Understanding Anxiety

We all feel fear and nervousness when we face the unknown, or before an important event like an exam, surgical procedure, business meeting, or a move to a new home or school. Some people, however, experience an ongoing cycle of irrational fear, anxiety, and dread that disrupts their thoughts, affects daily routines, and inhibits them from enjoying normal social interaction. Every year, millions of adult Americans, and one in eight children, suffer from excessive anxiety.

Periods of anxiety that last longer than a few weeks are a sign of an underlying anxiety disorder. Generalized anxiety disorder is characterized by irrational, uncontrollable worry about a variety of circumstances, out of proportion to the actual risk or danger. This includes a preoccupation with future events and potential negative outcomes. The anxiety is often accompanied by physical symptoms such as restlessness, fatigue, trouble concentrating, irritability, diarrhea, muscle tension, or difficulty falling asleep or staying asleep. Some people have unpredictable panic attacks.

Children with anxiety disorder worry excessively about grades, social relationships, appearance, family issues, and performance in sports. They can be very hard on themselves, striving for perfection, or seeking constant approval. Around the age of 7 to 9, a child with separation anxiety may worry that a parent will die while they are away at school.

Excessive anxiety causes mental distress and affects daily life, relationships, and performance at school and on the job.  It can be accompanied by depression or compulsive behaviors, or lead to abuse of alcohol or drugs.  Anxiety also has physical consequences, such as a weakened immune system and stress-related illnesses.

Anxiety disorders can be caused by a combination of factors:

  • Genetic predisposition (Are there other worriers in the family?)
  • Exposure to traumatic experiences
  • Environmental factors such as a poor diet, financial or emotional insecurity,  or a chaotic lifestyle
  • To some degree, parents who are fearful and nervous or overly controlling
  • An underlying medical condition such as diabetes or a thyroid imbalance
  • An overactive fight-or-flight response in the brain

Friends and family members often do not understand that a loved one's anxiety is very real emotional distress. It is easy to dismiss someone as a "worrier," and to become impatient or frustrated when he or she does not respond to reassurance or good advice. In fact, someone suffering from anxiety cannot control their feelings, no matter how much they want to. It is especially difficult for parents to watch a child suffer from irrational fear and worry.

There are many ways to help someone with anxiety. Stop trying to talk them out of their worries, and become a good listener. Acknowledge their distress and allow them to talk about their feelings without making judgments. Be empathetic, but do not participate in their anxiety. Do not expect the person to look and act happy when they do not feel that way. Create a peaceful, uncluttered environment. Encourage physical activity. Make sure a child gets regular meals and healthy snacks, and follow a regular routine. 

Anxiety disorders can be treated with counseling and medication.  A professional counselor employs various talk therapies, including Cognitive Behavior Therapy (CBT), to help each person understand the sources of their anxiety and learn strategies for coping with it. In some cases, medications are used to temporarily control anxiety. 

Talk to your doctor if you see signs of an anxiety disorder in a family member.  Anxiety disorder does not just go away if ignored. It will intensify over time, or recur each time the person experiences stress. Your doctor can evaluate the seriousness of the situation and recommend appropriate treatment.

Further reading:

Anxiety Disorders. National Institute of Mental Health (https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#part_145335

Generalized Anxiety Disorder (GAD). Anxiety and Depression Association of America (https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad)

What is Anxiety? (https://www.anxiety.org/what-is-anxiety)

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Internal Medicine

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