Anxiety

What is anxiety disorder?

Anxiety disorder is a mental health disorder that entails excessive, repeated bouts of worry, anxiety, and/or fear.

Feeling nervous or apprehensive is normal – even healthy at times. After all, that “fight or flight” feeling is what incentivizes you to prepare for a test or presentation, or makes your palms sweaty before a first date. But when anxiety runs deeper and feels unshakeable, it can potentially stand in the way of a healthy lifestyle.

When worrying becomes the go-to response to everyday situations, it becomes debilitating.  

Prevalence of anxiety disorder

Anxiety is very common in the United States. According to the ADAA, anxiety disorders are cumulatively the most common mental illnesses in the United States.

Additional stats on anxiety:  

• Anxiety disorders affect 40 million adults in the United States aged 18 and up – over 18% of the population
• Women are twice as likely to experience anxiety disorders as men, according to some studies

What are some symptoms of anxiety?

Symptoms of anxiety will vary, based on type. Here are some typical examples:  

• Excessive worrying: Spending a disproportionate amount of time worrying about “what could happen,” especially as pertains to everyday activities. Individuals who worry excessively are often constantly expecting the worst outcome to situations. 

• Physically uncomfortable symptoms: Such as a fast heartbeat, dry mouth, or a “lump in throat” feeling.

• Trouble sleeping: You might have trouble falling or staying asleep, and wake up feeling unrefreshed.  

• Difficulty concentrating: Your mind goes blank when you’re trying to focus. 

• Rumination: You find yourself repeatedly going over a thought, problem, or situation without finding a solution.
• Panic attacks: You have experienced an overwhelming, often unpredictable sensation with strong symptoms that may feel like a heart attack. 
Chest pain may either accompany a panic attack, or appear independently.
• Gastrointestinal (GI) disturbances: The occurrence of stomach aches, digestion issues, heart burn, nausea, etc., without a clear physical cause.

Different types of anxiety disorders

• Generalized Anxiety Disorder (GAD): Persistent and excessive worry and anxiety that gets in the way of daily activities. Physical symptoms of anxiety, such as tiredness or fatigue, headaches, and nausea, are not uncommon.
• Social Anxiety: Intense discomfort in social settings. Anxiety is triggered during social events like parties, and also when faced with tasks like public speaking, speaking with authority figures, or stating an opinion.
• Selective Mutism: Individuals with selective mutism are unable to speak in certain situations, such as classroom or work settings. It is more common in children than in adults.
• Panic Disorder: Recurring panic attacks and/or other symptoms of anxiety, like chest pain, tingling hands, or breathing difficulty; constant worry that you will experience another.
• Phobias: Avoiding certain situations (e.g., public spaces, heights) or objects due to fear.
• Agoraphobia: Agoraphobia entails fear or anxiety regarding certain situations where no “escape” is possible, and can prevent individuals from leaving the home, being in crowds, or using public transport. Agoraphobia typically develops after one or more panic attacks.
• Medication/substance-induced anxiety: Anxiety that is directly caused by the use of certain substances, including caffeine, alcohol, or some medications.
• Unspecified Anxiety Disorder: Meeting some, but not all, criteria for an anxiety diagnosis.

Additionally, many mental health professionals consider the following anxiety disorders, and treat them as such:

• Separation Anxiety Disorder: A condition in which an individual (typically a child) become worried beyond consolation at the thought of being separated from his or her principal caregiver.
• Obsessive-Compulsive Disorder (OCD): Obsessive Compulsive Disorder (OCD) is a mental health disorder marked by intrusive, unwanted thoughts that cause a sense of distress or anxiety and/or repetitive behaviors (e.g., hand washing, checking) that the person feels they must perform to reduce anxiety and distress or prevent something terrible from happening.
• Post-Traumatic Stress Disorder (PTSD): PTSD is a disorder that develops after exposure to a particularly traumatic experience. It can start days, months, or even years after the event. PTSD is typically manifested as intense emotional and physical reactions, like flashbacks, nightmares, extra sensitive startle response, and avoiding situations or thoughts/feelings that remind the person of the trauma.

What to do if you have anxiety

If you’re concerned that you’re experiencing levels of anxiety that are above normal, here are steps you can take to improve and alleviate symptoms:

• Therapy: Find a therapist who can help you navigate your anxiety with proven tools and techniques. (See more tips below on selecting a therapist for anxiety.)
• Mindfulness exercises: Learning certain mindfulness exercises specifically for anxiety can help you handle anxiety in the moment as it arises.
• Yoga for anxiety: Certain yoga classes and poses are especially beneficial for anxiety.
• Breathing exercises: Try square breathing to quell anxieties as they arise.
• Exercise: Studies show that aerobic activity can prevent panic disorders from recurring.
• Check-ups: Stay up-to-date on medical appointments, including your annual wellness visit with your primary care physician. She or he can help you rule out any physical conditions with symptoms that are similar to anxiety (e.g., anemia, overactive thyroid, etc.).

What should I look for in a therapist for anxiety?

Look for a therapist who has a specialty in treating anxiety

Most therapists are equipped to treat anxiety, but their approaches differ. Use the links below to learn more about approaches, or ask the therapist on your initial call what a typical session for anxiety with them looks like.

Common approaches for treating anxiety include:

• Cognitive Behavioral Therapy (CBT)
• Exposure therapy
• Acceptance and Commitment Therapy (ACT)
• Dialectical Behavioral Therapy (DBT)
• Interpersonal Therapy (IPT)
• Eye Movement Desensitization and Reprocessing (EMDR)

Know what questions you need to ask potential therapists

These questions may prove helpful when interviewing potential therapists:

• What therapy type (possibly one of the examples above) do you use when helping clients manage anxiety?
• Do you have experience working with clients who have my particular symptoms?

Prioritize personal fit

While personality fit is a nuanced factor, it is critical to your success in therapy. Multiple studies have revealed the importance of this factor, often referred to as “therapeutic alliance.”

On your initial phone call with the therapist, ask yourself:

• Could I see myself forming a connection with this therapist?
• Does their approach suit my personality?
• Do I feel like I will be heard and respected by this therapist?

Additionally, consider these factors:

• Some therapists are more reflective and spend most of the session listening and drawing insights about your patterns and coping styles.
• Some therapists are more directive, establishing weekly agendas and assigning tasks to complete between sessions.
• Some utilize specific techniques or tools (exposure exercises, eye movements, tapping, breath work, guided imagery, art and music, etc.).
• Some use a combination of multiple approaches.

Consider cost, location, and scheduling

Therapy will only work if it works for you. Before making an appointment, ask yourself honestly:

• Can I afford these session fees? The cost of therapy for addiction depends on location, practitioner, and whether you’re using insurance.
• Can I commit to attending sessions regularly? Remember to account for travel time, and other demands in your schedule.
• Do the therapists’ available times work for me? Some therapists offer evening and weekend appointments if you have an otherwise limited schedule.

New to therapy? Learn about how to find a therapist here.