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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 use disorder, drug abuse, and depression.

Causes    TOP

Anxiety disorders may result from a combination of factors, such as:

  • Genetics
  • Factors in the environment

Chemical imbalances in the brain may also play a role.

Risk Factors    TOP

Anxiety disorders are nearly twice as common in women than in men. Other factors that may increase your chance of anxiety disorders include:

  • Family member with anxiety disorders
  • Stressful life events
  • Poor coping strategies
  • History of physical or psychological trauma
  • Chronic medical illness
  • Substance abuse
  • History of self-harm as a teenager, with or without suicidal intent

Symptoms    TOP

Psychological symptoms may include:

  • Worry or dread
  • Intrusive or ruminative thoughts
  • Sense of imminent danger or catastrophe
  • Fear or panic
  • Restlessness
  • Irritability
  • Impatience
  • Uncertainty
  • Trouble concentrating

Physical symptoms may include:

  • Headache
  • Fatigue
  • Chest pain
  • 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
  • Abdominal discomfort
  • 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
Copyright © Nucleus Medical Media, Inc.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical and psychiatric exam will be done. Conditions with similar symptoms will be evaluated. Blood and urine tests may be done.

Your doctor will ask questions about your:

  • Use of alcohol and drugs
  • Mental health history
  • Family's mental health history

You may be referred to a psychotherapist for further evaluation.

Treatment    TOP

Effective treatment usually involves a combination of interventions, including:

Lifestyle Changes

  • Get sufficient rest and sleep.
  • If you smoke, talk to your doctor about ways to quit.
  • Reduce or eliminate caffeinated beverages.
  • Excess alcohol use can make anxiety worse—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    TOP

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

Psychotherapy    TOP

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    TOP

For severe anxiety or anxiety disorder, medications may include:

  • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants
  • Buspirone
  • Benzodiazepines

Talk to your doctor about the risks and benefits of these medications. Some types may cause dependence.

Prevention    TOP

To help reduce your chance of anxiety:

  • Be aware of 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. Moderation is (one drink or less per day for women and two drinks or less per day for men.

RESOURCES:

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

CANADIAN RESOURCES:

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

References:

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at:
...(Click grey area to select URL)
Updated December 23, 2014. Accessed January 26, 2016.
Generalized anxiety disorder. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated December 23, 2015. Accessed January 26, 2016.
Generalized anxiety disorder (GAD). National Institute of Mental Health website. Available at:
...(Click grey area to select URL)
Accessed January 26, 2016.
12/4/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
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
...(Click grey area to select URL)
Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.
11/6/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Mars B, Heron J, Crane C, et al. Clinical and social outcomes of adolescent self harm: Population based birth cohort study. BMJ. 2014;349:g5954.
Last reviewed December 2015 by Adrian Preda, MD
Last Updated: 1/26/2016

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