Anxiety

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

Physical Symptoms

	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

Psychological Symptoms

	Anger; irritability
	Lack of concentration; poor memory

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 and interferes with your day-to-day life.

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, caffeine, 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 “Phobias”.)
	Panic Attacks and Panic Disorder (See “Panic Attacks”.)
	Obsessive-Compulsive Disorder
	Posttraumatic Stress Disorder (PTSD) and Critical Incident Stress Syndrome. (See “Posttraumatic Stress Disorder”.)

When anxiety is mild and/or does not interfere with daily living, it can be dealt with using self-help techniques. (See “Self-Help” below.)

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

Treatment

	Treating any medical condition which causes the anxiety
	Psychological counseling
	Medication. Examples include anti-anxiety medicines, such as Xanax, and antidepressants, such as Tofranil and Prozac.
	Self-help groups, such as Agoraphobics in Motion (AIM). (See “National Resources”.)

Questions to Ask

With anxiety, are any of these heart attack signs present? Chest pressure or pain (may spread to the arm, neck, tooth, or jaw) Feeling of chest tightness, squeezing, or heaviness that lasts more than a few minutes or goes away and comes back Chest discomfort with: Shortness of breath; nausea; sweating; fast or uneven pulse; lightheadedness; or fainting Atypical chest pain, abdominal or stomach pain An uneasy feeling in the chest with: Unexplained anxiety, fatigue, or weakness; fluttering heartbeats; or severe indigestion (doesn’t go away with an antacid) Sweating for no reason; pale, gray, or clammy skin

With anxiety, are these signs present? 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 Problems sleeping Weight loss Muscle weakness, tremors Bulging eyes Feeling hot or warm all the time

If you have been through or seen a traumatic event, see “Questions to Ask” in “Posttraumatic Stress Disorder” .

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 a diabetic During the two weeks before your menstrual periods if you are female

Does the anxiety come only after any 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 one month by fears of getting another one Worry about what would happen with another panic attack A change in what you do related to panic attacks, such as avoiding places, not being able to leave the house, or being left alone

Do any of the following keep you from doing your daily activities? Checking something over and over again, such as checking 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

Is anxiety in general keeping you from doing the things you need to do every day?

Self-Help

	Look for the cause of the stress that results in anxiety and deal with it through the use of stress management techniques. (See “Stress - Self-Help”.)
	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 foods. Eat at regular times. Don’t skip meals.
	If you are prone to low blood sugar episodes, eat 5-6 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 boost in the event that you do get a low blood sugar reaction.
	Exercise regularly.
	Limit or avoid caffeine intake after 12:00 noon. Caffeine can worsen anxiety and lead to poor sleeping patterns. If you must drink coffee, switch to decaffeinated. Also drink decaffeinated teas, colas and other sodas. Limit your intake of chocolate.
	Avoid nicotine and use alcohol in moderation.
	Avoid medicines that have a stimulating effect which can cause anxiety-like symptoms. Examples are OTC diet pills and stay awake pills.
	Do some form of relaxation exercise daily. Examples include biofeedback, deep muscle relaxation, meditation, deep breathing exercises, yoga, and tai chi.
	Don’t overwhelm yourself. Plan your schedule for what you can handle both physically and mentally.
	Do a stress rehearsal for events that cause anxiety. Imagine yourself feeling calm and in control during the event several times before it really occurs.
	Use a *Thought Zapper*. By linking stressful or negative thoughts with an unpleasant event, you can learn to eliminate the thoughts. For example:

Place a rubber band around your wrist.

Become aware of a negative thought.

Stretch the rubber band and give yourself a zap.

Repeat as needed.

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 re-breathe 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.

What You Can Do For a Friend or Relative

	Be supportive - Take their anxiety seriously. Telling them they are being “silly” or “childish” will not help them. It will only serve to increase their feelings of anxiety and alienation.
	Engage in activities with your friend or relative to help take their mind off their anxiety (i.e., exercise, shopping, etc.).
	If your friend or relative is being treated for an anxiety disorder, remind them to do the things their health care provider has advised.
	If your friend or relative is not getting help for their anxiety, encourage them to seek treatment. (See “National Resources”.)
	Do not “force” your friend or relative to stay in or go to a place that causes anxiety.
	Be willing to accept your friend or relative’s need for “a way out” of a situation which they can’t deal with. For example, if your friend or relative sometimes has a lot of anxiety in a crowded theater, get aisle seats and plan ahead of time what you are willing to do in case your friend or relative has an anxiety attack. It would be comforting for them to know that you are willing to take them home whenever they want, if this is the case.
	Do not force your friend or relative into a direct, sudden confrontation with their anxiety-provoking situation. This will only intensify the problem.