Anxiety As a Symptom

Key Takeaways

• Anxiety disorders involve intense, persistent worry that causes dysfunction across multiple areas within an individual’s life.

• Physical symptoms accompany clinical anxiety, most commonly featuring a racing heartbeat, shortness of breath, and a churning stomach.

• Psychiatric treatment includes therapy, medication, or a combination of both, tailored to individual requirements.

Understanding Anxiety

Everyone experiences anxiety from time to time, but for those with anxiety disorders, feelings of fear and worry are frequently intense and overwhelming. These emotions are usually accompanied by physical symptoms such as a pounding heart or shortness of breath, as well as a variety of behavioral and psychological reactions. ^[1]

There are nine different types of anxiety disorders listed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), along with two categories for other specified and unspecified anxiety. According to the World Health Organization, anxiety disorders are the most common mental health conditions globally, impacting nearly 360 million people in 2021.^[1][2]

Anxiety disorders tend to develop gradually and typically emerge in early adulthood, though the condition can occur at any age. Women are more at risk of developing the disorder than men, with some affected during pregnancy or the initial period after giving birth. It is important to note that symptoms of anxiety may vary over time and often intensify during periods of stress.^[3]

Anxiety disorders can be hard to manage and persist for long periods if left untreated. Like other psychiatric disorders, anxiety can disrupt daily functionality and negatively affect relationships, social interactions, and performance at school or work. Fortunately, with appropriate treatment, individuals with anxiety disorders can learn to manage their symptoms and find relief.^[1][3]

Anxiety vs. Stress

The term “anxiety” is often used to describe a state of stress, but anxiety disorders are far more serious and defined by their impact on a person’s ability to function. In light of this, while it is normal for everyone to experience feelings of worry from time to time, for those with an anxiety disorder, these concerns are more frequent, intense, and often disproportionate to reality.^[3]

Anxiety can create a constant sense of being unsafe, along with an irrational dread of the future that interferes with a person’s perception of life to the point where relationships or work are negatively affected. Unlike typical stress or occasional worry, extreme anxiety tends to be accompanied by physical symptoms and can persist for months or even years.^[3]

What Anxiety Can Feel Like

Depending on an anxiety disorder’s level of severity, not all individuals with anxiety live in a permanent state of excessive stress. Still, many become consumed with fear anywhere from several times a day to several times a week. Anxiety can completely overwhelm a person with fear-based thoughts that are not supported by evidence, but feel like a certain probability.

Anxiety differs based on the type of disorder a person is living with. For example, those with social anxiety may fear judgment or public humiliation so intensely that they are unable to think clearly or speak within group interactions due to extreme bodily fear responses, such as physical trembling or a pounding heartbeat.

Signs of Anxiety

While the signs of anxiety differ from disorder to disorder, according to the DSM-5, the following symptoms are the most prominent features of the nine anxiety-related conditions: ^[2]

• Excessive uncontrollable anxiety.

• Persistent fear related to events, people, or stimuli.

• Intense worry and spiraling thoughts surrounding negative events in the future that may not occur.

• Reluctance or refusal to participate in essential activities (eg, leaving home, attending school or work, or engaging socially).

• Fear of being alone or without support figures.

• Difficulty speaking in certain social situations.

• Fear of negative evaluation, embarrassment, or humiliation.

• Repeated distress or panic when exposed to perceived threat.

• Persistent concern related to future panic attacks or anxiety episodes.

• Maladaptive changes in behavior (eg, avoidance); designed to prevent anxiety or panic.

• Restlessness or difficulty relaxing.

• Challenges with concentration or clear thought processes.

• Repeated nightmares related to irrational fears.

• Sleep disturbances.

• Irritability.

• Fatigue.

These symptoms must typically be present for a period of four weeks in children or at least six months in adults.

Physical Symptoms of Anxiety

Like the general symptoms of anxiety disorders, physical symptoms vary depending on the specific type of anxiety an individual is living with. That said, the following signs span across most anxiety disorders:^[2][3]

• Sweating.

• Shaking.

• Twitching.

• Headaches.

• Muscle tension.

• Numbness or tingling.

• Choking sensation.

• Difficulty swallowing.

• Shortness of breath.

• Hot sensations or cold chills.

• Frequent trips to the restroom.

• Heart palpitations, or a strong and accelerated heartbeat.

• Chest pain or discomfort (sometimes even in the absence of emotional symptoms).

• Nausea, vomiting, or an upset stomach.

• Dizziness, light-headedness, unsteadiness, or fainting.

• Derealization (feeling disconnected from reality).

• Depersonalization (a sense of being detached from oneself).

Anxiety Attack vs. Panic Attacks

Anxiety attacks and panic attacks are commonly confused as they share some overlapping symptoms (eg, a racing heart and shortness of breath). However, panic attacks tend to present suddenly without an obvious trigger, reach their peak within minutes, and subside quickly. On the other hand, anxiety attacks develop gradually in response to conscious stress, involve more psychological and emotional distress, and can continue for hours or longer.

What Anxiety Looks Like in Children

According to recent research, anxiety disorders are the most prevalent mental health conditions that present in children, impacting around 8% of individuals below the age of thirteen. Anxiety symptoms in children resemble those seen in adults, such as sweating, a rapid heartbeat, or avoidance of certain activities, objects, or people. Additionally, anxiety in children may manifest as tantrums or clinging when faced with, or anticipating, a perceived threat.^[4]

Anxiety Disorders

The DSM-5 classifies eleven separate categories of anxiety disorders within the anxiety chapter, including: ^[2]

• Separation anxiety disorder (frequent and excessive distress surrounding separation from attachment figures).

• Selective mutism (consistent inability to communicate verbally in specific social situations despite speaking elsewhere).

• Specific phobia (intense fear of a particular nature-related phenomenon, object, situation, animal, or medical procedure).

• Social anxiety disorder (fear of social situations involving possible negative judgment or embarrassment).

• Panic disorder (persistent panic attacks with ongoing fear of future recurrences).

• Agoraphobia (fear and avoidance of situations where escape or finding help may not be possible).

• Generalized anxiety disorder (continuous, excessive worry surrounding multiple aspects of life).

• Substance/medication-induced anxiety disorder (generalized anxiety symptoms caused by substance use or withdrawal).

• Anxiety disorder due to another medical condition (anxiety directly caused by a physical illness).

• Other specified anxiety disorder (clinically significant anxiety that does not fully meet the criteria for a specific disorder).

• Unspecified anxiety disorder (psychiatrically relevant anxiety where insufficient information prevents a specific diagnosis).

Other Disorders with Anxiety Symptoms

According to a 2023 review on anxiety, there are two primary disorders found outside of the anxiety disorder chapter of the DSM-5 that share overlapping symptoms with anxiety-related conditions. These include: ^[5]

Obsessive-Compulsive and Related Disorders (OCD)

Obsessive-compulsive disorder involves excessive worry triggered by obsessions that drive compulsive behaviors aimed at relief. Similarly, illness anxiety disorder and somatic symptom disorder are characterized by intense concerns surrounding health.

Trauma and Stressor-Related Disorders

Acute stress disorder and post-traumatic stress disorder are both marked by extreme anxiety, a heightened sense of vigilance, and avoidance following trauma. They share overlapping symptoms with other anxiety disorders, including dissociation and intense physical reactions.

When Should I Seek a Diagnosis?

To be diagnosed with an anxiety disorder, an individual must struggle to manage overwhelming worry on most days for at least six months. If you are battling to function due to irrational fears, it is essential to reach out to a psychiatrist or psychologist to prevent your mental health from worsening. ^[3]

Treatment For Anxiety

Treatment for anxiety disorders generally involves therapy, medication, or both (depending on the specific disorder and individual requirements). It is important to note that treatment may involve a process of trial and error before symptoms are effectively reduced. ^[3]

Therapy and Counseling

Therapy for anxiety disorders, including cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT), can be delivered in person or virtually. These modalities teach techniques such as mindfulness and thought reframing to help reduce anxiety. That said, different therapies work for different people, and many individuals may require medication. ^[3]

Medication

Medications for anxiety typically take the form of antidepressants (SSRIs and SNRIs) or anti-anxiety drugs (anxiolytics). While these pharmaceuticals can help to reduce anxiety, keep in mind that it may take weeks before symptoms are effectively reduced, and some individuals may experience mild side effects. ^[3]

How To Handle Daily Anxiety

Self-care has long been recognized as an integral aspect of maintaining holistic health. Many techniques used since ancient times, such as exercise, a nutritious diet, and mindfulness, are still effectively employed today to support emotional balance. These include:^[1]

• Avoiding or reducing the use of alcohol and illicit drugs.

• Consistent exercise (even in the form of a daily short walk or yoga session).

• Regular whole food meals and a predictable sleep routine.

• Relaxation techniques, such as deep breathing or progressive muscle relaxation.

• Daily mindfulness meditation (even if only for a few minutes).

How To Manage A Panic Attack

When a panic attack begins, focus on deep breathing techniques to soothe your body’s nervous system. You can also redirect your attention by listening to music, counting objects, engaging in enjoyable activities, or noticing sensory details. Using reassuring coping statements, such as reminding yourself that the attack is not dangerous, can further help to manage panic. ^[6]

Final Thoughts

Anxiety disorders are the most prevalent of all mental health conditions and can profoundly affect daily life, relationships, and one’s sense of well-being. Fortunately, with early recognition, professional treatment, and healthy lifestyle adjustments, individuals living with anxiety can effectively reduce symptoms and go on to experience a calmer quality of life.