Anxiety is a normal emotion and common experience. In general, it alerts us to potential danger, which can protect us from harm or unpleasant consequences. Anxiety can also motivate us toward action and problem solving.
However, when this anxiety doesn’t go away or intensifies to negatively impact your ability to function, you might have an anxiety disorder. Anxiety disorders are treatable under the care of a specially trained mental health professional.
The anxiety experts at The Ohio State University Wexner Medical Center in Columbus, Ohio, specialize in identifying tough-to-diagnose anxiety disorders and working with you to create a personalized treatment plan that can get you back to living and enjoying life.
What is anxiety?
Anxiety disorders are a group of mental health conditions that are marked by disabling fear and uncertainty. It’s common for everyone to experience anxiety every once in a while, but when these feelings become debilitating, control your life and cause distressing physical, emotional or cognitive symptoms, it’s important to talk to a mental health professional for help.
An anxiety disorder can last for several months and may get worse if not treated. It also can cause problems in relationships or with work or school, but anxiety is treatable with the right diagnosis and care.
Types of anxiety
- Generalized anxiety disorder: This most common form of anxiety disorder occurs when excessive worry about everyday topics (finances, family safety, scheduling) persists for at least six months, leads to uncomfortable physical sensations and interferes with routine situations, such as going to work, doing chores or hanging out with friends.
- Social anxiety disorder: Also called social phobia, this condition is marked by extreme anxiousness or self-consciousness in everyday social situations. People with this disorder tend to avoid any social encounter for fear of embarrassment or concern of being judged by others. This avoidance can impact your ability to develop friendships or romantic relationships, attend school or progress in your career.
- Obsessive compulsive disorder: With this disorder, people have frequent, upsetting thoughts called obsessions. Examples of obsessions include a fear of germs or of being hurt. To try to control these thoughts, a person with OCD may feel an overwhelming urge to repeat certain rituals or behaviors (compulsions). These thoughts and rituals cause distress and get in the way of normal daily living.
- Panic disorder: This condition is marked by recurring panic attacks, which are sudden episodes of intense fear with physical reactions when there is no real danger. You may feel as if you’re losing control. Panic attacks can happen anytime, anywhere and without warning. For some people, fear of an attack takes over their lives, and they struggle to leave their homes on their own, leading to a related condition called agoraphobia.
- Specific phobias: Phobias are strong, irrational fears of something that poses little or no real danger. Common phobias involve fear of heights, driving, closed-in places, water, animals or blood. People with phobias often try to avoid triggers to their fears, but this avoidance doesn’t treat the underlying fear, leading to problems in life if left untreated.
- Trauma and stressor-related disorders: This group of diagnoses, including post-traumatic stress disorder, involve numerous symptoms, such as anxiety, that result from the experience of extreme stress or trauma.
Anxiety disorder symptoms
Symptoms of anxiety don’t always present the same way and can vary from person to person. Anxiety symptoms can be physical, mental or behavioral in nature.
Physical anxiety symptoms
- Sweaty or clammy hands
- Chest pains
- Stomachaches
- Weakness or dizziness
- Difficulty breathing or shortness of breath
- Increased heart rate
- Sleep disturbances
- Heat or chill sensations
- Tingling or numb hands
Mental anxiety symptoms
- Uncontrollable worry or fear
- Difficulty concentrating
- Loneliness
- Feeling nervous all the time
- Becoming obsessed with certain ideas or actions
Behavioral anxiety symptoms
- Avoidance of things that may cause anxiety
- Rituals or repetitive compulsions
- Isolation or withdrawing from social activities
- Inability to sit still or remain calm
- Irritability or angry outbursts
How are anxiety disorders diagnosed?
Anxiety can be difficult to diagnose since we all experience feelings of worry and nervousness sometimes. If symptoms are persistent and impacting your quality of life, you’ll want to reach out to a health care provider.
First, we’ll work to determine if there is a medical cause — heart disease, diabetes, substance use withdrawal — for your anxiety. If there isn’t any medical cause and your symptoms are severe enough, you might need to see a mental health professional, who can give an initial psychiatric evaluation to determine how severe your anxiety is and what type you may have. During this evaluation, you’ll discuss your symptoms, what might trigger them, family history of mental illness and other feelings you’re having. Anxiety often occurs alongside other mental health conditions, making an accurate diagnosis vital.
Anxiety treatment at Ohio State
More than 10% of Americans will suffer from an anxiety disorder at some point in their lives. Fortunately, these conditions can be treated most of the time with effective, short-term methods.
The two main treatments for anxiety are medication and psychotherapy. Sometimes they’re used in combination, and for other people psychotherapy alone can be an effective way to improve symptoms.
The anxiety experts at the Ohio State Wexner Medical Center will create a personalized treatment plan for you based on your diagnosis and goals. They might recommend:
Medication for anxiety
There are several different types of medications that can be used to treat anxiety. They include:
- Anti-anxiety medications – These can help reduce symptoms of anxiety, panic attacks and extreme fear, but it’s important to remember that some people build up a tolerance to them or experience withdrawal when they stop them. Benzodiazepines are the most common anti-anxiety medications.
- Antidepressants – Some antidepressants can also be effective at treating anxiety by improving the way your brain and body handles stress. Sometimes you may need to try several different types of antidepressants before finding the one that works best for you.
- Beta blockers – Though beta blockers are typically used for high blood pressure, they can relieve physical symptoms of anxiety (increased heart rate, shaking, trembling) in some people.
Psychotherapy for anxiety
There are various types of talk therapy that can be used to treat anxiety. Providers at the Ohio State Wexner Medical Center use only evidence-based treatments that have demonstrated the highest level of effectiveness in research support.
Anxiety therapies include:
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy refers to a family of therapeutic approaches and techniques that emphasize the interrelationships among thoughts, feelings and behaviors. Depending on your condition and individual needs, you may learn to identify and modify unhelpful worrisome thoughts, change your behavioral responses to anxiety to improve coping, learn relaxation strategies to reduce tension and manage physical responses, and increase ability to tolerate distress and uncertainty in life.
Exposure therapy
Exposure therapy is a form of CBT that’s highly effective at treating the range of anxiety disorders by helping to break the pattern of avoidance associated with anxiety. In this form of therapy, the provider and client work together in a safe manner to gradually confront the feared objects, situations or activities.
There are several types of exposure therapy methods:
- In vivo exposures – This involves directly facing the fear in real life. For example, someone with a fear of enclosed places may ride on an elevator during a therapy session.
- Imaginal exposure – When the fear can’t be directly faced in real life, you might be instructed to imagine details of the feared scenario in real life.
- Virtual reality exposure – In some cases, you can practice facing fears with virtual reality technology. This can be a great option for those with the fear of flying, heights, bridges, public speaking, storms, darkness, dogs, spiders and roaches.
- Interoceptive exposures – Sometimes people with anxiety fear their own physical sensations. Therapists can help people overcome their “anxiety about anxiety” by deliberately and safely bringing on physical sensations. For example, someone with panic disorder might be instructed to run in place for two minutes to confront the sensation of a racing heart.
Mindfulness-based cognitive therapy
A form of CBT, MBCT is an eight-week, group-based intervention designed to facilitate recovery from depression and prevent future relapse. The evidence-based program combines elements of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness.
What to expect in psychotherapy for anxiety?
In some cases, treatment of a specific phobia may require only two to three sessions while most programs for other anxiety disorders consist of 10 to 20 weekly to bi-weekly sessions. Consistent therapy attendance and practicing skills in between sessions are important components to success.