McKesson Clinical Reference Systems: Adult Health Advisor 2002.1

What is anxiety?

Anxiety is a feeling of uneasiness, apprehension, or tension you feel in response to stressful or threatening circumstances. Some people feel more anxiety than others.

How does it occur?

Anxiety can either be mild or so intense that you feel panic. Normally anxiety is temporary, but when it lasts a long time or occurs in the absence of a stress or threat, it is considered an illness.

When anxiety is so extreme that a person is in a panic state, then the anxiety is a psychiatric disorder known as a panic disorder.

Anxiety can be brought on by certain drugs, including:

• alcohol
• cocaine
• caffeine
• certain sedatives
• amphetamines
• other drugs that affect the nervous system.

What are the symptoms?

The signs and symptoms of anxiety can be classified into two categories, psychological and physical.

Psychological signs and symptoms include:

• apprehension
• irritability
• panic
• impatience
• feeling of imminent danger
• restlessness
• fear
• inability to relax
• difficulty concentrating
• trouble sleeping
• lack of enjoyment.

Physical signs and symptoms include:

• dry mouth
• flushing
• nausea, vomiting
• faintness
• lightheadedness
• diarrhea
• constipation
• muscle tension
• frequent urination
• hyperactivity
• sexual difficulties
• tremors
• rapid or irregular heartbeat
• hyperventilation
• sweating, especially in the palms
• shortness of breath
• tingling
• choking sensation.

How is it diagnosed?

Anxiety is diagnosed by interview. Your doctor will try to identify symptoms associated with anxiety. He or she will ask you about life events, daily activities, and your view of how things are going.

In addition, the doctor will examine you. Lab tests may be done to rule out the possibility of a physical problem as the underlying reason for your anxiety. Possible tests include a complete blood count, blood analysis, thyroid function tests, and urine analysis.

How is it treated?

You and your doctor will discuss your symptoms. Then he or she will try to suggest ways to help you deal with anxiety. The doctor will also try to identify circumstances that trigger anxiety. The doctor may refer you to a psychotherapist, a specialist who can help you learn how to deal with anxiety due to stressful circumstances. Talking with your doctor or a therapist can be helpful in these cases.

If your doctor suspects your anxiety may be caused by drugs or physical problems, he or she will give you a physical exam and do lab tests. The doctor will then recommend treatment.

If your anxiety is severe or causing panic, your doctor may prescribe a medicine to help you cope with the symptoms initially. These medicines are most effective when used in combination with psychotherapy and stress management techniques.

To decrease anxiety, it is important to identify and use methods that relieve the symptoms. Your doctor may want to see you regularly if your anxiety attacks include physical signs and symptoms.

How can I take care of myself?

Increase your awareness of how anxiety and stress affect you and learn which coping methods work for you. Also, get enough rest, exercise, and learn to use relaxation techniques. Talk with your doctor or therapist about managing events in your life that trigger anxiety. In addition, learn to talk with friends and co-workers about the normal stresses of daily life.

What can I do to help prevent anxiety?

Anxiety may occur when life's demands are greater than your ability to cope with them. Therefore, prevention means improving your coping skills or modifying the demands and expectations in your life. To prevent anxiety, try these techniques:

• relaxation techniques such as self-hypnosis and meditation
• behavioral techniques aimed at improving ways of coping (exercising, getting adequate rest)
• counseling such as marital counseling, parent effectiveness training, and job or career counseling aimed at changing stressful life circumstances
• broadening and deepening positive relationships by finding group activities that encourage give and take and provide a feeling of support.

Mild anxiety can be useful; research has shown that encouraging mild anxiety in the classroom enhances learning. However, anxiety can be harmful because it puts your body and mind in a constant state of excitement, which changes some body functions such as heart rate. Allowing anxiety to continue or to become your main focus doesn't resolve the events in life that cause the anxiety.

Knowing how to lessen anxiety can build emotional strength to cope with life events that cause anxiety. To minimize negative stress that can cause anxiety:

• Exercise for 20 minutes, at least three times a week.
• Change your drinking, eating, and sleeping habits:
  • Rest or sleep 6 to 10 hours a day.
  • Drink less coffee and alcohol.
• Find improved ways to cope with stress:
  • Change or eliminate what causes your stress.
  • Develop methods of relaxation like talking with positive-minded people, listening to music, sewing, playing cards, walking, or enjoying hobbies.
  • Learn to use stress management techniques like muscle relaxation exercises, mental imagery, and diaphragmatic breathing.
  • Use positive thoughts to overcome negative ones, such as telling yourself, "I am doing a good job."
  • Develop and maintain an attitude that things will work out.
  • Ask for help at home and work when the load is too great to handle.
  • Seek professional help for dealing with life events that produce stress, and for developing positive ways of coping.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.