Anxiety: A normal response that can feel overwhelming
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* By Kim Krisberg

Anxiety: It’s a normal feeling we all experience at some point in our lives. In fact, anxiety can often be a good thing, motivating you to study harder for tomorrow’s big test or sending a signal to run from a dangerous situation. However, overwhelming and out-of-control anxiety that doesn’t go away could be a sign that it’s time to seek professional help.

Anxiety disorders are the most common mental illnesses among children and adults in the United States. According to the Anxiety and Depression Association of America, about 40 million U.S. adults struggle with anxiety disorders.

Disability and distress are two signs that your anxiety has gone from something that everyone feels on occasion to a disorder, says Simon Rego, PsyD, a licensed clinical psychologist and director of psychology training at Montefiore Medical Center in New York City. In other words, if anxiety causes so much distress that you’re having trouble managing it, or if anxiety is disabling your ability to make decisions or go about daily routines, it might be a sign of a disorder.

“Anxiety is good at the right levels and in the right conditions,” Rego says. “We need it. It fuels us to focus our attention and to think about behavioral solutions to threats in front of us. But it’s when it’s like a pot that bubbles over that it’s bad.”

Another symptom of an anxiety disorder is excessive worrying. Sally Winston, PsyD, founder and co-director of the Anxiety and Stress Disorders Institute of Maryland, described such worry as “what-if” thinking.

“If I’m worried that I have a cavity and have an actionable plan, that’s normal and productive,” Winston says. “But if I’m not able to tolerate uncertainty, if I’m going around and around on unanswerable questions, if the worry is excessive and unproductive, then that’s a sign of a disorder.”

While anxiety symptoms aren’t necessarily harmful, constant anxiety can affect a person’s physical health, Winston notes. For example, a panic attack — which may feel serious — is not dangerous in an otherwise healthy person. However, chronic anxiety and high levels of stress can disrupt sleep and affect your cardiac, endocrine and gastrointestinal systems, Winston says.

“Anxiety, in general, exacerbates just about everything,” she says. “A lot of problems are not caused by anxiety but are very sensitive to stress.”

Fortunately, anxiety disorders are highly treatable, either with medication or talk therapy or a combination of both. Winston says a key to dealing with excessive anxiety isn’t fighting the feeling, but changing how one views the symptoms of anxiety.

“The paradoxical thing about anxiety symptoms is that if you fight them, they tend to fight back and get stronger,” she says. “If you try to force yourself to relax, you just get more tense. Instead, make (the symptoms) not matter as much so you’re not anticipating them with dread.”

Rego says that although the most common way people deal with anxiety is by avoiding it, he recommends that people face their fears. But start small, he says. For example, if you have anxiety about heights, don’t start by going to the top of a skyscraper.

“If you’re afraid to get up and give a talk, we know that nothing bad will happen if you try,” Rego says. “So I encourage people to practice by facing that fear and learning to tolerate their anxiety.”

Winston adds that healthy lifestyle habits, such as getting enough sleep, exercising and eating right, can also help lessen anxiety symptoms.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/44/2/24/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/44/2/24/F1)

Photos courtesy iStockphoto

Anxiety disorders can occur in children at very young ages, and treatment can help. However, parents can create supportive environments at home, too, Winston says. For instance, don’t focus on perfectionism or make small problems into big disasters.

Finally, don’t be afraid to seek professional help if anxiety is beginning to disrupt your or a loved one’s life.

“There are lots of resources available,” Rego says. “You don’t have to do this alone.”

## Anxiety disorders: Are you at risk?

Genetics play a big role in who is at risk for an anxiety disorder. However, stressful environments or trauma can also trigger an anxiety disorder.

For example, severe trauma can result in post-traumatic stress disorder, a type of anxiety disorder. Overall, women are 60 percent more likely than men to experience an anxiety disorder, and whites are more likely to experience an anxiety disorder than blacks or Hispanics, according to the National Institute of Mental Health.

Also, about 8 percent of teens ages 13-18 are living with anxiety disorder, and symptoms can occur as early as age 6.

*   Copyright The Nation’s Health, American Public Health Association