| Anxiety
		
			| Topic OverviewAnxietyFeeling worried or nervous is a normal part of everyday
		  life. Everyone frets or feels anxious from time to time. Mild to moderate
		  anxiety can help you focus your attention, energy, and motivation. If anxiety
		  is severe, you may have feelings of helplessness, confusion, and extreme worry
		  that are out of proportion with the actual seriousness or likelihood of the
		  feared event. Overwhelming anxiety that interferes with daily life is not
		  normal. This type of anxiety may be a symptom of an anxiety disorder, or it may be a symptom of another problem, such as
		  depression. Anxiety can cause physical and
		  emotional symptoms. A specific situation or fear can cause some or all of these
		  symptoms for a short time. When the situation passes, the symptoms usually go
		  away. Physical symptoms of anxiety include: Trembling, twitching, or
			 shaking.Feeling of fullness in the throat or
			 chest.Breathlessness or rapid heartbeat.Lightheadedness or
			 dizziness.Sweating or cold, clammy
			 hands. Feeling jumpy.Muscle tension, aches, or
			 soreness (myalgias).Extreme tiredness.Sleep problems,
			 such as the inability to fall asleep or stay asleep, early waking, or
			 restlessness (not feeling rested when you wake up).
 Anxiety affects the part of the brain that helps control how
		  you communicate. This makes it harder to express yourself creatively or
		  function effectively in relationships. Emotional symptoms of anxiety
		  include:  Restlessness, irritability, or feeling on edge
			 or keyed up.Worrying too much.Fearing that something
			 bad is going to happen; feeling doomed. Inability to concentrate;
			 feeling like your mind goes blank.
 Anxiety disordersAnxiety disorders occur when people
		  have both physical and emotional symptoms. Anxiety disorders interfere with how
		  a person gets along with others and affect daily activities. Women are twice as
		  likely as men to have problems with anxiety disorders. Examples of anxiety
		  disorders include panic attacks, phobias,
		  and generalized anxiety disorder.  Often the cause of anxiety disorders is not known. Many people with an
		  anxiety disorder say they have felt nervous and anxious all their lives. This
		  problem can occur at any age. Children who have at least one parent with the
		  diagnosis of depression are more than twice as likely to have an anxiety
		  disorder than other children. Anxiety disorders often occur with
		  other problems, such as: Mental health problems, such as depression.Substance use problems.A physical problem, such
			 as heart or lung disease. A complete medical examination may be needed before
			 an anxiety disorder can be diagnosed.
 Panic attacks A
		  panic attack is a sudden feeling of extreme anxiety or
		  intense fear without a clear cause or when there is no danger. Panic attacks
		  are common. They sometimes occur in otherwise healthy people.  Panic attacks usually last
only a few minutes, but an attack may last longer. And for some people, the anxiety can get worse quickly during the attack.
  Symptoms include feelings of
		  dying or losing control of yourself, rapid breathing (hyperventilation), numbness or tingling of the hands or lips, and a racing heart. You may feel
		  dizzy, sweaty, or shaky. Other symptoms include trouble breathing, chest pain
		  or tightness, and an irregular heartbeat. These symptoms come on suddenly and
		  without warning. Sometimes symptoms of a panic attack are so
		  intense that the person fears he or she is having a
		  heart attack. Many of the symptoms of a panic attack
		  can occur with other illnesses, such as
		  hyperthyroidism,
		  coronary artery disease, or
		  chronic obstructive pulmonary disease (COPD). A
		  complete medical examination may be needed before an anxiety disorder can be
		  diagnosed.  People who have repeated unexpected panic attacks and
		  worry about the attacks are said to have a
		  panic disorder.  PhobiasPhobias are
		  extreme and irrational fears that interfere with daily life. People with phobias have fears that are out of proportion to real danger, and they are not able to control them. Phobias are common and are sometimes present with
		  other conditions, such as panic disorder or
		  Tourette's disorder. Most people deal with phobias by
		  avoiding the situation or object that causes them to feel panic (avoidance
		  behavior). A phobic disorder occurs when the avoidance behavior
		  becomes so extreme that it interferes with your ability to participate in your
		  daily activities. There are three main types of phobic disorders: Fear of being alone or in public places where
			 help might not be available or escape is impossible (agoraphobia).Fear of situations where the individual might be exposed to
			 criticism by others (social phobia).Fear of specific things (specific phobia).
 Phobias can be treated to help reduce feelings of fear and anxiety. Check your symptoms to decide if and when
		you should see a doctor.Check Your SymptomsAre you having a problem with anxiety? This also could include concerns about panic attacks, fear, or obsessive or compulsive behaviors. Yes Anxiety or anxiety-related concernNo Anxiety or anxiety-related concernHow old are you? Less than 12 years Less than 12 years12 years or older 12 years or olderAnxiety and stress can cause symptoms similar to those of a heart attack. Yes Symptoms of heart attackNo Symptoms of heart attackAre you thinking seriously of committing suicide  or harming someone else right now?Yes Thinking seriously of committing suicide or harming someone elseNo Thinking seriously of committing suicide or harming someone elseAre you thinking about suicide but do not have a plan? Yes Considering suicide but does not have a planNo Considering suicide but does not have a planIs a concern about abuse causing feelings of anxiety or depression? Yes Concern about abuse causing feelings of anxiety or depressionNo Concern about abuse causing feelings of anxiety or depressionAre you concerned about self-harm? It can include acts like cutting, burning, or choking yourself on purpose, or pushing objects under your skin (like pieces of metal, glass, or wood). People doing these acts usually are not trying to kill themselves, but the results can still be dangerous. Yes Concerns about self-harmNo Concerns about self-harmDo you think that a medicine  may be causing the anxiety?Think about whether the anxiety started soon after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing anxietyNo Medicine may be causing anxietyDoes anxiety, fear, or obsessive or compulsive behavior  interfere with your daily activities at work, school, or home?Yes Anxiety interferes with daily activitiesNo Anxiety interferes with daily activitiesAre you able to do your daily activities at all? Yes Able to perform daily activitiesNo Not able to perform daily activitiesDo you have sudden, severe attacks of fear or anxiety when there is no clear reason to be afraid? Yes Sudden, severe attacks of fear or anxietyNo Sudden, severe attacks of fear or anxietyDo you often have nightmares or have flashbacks to a traumatic event? The event could have been something that happened to you directly or something that you saw or heard about. Yes Frequent nightmares or flashbacks to traumatic eventsNo Frequent nightmares or flashbacks to traumatic eventsHave you had severe anxiety for more than a week? Yes Severe anxiety for more than 1 weekNo Severe anxiety for more than 1 weekMany things can affect how your body responds to a symptom and what kind
	 of care you may need. These include: Your age. Babies and older
		adults tend to get sicker quicker.Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
		disease, you may need to pay closer attention to certain symptoms and seek care
		sooner.Medicines you take. Certain
		medicines, herbal remedies, and supplements can cause symptoms or make them
		worse.Recent health events, such as surgery
		or injury. These kinds of events can cause symptoms afterwards or make them
		more serious.Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
		use, sexual history, and travel. 
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
		able to take care of this problem at home. Try home treatment to relieve the
		  symptoms. Call your doctor if symptoms get worse or you have any
		  concerns (for example, if symptoms are not getting better as you would expect).
		  You may need care sooner.
A few examples of obsessive or compulsive behaviors that can interfere with your daily activities include: Frequently washing your hands, showering, or
		brushing your teeth.Constantly cleaning, straightening, and
		ordering certain objects.Checking lights, appliances, or doors
		again and again to be sure they are turned off or closed.Repeating
		certain physical activities, such as sitting down and getting up from a chair,
		or saying the same thing over and over.Hoarding objects, such as
		newspapers.Avoiding public places or taking extreme measures to
		prevent harm or embarrassment to yourself or others.
The risk of a suicide attempt is
	 highest if: You have the means to kill yourself, such as a
		weapon or medicines.You have set a time and place to do
		it.You think there is no other way to solve the problem or end the
		pain.
Many prescription and nonprescription medicines can cause
	 anxiety. A few examples are: Decongestants.Diet
		pills.Steroid medicines.Thyroid medicines.
 Some illegal drugs, such as cocaine, crack, and speed
	 (amphetamines), also can cause anxiety.Symptoms of a heart attack may
	 include: Chest pain or pressure, or a strange feeling in the chest.Sweating.Shortness of
				  breath.Nausea or vomiting.Pain, pressure, or a
				  strange feeling in the back, neck, jaw, or upper belly, or in one or both
				  shoulders or arms.Lightheadedness or sudden
				  weakness.A fast or irregular heartbeat. 
 The more of these symptoms you have, the more likely it is that
	 you're having a heart attack. Chest pain or pressure is the most common
	 symptom, but some people, especially women, may not notice it as much as other
	 symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.Make an Appointment Based on your answers, the problem may not improve without medical
		care.Make an appointment to see your doctor in the
		  next 1 to 2 weeks.  If appropriate, try home treatment while you
		  are waiting for the appointment.If symptoms get worse or you have
		  any concerns, call your doctor. You may need care sooner.
Seek Care TodayBased on your answers, you may need care soon. The
		problem probably will not get better without medical care.Call your doctor today to discuss the symptoms
		  and arrange for care.If you cannot reach your doctor or you don't
		  have one, seek care today.If it is evening, watch the symptoms and
		  seek care in the morning.If the symptoms get worse, seek care
		  sooner.
Call  911  NowBased on your answers, you need
		emergency care.Call911or other emergency services now.Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care.Call your doctor now to discuss the symptoms and
		  arrange for care.If you cannot reach your doctor or you don't have
		  one, seek care in the next hour.You do not need to call an
		  ambulance unless: 
		  You cannot travel safely either by driving
				yourself or by having someone else drive you.You are in an area
				where heavy traffic or other problems may slow you down.
Call  911  NowBased on your answers, you need
		emergency care. Call911or other emergency services now.After you call
		 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
		to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.Home TreatmentHome treatment, combined with
		professional treatment, can help relieve
		anxiety. Recognize and accept your anxiety about specific
		  fears or situations, and then make a plan for dealing with it. For example,
		  if you are constantly worrying about finances, set up a budget or savings
		  plan.Don't dwell on past problems. Change what you can to help you
		  feel more comfortable with present concerns, but let go of past problems or
		  things you cannot change.Be kind to your body: 
		  Relieve tension with exercise or
				massage.Try stress-relief techniques that focus on relaxing your mind and your body.  For more information, see
				the topic
				Stress Management.Get enough rest. If you
				have trouble sleeping, see the topic
				Sleep Problems, Age 12 and Older.Practice healthy thinking and stop negative thoughts.Avoid
				alcohol, caffeine, chocolate, and nicotine. They may increase your anxiety
				level. Some illegal drugs, such as cocaine, crack, and speed (amphetamines), also can cause anxiety.
Engage your mind: 
		  Get out and do something you enjoy, such as
				going to a funny movie or taking a walk or hike.Plan your day.
				Having too much or too little to do can make you more anxious.Keep
				a
				diary of your symptoms(What is a PDF document?). Discuss your fears with a good friend. Confiding in others
				sometimes relieves stress.
Get involved in social groups, or volunteer to help
		  others. Being alone can make things seem worse than they are.Learn
		  about resources available in your community: 
		  Talk with your human resources officer about
				counseling benefits that may be available through your employee assistance
				program.Check with your insurance company to see what mental
				health benefits are available.Contact your public health
				department for information on community mental health programs.
 Symptoms to watch for during home treatmentCall  your doctor if symptoms become more frequent or severe during home
		  treatment.PreventionYou can help prevent
		anxiety attacks: Avoid caffeine, especially in coffees, teas, colas, energy drinks, and chocolate. Caffeine can keep you in a tense, aroused condition. For more information, see the topic
		  Healthy Eating.Do not smoke or use
		  smokeless (spit) tobacco products. Nicotine stimulates many physical and
		  psychological processes, causes your blood vessels to constrict, and makes your
		  heart work harder. For more information, see the topic
		  Quitting Smoking.Exercise during the day.
		  Even a brisk walk around the block may help you stay calm. For more
		  information, see the topic
		  Fitness.
 Talk with your doctor about your symptoms
		of anxiety or panic. A licensed counselor or other health professional can help you find ways to reduce your symptoms with techniques such as biofeedback, hypnosis, or cognitive-behavioral therapy. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment.  You can help your
		doctor diagnose and treat your condition by being prepared to answer the
		following questions: What is your major symptom?How long
		  have you had your symptoms? Do they come and go, or are they always
		  present?What triggers the onset of your symptoms?What
		  makes your symptoms better or worse?Do you have other symptoms
		  that may be related to your major symptom? These other symptoms may include: 
		  Rapid or irregular
				heartbeat.Nausea or vomiting.Numbness or
				weakness.Excessive sweating.Feeling that you are not
				able to get enough air (air hunger).Restlessness, irritability, or
				feeling on edge.Feeling depressed.
Have you ever had a similar problem in the past? If
		  so, how was it treated?Has anyone else in your family ever been
		  diagnosed with an
		  anxiety disorder, depression, or another mental
		  illness? Has anyone in your family tried suicide or died by suicide?What home treatment measures have you tried? Did
		  they help?What prescription or nonprescription medicines are you
		  currently using?What herbal supplements are you
		  taking?Are you using alcohol or illegal drugs, such as marijuana
		  or cocaine, to manage your symptoms?Do you smoke or use other
		  tobacco products?Do you have any
		  health risks?
 While waiting for your appointment, it may be helpful to keep
		a
		diary of your symptoms(What is a PDF document?).CreditsByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
 Kathleen Romito, MD - Family Medicine
 Adam Husney, MD - Family Medicine
 Specialist Medical ReviewerDavid Messenger, MD
Current as ofMarch 20, 2017Current as of:
                March 20, 2017 Last modified on: 8 September 2017  |  |