Anxiety Symptoms

The signs and symptoms of anxiety may vary with the type of the anxiety disorder. However, most of the symptoms of anxiety disorders cluster around excessive, irrational fear and dread. This page describes the nature, symptoms, characteristics, and effects of various anxiety disorders.

Everyone experiences worries, apprehensions, tension, and anxiety from time to time. However, in certain cases, the anxiety symptoms can be so excessive and overwhelming that they can interfere with normal day-to-day activities. These anxiety symptoms and effects fall into emotional, physiological, cognitive, and behavioral categories.

When anxiety causes excessive distress and a significant impairment in social, academic, occupational, or other important areas of functioning, the person may be suffering from an anxiety disorder, and he or she may require counselling, psychotherapy or anti-anxiety medications. Anxiolytic medications, which include certain herbs for anxiety provide symptomatic relief from anxiety.

The following are the most common anxiety symptoms: -

i. Emotional Symptoms: The most common emotional symptoms of anxiety are excessive worries, uneasy and fearful feelings, feelings of some foreboding, apprehensions of some impending doom, feelings of "a lump in the throat," irritability, being easily startled, nervousness, restlessness, difficulty falling or staying asleep, nightmares, unrealistic or irrational dread or fear, etc.

ii. Physiological Symptoms: The most common physiological symptoms of anxiety are muscle tension, muscle weakness, shortness of breath, trembling, sweating, dry mouth, palpitations, abnormal or rapid heart beats (tachycardia), chest pain, high blood-pressure, headaches, nausea, frequent urination, stomach upset, heartburn/hyper-acidity, tiredness/fatigue, dizziness, faintness, etc.

iii. Cognitive Symptoms: The most common cognitive symptoms of anxiety are unpleasant thoughts about perceived dangers, lack of concentration, racing thoughts, distractibility, memory problems, decreased problem-solving ability, confusion, perceiving some situation or situations as uncontrollable or unavoidable even-though others might find the same situations as innocuous or mildly threatening, an unrealistic view of problems, cognitive distortions i.e. exaggerated or irrational thoughts, for example, "The boss asked me to meet him at his office; this is a sure sign that he is going to fire me."

iv. Behavioral Symptoms & Effects: The most common behavioral effects of anxiety are avoiding situations that provoke anxiety or have provoked anxiety in the past, changes in sleeping patterns, excessive drinking or drug abuse in an effort to reduce anxiety.

The symptoms of anxiety depend upon the type of the anxiety disorder. The following are the symptoms of the most common anxiety disorders: -

1. Characteristics & Symptoms of Generalized Anxiety Disorder (GAD)

  • Excessive apprehensions and worries about many different events or activities.
  • Exaggerated worries and tension occur on most days. For example, constantly anticipating disaster or worrying excessively or irrationally about work issues, health, money, family problems, etc., even though there is little or nothing to provoke such feelings. Such exaggerated worries must have occurred for at least 6 months in order to meet the diagnostic criteria for GAD.
  • Difficulty controlling the worries, even if the sufferer realizes that their anxiety is more intense than the situation warrants.
  • Feelings of restlessness or of "being on the edge."
  • Irritability.
  • Difficulty concentrating or mind going blank.
  • Difficulty falling or staying asleep, or restless unsatisfying sleep.
  • Muscle tension.
  • Being easily fatigued.
  • Significant impairment in social, occupational, or other important areas of functioning due to overwhelming anxiety.

2. Characteristics & Symptoms of a Panic Attack

A panic attack is characterized by sudden, unexpected, unexplained attacks of intense fear or terror in which four or more of the following symptoms develop rapidly and reach a peak within 10 minutes: -

  • Palpitations, pounding heart, or fast heart rate.
  • Sweating.
  • Trembling or shaking.
  • Sensations of shortness of breath or smothering.
  • Feeling of choking.
  • Chest pain or discomfort.
  • Nausea or abdominal distress.
  • Feeling dizzy, unsteady, lightheaded, or faint.
  • Derealization (feelings of unreality) or depersonalization (feelings of being detached from oneself).
  • Fear of losing control or going crazy.
  • Fear of dying.
  • Numbness or tingling sensations (paresthesias).
  • Chills or hot flushes.

A panic attack can occur "out of the blue" at any time, even when the person is asleep! It is often so sudden and unexpected that the sufferer may think that they are getting a heart-attack or that they are going to die. The presence of recurrent, unexpected panic attacks, followed by at least 1 month of persistent concern about having another panic attack, apprehensions about the possible consequences of the attacks (e.g. losing control, having a heart attack, "going crazy"), and significant behavioral changes (e.g. avoiding places or situations in which panic attacks have occurred in the past) related to the attacks are characteristic of panic disorder.

A panic disorder may be accompanied by agoraphobia (fear of open spaces). Often due to the fear of getting another panic attack and losing control in public, the lives of some people may become so restricted that they may avoid many normal day-to-day activities. For example, some people may avoid driving, shopping, traveling by public transport, or even going out of the house without being accompanied by a spouse or some other trusted person. When the condition progresses this far, it is called panic disorder with agoraphobia.


3. Characteristics & Symptoms of Social Phobia or Social Anxiety Disorder

  • Intense, persistent and chronic fear of social situations, especially meeting new people or being exposed to strangers.
  • Excessive self-consciousness and fear of being watched, judged or scrutinized by others.
  • Exaggerated fear of acting in humiliating or embarrassing ways in a social situation.
  • Exposure to the feared social situation provokes severe, uncontrollable anxiety, even though the person knows that the fear is excessive or unreasonable.
  • A feared social encounter may provoke unpleasant physical symptoms such as fast heart-beat, trembling, difficulty talking, profuse sweating, dry mouth, blushing, churning stomach, feelings of nausea, etc. While experiencing such symptoms, the sufferer might feel as though all eyes are focused on them, and this in turn might further exacerbate the anxiety.
  • The person either endures the dreaded social or performance situation with great distress, or totally avoids the situation.
  • Avoiding or feeling overwhelmed by social or performance situations causes great distress and interferes significantly with the person's normal routine, academic or work performance, relationships and social activities.

4. Characteristics & Symptoms of Specific Phobias

  • An extreme and irrational fear of a specific thing or situation that actually poses little or no threat. For example, intense fear of a particular animal or a particular insect, intense fear of a particular natural environment such as storms or heights, intense fear of seeing blood or an injury, intense fear of a specific situation such as flying, being in an elevator, traveling through a tunnel, etc.
  • An intense anxiety response is provoked by exposure to the phobic stimulus, even though the person recognizes that the fear is unreasonable and excessive.
  • The person either endures the phobic thing or situation with great distress or avoids them altogether.
  • The avoidance or fear of the phobic thing or situation significantly interferes with the person's day-to-day activities, relationships, social activities, academic or job demands.

5. Characteristics & Symptoms of Obsessive-Compulsive Disorder (OCD)

  • Obsessive-compulsive disorder is characterized by the presence of persistent, unwanted, anxiety-provoking thoughts called obsessions and repetitive, ritualistic behavior called compulsions carried out in an attempt to neutralize the anxiety provoked by these obsessions. For example, a person who is anxiously obsessed with strangers intruding in his or her house might repeatedly check if the doors and windows are locked, each night before going to bed, in spite of realizing that such fears and rituals are unrealistic and excessive.
  • Inappropriate, recurrent, persistent, and intrusive thoughts, impulses, or mental images pop-up in the person's head and the person has no control over them. These thoughts cause marked anxiety or distress. They are not simply excessive worries about real-life problems, but irrational thoughts, for example, getting contaminated with germs, even though there is a remote or no chance of such a thing happening in reality. Other examples of obsessions are: repeatedly worrying if the gas stove is off or not; frequent, unwanted, and anxiety-provoking thoughts of violence and harming loved ones; persistently thinking about performing unwanted sexual acts that the person may actually dislike, having thoughts that are prohibited by religious beliefs, even though the person does not want to have such anxiety-provoking thoughts.
  • The person attempts to ignore or suppress their obsessive thoughts, impulses, or mental images or tries to neutralize them with some other thought or action. The person may feel a strong need to perform some repetitive behavior in response to an obsession, and may often follow some rigid, self-made rules. For example, in response to obsessions with germs, the person might wash hands repeatedly. Other examples of compulsions include checking again and again if the gas stove is off, ordering and re-ordering things in a particular fashion, performing some mental acts such as praying again and again to get rid of thoughts or obsessions that are prohibited by religious beliefs, repeating some words silently or repeatedly counting to divert the mind from obsessive thoughts, etc.
  • The compulsive behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.
  • The person is aware that these obsessions are a product of their own mind. The person often recognizes that the obsessions and compulsions are excessive or unreasonable.
  • The obsessions or compulsions cause marked distress, unnecessarily consume time (more than 1 hour per day), and significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.

6. Characteristics & Symptoms of Post Traumatic Stress Disorder (PTSD)

Post traumatic stress disorder (PTSD) may develop after a person has been exposed to a severe traumatic event, which is outside the range of usual human experience and which could have produced significant symptoms of distress in almost anyone. The traumatic event could have lead to the person's death, or caused serious injury, or threatened the physical integrity of self or others. A person typically responds with horror, helplessness, and intense fear to such an event. Provided such a traumatic event occurred, a person who develops PTSD may be the one who was harmed, or he or she may be the one who witnessed the harm happening to a loved one or even to a stranger or strangers.

Some examples of traumatic events commonly associated with PTSD are devastations caused by war, riots, bombings, earthquakes, floods, hurricanes, volcanic eruptions, plane crashes, car or train accidents, etc. Other traumatic incidents that can lead to PTSD include child abuse, rape, violent assault, mugging, robbery, torture, kidnapping, being held a hostage, etc. War veterans and survivors of natural or man-made disasters may have a high incidence of PTSD. It may be noted that all people who go through the same traumatic event at the same time and at the same place do not develop PTSD, and it is not known why some people develop the disorder whereas others don't.

Provided a person has witnessed and survived a severe traumatic event and responded with horror and helplessness to the event as described above, the following are the symptoms of PTSD: -
  1. Persistent flashbacks of the traumatic event or re-experiencing the traumatic event in one or more of the following ways: -
    • Disturbing recollections of the traumatic event which include thoughts, perceptions and recalled images of the incident. These recollections are recurrent, intrusive and highly distressing.
    • Recurrent nightmares or dreams of the event. These nightmares related to the traumatic incident are very disturbing in nature.
    • Feeling and acting as if the traumatic event is occurring again. The person may get hallucinations and dissociative flashback episodes which create feelings of reliving the experience. Flashbacks may be triggered by ordinary occurrences, such as the sound of a door slamming or a sudden, loud sound of an automobile on the street. A person having a flashback may temporarily lose touch with reality and believe that the traumatic incident is happening all over again! Some of these flashbacks may occur even when the person is awakening from sleep or when the person is intoxicated.
    • Exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event can cause intense psychological and/or physiological distress.
  2. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness, which was not present before the trauma, as indicated by three (or more) of the following: -
    • Avoiding people, places, or activities that remind the person of the trauma.
    • Avoiding talking or thinking about things that remind the person of the trauma.
    • Being unable to recall an important aspect of the trauma.
    • Greatly reduced interest or participation in significant activities, which the person used to enjoy before the trauma.
    • Feelings of estrangement or detachment from others.
    • Restricted range of affect. For example, unable to have loving feelings, or feeling emotionally numb, especially in relation to people with whom the person used to be close prior to the trauma.
    • A sense of a foreshortened future. For example, the person may not expect to have a career, marriage, children, or a normal life span.
  3. Persistent symptoms of increased arousal, which were not present before the trauma, as indicated by two (or more) of the following: -
    • Hypervigilance or an exaggeratedly high degree of arousal and responsiveness to stimuli, the purpose of which is to scan the environment and detect perceived threats.
    • Exaggerated startle response. For example, a marked overreaction to a sudden, unexpected loud noise.
    • Difficulty concentrating.
    • Difficulty falling or staying asleep.
    • Irritability or outbursts of anger, aggression, or even violence.
  4. Other miscellaneous symptoms may include feelings of ineffectiveness, shame, despair, or hopelessness; feelings of guilt about having survived while others died ("survivor guilt"); personality changes or loss of previously sustained beliefs; social withdrawal; somatic complaints; self-destructive and impulsive behavior; feelings of being constantly threatened; feelings of hostility and anger; feelings of being "permanently damaged."
The symptoms of PTSD described above cause intense distress and significant impairment in social, academic, occupational, or other important areas of functioning. These symptoms must have persisted for more than a month in order to meet the criteria for PTSD. Usually the symptoms begin within 3 months of the traumatic incident but in some cases they may emerge months or years after the incident. Some people recover within 3 to 6 months, while others have anxiety symptoms that may last for years.

See also: How certain herbal remedies for anxiety may gently provide relief from anxiety symptoms. The herbs for anxiety page lists a number of herbs used to treat anxiety.

References: View

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