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.
What Is Extreme Anxiety?
It is important to understand that extreme anxiety is not a clinical term or a diagnosis. Instead, it is a way that people can describe the subjective experience of severe anxiety or an anxiety disorder.
How people experience anxiety can differ from one person to the next. One person may feel symptoms like butterflies in their stomach, while another person might have a full-blown panic attack.
Suppose you are experiencing life-limiting anxiety and makes it difficult to function in different areas of life including work, school, and relationships. In that case, there is a chance that you might have an anxiety disorder.
Normal Anxiety vs. Anxiety Disorders
Not all anxiety is a bad thing. Normal levels of anxiety can be adaptive because it helps prepare you for situations where you need to respond to stresses in the environment.
The difference between normal anxiety and what would be characterized as extreme anxiety is how it affects your ability to function and the level of distress that it creates.1
When anxiety is extreme or severe, it makes it difficult or impossible for you to function normally in different situations. It may make it so you cannot work or socialize like you normally would. It can create such severe distress that you actually begin to avoid situations that are likely to trigger feelings of anxiety.
Recognize the Signs.
If your feelings of anxiety are severe in their duration, intensity, and impact on your life, there is a strong likelihood that you have some type of anxiety disorder. Only a doctor or mental health professional can diagnose an anxiety disorder, but some of the symptoms that may indicate a problem include:
- Physical symptoms of anxiety such as rapid heart rate, increased breathing rate, sweating, trembling, and shortness of breath
- Extreme feelings of fear or anxiety that are out of proportion to the actual threat
- Irrational fear or worry about different objects or situations
- Avoiding the source of your fear or only enduring it with great anxiety
- Withdrawing from social situations or isolating yourself from friends and family
- Feelings of irritability and agitation
- Sleep difficulties such as trouble falling or staying asleep
- Gastrointestinal issues such as stomach aches or digestive problems
- Feeling uneasy and worried
- Difficulty concentrating
- Problems with doing your typical everyday tasks
- Interpersonal and relationship issues
- Thoughts of suicide
Extreme anxiety can also manifest as a panic attack. Panic attacks are characterized by an abrupt surge of intense fear or discomfort accompanied by a variety of physical sensations including rapid heart rate, choking sensations, nausea, trembling, chills, a sense of unreality, impending doom and a feeling of losing control, “going crazy” or dying.
Risk Factors.
Researchers are finding that both genetic and environmental factors contribute to the risk of developing an anxiety disorder.
The risk factors for each type of anxiety disorder vary. However, some general risk factors include:
- Shyness or feeling distressed or nervous in new situations in childhood
- Exposure to stressful and negative life or environmental events
- A history of anxiety or other mental disorders in biological relatives
Anxiety symptoms can be produced or aggravated by:
- Some physical health conditions, such as thyroid problems or heart arrhythmia
- Caffeine or other substances/medications
If you think you may have an anxiety disorder, getting a physical examination from a health care provider may help them diagnose your symptoms and find the right treatment.
Treatments and Therapies.
Anxiety disorders are generally treated with psychotherapy, medication, or both. There are many ways to treat anxiety, and you should work with a health care provider to choose the best treatment for you.
Psychotherapy
Psychotherapy or “talk therapy” can help people with anxiety disorders. To be effective, psychotherapy must be directed at your specific anxieties and tailored to your needs.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is an example of one type of psychotherapy that can help people with anxiety disorders. It teaches people different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful. CBT has been well studied and is the gold standard for psychotherapy.
Exposure therapy is a CBT method that is used to treat anxiety disorders. Exposure therapy focuses on confronting the fears underlying an anxiety disorder to help people engage in activities they have been avoiding. Exposure therapy is sometimes used along with relaxation exercises.
Acceptance and Commitment Therapy
Another treatment option for some anxiety disorders is acceptance and commitment therapy (ACT). ACT takes a different approach than CBT to negative thoughts. It uses strategies such as mindfulness and goal setting to reduce discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data are available on its effectiveness.
Medication
Medication does not cure anxiety disorders but can help relieve symptoms. Health care providers, such as a psychiatrist or primary care provider, can prescribe medication for anxiety. Some states also allow psychologists who have received specialized training to prescribe psychiatric medications. The most common classes of medications used to combat anxiety disorders are antidepressants, anti-anxiety medications (such as benzodiazepines), and beta-blockers.
Antidepressants
Antidepressants are used to treat depression, but they can also be helpful for treating anxiety disorders. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects.
Antidepressants can take several weeks to start working so it’s important to give the medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a health care provider. Your provider can help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
In some cases, children, teenagers, and adults younger than 25 may experience increased suicidal thoughts or behavior when taking antidepressant medications, especially in the first few weeks after starting or when the dose is changed. Because of this, people of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
Anti-anxiety Medications
Anti-anxiety medications can help reduce the symptoms of anxiety, panic attacks, or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines. Although benzodiazepines are sometimes used as first-line treatments for generalized anxiety disorder, they have both benefits and drawbacks.
Benzodiazepines are effective in relieving anxiety and take effect more quickly than antidepressant medications. However, some people build up a tolerance to these medications and need higher and higher doses to get the same effect. Some people even become dependent on them.
To avoid these problems, health care providers usually prescribe benzodiazepines for short periods of time.
If people suddenly stop taking benzodiazepines, they may have withdrawal symptoms, or their anxiety may return. Therefore, benzodiazepines should be tapered off slowly. Your provider can help you slowly and safely decrease your dose.
Beta-blockers
Although beta-blockers are most often used to treat high blood pressure, they can help relieve the physical symptoms of anxiety, such as rapid heartbeat, shaking, trembling, and blushing. These medications can help people keep physical symptoms under control when taken for short periods. They can also be used “as needed” to reduce acute anxiety, including to prevent some predictable forms of performance anxieties.
Choosing the Right Medication
Some types of drugs may work better for specific types of anxiety disorders, so people should work closely with a health care provider to identify which medication is best for them. Certain substances such as caffeine, some over-the-counter cold medicines, illicit drugs, and herbal supplements may aggravate the symptoms of anxiety disorders or interact with prescribed medication. People should talk with a health care provider, so they can learn which substances are safe and which to avoid.
Choosing the right medication, medication dose, and treatment plan should be done under an expert’s care and should be based on a person’s needs and their medical situation. Your and your provider may try several medicines before finding the right one.
Talk to a Professional.
Anxiety is one of the most common types of mental health conditions. According to the National Institute of Mental Health (NIMH), 19.1% of adults in the United States experience an anxiety disorder each year and an estimated 31.1% of adults will experience an anxiety disorder at some point during their lives.3
Anxiety disorders also tend to be more prevalent among women than men. Because women are twice as likely as men to be affected by an anxiety disorder, experts suggest that women and girls age 13 and older should be screened for anxiety during regular health exams.4
If anxiety is making it difficult to function normally or creating significant distress in your life, it is important to get help. This anxiety typically will not go away on its own and it often grows worse over time. Many of the coping strategies that people use to decrease anxiety—such as avoidance—end up making the problem worse.
Anxiety is a common problem that tends to affect women more than men. If you are experiencing extreme anxiety, it is important to seek help from a health professional. A mental health professional can diagnose your condition and recommend treatment options that can help you combat feelings of extreme anxiety.
