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Anxiety Disorders

(Chronic Free-Floating Anxiety)

Definition

Anxiety is a state of dread, tension, and unease. It is considered a normal response to stress or uncertain situations. Feeling anxious for long periods of time or at intense levels may mean that you have an anxiety disorder. You may be diagnosed with an anxiety disorder if the anxiety:
  • Occurs without an external threat (called "free-floating" anxiety)
  • Is excessive or unreasonable for the situation or threat
  • Negatively affects how you function during the day
The most common types of anxiety disorders are:
Anxiety may occur with other conditions, such as alcohol abuse, drug abuse, and depression.

Causes

Anxiety disorders may result from a combination of factors, such as:
  • Genetics
  • Factors in the environment
Chemical imbalances in the brain (e.g., serotonin, norepinephrine) may also play a role.

Risk Factors

Factors that may increase the risk of anxiety disorders include:
  • Sex: female
  • Family member with anxiety disorders
  • Stressful life events
  • Poor coping strategies
  • History of physical or psychological trauma

Symptoms

Psychological symptoms may include:
  • Worry or dread
  • Obsessive or intrusive thoughts
  • Sense of imminent danger or catastrophe
  • Fear or panic
  • Restlessness
  • Irritability
  • Impatience
  • Ambivalence (uncertainty)
  • Trouble concentrating
Physical symptoms may include:
  • Rapid heartbeat
  • Sweating (especially the palms)
  • Dry mouth
  • Flushing or blushing
  • Muscle tension
  • Shortness of breath
  • Feeling lightheaded or fainting
  • Difficulty sleeping
  • Shaking
  • Choking sensation
  • Nausea or vomiting
  • Diarrhea
  • Feeling of "butterflies" in the stomach
  • Sexual difficulties
  • Tingling sensations
  • Nail biting or other habitual behavior
Symptoms of Anxiety
Physiological effects of anxiety
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Diagnosis

Your doctor will ask about your symptoms and medical history and perform a psychiatric evaluation. Your doctor may also do a physical exam and order tests to look for other causes of your symptoms. You may be referred to a psychotherapist for further evaluation.

Treatment

Effective treatment usually involves a combination of interventions, including:

Lifestyle Changes

  • Get sufficient rest and sleep.
  • If you smoke, quit.
  • Reduce or eliminate caffeinated beverages.
  • Drink alcohol in moderation.
  • Avoid using drugs.
  • Reduce exposure to stressful environments.
  • Exercise regularly.

Relaxation Techniques

  • Practice deep breathing and meditation.
  • Learn how to do progressive muscle relaxation.
  • Work with a massage therapist.
  • Engage in pleasurable activities.
  • Do yoga.

Social Support

  • Have a strong support system of family and friends.
  • Seek therapy to improve your coping skills.
  • Join a support group.

Psychotherapy

This therapy addresses thoughts, feelings, and behaviors that play a role in anxiety. It helps you work through traumas and conflicts.
Cognitive behavioral therapy (CBT) can help you identify negative thought patterns and behaviors. Over time, you can learn to retrain your thinking. This will help you respond better to stress and anxiety.
CBT has been very effective in children and teens.

Medication

For severe anxiety or anxiety disorder, medicines may include:
  • Benzodiazepines
  • Buspirone
  • Antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors [SSRIs])
If you are diagnosed with an anxiety disorder, follow your doctor's instructions.

Prevention

To help prevent anxiety, consider taking the following steps:
  • Avoid situations, occupations, and people that cause you stress.
  • If unavoidable, confront and overcome situations that provoke anxiety.
  • Find a relaxation technique that works for you. Use it regularly.
  • Develop and maintain a strong social support system.
  • Express your emotions when they happen.
  • Challenge irrational beliefs and thoughts that are not helpful to you.
  • Correct misperceptions. Ask others for their points of view.
  • Work with a therapist.
  • Avoid using nicotine or other drugs. If you drink alcohol, drink only in moderation.

RESOURCES

Anxiety and Depression Association of America http://www.adaa.org/

Mental Health America http://www.nmha.org/

CANADIAN RESOURCES

Canadian Psychiatric Association http://www.cpa-apc.org/

Canadian Psychological Association http://www.cpa.ca/

References

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Published May 22, 2009. Accessed August 27, 2012.

Generalized anxiety disorder. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated May 23, 2012. Accessed July 31, 2012.

Generalized anxiety disorder (GAD). National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml. Accessed August 27, 2012.

12/4/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Javnbakht M, Hejazi Kenari R, Ghasemi M. Effects of yoga on depression and anxiety of women. Complement Ther Clin Pract. 2009;15(2):102-104.

9/12/2012 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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