Anxiety: Signs & Symptoms, Types, Causes, and Treatment [Expert Guide]

Overview of Anxiety Disorders

As per the DSM-V (Diagnostic Statistical Manual of Mental Disorders), anxiety disorders are characterised by intense worry, along with at least three of the following six symptoms: 

1. Restlessness or feeling ‘on edge’
2. Fatigue 
3. Difficulty concentrating or zoning out 
4. Irritability 
5. Muscle tension 
6. Sleep disturbances

Further, the DSM clarifies that these symptoms should persist for at least six months, wherein they occur more often than not, for one to qualify for an anxiety disorder. 

What is Anxiety?

Brief Definition of Anxiety

All of us feel anxiety at some point or another, and some amount of anxiety can be useful for us. Anxiety alerts us to threat, danger, or a general feeling of being unsafe, and we can utilize this feeling to adapt to circumstances. Some of us also feel anxious before a big event, like an exam or a date, and this, too, is normal and healthy, and can be utilized to motivate us to do better. 

In short, anxiety is a feeling of worry or fear, and in many cases, it is a normal response. However, when this worry-state persists even when the threat has passed or in the absence of a real threat, it may become a cause of concern and require professional support. 

Is Anxiety a Mental Illness?

While anxiety in and of itself is not a mental illness, on the far end of the spectrum where it begins to impact one’s daily functioning and life, it may be treated as a mental health concern. As mentioned above, the DSM states that worry must be accompanied by at least three other symptoms, and persist on most days for at least three months for it to be considered a mental illness.

Read more about the signs of a mental health condition in this article. 

Can Anxiety Be Cured?

Since anxiety exists on a spectrum, a better question to ask is ‘can anxiety be managed?’, and the answer is yes, anxiety can be managed. 

When anxiety becomes extreme and feels unmanageable, one can learn coping mechanisms and build insight and awareness to bring the level of anxiety under control. 

This can be done by working closely with a psychotherapist. If the symptoms are too severe, medication may also be helpful to dial them down so that one can integrate the work they do in therapy to manage anxiety. 

Types of Anxiety Disorders

The DSM lists three main types of anxiety disorders. These include: 

1. Generalized anxiety disorder, wherein the individual’s feelings of worry or anxiety are not related to a specific object, person or event, but are generalised and may show up in many different situations or settings. If you’d like to learn more, here’s a detailed article about GAD. 
2. Panic disorder, in which the individual may also experience extreme and intense panic or “panic attacks”, along with feelings of anxiety. 
3. Specific anxiety or phobias, wherein the individual may experience anxiety or intense fear related to something specific. Specific phobias include agoraphobia and claustrophobia, social anxiety (previously called social phobia), and separation anxiety. 

Recognizing Common Signs and Symptoms of Anxiety

Physical Symptoms of Anxiety

Physical symptoms of anxiety include: 

• Dizziness or light-headedness 
• Increased heart rate. This can be a scary symptom. 
• Breathlessness. You can learn more about how shortness of breath shows up in anxiety. 
• Tightness in the muscles 
• Headaches 
• Nausea, or gut-related issues 
• Excessive sweating 
• Shaking or tremors. 
• Changes in appetite. Anxiety can lead to loss of appetite and stress eating. If you find yourself eating more when you’re stressed, here are some ways to cope with anxiety eating. 

Emotional Symptoms of Anxiety

Emotional symptoms of anxiety include: 

• Excessive worry or fear 
• Trouble concentrating 
• Indecisiveness
• Irritability 
• Anticipation of an event may cause anxiety 

Behavioural Symptoms of Anxiety

Behavioural changes that can be seen as a result of anxiety include: 

• Avoiding situations or people that provoke anxiety 
• Relying on others to make decisions 
• Seeking reassurance from others 
• Agitation 
• Freezing when feeling uncomfortable or threatened
• Wanting to escape situations that provoke anxiety 

What Causes Anxiety Disorders?

General Causes of Anxiety Disorders

While the causes of anxiety are not fully understood, it is usually seen to be triggered by stressful life events, trauma, interpersonal conflict and life transitions like the loss of a loved one or migration. 

Research also indicates that some biological and environmental factors may contribute to the development of anxiety. 

Biological Factors

An underlying health issue like a chronic illness, hormonal imbalance, vitamin deficiencies, or injury may contribute to anxiety. Some medications can also cause symptoms of anxiety as a side effect. 

Environmental Factors

Environmental or social factors that may contribute to anxiety include isolation, lack of work-life balance, social pressure and one’s position in society. 

For example, in India, it is common for women to experience bouts of anxiety related to gender-based violence in the country. 

Risk Factors for Anxiety Disorders

Common Risk Factors

Common risk factors for developing an anxiety disorder include having a family history of anxiety, substance use, physical or psychological health conditions and traumatic events. Certain personality traits or thought patterns are also seen to make one more vulnerable to developing anxiety. 

For example, extreme introversion and shyness seems to be associated with clinical anxiety. People who score high on neuroticism - the trait associated with negative thinking - also seem to be more prone to anxiety. 

Specific Concerns for Different Gender on Anxiety

1. Anxiety In Females

Women are more likely to be diagnosed with anxiety than men. While this could be because of the fact that women are more likely to seek help, there are unique stressors in women’s lives that make them more prone to anxiety. 

Women go through drastic psychosocial transitions as they enter puberty, get married, become mothers and go through menopause. 

These transitional periods make them prone to psychological discomfort. Women’s position in society and general lack of safety can also pose a threat to their psychological well-being. 

2. Anxiety In Males

Studies show that men are less likely to seek help for mental health concerns. Men tend to cope with anxiety by drowning themselves in work, with substance use, and distractions such as playing video games excessively. Common risk factors for men developing anxiety include financial or professional troubles or setbacks, interpersonal conflict and health issues. 

3. Anxiety In College Students

College years are a time of self-discovery and navigating the adult world with lesser support and supervision than before. Trying to find their place in society while at the same time, dealing with academic pressure, makes them prone to developing anxiety. 

4. Anxiety In Teens

During adolescence, one goes through rapid physical, emotional and social changes. This in itself can be anxiety-provoking. During teenage years, one also tends to become more self-conscious and body-conscious, which can contribute to feelings of anxiety. Another source of anxiety for teenagers is peer pressure, and the need to fit in. This is seen in several contexts, including body image, pop culture, hobbies and activities, as well as substance abuse.  

5. Anxiety In Children

When a child presents with anxiety, it is usually because something is going on in the family that the child is not able to cope with or make sense of. 

There may be conflict between the parents, instability in the home environment, or a parent may be going through anxiety or some other emotional or physical health challenge. However, sometimes, the child’s temperament may play a role in the anxiety. 

Even when this is the case, the intervention is usually done at the parental level, where parents are coached on how to help the child regulate. 

In Historically Marginalised Groups

Historically marginalised groups are prone to mental health concerns because of the oppression and discrimination they have faced. Marginalisation can make one feel unsafe and threatened, and this feeling can seep into many areas of one’s identity. In India, marginalisation has been done - and continues to happen - based on caste, gender and sexuality, religion and class. 

Treatment Options for Anxiety Disorders

Basic Overview of Treatments

The primary treatment for anxiety is psychotherapy. The benefits of therapy for anxiety include greater insight, non-judgemental acceptance of one’s feelings and thoughts, and developing actions to promote health and wellbeing. We explore these benefits in depth, here. However, if one’s symptoms are severe and debilitating, medication can help with symptom management. 

1. Psychotherapy

Therapy can help with short-term strategies for symptom management as well as developing insights and strategies that can help in the long run. If you’d like to learn more about what psychotherapy entails, as well as other mental health services that might be useful.  

a. Cognitive Behavioral Therapy (CBT)

CBT has been seen to be useful for an array of anxiety-related concerns. Techniques like exposure therapy and cognitive restructuring can help develop more control over a situation that makes one anxious. CBT’s focus is on working with thoughts and behavioural responses to anxiety triggers.  

b. Acceptance and Commitment Therapy (ACT)

A common wish of an individual experiencing anxiety is to quickly get rid of the discomfort. However, it is important to accept and work through the discomfort rather than try to stop feeling it. ACT helps individuals accept the negative emotions and thoughts in order to work through them effectively. 

c. Psychodynamic Therapy

Much of our anxious responses to life’s events come from associations we have built over the years. These may have been built due to childhood experiences, or life events that impacted us deeply. Psychodynamic therapy helps uncover the subconscious factors that may be contributing to anxiety. 

2. Medications

Medication for anxiety is prescribed by a psychiatrist. A psychiatrist may prescribe anti-anxiety medication or in some cases, anti-depressants. You can find more information about how psychiatrists treat anxiety. 

a. Anti-Anxiety Medicines

Anti-anxiety medications include benzodiazepines and beta-blockers. Benzodiazepines work by enhancing the activity of GABA - a neurotransmitter associated with producing a feeling of calm. Beta-blockers are given when the body enters the fight-or-flight response due to high anxiety, and is best used as an SOS medication. 

b. Antidepressants

Although anxiety and depression are distinct diagnoses, sometimes, anxiety may present with symptoms that overlap with depression. In cases like this, antidepressants may be prescribed. Common anti-depressants used for anxiety include SSRIs, SNRIs and tricyclic antidepressants. Sometimes, anxiety and depression may co-occur. 

Anxiety Medication Side Effects

Common side effects of anti-anxiety and anti-depressant medications include: 

• Drowsiness 
• Dry mouth 
• Low libido 
• Loss of balance 
• Confusion 
• Diaohhrea 
• Loss of appetite
• Headaches 

3. Alternative Therapies for Anxiety

Alternative therapies and practices like yoga and relaxation are also useful for managing the symptoms of anxiety. 

However, it is important to keep in mind that these practices are helpful when they are a part of one’s life rather than an SOS for quick relief. 

With regular practice, yoga and relaxation can benefit your mental health in many ways. 

Some other useful alternative therapies for mental health include: 

1. Guided imagery 
2. Mindfulness
3. Acupuncture 
4. Biofeedback 
5. Light Therapy 

4. Food and Diet to help in reducing Anxiety

Our gut health and mental health are closely linked, and what we eat impacts how we feel. Ultra-processed foods, heavy meals and high sugar intake are seen to impact our mental health as well. A clean and nutritious diet can help us feel more alert. 

Micronutrients for reducing anxiety include: 

1. Vitamin B complex 
2. Vitamin C 
3. Magnesium 
4. Omega-3 fatty acids 
5. Iron 

These are found to be useful for individuals struggling with anxiety. 

It’s also important to include adequate plant-based foods and protein in your diet. 

There are many ways to deal with anxiety without using medication. At Mave Health, we also provide tDCS - a non-invasive neurostimulation technique which is seen to be promising in managing symptoms of anxiety. You can learn more about tDCS for anxiety. 

8 Easy Coping Strategies for Anxiety in 2024

Practical Coping Mechanisms

Breathing exercises, mindfulness, and relaxation techniques: Sometimes, a bout of anxiety may catch us off guard, with no one to reach out to for support. It’s useful to have a few strategies handy for when you feel too overwhelmed. Here are a few things that can help: 

1. Taking a few deep, mindful breaths can provide quick relief. 
2. Mindfulness exercises like the 54321 technique are also helpful. 
3. Muscle relaxation can help release some of the physical tension that often accompanies anxiety.
4. Try the 3-3-3 rule for anxiety where you name 3 things you can see, 3 things you can hear and then, move 3 parts of your body.  
5. Butterfly hug is another self-soothing technique that can be helpful when anxiety creeps up on us.

Importance of maintaining a healthy lifestyle and regular exercise: Ultimately, though, it is important to create a lifestyle where our proneness to anxiety reduces. Maintaining a heathy lifestyle and taking care of the pillars of wellbeing can help us build resilience and adaptability. The pillars of wellbeing are: 

6. Adequate sleep. Sometimes, anxiety may peak at night, which can interfere with getting adequate sleep. If this happens, try these tips on how to overcome nighttime anxiety. 

7. Good and balanced nutrition. Learn more about the role of nutrition in managing anxiety. 

8. Regular movement 

When to Seek Professional Help

Indicators for Professional Help

While therapy can be useful for building self-awareness even when one is not debilitated by symptoms of anxiety, some indicators for seeking professional help are: 

• When anxiety begins to interfere with daily life, relationships, or work. You may find yourself unable to concentrate, worrying excessively, or becoming indecisive or less confident. 
• If other mental health concerns accompany anxiety, as is sometimes the case. Sometimes, anxiety may be a part of other mental health concerns like depression and PTSD. 
• If you experience suicidal thoughts, or find yourself doing self-harm of any form. Although self-harm and suicidal ideation are different and don’t co-occur every time, it’s important to pay attention to both. 

If you know someone who may be showing signs of anxiety, and you’d like to support them in a useful way, you might find this guide on how to help someone with anxiety helpful. 

Frequently Asked Questions (FAQ)

What does anxiety do to the brain?

Chronic stress and anxiety can lead to changes in the hippocampus and the prefrontal cortex, which can over time, make us more vulnerable to developing other mental health concerns too. These changes in the brain can have a cascading impact on the rest of the body. 

Does anxiety change your personality?

While personality traits are more or less constant, anxiety can impact our behaviour in many ways. It may make us more cautious or worrisome. It may make us distracted or easily agitated. If anxiety is managed well, these behavioural changes can also be mitigated. 

Does anxiety affect your thinking?

Anxiety can cloud our thinking and make us view things from a lens of fear and worry. It can also make it difficult for us to concentrate, and impact our decision making and problem solving abilities. 

Conclusion: Recap of Key Points

While anxiety is a part of life, and in some amounts can be helpful, excessive and pathological anxiety can adversely impact our lives.

Clinical anxiety usually persists on more days than not for at least six months and is accompanied by other symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension and sleep disturbances. 

However, help is available and should be accessed. Psychotherapy can help one learn coping strategies as well as gain insights into long-term patterns.

Medication can help in symptom management, and sustainable lifestyle changes can increase our resilience. If you’d like to speak to a mental health professional, feel free to reachout to someone at Mave Health’s Therapy Club.

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