Anxiety is a normal human emotion that everyone experiences from time to time. However, for some people, anxiety can become excessive, persistent, and disruptive – leading to significant distress or problems functioning. This severe and chronic anxiety is considered a mental health condition.
What is anxiety?
Anxiety is characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. People with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. These worries often interfere with daily activities and are difficult to control.
There are several different types of anxiety disorders, each with different symptoms:
- Generalized Anxiety Disorder (GAD) – chronic, exaggerated worrying about everyday life
- Social Anxiety Disorder – extreme fear around social situations and interacting with others
- Panic Disorder – sudden, unexpected panic attacks
- Phobias – intense fear about a specific object or situation
- Separation Anxiety – excessive fear about being away from home or family
- Illness Anxiety Disorder – preoccupation with having or getting sick
While anxiety causes distress, it should not be confused with the stresses of daily life. Mild to moderate anxiety is a normal part of living and does not require treatment. However, if anxieties become so consuming that they significantly impact daily life, treatment may be needed.
When does anxiety become a disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the handbook used by healthcare professionals to diagnose mental disorders, anxiety rises to the level of a disorder when:
- Symptoms cause significant distress or negatively impact relationships, work, or school
- The individual struggles to control their anxiety
- The anxiety lasts for 6 months or more
- The anxiety is not attributed to substance use or another medical condition
It is normal to feel anxious during stressful events, such as speaking in public or going through financial problems. However, individuals with anxiety disorders often experience fear or anxiety that is out of proportion to the actual situation. The intensity, duration, and frequency of anxiety reactions impair normal functioning.
Common symptoms of anxiety disorders
While each anxiety disorder has its own distinct features, there are many shared symptoms and signs that indicate someone is struggling with anxiety:
- Excessive fear or worry about everyday situations
- Restlessness or feeling keyed up
- Being easily fatigued
- Difficulty concentrating
- Muscle tension
- Sleep disturbance
- Panic attacks
- Avoiding situations that cause anxiety
People with anxiety disorders may experience a racing heartbeat, sweating, trembling, dizziness, stomach aches, headaches, and other physical symptoms when they feel anxious. These symptoms are due to the body’s natural “fight or flight” response.
Prevalence of anxiety disorders
Anxiety disorders are among the most common mental illnesses in the United States and globally. According to the National Institute of Mental Health (NIMH), 19.1% of U.S. adults had an anxiety disorder in the past year. That’s over 40 million people.
The most common anxiety disorders are:
- Phobias – 7.7% of U.S. adults
- Social Anxiety Disorder – 6.8%
- Generalized Anxiety Disorder – 2.7%
- Panic Disorder – 2.7%
Anxiety disorders also often occur along with other mental or physical illnesses, such as major depression, eating disorders, and chronic pain.
Causes and risk factors
There is no single cause for anxiety disorders. Both genetic and environmental factors play a role:
- Genetics – Anxiety disorders tend to run in families. People with a close relative with anxiety have a higher risk. Genes regulate neurotransmitters like serotonin and norepinephrine, which are implicated in anxiety disorders.
- Brain structure and function – Small differences in brain areas that regulate fear and emotion responses have been linked to anxiety disorders.
- Trauma – Stressful or traumatic experiences, especially in childhood, can increase the risk of developing anxiety disorders.
- Substance use – Use of alcohol, caffeine, or recreational drugs can trigger anxiety symptoms. Withdrawal from certain drugs can also cause anxiety.
Other factors that may contribute to anxiety disorders include:
- Stress – Ongoing stress due to work, relationships, finances, illness, or other pressures can trigger anxiety disorders in susceptible individuals.
- Medical conditions – Certain illnesses such as thyroid disease, heart disease, and respiratory disorders can be linked to anxiety symptoms.
- Medications – Some prescription and over-the-counter drugs may produce anxiety as a side effect.
Is anxiety a mental illness?
Yes, severe, chronic anxiety that causes significant distress or functional impairment is considered a mental illness. While anxiety exists on a spectrum, at the highest levels it meets criteria as a diagnosable psychiatric disorder.
According to the DSM-5, anxiety disorders fall under the category of Trauma- and Stressor-Related Disorders. This reflects current thinking that anxiety arises from various stressors coupled with an individual biological vulnerability.
Viewing high anxiety as a mental health disorder helps ensure that people get professional care rather than having their symptoms dismissed. Attaching a clinical diagnosis also aids psychiatrists in developing treatment plans tailored to each individual.
Differences from everyday anxiety
It is important to understand the differences between normal anxiety and an anxiety disorder. Everyone feels worried or anxious at times. Here are some ways to distinguish between regular anxiety and a potential disorder requiring medical intervention:
|Everyday Anxiety||Anxiety Disorder|
|Temporary worry or nervousness||Chronic, persistent anxiety|
|Proportional emotional response||Anxiety that is disproportionate to the situation|
|Does not usually interfere with work, activities, relationships||Causes significant life interference and impairment|
|Does not include panic attacks||May include repeated panic attacks or compulsions|
|Subsides once the stressful event ends||Persists for 6 months or longer|
|Can be managed without professional help||May require psychotherapy or medications|
Simply feeling anxious does not mean someone has a diagnosable disorder. But when anxiety is highly distressing, long-lasting, and disruptive to functioning, it may be appropriate to seek professional treatment.
When to see a doctor or mental health professional
You may benefit from evaluation and treatment if:
- You feel anxious or worried most days
- You avoid situations, places, objects that cause anxiety
- Anxiety interferes with work, school, relationships, or daily activities
- Physical symptoms of anxiety are upsetting or disruptive
- You have panic attacks that seem to arise unexpectedly
- You abuse alcohol or drugs to cope with anxiety
- Anxiety disrupts your sleep or causes depression
- You struggle with obsessions, compulsions, or phobias
A trained mental health provider can check for underlying medical conditions, screen for specific anxiety disorders, determine if treatment is indicated, and create an appropriate treatment plan which may include medications, therapy, or both.
Types of treatment for anxiety disorders
Anxiety disorders respond best to a combination of medication and psychotherapy. Treatment is tailored to each individual based on the severity of symptoms, the degree of impairment, coexisting conditions, and patient preference.
Antidepressants and anti-anxiety medications, particularly SSRIs and SNRIs, are commonly prescribed to treat anxiety. These include:
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor)
Benzodiazepines like alprazolam (Xanax) may provide short-term relief of anxiety symptoms. However, they carry risks of dependency and withdrawal.
Cognitive behavioral therapy (CBT) is an effective form of talk therapy for treating anxiety disorders. CBT aims to change negative thought patterns and behaviors that reinforce anxiety. Exposure therapy is also used to gradually confront feared situations in a safe, controlled way.
Other therapeutic approaches that may help anxiety include:
- Acceptance and commitment therapy (ACT)
- Mindfulness-based therapies
- Support groups
Improving coping skills through psychotherapy can reduce anxiety sensitivity and teach individuals how to calm themselves during symptoms of anxiety.
Certain lifestyle adjustments may complement anxiety treatment and help manage symptoms:
- Stress management techniques like meditation, yoga, exercise
- Avoiding alcohol and illicit drugs
- Reducing caffeine intake
- Getting enough sleep and improving sleep habits
- Eating a healthy, balanced diet
Making healthy lifestyle changes can enhance quality of life and support recovery.
When to seek emergency treatment
Seek immediate medical care if anxiety is accompanied by:
- Thoughts of harming yourself or others
- Seeing or hearing things that are not real (hallucinations)
- Anxiety that is triggered by a medical issue like thyroid disease
- Sudden, crushing chest pain or pressure
- Severe tightness or pain in your chest
- Extreme difficulty breathing
- Feeling like you might pass out
These may be signs of a medical emergency needing urgent evaluation. Some health conditions like heart problems can initially manifest as anxiety.
Prognosis for anxiety disorders
With appropriate treatment, many people with anxiety disorders improve significantly or recover completely. Symptoms may continue to fluctuate but become more manageable. Medications need to be monitored for side effects and efficacy.
Psychotherapy provides long-lasting benefits by teaching coping strategies. It may take some trial and error to find the most effective treatment approaches for each individual.
Without treatment, anxiety disorders tend to be chronic and recurring conditions. Anxiety symptoms may worsen over time and lead to major depression or substance abuse. Untreated anxiety can disrupt work performance, relationships, and overall health.
High, persistent anxiety that interferes with normal functioning can be considered a mental illness. Anxiety disorders involve more than temporary worry or fear. They are associated with changes in thinking, behavior, body sensations, and brain functions.
Anxiety exists on a spectrum – from adaptive anxiety that is beneficial at times, to problematic anxiety requiring clinical intervention. Anxiety rises to the level of a disorder when it causes significant distress, impairs functioning, and distorts thinking.
Evidence shows that anxiety disorders have genetic, neurological, and environmental bases. There are effective treatments available to help people regulate emotions, change thinking patterns, and learn to manage symptoms of anxiety disorders.
With professional care, individuals can reduce anxiety to levels where it no longer disrupts their daily lives. Recovery from anxiety disorders is very possible, allowing people to thrive and reach their full potential.