Anxiety Articles

Cheat Sheet / Updated 03-15-2022

Anxiety is the most common mental disorder, but it’s also one of the most treatable. Because anxiety can produce a wide range of symptoms, all sorts of techniques and therapies can be used to treat your anxious thoughts, behaviors, and feelings.

Cheat Sheet / Updated 08-31-2021

Anxiety appears in different ways for different people. Some people have anxious thoughts; others feel anxiety in their body. Most people with anxiety try to avoid what makes them anxious, but that just makes things worse. Instead, you can take a measured approach to confronting whatever causes your anxiety.

Article / Updated 03-29-2021

If you have a child with anxiety, don’t make yourself anxious by blaming yourself for the problem. Anxiety in children is common, and multiple factors probably went into making your kid anxious. So now what do you do? Read on. Help yourself first If you’ve traveled on a commercial flight, you’ve probably heard flight attendants instruct you about how to deal with the oxygen masks should they drop down. They tell you to put the mask on yourself prior to assisting your child. That’s because if you don’t help yourself first, you won’t be in any condition to help your child. The same principle applies to anxiety in your kids. You need to tackle your own anxiety prior to trying to help your children. Children learn many of their emotional responses by observing their parents; it makes sense that anxious parents more often end up with anxious children. The nice part of getting rid of your own anxiety first is that this is likely to help your children, as well as give you the resources for assisting with their worries. Pick and choose the strategies that best fit your problem and personality. However, if the ideas you choose first don’t seem to work, don’t despair. The vast majority of the time, one or more of the techniques that we describe do help. Consider consulting a mental health professional who’s trained in cognitive behavioral therapy. Modeling mellow If you don’t have a problem with anxiety or if you’ve overcome your excessive worries for the most part, you’re ready to teach by example. Children learn a great deal by watching the people they care about. You may recall a time when your child surprised you by repeating words you thought or wished he hadn’t heard. Trust us, kids see and hear everything. Therefore, take advantage of every opportunity to model relatively calm behavior and thinking. Don’t invalidate your child’s anxiety by saying it’s a stupid or silly fear. Furthermore, demonstrating complete calm is not as useful as showing how you handle the concern yourself. This table shows some common childhood fears and how you can model an effective response. Modeling a Better Way Fear Parental Modeling Thunderstorms “I understand a thunderstorm is coming tonight. Sometimes, I get a little nervous about them, but I know we’re safe at home. I’m always careful to seek shelter during a thunderstorm. But I know that thunderstorms can’t really hurt you when you’re inside.” Insects “I used to think that insects were gross, awful, and scary, but now I realize that they’re more afraid of me than I am of them. Insects run away from people when they can. Sometimes, they’re so scared that they freeze. I admit that I still use plenty of tissue to pick them up, and that’s okay. Let me show you how I do it.” Heights “I sometimes feel a little nervous looking down from high places. Here we are on the top of the Washington Monument. Let’s hold hands and go to the window together. You can’t fall off, and it can’t hurt you. Looking down from heights is kind of fun. The scariness is kind of exciting after you get used to it.” Being alone (don’t say this unless your child expresses anxiety about feeling safe alone) “Your father’s going on a trip tomorrow. I used to feel afraid staying at home by myself, but I realize that I can take pretty good care of myself and of you. We have a security door, and if anyone tries to get in, we can always call the police. Our dogs are pretty good protection, too. Do you ever get scared? If you do, we can talk about it.” Lead children through anxiety Gradual exposure to whatever causes anxiety is one of the most effective ways of overcoming fear. Whether the anxious person is a child or an adult, the strategy is much the same. Therefore, if you want to help your children who already have anxiety, first model coping as we describe in the table. Then, consider using exposure, which involves breaking the feared situation or object into small steps. You gradually confront and stay with each step until your child feels a bit better. Keep a few things in mind when doing this as a guide for your child: Break the steps down as small as you possibly can. Don’t expect your child to master a fear overnight. It takes time. And children need smaller steps than adults. For example, if you’re dealing with a fear of dogs, don’t expect your child to immediately walk up to and pet a dog on the first attempt. Instead, start with pictures and storybooks about dogs. Then progress to seeing dogs at a distance, behind an enclosed fence. Gradually work up to direct contact, perhaps at a pet store. Expect to see some distress. This is the hard part for parents. No one likes to see their kids get upset. But you can’t avoid having your kids feel modest distress if you want them to get over their anxiety. Sometimes, this part is more than some parents can handle. In those cases, a close friend or relative may be willing to pitch in and help. At the same time, if your child exhibits extreme anxiety and upset, you need to break the task down further or get professional help. Praise your child for any successes. Pay attention to any improvement and compliment your child. However, don’t pressure your child by saying that this shows what a big boy or girl he or she is. Show patience. Don’t get so worked up that your own emotions spill over and frighten your child further. Again, if that starts to happen, stop for a while, enlist a friend’s assistance, or seek a professional’s advice. The following story shows how parents dealt with their son’s sudden anxiety about water. Kids frequently become afraid when something unexpected happens. Penny and Stan plan a Caribbean vacation at a resort right on the beach. The brochure describes a family-friendly atmosphere. They purchase a snorkel and diving mask for their 3-year-old, Benjamin, who enjoys the plane ride and looks forward to snorkeling. When they arrive, the hotel appears as beautiful as promised. The beach beckons, and the ocean water promises to be clear. Penny, Stan, and Benjamin quickly unpack and make their way down to the beach. They walk into the water slowly, delighted by the warm temperature. Suddenly, a large wave breaks in front of them and knocks Benjamin over. Benjamin opens his mouth in surprise, and saltwater gags him. He cries and runs back to the shore, screaming. Stan immediately pulls Benjamin back into the water. He continues to scream and kick. Penny and Stan spend the rest of the vacation begging Benjamin to go into the ocean again to no avail. The parents end up taking turns babysitting Benjamin while their vacation dream fades. At home, Benjamin’s fear grows, as untreated fears often do. He fusses in the bath, not wanting any water to splash on his face. He won’t even consider getting into a swimming pool. Benjamin’s parents take the lead and guide him through exposure. First, on a hot day, they put a rubber, inflated wading pool in the backyard. They fill it and model getting in. Eventually, Benjamin shows a little interest and joins them in the pool. After he gets more comfortable, the parents do a little playful splashing with each other and encourage Benjamin to splash them. He doesn’t notice that his own face gets a little water on it. Then his parents suggest that Benjamin put just a part of his face into the water. He resists at first, but they encourage him. When he puts his chin into the water, they applaud. Stan puts his face entirely under water and comes up laughing. He says that Benjamin may not be ready to do that. Benjamin proves him wrong. Benjamin and Stan take turns putting their faces into the water and splashing each other. What started out as fear turns into fun. The parents provide a wide range of gradually increasing challenges over the next several months, including using the mask and snorkel in pools of various sizes. Then they go to a freshwater lake and do the same. Eventually, they take another vacation to the ocean and gradually expose Benjamin to the water there as well. If Benjamin’s parents had allowed him to play on the beach at the edge of the water instead of insisting that he get back in the water immediately, he may have been more cooperative. They could have then gradually encouraged him to walk in the water while watching for waves. That way, they may have been able to enjoy their vacation. They made the mistake of turning a fear into a power struggle, which doesn’t work very well with children — or, for that matter, with adults. Exorcize anxiety through exercise Exercise burns off excess adrenaline, which fuels anxiety. All kids obviously need regular exercise, and studies show that most don’t exercise enough. Anxious kids may be reluctant to engage in intense physical activities like hiking, jogging, biking, or organized sports. They may feel inadequate or even afraid of negative evaluation by others. Yet it may be more important for anxious kids to participate in sports or other physical activities for two reasons. First, these activities provide them with important mastery experiences. Although they may feel frustrated and upset at first, they usually experience considerable pride and a sense of accomplishment as their skills improve. Second, aerobic activity directly decreases anxiety. The challenge is to find an activity that provides your child with the greatest possible chance of at least modest success. Consider the following: Swimming: An individual sport that doesn’t involve balls thrown at your head or collisions with other players. Swimmers compete against themselves, and many swim teams reward most participants with ribbons, whether they come in first or sixth. Hiking: This can be done with organized groups or as a family outing. Difficulty can be low, medium, or intense. Kids can learn about how to handle weather emergencies and what supplies they need. They can acquire mastery skills by learning about dangerous plants and creatures. Track and field: An individual sport that has a wide variety of different skill possibilities. Some kids are fast and can run short dashes. Others discover that they can develop the endurance to run long distances. Still others can throw a shot put. Tennis: A low-contact and relatively safe sport. Good instruction can make most kids adequate tennis players. Martial arts: Good for enhancing a sense of competence and confidence. Many martial arts instructors have great skill for working with uncoordinated, fearful kids. Almost all kids can experience improvements and success with martial arts. Dance: A sport that includes many variations, from ballet to square dancing. Musically inclined kids often do quite well with dance classes. In other words, find something for your kids to do that involves physical activity. They can benefit in terms of decreased anxiety, increased confidence, and greater connections with others. Don’t forget to include family bike rides, camping trips, and walks. Model the benefits of lifelong activity and exercise.

Article / Updated 03-29-2021

This article reviews some of the biological roots of anxiety, as well as the consequences of chronic stress on health. Most people with anxiety describe uncomfortable physical symptoms that go along with their worries. They may experience heart palpitations, nausea, dizziness, sweats, or muscle tension. Those symptoms are evidence that anxiety is truly a disorder of both the mind and the body. The anxious brain The brain takes in information about the world through sight, taste, smell, sound, and touch. Constantly scanning the world for meaning, the brain integrates information from the past with the present and plans what actions to take. For most people, most of the time, the brain does a pretty good job. But for those with chronic anxiety, something goes awry. Billions of nerve cells (neurons) reside in the brain. They’re organized into a variety of complex structures or circuits. Some of these structures are particularly involved in producing feelings of anxiety, fear, and stress. These brain structures communicate with one another by sending chemical messengers, known as neurotransmitters, back and forth among them. In the following sections, we explain how the brain interprets information and what role the brain’s chemicals play in making you anxious. How the brain’s circuits connect Think of the brain as having many interconnected circuits. One circuit involves both the limbic system and the frontal lobes. To keep it simple, the limbic system is a primitive region of the brain and is responsible for immediate reflexive responses to threat. The thalamus and the amygdala form part of the limbic system. The frontal lobes, which handle judgment and reasoning, respond more slowly and thoughtfully. When the brain perceives something as being dangerous, it immediately registers in the brain’s control center known as the thalamus. The thalamus rapidly sends a signal directly to the amygdala, which activates reflexive fear responses. Those responses prepare the body to fight or flee. The thalamus also delivers a warning signal through the frontal lobes. The frontal lobes, where rational thought occurs, take a little more time and use reason and logic to determine the veracity of the incoming threat. That’s why when you perceive something as being scary, your body immediately responds with a rapid heartbeat, tension, and dread. If and when the rational frontal lobes figure out that the scary thing actually doesn’t pose a significant threat, you calm down. That’s the way the brain is supposed to work. For example, around the Fourth of July you hear loud popping sounds. Your limbic system may initially interpret those as gunshots, but your frontal lobes take a few seconds longer and conclude that the sounds are likely to be firecrackers. However, dogs, who don’t understand calendars or have well-developed frontal lobes, remain fearful. In anxiety disorders, either the limbic system or the frontal lobes (or both) may fail to function properly. Thus, the limbic system may trigger fear responses too easily and too often, or the frontal lobes may fail to use logic to quell fears set off by the limbic system. When the brain signals danger, the body responds by getting ready for action. The next section explains the chemical aspects of fear. Neurotransmitters Neurotransmitters help nerve cells communicate feelings, fears, emotions, thoughts, and actions through an intricate orchestration. Four major neurotransmitter systems and some of their functions include The noradrenergic system, which produces norepinephrine and epinephrine. It also stimulates organs required in the fight-or-flight response (see the following section). The cholinergic system, which activates the noradrenergic neurotransmitters and facilitates formation of memories. The dopaminergic system, which is involved in movement and is also related to feelings of pleasure and reward. Dopamine disruptions cause problems with attention, motivation, and alertness, and appear to be quite important in the development of fear responses. The serotonergic system, which is related to moods, anxiety, and aggression. As these neurotransmitters pulse through your brain, the brain circuitry involved in fear and anxiety lights up. Your body then responds with a full-system alert known as the fight-or-flight response. Preparing to fight or flee When danger presents itself, you reflexively prepare to stand and fight or run like you’ve never run before. Your body mobilizes for peril in complex and fantastic ways. This figure gives you the picture. Your body responds to threats by preparing for action in three different ways: physically, mentally, and behaviorally. Physically: The brain sends signals through your nervous system to go on high alert. It tells the adrenal glands to rev up production of adrenaline and noradrenaline. These hormones stimulate the body in various ways. Your heart pounds faster and you start breathing more rapidly, sending increased oxygen to your lungs while blood flows to the large muscles, preparing them to fight or flee from danger. Digestion slows to preserve energy for meeting the challenge, and pupils dilate to improve vision. Blood flow decreases to hands and feet to minimize blood loss if injured and keep up the blood supply to the large muscles. Sweating increases to keep the body cool, and it makes you slippery so aggressors can’t grab hold of you. All your muscles tense to spring into action. Mentally: You automatically scan your surroundings intensely. Your attention focuses on the threat at hand. In fact, you can’t attend to much of anything else. Behaviorally: You’re now ready to run or fight. You need that preparation in the face of danger. When you have to take on a bear, a lion, or a warrior, you’d better have all your resources on high alert. Granted, in today’s world, you’re not very likely to encounter lions and bears. Unfortunately, your body reacts too easily with the same preparation to fight traffic, meet deadlines, speak in public, and cope with other everyday worries. When human beings have nothing to fight or run from, all that energy has to be released in other ways. So you may feel the urge to fidget by moving your feet and hands. You may feel like jumping out of your skin. Or you may impulsively rant or rave with those around you. Most experts believe that experiencing these physical effects of anxiety on a frequent, chronic basis doesn’t do you any good. Various studies have suggested that chronic anxiety and stress contribute to a variety of physical problems, such as abnormal heart rhythms, high blood pressure, irritable bowel syndrome, asthma, ulcers, stomach upset, acid reflux, chronic muscle spasms, tremors, chronic back pain, tension headaches, a depressed immune system, and even hair loss. The following figure illustrates the toll of chronic anxiety on the body. Before you get too anxious about your anxiety, please realize that chronic anxiety contributes to many of these problems, but we don’t know for sure that it’s a major cause of all of them. Nevertheless, enough studies have suggested that anxiety or stress can make these disorders worse to warrant taking chronic anxiety seriously. In other words, be concerned, but don’t panic. When people perceive danger, their most common response is to fight or flee. However, sometimes there is another reaction — freezing. This response is common in animals but less understood in humans. The well-known phrase “like a deer caught in the headlights” is an example of a freeze response. During this state, heart rate actually decreases, and the body becomes immobilized. Usually, this freezing state is brief and can immediately change to fight or flight. This phenomenon explains why some people freeze during an emergency or find themselves unable to respond in a threatening situation. However, not as much is known about the human freeze response, and more research is needed to explain the nuances of why and when this occurs.

Article / Updated 03-29-2021

If you’re reading this article, you’ve probably made some headway with your anxiety. Maybe, after all your hard work, you’ve experienced a setback, or perhaps you’re worried about one. Not to worry. We have ten ideas for you to use when anxiety shows up again in your life. Expecting anxiety Perhaps you’ve worked hard to overcome your anxiety, and now your hard work has paid off. You’ve beaten it. Congratulations! But, alas, one day you wake up suddenly with anxiety staring you in the face. You turn it into a catastrophe and assume that you’ve failed. Oh, get real. You’ll never totally annihilate anxiety. That is, until you stop breathing. It’s bound to show up from time to time. Expect anxiety. Look for its early warning signs. But don’t compound matters by getting anxious about your anxiety. If you understand that anxiety happens, you can lessen the impact. Counting the swallows The proverb “One swallow doesn’t make a summer” reflects the fact that a single sign doesn’t necessarily indicate that something more is inevitable. The arrival of a lone bird doesn’t mean the whole flock is back for the season. Anxiety has an ebb and flow. Having an anxious episode or two doesn’t mean that you’re back to square one. You figured out how to handle some of your anxiety, and that knowledge can still help you. You don’t need to start all over again. You do need to move forward and reapply what you practiced. Thinking of minor setbacks as catastrophes will only increase your anxiety and immobilize your efforts. Regroup, reorganize, and go back at it! Checking out why anxiety returned Minor relapses are a great opportunity to discover what gives you trouble. Figure out what events preceded your latest bout of anxiety: Have you had some recent difficulties at work, such as deadlines, promotions, problems with co-workers, or financial setbacks? Have you had recent problems at home, such as divorce, problems with a child, or other stressors? If so, understand that an increase in your anxiety is a natural response and likely to be temporary. Use the new information about your anxiety triggers to challenge your anxious thinking or work on accepting a little bit of anxiety into your life. Seeing a doctor If you’ve looked high and low for situations or events that may have set off your relapse and can’t come up with anything at all, consider making an appointment with your primary care physician. Anxiety can have a number of physical causes, such as side effects from prescription medication or over-the-counter medications and supplements, excessive caffeine, and other health problems. Don’t try to diagnose yourself. If you experience anxiety with absolutely no apparent cause, please check it out with your primary care provider. Revisiting what worked before If anxiety creeps back into your life, review the strategies that worked for you previously. Some of those techniques may need to become lifelong habits. Keep relaxation in your life. Exercise on a regular basis. Anxiety isn’t a disease that you can cure with a one-time injection, pill, or surgery. Anxiety is a natural part of life. When it mushrooms to a distressing degree, you merely need to reapply the strategies that worked for you. Doing something different We’ve presented a variety of strategies for overcoming anxiety. Most likely, you’ve picked a few that have felt compatible with your lifestyle. Now consider looking at some ideas you haven’t yet attempted. We urge you to do something different. Take a look at the list that follows, and choose one you haven’t gotten around to trying yet: Rethinking your anxiety Facing fear head-on Accepting anxiety Exercising and getting a good night’s sleep If you’ve simply dabbled at one or more of these techniques, pursue it more aggressively and see whether it works better that way. Anything in this book that you haven’t tried yet is worth considering. Getting support You don’t have to face anxiety relapses alone. Talking with others helps you deal with emotional distress. A great source of such support can be found in self-help groups listed in your local newspaper. Perhaps your place of worship has an adult group for people dealing with emotional challenges. You may have a special trusted friend to talk things over with, but be careful not to be too burdensome or one sided in your relationship. But what if you live in Pie Town, New Mexico: population 93? Pie Town may not have an anxiety support group. But all is not lost. You can search online for “chat rooms for anxiety.” You’ll find more than enough interesting sources of support. Try out a few and see whether you can find a group that feels compatible. Millions of people suffer from anxiety, and they have great advice and support to offer you. You don’t need to suffer alone. The best support groups give you ideas for coping. Beware of groups that seem to encourage whining and complaining. Also, be very careful of sharing personal information online. Considering booster sessions If you’ve seen a professional and later experience an unexpected increase in your anxiety, think about calling for a few booster sessions. Your therapist isn’t going to think you failed. Usually, a second round of therapy helps and doesn’t take as long as the first. In addition, some people like to check in every few weeks or months as a kind of prevention. Again, anxiety isn’t a disease with a single, one-shot cure. On the other hand, if you’ve never seen a professional and you experience a relapse, you should consider it now. If you’ve had previous success on your own, you’re likely to improve rapidly with a little assistance. Doubling down on exposure Consider a return of anxiety an opportunity to practice exposure. Exposure involves facing your fears until they become less intense. Avoidance of anxiety guarantees that anxiety will only persist and usually grow. So, when you experience a relapse of anxiety, try to welcome it as a potentially positive lesson in developing solid tools for growth. Accepting anxiety With this tip, we come full circle — back to the top of the list: Anxiety happens. It will return. Welcome it with open arms. It means that you’re still alive! Appreciate the positive aspects. Anxiety tells you to pay attention to what’s going on around you. Go with the flow. We’re not suggesting that you need to feel horrendous amounts of anxiety, but a little anxiety is unavoidable. And anxiety, when not overwhelming, may help mobilize your resources during difficult challenges.

Article / Updated 03-29-2021

Some people find that self-help is all they need. They read about good ways of dealing with their anxiety, and then they apply what they’ve discovered. Voilà! Their anxiety gradually fades to a manageable level. However, no self-help book is intended to completely replace professional help. And anxiety sometimes requires the assistance of a professional, just like complicated tax matters may call for a certified public accountant or deciding to draw up a will may send you to an attorney. We hope you understand that seeking a mental health professional’s assistance is a reasonable choice, not a sign of weakness. This article tells you how to know whether you should consider professional assistance for yourself or someone you care about. It’s not always an obvious decision, so we give you a list of indicators. And if you still aren’t sure, you can always talk with your primary care doctor, who should be able to help you decide. Suicidal thoughts or plans If you find yourself thinking about harming yourself, get help now. Take these thoughts very seriously. Call the national suicide hotline at 1-800-273-TALK (1-800-273-8255). If your thoughts become overwhelming, call 911 and get to an emergency room. Help is available. And when you do access professional help, be honest about your thoughts; hold nothing back. A professional can help gather other options and solutions that seem out of reach when someone is feeling tremendously anxious or depressed. Feeling hopeless From time to time, everyone feels defeated. But if you begin to feel hopeless about getting better, thinking that the future looks bleak and you can’t do much to change it, get professional help. Feelings of hopelessness put you at greater risk for suicide. You need to know that you can feel better. Let others help you. How you handle anxiety and depression You may be experiencing depression mixed with anxiety if you find yourself having some of the following symptoms: Feeling sad most of the day Losing interest or pleasure in activities Change in weight Changes in your sleep patterns and habits Decreased interest in sex Feeling keyed up or slowed down Feeling worthless Feeling excessively guilty Poor concentration Thoughts of death If you do have both anxiety and depression, seek professional help. Depression is a treatable condition. Having the energy to fight both can be hard. Trying self-help to no avail Perhaps you’ve read Anxiety For Dummies and given the recommendations your best shot at overcoming anxiety, but for whatever reason, they just haven’t worked. That’s okay. Don’t get more anxious because you didn’t get rid of worry and stress. Something else may be going on. Get an experienced mental health professional to help you figure out the next step. Struggling at home You’re anxious. The anxiety causes you to be irritable, jumpy, and upset. You hold it together at work and with strangers, but you take it out on the people you care about most, your family. Then you feel guilty, which increases your anxiety. If this sounds like you, a professional may help you decrease the tension at home and ease the pathway to finding peace. Dealing with major problems at work Maybe you have no one at home to take out your anxiety on, or perhaps home is the haven away from stress. If that’s the case, work stress may overwhelm you. If you find your anxiety exploding at work, consider professional help. First, anxiety sometimes causes irritability and moodiness with co-workers or bosses; such behavior can cause plenty of trouble. Anxiety can also rob you of your short-term memory, make it difficult to focus, or make decisions feel overwhelming. So if anxiety affects your job performance, get help before you hit the unemployment line. Suffering from severe obsessions or compulsions Anxiety is a problem that often co-occurs with other emotional disorders. Obsessive-compulsive disorder (OCD) is one of those disorders. OCD can easily consume many hours of time and cause serious impairment in the lives of those who suffer from it. The problem is that people with the disorder often don’t seek help until their lives are overwhelmed by unwanted thoughts or repetitive actions. Most people with OCD need professional help. If you or someone you love has more than mild OCD, get professional help. Post-traumatic stress disorder You feel agitated and keyed up. Were you also exposed to a traumatic event that resulted as follows? At the time, you felt helpless and afraid. Later, you try not to think about it. In spite of your efforts not to think about it, the thoughts and images keep popping up. If so, you may have post-traumatic stress disorder (PTSD). The treatment of PTSD is probably best done by an experienced professional. Many people with PTSD try to tough it out and live life less fully because of their stubbornness. Sleepless nights Is anxiety keeping you awake? That’s quite common. Too many sleepless nights make it hard to function and more difficult to help yourself in the fight against anxiety. If you sleep poorly night after night and awaken tired, check it out with a professional. You may be experiencing depression along with anxiety. Furthermore, insomnia is a treatable condition by professionals. Getting high Sure, a beer or three can seemingly soothe the soul, but excessive drinking or drug abuse is a common problem among those with anxiety disorders. It makes sense; anxious feelings are uncomfortable. What begins as an innocent attempt at feeling better can become another big problem later on. If you find yourself consuming too much alcohol or another drug to calm your feelings, get professional help before the crutch turns into an addiction. Finding help In the days of high-cost health care, you may not always have as much freedom to consult any professional you want. However, whether you receive a restricted list of professionals from your insurance company or not, it’s still a good idea to check out one or more of the following: Ask the insurance company or the state licensing board for the specific profession or license of the referred professional. Ask your friends if they know of someone with whom they had a good experience. Ask your primary care provider. Family physicians usually have a good idea about excellent referrals for various types of problems. Talk to the professional before making an appointment. Ask about his experience with treating anxiety and what approach he takes. Ask about whether you’ll receive a scientifically verified approach for dealing with anxiety. Call the psychology department of your local college or university. Sometimes they have referral lists. Call or use a search engine on the web to find your state psychological, psychiatric, or counseling association. Or check out national consumer organizations.

Article / Updated 03-29-2021

As common as anxiety disorders are, believing that you’re suffering from anxiety when you’re not is all too easy. Prescription drugs may have a variety of side effects, some of which mimic a few of the symptoms of anxiety. Sometimes what you eat or drink can make you feel anxious. Various medical conditions also produce symptoms that imitate the signs of anxiety. Anxiety-mimicking drugs Medicines prescribed to treat common conditions, such as asthma, inflammation, and depression, often have side effects. Sometimes those side effects can resemble the symptoms of anxiety. We list a few of the most widely prescribed types of drugs and their anxiety-mimicking side effects in the following table. These medications have many other side effects that we don’t list here. Angst in the Medicine Cabinet Drug Name or Category Purpose Anxiety-Like Side Effects Angiotensin-converting enzyme (ACE) inhibitors Reduce high blood pressure Nervousness, dizziness, insomnia, headaches, nausea, vomiting, weakness Corticosteroids Treat arthritis, inflammation, and pain Fatigue, anxiety, dizziness, nervousness, insomnia, nausea, vomiting, sweating, tremors, confusion, shortness of breath, irritability Bronchodilators Treatment of asthma Trembling, nervousness, sweating, shakiness, feelings of panic Benzodiazepines Treat anxiety Dizziness, headache, anxiety, tremors, stimulation, insomnia, nausea, diarrhea, irritability Beta blockers Reduce angina and high blood pressure, treat dysrhythmia Dizziness, nausea, palpitations, insomnia, excessive sweating, disorientation Novocaine Still used by some dentists as a numbing agent, but newer agents are becoming more popular due to reduced side effects. Rare side effects can include anxiety, irregular heart beat, and dizziness, which are especially troubling for patients who already have dentist-related anxiety. Selective serotonin reuptake inhibitors (SSRIs) Treatment of depression, anxiety, and bulimia Headache, insomnia, anxiety, tremor, dizziness, nervousness, fatigue, poor concentration, agitation, nausea, diarrhea, decreased appetite, sweating, hot flashes, palpitations, twitching, impotence Stimulant medications Treatment of attention deficit disorder Nervousness, rapid heartbeat, disturbed sleep, panic feelings Thyroid replacement medications Treatment of hypothyroidism Hives, chest pain, irregular heartbeat, nervousness, shortness of breath Interesting, isn’t it? Even medications for the treatment of anxiety can produce anxiety-like side effects. Of course, most people don’t experience such side effects with these medications, but they do occur. And many other prescribed drugs may have anxiety-like side effects. If you’re taking one or more prescription drugs and feel anxious, check with your doctor. In addition, various over-the-counter medications sometimes have anxiety-mimicking side effects. These include antihistamines that can cause both drowsiness and insomnia as well as restlessness and rapid heartbeat. Decongestants can also cause rapid heartbeat as well as sweating, dizziness, and blurred vision. Also, many types of aspirin contain caffeine, which can produce symptoms of anxiety if consumed excessively. These medications can cause restlessness, heart palpitations, tension, shortness of breath, and irritability. Ingest calmness into your diet Stress and anxiety often provoke people to binge on unhealthy foods and substances, which may lead to increased anxiety over the long run. Here, we tell you how to avoid foods or drinks that may worsen problems with anxiety. Notice whether you have special sensitivities to certain types of food. Whenever you feel out of sorts or especially anxious for no particular reason, ask yourself what you’ve eaten in the past couple hours. Take notes for a few weeks. Although food sensitivities aren’t generally a major cause of anxiety, some people have adverse reactions to certain foods, such as nuts, wheat, dairy, shellfish, or soy. If your notes say that’s true for you, avoid these foods! Alcohol may be very tempting to people with anxiety. Although alcohol may relax you in small quantities, too many anxious people try to self-medicate by imbibing. People with anxiety disorders easily become addicted to alcohol. Furthermore, in excess, alcohol can lead to a variety of anxiety-like symptoms. For example, after a night of heavy drinking, alcohol can leave you feeling more anxious because it clears the system quickly and the body craves more. That craving can lead to addiction over time. Even a couple of glasses of wine in the evening may help you sleep initially but disturb the quality of your sleep leading to fatigue in the morning. So, anxious people need to be cautious about their use of alcohol. Caffeine can also spell trouble. Some people seem to thrive on triple espressos, but others find themselves up all night with the jitters. Caffeine lurks in most energy drinks as well as chocolate, so be careful if you’re sensitive to the effects of caffeine. Speaking of energy drinks, these sometimes contain unusually large quantities of not only caffeine but also other stimulants. You’ll see herbal stimulants such as taurine, guarana (loaded with caffeine), ginseng, and ginkgo biloba, among others. Reported adverse effects include nervousness, sleeplessness, abnormal heart rhythms, and seizures. If you have excessive anxiety, you don’t want to be chugging down these concoctions. Finally, lots of people get nervous after eating too much sugar. Watch kids at birthday parties or Halloween. Adults can have the same reaction. Furthermore, sugar is bad for your body in a variety of ways, such as spiking blood glucose levels and contributing to metabolic syndrome (a condition that often leads to high blood pressure and diabetes). Medical anxiety imposters More than a few types of diseases and medical conditions can create anxiety-like symptoms. That’s why we strongly recommend that you visit your doctor, especially if you’re experiencing significant anxiety for the first time. Your doctor can help you sort out whether you have a physical problem, a reaction to a medication, an emotionally based anxiety problem, or some combination of these. The following table lists just some of the medical conditions that produce anxiety symptoms. Getting sick can cause anxiety, too. For example, if you receive a serious diagnosis of heart disease, cancer, or a chronic progressive disorder, you may develop anxiety about dealing with the consequences of what you’ve been told. Medical Imposters Medical Condition What It Is Anxiety-Like Symptoms Hypoglycemia Low blood sugar; sometimes associated with other disorders or can occur by itself. A common complication of diabetes. Confusion; irritability; trembling; sweating; rapid heartbeat; weakness; cold, clammy feeling Hyperthyroidism Excess amount of thyroid hormone. Various causes. Nervousness, restlessness, sweating, fatigue, sleep disturbance, nausea, tremor, diarrhea Other hormonal imbalances Various conditions associated with fluctuations in hormone levels, such as premenstrual syndrome (PMS), menopause, or postpartum. Highly variable symptoms. Tension, irritability, headaches, mood swings, compulsive behavior, fatigue, panic Lupus An autoimmune disease in which the patient’s immune system attacks certain types of its own cells. Anxiety, poor concentration, irritability, headaches, irregular heartbeat, impaired memory Mitral valve prolapse The mitral valve of the heart fails to close properly, allowing blood to flow back into the left atrium. Often confused with panic attacks in making the diagnosis. Palpitations, shortness of breath, fatigue, chest pain, difficulty breathing Heart disease (including arrhythmias and tachycardia) Conditions that involve narrowed or blocked blood vessels, problems with muscle, valves, or rhythm Shortness of breath, noticeable changes in rhythm or skipped beats, chest tightness or pain Chronic lung conditions (e.g., COPD, asthma) Irritation or damage to the lungs Shortness of breath, tightness in the chest, feelings of not getting enough air, panic Ménière’s syndrome An inner ear disorder that includes vertigo, loss of hearing, and ringing or other noises in the ear. Vertigo that includes abnormal sensations associated with movement, dizziness, nausea, vomiting, and sweating When you notice new signs of anxiety, ponder what changes you’ve made in your life. Have you started a new medication? Is something unusually stressful going on? How is your health? Have you made major changes to your diet or exercise routines? Answers to these questions may give you clues as to what’s causing your uptick in anxiety. But, it’s never a bad idea to check out these symptoms with your primary healthcare provider to play it safe.

Article / Updated 06-06-2016

Consider using mindfulness practices to help calm anxiety. Anxiety is a natural human emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. You feel anxious when you think that you’re being threatened. Fear is part of your survival mechanism – without feeling any fear at all, you’re likely to take big risks with no concern about dangerous consequences. Anxiety and panic can be due to a combination of factors, including your genes, the past life experiences you’ve had, the current situation you’re in, and if you’re under the influence of drugs, including caffeine. Eliminating fearful thoughts isn’t easy. The thoughts are sticky and the more you try and push them out, the stronger the worries and anxieties seem to cling on. In this way, you can easily get into a negative cycle in which the harder you try to block out the negatives, the stronger they come back. Mindfulness encourages you to face up and experience all your experiences, including the unpleasant ones. In this way, rather than avoid anxious thoughts and feelings, which just makes them stronger and causes them to control your life, you begin to slowly but surely open up to them, in a kind and gentle way, preventing them building up out of proportion. Use mindfulness to cope with anxiety If you worry a lot, the reason for this is probably to block yourself from more emotionally distressing topics. Although the worry is unpleasant and creates anxiety, the thoughts keep you from feeling deeper emotions. However, until you open up to those deeper emotions, the worry continues. Worry is an example of experiential avoidance. Mindfulness trains you to become more open and accepting of your more challenging emotions, with acknowledgement, curiosity and kindness. Mindfulness also allows you to see how you’re not your emotions, and that your feelings are transient, and so it helps you to reduce anxiety. Mindfulness encourages you to let go of worries by focusing your attention on the present moment. Here’s a mindful exercise for anxiety. Get comfortable and sit with a sense of dignity and poise on a chair or sofa. Reflect on the thoughts flowing through your mind, emotions arising in your being, and physical sensations in your body. As best you can, open up to the experiences in the here and now for a few minutes. Place your hand on your belly and feel your belly rising and falling with your breath. Sustain your attention in this area. If anxious thoughts grasp your attention, acknowledge them but come back to the present moment and, without self-criticism if possible, focus back on the in- and out- breath. Continue for a few minutes. When you’re ready, expand your awareness to get a sense of your whole body breathing, with wide and spacious attention, as opposed to the focused attention on the breath alone. If you like, imagine the contours of your body breathing in and out, which the body does, through the skin. Continue for as long as you want. Note your transition from this mindfulness exercise back to your everyday life. Continue to suffuse your everyday activities with this gentle, welcoming awareness, just to see what effect mindful attention has, if any. If you find the practice supportive, come back to this meditation to find some solace whenever you experience intrusive thoughts or worries. Mindfulness isn’t about trying to get rid of your anxiety, or any other difficult experience. Mindfulness offers the possibility of developing a healthy stance towards your unpleasant experience. This changes your relationship with the anxiety and therefore gives freedom for that emotion to move on, when you’re ready. Use mindfulness to be with anxious feelings If you want to change anxiety, you need to begin with the right relationship with the anxiety, so you can be with the emotion. Within this safe relationship, you can allow the anxiety to be there, neither suppressing nor reacting to it. By maintaining a mindful awareness, the anxiety may settle. Even if it doesn’t go away, by sitting calmly next to it, your experience isn’t such a struggle. You don’t need to face anxiety head-on straight away – here are the steps you can take over a period of days, weeks or months. Observe how you normally react when anxiety arises, or if you’re always anxious, notice your current attitude towards the emotion. Consider the possibility of a more mindful attitude to take towards the anxiety. Feel the anxiety for about a minute with as much kindness and warmth as you can, breathing into it. Notice the color, shape and texture of the feeling. What part of your body does it manifest in? Does the intensity of the sensation increase or decrease with your mindful awareness? Explore the area somewhere between retreating away from and diving into the anxiety and allow yourself to be fascinated by what happens on this edge with your kindly, compassionate awareness. Watch the feeling as you may look at a beautiful tree or flower, with a sense of warmth and curiosity. Breathe into the various sensations and see the sensations as your teacher. Welcome the emotion as you may welcome a guest with open arms. This isn’t a competition to go from Steps 1 to 5 but is a process, a journey you take at your own pace. Step 1 is just as important, significant and deep as Step 5. Remember that these steps are a guide – move into the anxiety, or whatever the emotion is, as you see fit. Trust in your own innate wisdom to guide your inner journey.

Article / Updated 03-26-2016

Anxiety appears in different forms for different folks. You may find that anxiety affects your thoughts, behaviors, and feelings. Some of the more common symptoms are listed as follows: You’re thinking anxiously if you’re . . . Making dire predictions about the future. Thinking you can’t cope. Frequently worrying about pleasing people. Thinking that you need to be perfect. Having excessive concerns about not being in control. You’re behaving anxiously if you’re . . . Avoiding many social events. Leaving situations that make you anxious. Never taking reasonable risks. Staying away from feared objects or events, such as spiders or flying. Procrastinating so much on tasks that you fall badly behind. You’re feeling anxious if you have . . . Butterflies in your stomach Dizziness Muscle tension A racing heart A shaky feeling Sweaty palms The physical symptoms of anxiety may result from medical problems. If you have a number of these symptoms, please see a physician for a checkup.

Article / Updated 03-26-2016

The words you use to think about yourself and the world can contribute to your anxiety. When you take some time to examine your anxious thoughts, you may find that your anxiety decreases. If your mind is filled with worries and concerns, try asking yourself these questions: How will I look at this concern six months from now? Have I had this worry before only to discover that what I worried about never actually occurred? What evidence truly supports or refutes my worry? If a friend of mine had this thought, what advice would I give? If the worst happens, could I find a way to cope with it?