8 Things Doctors Want You to Know About Anxiety

Anxiety disorders affect nearly 20% of people in the United States, making it the most common mental illness among Americans, and women are 60% more likely than men to develop an anxiety disorder in their lifetime. While it’s normal to feel stress or worry at times, an anxiety disorder is more serious because it interferes with daily activities, sometimes in a debilitating way. Untreated, severe cases can be crippling. Some people have to leave their job or become homebound. But there are several ways to successfully treat anxiety disorders. Here’s what anxiety experts want you to know about these disorders. 

“With generalized anxiety, there’s constant, baseline background anxiety,” says Dr. James Seymour, MD, director of the Trauma Recovery Program at Sierra Tuscon in Tuscon, Ariz. “There are also social phobias, which are an intense fear of situations with people you haven’t met, such as at job interviews. You’ll fear that someone will look down on you or think badly about you.” He says sudden panic attacks, agoraphobia (the fear of going somewhere you think you wouldn’t be able to escape), and post-traumatic stress disorder are also all official types of anxiety disorders.   

“Sometimes there’s a trigger to the onset of an anxiety disorder, but often there’s not,” says Dr. Anna Glezer, MD, assistant clinical professor in the department of psychiatry in the University of California, San Francisco School of Medicine. “Anxiety can run in families, or maybe there’s a period of stress or loss that increases vulnerability. People who are normally shy or worriers at baseline, and people with a history of traumatic experience or loss, might be more vulnerable to a mental health condition.”

But “most people have symptoms of each one to some degree,” Dr. Seymour says. “With social phobias, you’ll start sweating, blushing, and feel a sense of inferiority,” he says. “This type of disorder often starts in childhood with school phobias, and the child will often come home with stomachaches or headaches.” Generalized anxiety symptoms include chest pains, stomach pain, and irritable bowel syndrome, Dr. Seymour says, and with sudden panic attacks, people feel like they’re going to pass out or die. “With post-traumatic stress disorder, a person will have intrusive thoughts of the trauma, such as visual memories, or physical flashbacks, where they feel like the event is happening again.” Dr. Seymour says. 

Dr. Glezer explains there are two broad categories of medication. Some, called benzodiazepines, treat anxiety in the moment to make a person feel better—“like a Band-Aid.” Others, called selective serotonin reuptake inhibitors (SSRIs), are taken regularly to decrease the frequency and intensity of anxiety. “The Band-Aids are usually just taken in the moment, such as during a panic attack, but if there’s significant anxiety on a daily basis, they might also take this daily.”

The problem with benzodiazepines is that people can become tolerant, and if they have been on the medicine for a while and have to stop, they’ll go through withdrawal, says Dr. Seymour. “These shouldn’t be given to alcoholics or people with drug problems because they might have difficulty staying sober and are more likely to relapse,” he says, and adds that people will also often feel sedated, with slower reaction times. With SSRIs, the main problems are some gastrointestinal upset and sexual side effects, including loss of interest, arousal, or ability to orgasm. While there’s no way to know for sure which medication is best for any individual, there are new methods to help choose appropriate ones. “We now have genetic testing, so we can narrow down the medications because we know which will be metabolized better,” Dr. Seymour said. “It’s much better because it used to be a shot in the dark.”

“If you can learn positive ways to deal with stress, a lot of times you can reduce the problem without medication,” says Lindsey Fowler, a licensed professional counselor at Bowie Christian Counseling in Bowie, Texas. “Deep breathing is fundamental to coping with anxiety.” She says depending on the person’s feelings, different tools will be needed to handle the anxiety. “If they’re having circular thoughts, I start with journaling,” she says. “You naturally write [in a] linear [way]. You aren’t going to write the same thing over and over. Journaling helps us escape and move forward.” She also recommends prayer and guided imagery as other effective coping strategies to help with relaxation and slowing down both the body and mind.

“Some people have the sense that, ‘It’s not serious. Everyone worries,’” Dr. Glezer says. “But that makes people with true anxiety disorders feel undervalued and that their condition isn’t appreciated. We live in a stressful environment, but true anxiety disorders can severely impact everyday functioning, and some people can even become shut-ins.” 

With treatment, whether medication or psychotherapy, people can recover from anxiety disorders. “Most people will suffer with anxiety disorders for years before they come for help,” Dr. Seymour says. “If you have an anxiety disorder as an adult, you’ll often find a genetic tendency for it or a history of significant trauma, such as alcoholic parents, sex abuse, or physical abuse.” People with disorders can often get off medication if they deal with those underlying issues, he says. “Cognitive behavior therapy can be as effective as medication,” Dr. Seymour says. “People will need at least 12 to 16 weeks of therapy to make significant changes, but it’s not needed for years and years necessarily.”