WHAT IS ANXIETY?
Anxiety is a feeling of unwelcome anticipation that can be debilitating and often all-consuming at times. For most people, anxiety is situation specific, meaning that it only occurs in certain situations. For example, you may feel anxious about a job interview, an upcoming test, or a presentation for work. Other situations which can often lead to longer-term anxiety include changes to family structure, moving to a new town, and illnesses (1). Unfortunately for many people, anxiety is a consistently pressing feeling that prevents them from fulfilling normal responsibilities and living a full life.
A feeling of intense anxiety that regularly interferes with normal daily activities is a sign of an anxiety disorder (2). Due to anxiety takes varying forms in different people, anxiety disorder also varies in symptoms and intensity. The grouping together of similar forms of anxiety is an attempt to find ways to understand and help those living with anxiety. Some of the groupings include generalized anxiety disorder, panic attacks, and social anxiety disorder.
- Generalized anxiety disorder is the term used for those with a general feeling of anxiety for more than six months, not associated with one particular stressor. Those living with generalized anxiety worry excessively about multiple factors of their lives and often are unable to see past the worst-case scenario. For them, anxiety feels beyond their control, and they may feel unable to comfortably make it through an entire day because they worry about so many aspects of their lives (3).
- Panic attacks are sudden onset feelings of terror. They can strike at any time and those suffering with them live in fear of future attacks. These people will often avoid a place where an attack has taken place and sometimes will confine themselves to their home as a safeguard (4).
- Social anxiety disorder is when the person is focused on social situations or performance in front of a group. The fear of being judged and rejected by others leads those with social anxiety disorder to avoid many healthy and potentially uplifting social interactions. This disorder can be especially taxing because people’s social needs are integral to mental health (5).
RISK FACTORS FOR ANXIETY
- Having blood relatives with anxiety
- Socioeconomic status
- The death of a loved one
- Traumatic life events (5,6)
SYMPTOMS OF ANXIETY
At its root, anxiety exerts a psychological rather than physical influence. It is associated with sleep abnormalities including fatigue, insomnia, irritability, and difficulty concentrating (1). Despite an understanding of the irrationality of their worry, those with anxiety disorders often cannot control their feelings and they begin to feel helpless. Often, the psychological effect of anxiety is so great that it can lead to physical symptoms such as headaches and or stomach aches (3). Overpowering anxiety, as seen in panic attacks, can even result in heart palpitations, chest pain, difficulty breathing, and sweating (4) caused by an increase in the stress hormone known as adrenalin (7).
If you are experiencing any of the above symptoms, seek the attention of your health care provider, or counselor. For more information on anxiety: 1. Talk to you physician 2. Visit the Anxiety and Depression Association of America website 3. Visit the National Institute of Mental Health website
ANXIETY FACTS AND STATISTICS
Anxiety affects approximately 44 million American adults making anxiety the most common form of psychiatric illness experienced in the United States. Sadly, those suffering from anxiety disorders often do not seek help. In fact, an estimated 1/3 of those living with anxiety disorders fail to do so (2). This can likely be attributed to the stigma against mental health disorders or even seeking out help if you believe to have one (8). As stated above, our hope is that you feel comfortable enough to seek help if you are unsure about your anxiety.
MEDICAL TREATMENT OF ANXIETY
Anxiety is preferentially treated with therapy of one kind or another, this includes psychotherapy, cognitive behavioral therapy, and support groups. Psychotherapy is a one-on-one talk with a therapist about the anxiety. It is often termed “talk therapy”. Cognitive behavioral therapy can be broken up into cognitive therapy and exposure therapy. Cognitive therapy entails learning to identify anxiety triggering thoughts and training to think in new patterns to avoid destructive ideas. Exposure therapy, though not as effective as cognitive therapy, desensitizes those with specific anxieties. This allows people to confront their fears slowly, thereby building up a tolerance. Support groups can help those involved feel less isolated and understand that others struggle with similar hardships (5).
The medications used to treat the various forms of anxiety include many classes of drugs active in the brain. Those medications include (9):
- Benzodiazepines such as Xanax and Valium. Possible side-effects include drowsiness, impaired memory, impaired motor coordination or balance, and lightheadedness (10).
- Beta-blockers such as Inderal and Tenormin. Possible side-effects include cold extremities, dizziness, and tiredness (11).
- Tricyclic antidepressants including Tofranil and Anafranil. Possible side-effects include dry mouth, blurred vision, constipation, and difficulty in urination; postural hypotension; tachycardia (11).
- Selective serotonin reuptake inhibitors including Prozac and Zoloft. Possible side-effects include nausea, insomnia, headaches, sexual difficulties, initial agitation (11).
- Anticonvulsants including Lyrica and Neurontin (8). Possible side-effects include nausea, vomiting, indigestion, headaches, confusion, and drowsiness (11).
These are best utilized in conjunction with therapy when the condition is sufficiently severe.
NATURAL WAYS TO SUPPORT MENTAL HEALTH
Practices to Support Mental Health:
- Aerobic exercise (5)
- Taking comfort in supportive family members or friends (5)
- Meditation and yoga have been found to help in the management of stress, anxiety, and pain (5)
- Compartmentalization and proper planning to reduce anxiety induced by procrastination (12)
- Avoidance of highly caffeinated products, although dark chocolate does confer benefit (5)
Natural Supplements that Support Mental Health:
- Cocoa seed extract (13)
- Ashwagandha root extract (Withania somnifora) (14)
- GABA (15)
- Kava Kava (16)
- L-Theanine (17)
- Magnesium (18)
- Le, Tao, and Vikas Bhushan. First Aid for the USMLE Step 1 2017. 27th edition. New York: McGraw-Hill Medical, 2017.
- Understanding the Facts. Anxiety and Depression Association of America. https://adaa.org/understanding-anxiety. Accessed April 14, 2018.
- Generalized Anxiety Disorder. Anxiety and Depression Association of America. https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad. Accessed April 16, 2018.
- Panic Disorder. Medline Plus. https://medlineplus.gov/panicdisorder.html. Accessed April 16, 2018.
- Anxiety Disorders. National Institute for Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed April 13, 2018.
- Anxiety. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961. Accessed April 20, 2018.
- van Zijderveld GA, Veltman DJ, van Dyck R, van Doornen LJ. Epinephrine-induced panic attacks and hyperventilation. J Psychiatr Res. 1999;33(1):73-8.
- 8 Fascinating Facts about Anxiety: Symptoms, Statistics, and Efforts to Reduce the Stigma. Neurocore Brain Performance Centers. https://www.neurocorecenters.com/8-facts-anxiety-symptoms-statistics. Accessed April 20, 2018.
- Introduction: Common Medications for Anxiety Disorder. Anxieties.com. https://www.anxieties.com/152/introduction-common-medications-for-anxiety-disorders#.Wyz5_KdKjD4. Accessed April 20, 2018.
- Valium vs. Xanax: Is There a Difference? Healthline. https://www.healthline.com/health/mental-health/valium-vs-xanax#side-effects. Accessed June 15, 2018.
- Medication Profiles. Anxiety.com https://www.anxieties.com/154/med-profiles#.WyPUKadKjD4. Accessed June 15, 2018.
- 6 Tips for Overcoming Anxiety-Related Procrastination. Psychology Today. https://www.psychologytoday.com/us/blog/in-practice/201303/6-tips-overcoming-anxiety-related-procrastination. Accessed April 21, 2018.
- Nehlig A. The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. Br J Clin Pharmacol. 2013; 75(3): 716–727. doi:10.1111/j.1365-2125.2012.04378.x
- Pratte M A, Nanavati K B, Young V, Morley C P. An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera). J Altern Complement Med. 2014; 20(12): 901–908. doi:10.1089/acm.2014.0177
- Goddard A W. Cortical and subcortical gamma amino acid butyric acid deficits in anxiety and stress
- Boyles, Salynn. Kava for Anxiety: Is Short-Term Use Safe?. WebMD. https://www.webmd.com/anxiety-panic/news/20090514/kava-for-anxiety-is-short-term-use-safe#1. Accessed April 21, 2018.
- Ritsner MS, Miodownik C, Ratner Y, Shleifer T, Mar M, Pintov L, Lerner V. L-theanine relieves positive, activation, and anxiety symptoms in patients with schizophrenia and schizoaffective disorder: an 8-week, randomized, double-blind, placebo-controlled, 2-center study. J Clin Psychiatry. 2011;72(1):34-42. doi:10.4088/JCP.09m05324gre.
- Neil Bernard Boyle, Clare Lawton, and Louise Dye. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress- A Systematic Review. Published online 2017 Apr 26. doi:10.3390/nu9050429.