such as psylocibin, are non-addicting. Please consult with your doctor before moving forward with any hallucinogenic or other new or experimental medicine.
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Ketamine - Ketamine is a man-made hallucinogen that has been legally available and used for decades in US hospitals as an anesthesia. In the past few years, ketamine has gained more interest and usage as an effective treatment for suicidal depression and other forms of depression. Ketamine clinics, where ketamine is administered intraveniously, on-site are now operating in many States in the US. Ketamine differs from traditional antidepressants in its mechanism of action – it affects different brain systems, neurotransmitters, and neural pathways.
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Psychedelics -The natural, psychedelic substance psilocybin (derived from "magic mushrooms") is having a revival of interest as a potential therapy for major depression and for substance abuse. A number of clinical studies are currently underway at major universities, including Johns Hopkins, University of Michigan, NYU and UCLA, with some promising results that may lead to greater availability of this therapy. Psychedelic therapy is currently not legal in any State in the US other than Oregon, but it is legal in a number of countries outside of the US, including the Bahamas, Jamaica, the Netherlands and Portugal.
Natural Herbs and Medicines:
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Ashwagandha is used as a popular home remedy in India and it has shown promise in the reduction of anxiety
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Ginko is one of the best researched medicinal plants has also been found effective in the treatment of anxiety
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American skullcap is widely used for complaints involving an overactive nervous system such as insomnia, anxiety, and epilepsy.
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Lemon balm is mainly known as an anxiolytic (reduces anxiety), nootropic, anti-depressant, and carminative (reduces excess gas). Double-blind placebo-controlled human studies have shown positive results for lemon balm extracts in the improvement of mood, reduction of anxiety, and improvement of cognitive abilities.
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Minchex - It is said to help keep the nervous system healthy. The ingredients found in Min-Chex are said to induce a natural calming effect by exerting their individual influence on specific parts of the central nervous system.
Medical
Procedures
Vagus Nerve Stimulation (VNS)- VNS uses a pulse generator, about the size of a stopwatch, placed in the upper left side of the chest to stimulate the vagus nerve, which carries messages to parts of the brain that control mood and sleep, with electrical impulses.
Electroconvulsive Therapy (ECT)- ECT is a procedure where controlled electric currents are passed through the brain while the person is under general anesthesia. This results in a brief, controlled seizure that affects neurons and chemicals in the brain. It is most often used to treat severe depression and depression with psychosis that has not responded to medications.
Deep Brain Stimulus (DBS) - Deep brain stimulation is currently being studied as treatment for Tourette’s syndrome and major depression. DBS involves two electrodes put surgically directly in the brain and a pulse generator put in a person’s chest.
Transcranial Magnetic Stimulation (TMS) - TMS is a procedure that creates magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS should not be used to treat anyone experiencing depression with psychosis or bipolar disorder or having a high risk of suicide.
Systematic Treatment Enhancement- The NIMH-funded Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) is a long-term outpatient study designed to find out which treatments, or combinations of treatments, are most effective for treating episodes of depression and mania and for preventing recurrent episodes in people with bipolar disorder.
Alternative
Therapies
Additional
Resources
Support Programs
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The Support Network - Address and promote student mental health and well-being through peer support initiatives in high schools and colleges.
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The Jed Foundation - Protects emotional health and prevents suicide for our nation’s teens and young adults
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Peer-to-Peer - Depression awareness and suicide prevention education, training, and support for middle and high school students
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The Mighty - A community to share and interact with others going through mental health issues
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ReachOut - An Australian site dedicated to providing self-help information, peer-support program and referral tools for those suffering with a mental illness or having a tough time
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You Are Not Alone from NAMI - A forum for users to read and share their personal stories
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Stigma-Free Society - A resource for parents, guardians, and caregivers to talk to their teens about mental wellbeing
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The 7 Best Online Therapy and Mental Health Support Options for Teens for 2022
Blogs
Videos
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Nick Ortner’s Tapping Technique to Calm Anxiety & Stress in 3 Minutes
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How to Repair the Brain Through Healthy Living from Dr. Daniel Amen
Books
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The Anxiety and Depression Workbook: Simple, Effective CBT Techniques to Manage Moods and Feel Better Now by Michael A. Tompkins PhD ABPP
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The Listening Cure: Healing Secrets of an Unconventional Doctor
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Eat to Beat Depression and Anxiety by Drew Ramsey M.D.
Articles
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Relieving Anxiety: Meditation Neutralizes Thought Polarity from EOC Institute
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How Yoga Can Help Ease Anxiety and Panic Disorder Symptoms from Very Well Mind
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What It's Really Like to Struggle with Anxiety and Depression from The Independent
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The Benefits of Tai Chi - See how tai chi boost your health and wellbeing from VeryWell Health
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Friendship Bench—A Model for Accessible Mental Health Care from BrainBlogger.com
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Stress, Inflammation, and Microbes: A Moody Trinity Psychological stress leads to physical stress, anxiety, and depression.
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How Misreading Bodily Signals Causes Anxiety from BrainBlogger.com
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The Power of Positive Thinking from Harvard Health Publishing
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Little Treatments Show Big Promise for Youth Psychiatric Problems from MDEdge
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Quick Facts on Disruptive Mood Dysregulation Disorder (DMDD) from The Child Mind Institute
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The Relationship between the Physical Activity & Anxiety from the National Center for Biotechnological Information (NCBI)
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What is Cognitive Behavior Therapy? from Good Therapy
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How to Sleep: Cognitive Behavior Therapy for Insomnia from Psych Education
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What is Dialectical Behavior Therapy (DBT)? from Good Therapy
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What is Narrative Therapy? from Good Therapy
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Nutritional Psychiatry: The Gut-Brain Connection from Psychiatric Times
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Mental Illness: Brain Disease or Gut Disease? from Psychology Today
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I Was Paralyzed by Severe Depression. Then Came Ketamine from NYT OpEd
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Using Hallucinogens as Therapeutic Drugs from VeryWellMind
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Could the Embrace of Psychedelics Lead to a Mental-Health Revolution? from Vogue
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Peer-to-peer Counselors - Demand for college peer counselors is booming from NPR
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Pandemic leads colleges to revise, and improve mental health efforts from The Washington Post
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5 Reasons Group Therapy Is the Best Choice Struggling Teens from Psychology Today
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NAMI Applauds Key Mental Health Investments Made in FY 2022 Federal Budget
Websites
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HelpGuide - Trustworthy resources and content to help improve your mental health and make healthy changes.
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Moodgym - An online self-help program designed to help users prevent and manage symptoms of depression and anxiety which teaches skills based on cognitive behavior therapy
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Mental Health Online - Free self-help resources and therapist support
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ThisWayUp - Offers self-paced online courses that teach clinically-proven strategies to help you improve the way you feel
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myCompass - A personalized self-help tool for your mental health
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MindSpot - A digital mental health clinic
Podcasts
Handouts
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Information Sheets & Worksheets from The Centre for Clinical Interventions
Apps