Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe.
Everyone has feelings of anxiety at some point in their life. For example, you may feel worried and anxious about sitting an exam, or having a medical test or job interview.
During times like these, feeling anxious can be perfectly normal. But some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives.
Anxiety is the main symptom of several conditions, including:
- panic disorder
- phobias, such as agoraphobia or claustrophobia
- post-traumatic stress disorder (PTSD)
- social anxiety disorder (social phobia)
The information in this section is about a specific condition called generalised anxiety disorder (GAD).
GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than 1 specific event. People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed.
As soon as 1 anxious thought is resolved, another may appear about a different issue.
Slightly more women are affected than men, and the condition is more common in people from the ages of 35 to 59.
Key facts
- Anxiety disorders differ from normal feelings of nervousness or anxiousness because they involve excessive fear or anxiety, and typically cause reactions out of proportion to the circumstances. Anxiety disorders can interfere with job performance, school work, and relationships.
- Anxiety can produce both physical and emotional symptoms. People with generalized anxiety disorder (GAD) experience restlessness, irritability, difficulty concentrating, chronic fatigue, nausea, dizziness, and worsening worry or fear over extended periods of time.
- Other common anxiety disorders include panic disorder, specific phobias, separation anxiety disorder, social anxiety, and selective mutism.
- Anxiety disorders are the most common of mental disorders and will affect nearly 30% of adults at some point in their lives.
- women are twice as likely to be affected as men.
- Nearly 50% of Americans diagnosed with depression are also diagnosed with an anxiety disorder.
- Closely related to anxiety disorders are eating disorders, sleep disorders, bipolar disorder, body dysmorphic disorder (BDD), post-traumatic stress disorder (PTSD), chronic pain, and obsessive-compulsive disorder (OCD).
- Though anxiety disorders are highly treatable, only about 1/3 of those suffering receive adequate treatment or counselling. Even fewer in Nigeria.
- Anxiety disorders can be caused by a number of factors, including trauma, stress buildup or stress due to an illness, withdrawal from drugs or alcohol, or family history of mental health issues.
- Approximately 8% of children and teenagers experience an anxiety disorder, with many symptoms developing before age 21.
- An estimated 284 million people worldwide experienced an anxiety disorder in 2017, making it the most prevalent mental health disorder around the globe.
Symptoms
Generalised anxiety disorder (GAD) can affect you both physically and mentally. How severe the symptoms vary from person to person. Some people have only 1 or 2 symptoms, while others have many more.
Psychological symptoms of GAD
GAD can cause a change in your behaviour and the way you think and feel about things, resulting in symptoms such as:
- restlessness
- a sense of dread
- feeling constantly “on edge”
- difficulty concentrating
- irritability
Your symptoms may cause you to withdraw from social contact (seeing your family and friends) to avoid feelings of worry and dread.
You may also find going to work difficult and stressful and may take time off sick. These actions can make you worry even more about yourself and increase your lack of self-esteem.
Physical symptoms of GAD include;
- dizziness
- tiredness
- a noticeably strong, fast or irregular heartbeat (palpitations)
- muscle aches and tension
- trembling or shaking
- dry mouth
- excessive sweating
- shortness of breath
- stomach ache
- feeling sick
- headache
- pins and needles
- difficulty falling or staying asleep (insomnia)
Diagnosis
A doctor or mental health professional may diagnose GAD according to the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
To receive a diagnosis of GAD, a person must have:
- excessive anxiety and worry in several areas of their life on more days than not for at least 6 months
- difficulty controlling these worries
- at least three of the following symptoms (or just one symptom in the case of children):
- restlessness
- fatigue
- difficulty concentrating
- irritability
- tense muscles
- sleep problems
- significant distress or problems functioning in social settings or at work
- Also, these symptoms must not result from substance use or another medical condition.
To confirm a diagnosis or rule out physical conditions that may be causing symptoms, a doctor may:
- perform a physical examination
- take a detailed medical and family history
- use a psychological questionnaire
- order blood or urine tests
Causes
The exact cause of GAD is not fully understood, although it is likely that a combination of several factors plays a role. Research has suggested that these may include:
- overactivity in areas of the brain involved in emotions and behaviour
- an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood
- the genes you inherit from your parents – you’re estimated to be 5 times more likely to develop GAD if you have a close relative with the condition
- having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying
- having a painful long-term health condition, such as arthritis
- having a history of drug or alcohol misuse
But many people develop GAD for no apparent reason.
Prevention
Many people can find relief by adopting certain lifestyle habits. These may include:
- regular exercise, a healthy diet, and plenty of sleep
- yoga and meditation
- avoiding stimulants, such as coffee and some over-the-counter medications, such as diet pills and caffeine pills
- talking with a trusted friend, spouse, or family member about fears and worries
The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best.
TALK THERAPY
Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioural therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviours, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to:
- Understand and gain control of distorted views of stressors, such as other people’s behaviour or life events.
- Recognize and replace panic-causing thoughts to help you feel more in control.
- Manage stress and relax when symptoms occur.
- Avoid thinking that minor problems will develop into terrible ones.
Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder.
MEDICINES
Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider.
Medicines called sedatives or hypnotics may also be prescribed. These medicines should only be taken under a doctor’s direction.
Your doctor will prescribe a limited amount of these drugs. They should not be used every day. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine.
SELF-CARE
Other than taking medicine and going to therapy, you can help yourself get better by:
- Reducing caffeine
- Not using street drugs or large amounts of alcohol
- Exercising, getting enough rest, and eating healthy foods
Support Groups
You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition.
Most people can manage GAD with a combination of therapy, medication, and lifestyle changes. Talk to your doctor if you are concerned about how much you worry. They can refer you to a mental health specialist.
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