Treating Anxiety and Anxious Depression

Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) usually involves a persistent feeling of anxiety or dread, which can interfere with daily life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. People living with GAD experience frequent anxiety for months, if not years.³¹

Symptoms of GAD include:

• Feeling restless, wound-up, or on-edge
• Being easily fatigued
• Having difficulty concentrating
• Being irritable
• Having headaches, muscle aches, stomachaches, or unexplained pains
• Difficulty controlling feelings of worry
• Having sleep problems, such as difficulty falling or staying asleep

Panic Disorder
People with panic disorder have frequent and unexpected panic attacks. Panic attacks are sudden periods of intense fear, discomfort, or sense of losing control even when there is no clear danger or trigger. Not everyone who experiences a panic attack will develop panic disorder.

During a panic attack, a person may experience:

• Pounding or racing heart
• Sweating
• Trembling or tingling
• Chest pain
• Feelings of impending doom
• Feelings of being out of control

People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks. Panic attacks can occur as frequently as several times a day or as rarely as a few times a year.

Social Anxiety Disorder
Social anxiety disorder is an intense, persistent fear of being watched and judged by others. For people with social anxiety disorder, the fear of social situations may feel so intense that it seems beyond their control. For some people, this fear may get in the way of going to work, attending school, or doing everyday things.

People with social anxiety disorder may experience:

• Blushing, sweating, or trembling
• Pounding or racing heart
• Stomachaches
• Rigid body posture or speaking with an overly soft voice
• Difficulty making eye contact or being around people they don’t know
• Feelings of self-consciousness or fear that people will judge them negatively

Phobia-related disorders
A phobia is an intense fear of—or aversion to—specific objects or situations. Although it can be realistic to be anxious in some circumstances, the fear people with phobias feel is out of proportion to the actual danger caused by the situation or object.

People with a phobia:

• May have an irrational or excessive worry about encountering the feared object or situation
• Take active steps to avoid the feared object or situation
• Experience immediate intense anxiety upon encountering the feared object or situation
• Endure unavoidable objects and situations with intense anxiety

Social anxiety disorder (previously called social phobia): People with social anxiety disorder have a general intense fear of, or anxiety toward, social or performance situations. They worry that actions or behaviors associated with their anxiety will be negatively evaluated by others, leading them to feel embarrassed. This worry often causes people with social anxiety to avoid social situations. Social anxiety disorder can manifest in a range of situations, such as within the workplace or the school environment.

Agoraphobia: People with agoraphobia have an intense fear of two or more of the following situations:

• Using public transportation
• Being in open spaces
• Being in enclosed spaces
• Standing in line or being in a crowd
• Being outside of the home alone
• People with agoraphobia often avoid these situations, in part, because they think being able to leave might be difficult or impossible in the event they have panic-like reactions or other embarrassing symptoms. In the most severe form of agoraphobia, an individual can become housebound.

Separation anxiety disorder: Separation anxiety is often thought of as something that only children deal with; however, adults can also be diagnosed with separation anxiety disorder. People who have separation anxiety disorder have fears about being parted from people to whom they are attached. They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated. This fear leads them to avoid being separated from their attachment figures and to avoid being alone. People with separation anxiety may have nightmares about being separated from attachment figures or experience physical symptoms when separation occurs or is anticipated.

You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.35

However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your mental health provider may:

• Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
• Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.