Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 16, 2015

Anxiety is more than just worrying about stressful situations and daily obstacles. True anxiety disorder completely consumes a person with worry at a level far above just feeling anxious. For some people, anxiety dominates their entire day, interferes with their sleep, and dictates their life. It is treatable with professional help. To treat the anxiety disorder, it must first be understood. Once the source of anxiety is understood, there are many ways to ease and prevent anxiety attacks.


Definition & Facts

Anxiety disorder is an exaggerated anxiety and tension that persists for long periods of time, months. It is estimated to affect approximately 6.8 million Americans of all ages including children and adolecents. Anxiety disorder causes excessive worry over a wide variety of topics including simple daily activities to larger problems associated with any topic including decisions, health, work, family, money, and many more. The excessive internal worry often leads to outwardly showing physical symptoms.

There are 7 generalized types of anxiety disorders including:

  • Generalized anxiety disorder (GAD) – excessive worry for no real reason
  • Phobias – an irrational fear of something that does not pose a threat
  • Agoraphobia – a fear of certain environments that leads the person to avoid that particular place
  • Obsessive-compulsive disorder – causes people to check things repeatedly or have certain rituals that they perform over and over. Some are obsessed with cleanliness or develop compulsions.
  • Panic attacks (disorder) – abrupt onset of fear that overwhelms someone. The person usually has a rapid heart rate, feeling they can’t breathe and trembling or shaking.


The causes of anxiety disorder are not fully understood. Researchers are finding that several parts of the brain are involved with fear and anxiety. By continually learning more about fear and anxiety in the brain, scientists can continue to improve treatments. One factor that can contribute to being at a higher risk is genetics.

Family history of anxiety disorders increases the chances that others in the family will have it. Anxiety disorder can start at any age, but it usually starts during childhood or as a teenager. Many patients report having anxiety issues for so long that they can’t pinpoint when it started. Other causes include one’s personality, environmental factors, medical factors, substance abuse, or brain chemistry.

Environmental factors for anxiety disorder can include:

  • Trauma from abuse, victimization, or a death
  • Stress from relationships
  • Stress from work or school
  • Stress over money, finances, or bills
  • Stress due to a natural disaster

Medical factors for anxiety disorder can include:

When to see a doctor

Remember that some anxiety is normal, but you should consider seeing a doctor if your worries are not subsiding or if you are experiencing any of the following:

Anxiety can cause emotional ailments such as:

  • Irritability
  • Restlessness
  • Feeling apprehensive
  • Dreading tasks or events
  • Tenseness or jumpy
  • Constantly looking for signs of danger
  • Anticipating the worst
  • Avoiding situations
  • Irrational fears
  • Lack of focus on anything besides the cause of the anxiety
  • Anxiety is interfering with your work, relationships or other important parts of your life
  • Fear, worry, or anxiety becomes upsetting
  • Depression sets in
  • Alcohol or drug use becomes routine
  • Other mental health concerns arise along with anxiety

Anxiety can cause physical health ailments such as:

If one truly has an anxiety disorder the symptoms may never dissipate on their own. It is best to contact a health care provider so that they can offer treatment to control the anxiety.

Treatment & Therapy

If left untreated, anxiety disorders can lead to long-term problems like job loss, avoidance of places or situations, social awkwardness, depression, or drug and alcohol abuse. Anxiety disorders can be treated with professional care.

Every person’s care will be distinct because there are many types of anxiety, and patients will respond differently. There will also be variations in the success of the treatment. Treatment may take a few weeks or months. Others may exceed a year of treatment. If a person has more than one type of anxiety, treatment is more complicated. For example, if the patient suffers from depression, substance abuse, or other related conditions then more than one treatment or a combination of treatments is necessary.

Although treatment is individualized, there are several standard approaches that are effective. These include forms of therapy, medication, alternative treatment, or a combination of two treatments. Most medication is used for only short periods of time to alleviate severe symptoms, but cognitive behavioral therapy is most effective.

Prevention & Prophylaxis

There is no way to predict the onset of an anxiety attack. There are ways to prevent one though. Here are some ways to avoid or ease tension:

  • Early treatment – the earlier you accept that you have anxiety disorder and seek professional help, the better.
  • Avoid alcohol and drug use – drugs and alcohol worsen anxiety disorders. They should not be used to self-medicate because self-medication is only temporary relief from the problem. The after effects of alcohol and drugs can also worsen anxiety and cause depression.
  • Write – writing in a journal about each day helps to show trends on what triggers the anxiety. This is a good tool to take to a health care provider as well.
  • Limit caffeine – Caffeine can intensify anxiety, so limit daily intake.
  • Massage Therapy – massages help to slow the release of hormones that cause

stress. Aim to get one massage per week.

Books about Anxiety at

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