Anxiety

Anxiety is a feeling of dread, fear or distress over a real or imagined threat to your mental or physical well-being.

Symptoms


Symptoms of anxiety are both physical and psychological. They include:

• Rapid pulse and/or breathing rate
  
• Racing or pounding heart
  
• Dry mouth
  
• Sweating
  
• Trembling
  
• Shortness of breath
  
• Faintness
  
• Numbness/tingling of the hands, feet, or other body part
  
• Feeling a “lump in the throat”
  
• Stomach problems
  
• Insomnia
  

A certain amount of anxiety is normal. It can prompt you to study for a test. It can alert you to seek safety when you are in physical danger. Anxiety is not normal, though, when there is no apparent reason for it or when it overwhelms you and interferes with your day-to-day life.

Causes


Anxiety can be a symptom of medical conditions such as:

• A heart attack
  
• An overactive thyroid gland (hyperthyroidism)
  
• Low blood sugar (hypoglycemia)
  
• An excess of hormones made by the glands located above the kidneys called the adrenal glands (Cushing’s syndrome)
  
• A side effect of some medications
  
• A withdrawal reaction from nicotine, alcohol, drugs, or medicines, such as sleeping pills
  

Anxiety can also be a symptom of a number of illnesses known as anxiety disorders. These include:

• Phobias (see page 203)
  
• Panic attacks and panic disorder (see page 200)
  
• Obsessive-Compulsive Disorder An anxiety disorder where the sufferer has persistent, involuntary thoughts or images (obsessions) and engages in ritualistic acts such as washing their hands according to certain self-imposed rules (compulsions).
  
• Post-Traumatic Stress Disorder A condition where a person reexperiences a traumatic past event like a wartime situation, hostage taking, or rape. Symptoms include nightmares, flashbacks of the event, excessive alertness, and emotional numbness to people and activities.
  

Treatment


When anxiety is mild and/or does not interfere with daily living, it can be dealt with using self-help. (See Self-Care Tips in this section on page 183.)

Treatment for anxiety includes:

• Treating any medical condition which causes the anxiety
  
• Medication. Examples include antianxiety medicines such as Xanax, and antidepressants such as Tofranil and Prozac. Another medicine, Tenormin, which is usually used for high blood pressure, has been shown to help persons with the anxiety that comes with stage fright.
  
• Psychological counseling
  
• Changing jobs or other life situations
  
• Self-help groups such as Agoraphobics in Motion (AIM). (See “Places to Get Information & Help” under “Anxiety/Phobias” on page 375.)
  

Anxiety disorders are some of the most common conditions people suffer with. They often respond to treatment.

Questions to Ask

Are any of these symptoms of a heart attack present with the anxiety? Chest pressure or pain (may spread to the arm, neck, or jaw) Chest discomfort with any of these problems: Shortness of breath or trouble breathing; nausea or vomiting; sweating; uneven heartbeat or pulse; or sense of doom
Are these symptoms present with the anxiety? Excessive hair growth Round face and puffy eyes Skin changes reddening, thinning, and stretch marks High blood pressure
Do you have these symptoms with the anxiety? Rapid heartbeat Hyperactivity Weight loss Muscle weakness, tremors Bulging eyes Feeling hot or warm all the time
If you have been through or seen a traumatic event, do you suffer from any of these problems? Nightmares, night terrors, and/or flashbacks of the event Lack of concentration, poor memory, sleep problems Feelings of guilt for surviving the event Startled easily by loud noises or anything that reminds you of the event Lack of interest in the activities and people you once enjoyed	Or
Do you have anxiety only under the following conditions? When you don’t eat or when you do too much physically, especially if you are diabetic During the 2 weeks before your menstrual period if you are a woman
Does the anxiety come only after 1 or both of the following? Taking an over-the-counter (OTC) or prescription medicine Withdrawing from medication, nicotine, alcohol, or drugs
Have you had any of these problems? Panic attacks followed for 1 month by fears of getting another one Worry about what would happen with another panic attack, or A change in what you do related to panic attacks such as avoiding places, not being able to leave the house or be left alone	Or
Do any of the following keep you from doing your daily activities? Checking something over and over again, such as seeing if you’ve locked the door, even though it is locked Repeated, unwanted thoughts such as worrying you could harm someone Repeated, senseless acts such as washing your hands over and over again	Or
Is anxiety keeping you from doing the things you need to do every day?	Or

Self-Care Tips

• Look for the cause of the stress that results in anxiety and deal with it through the use of stress management techniques, such as deep breathing exercises and meditation. (See “Self-Care Tips” under “Stress” on pages 212 and 213.)
  
• Lessen your exposure to things that cause you distress.
  
• Talk about your fears and anxieties with someone you trust such as a friend, spouse, teacher, etc.
  
• Eat healthy and at regular times. Don’t skip meals.
  
• If you are prone to low blood sugar episodes, eat 56 small meals per day instead of 3 larger ones. Avoid sweets on a regular basis, but carry a quick source of sugar with you at all times, such as a small can of orange juice. This will give you a quick source of sugar in the event that you do get a low blood sugar reaction.
  
• Exercise regularly.
  
• Limit or avoid caffeine intake after noon. Caffeine can worsen anxiety and lead to poor sleeping patterns. If you must drink coffee, switch to decaffeinated. Also use decaffeinated teas, colas, and other sodas. Limit your intake of chocolate.
  
• Avoid nicotine and alcohol.
  
• Avoid medicines that have a stimulating effect, which can cause anxietylike symptoms. Examples are over-the-counter diet pills and pills to keep you awake.
  
• Do some form of relaxation exercise daily. Examples include biofeedback, deep muscle relaxation, meditation, and deep breathing exercises.
  
• Don’t “bite off more than you can chew.” Plan your schedule for what you can handle both physically and mentally.
  
• Rehearse for events that are coming up about which you have felt anxious in the past or think will cause anxiety. Imagine yourself feeling calm and in control during the event several times before it really occurs.
  
• Be prepared to deal with symptoms of anxiety if you think they will happen. For example, if you have hyperventilated in the past, carry a paper bag with you. If you do hyperventilate, cover your mouth and nose with the paper bag. Breathe into the paper bag slowly and rebreathe the air. Do this in and out at least 10 times. Remove the bag and breathe normally a few minutes. Repeat breathing in and out of the paper bag as needed.
  
• Help others. The positive feelings from this can help you overcome or forget about your anxiety.