We all worry. We worry about our health. We fret over finances. We anguish over work, personal and family relationships.
Worrying can be helpful, such as when stressing over a deadline helps us meet it.
When that worry is out of proportion to the object of that concern, however, it can turn into something psychiatrists call anxiety. And it’s a condition that tends to feed upon itself. Because of the brain’s plasticity, worrying begets more worrying.
UCI Health psychiatrist Rimal Bera, MD, says anxiety can lead to debilitating symptoms such as:
According to the National Institutes of Health, nearly 20% of adults and about 25% of adolescents age 13 to 18 will experience anxiety. Only 4% will have severe cases.
What is anxiety disorder?
“There are many kinds of anxiety disorders,” says Bera, an associate professor of psychiatry and human behavior at the UCI School of Medicine.
“Everything in psychiatry is related, and you’ll find many of the same symptoms in different disorders. You’ll also often find anxiety and depression together.”
A common form of anxiety is generalized anxiety disorder, which is experienced as persistent worry or anxious feelings unrelated to an actual threat.
Other forms of anxiety disorder include:
- Panic attacks — severe episodes of anxiety that come without warning
- Phobias — intense fears of certain objects or situations
- Social phobias — inability to interact with people for fear of being embarrassed or judged
- Agoraphobia — intense fear or anxiety triggered by real or anticipated exposure to a wide range of situations
- Anxiety disorder due to another medical condition — best explained as a physiological effect of a medical condition
Other conditions that were formerly classified as anxiety conditions are:
Reach out for help
If you have symptoms of anxiety that increase over a period of time and begin to affect your daily life, Bera says it’s time to seek help.
“About 60 percent to 70 percent of people with anxiety are treated successfully by their primary care physicians and never see a psychiatrist,” Bera says. “People who don’t respond to medications or other interventions, initiated by primary care doctor, as expected should be referred to a psychiatrist.”
Doctors frequently treat anxiety with antidepressants or benzodiazepine-based tranquilizers such as Xanax, Ativan, Klonopin and Valium. For Bera, the relationship of trust between patients and their primary care providers can be just as helpful as the treatment interventions.
“There’s an expectation that something good will result if there is a strong therapeutic relationship and patients understand well the options available to them,” Bera explains, adding, “Up to sixty percent of the time, psychiatric illness responds to the first intervention.”
Be wary of drug dependence
There is a danger of addiction when certain medications are involved, especially with benzodiazepines. Bera notes that doctor and patient must work in partnership to eliminate psychiatric symptoms and decrease functional impairment while avoiding dependence.
Some people prefer to avoid drugs. Some cannot tolerate them.
Alternative ways to reduce anxiety
Whether you take medication or not, there are plenty of other actions that can help lessen anxiety.
Bera suggests these:
- Exercise, exposure to the sun and interaction with people
- Therapy, especially cognitive behavioral therapy, which focuses on identifying, understanding, and changing thinking and behavior patterns
- Education about stress and ways to steer the mind into a parasympathetic response, such as breathing exercises, meditation, qigong, tai chi or yoga
- Disciplined healthy eating, including getting ample amounts of fish oil with omega 3 and vitamin B12 or vitamin D, as indicated
- Online cognitive behavioral therapy courses to help with common symptoms like sleep problems
- Support groups
The benefits of being social
Humans are social creatures who benefit from interacting with others.
“At the end of the day, we all need each other,” Bera says. “We all need to know that we matter, and if that is lacking, we suffer.”