Anxiety: everything you need to know

By Cristiano Antonino On Jan 31, 2023

Anxiety is the body’s natural response to stress. It is a feeling of fear or apprehension about what might happen

While it is perfectly normal to feel fear and nervousness on certain occasions, when these feelings are extreme, last for a long time, are difficult to control, are out of proportion to the real danger and interfere with a person’s life, they could denote the presence of a genuine anxiety disorder, quite different from passing worries or tensions due to a busy period.

Anxiety: is it an illness?

In certain situations it is quite normal to be anxious: for example, before an important test, when you have to move, if you are expecting important news, on the first day of a new job, if you have to give a speech in public.

This kind of worry is certainly unpleasant, but it can also be positive: in fact, it motivates one to try harder.

Ordinary anxiety is a feeling that comes and goes, lasting only for a short time and not coming to interfere with daily life.

In the case of an anxiety disorder, on the other hand, the feeling of fear may accompany the patient constantly, never disappearing, being intense and sometimes debilitating.

This type of anxiety may be so impactful that it may push the person to stop doing the things he or she enjoys doing. In extreme cases, it may prevent one from entering a lift, crossing the street or even leaving the house.

If left untreated, the problem will continue to worsen.

Anxiety disorders are the most common form of emotional disturbance and can affect anyone, at any age.

Symptoms can also begin during childhood or adolescence and continue into adulthood.

Anxiety, the symptoms

There is no single type of anxiety.

This condition can take on different connotations depending on the person experiencing it.

Therefore, it is important to know all the ways in which it can present itself.

There are those who experience discomfort in the stomach and those who experience an acceleration of the heartbeat (tachycardia), there are those who feel out of control as if they feel a disconnect between their mind and body and those who manage to maintain an apparent balance.

In any case, one needs to know that when feeling anxious, the body goes on alert, looking for possible dangers and activating fight-or-flight responses.

This is why, in principle, symptoms of general anxiety include:

increased heart rate
rapid breathing or hyperventilation
feeling of weight/annoyance in the stomach and/or throat
restlessness, nervousness, tension
feeling of imminent danger, fear and worry
increased or profuse sweating
muscle tremors or twitching
weakness and lethargy
concentration problems
inability to take one’s mind off what is worrying and think clearly about something else
digestive or gastrointestinal problems
difficulty falling asleep and insomnia
nightmares
obsessions about certain ideas and/or behaviour
painful thoughts or memories that you are unable to control
fear of a specific event or place
desire to avoid things that trigger anxiety.

Panic attacks

In some cases, this condition triggers true panic attacks, i.e. a feeling of fear or anxiety that peaks within a few minutes and is associated with at least four of the following symptoms Palpitations, sweating, trembling, shortness of breath or choking, chest pain or tightness, nausea or gastrointestinal problems, dizziness, lightheadedness or feeling faint, feeling hot or cold, feeling numb or tingling (paresthesias), feeling detached from oneself or reality (known as depersonalisation and derealisation), fear of ‘going crazy’ or losing control, fear of dying.

How many anxiety disorders exist

The most common anxiety disorder is generalised anxiety disorder, characterised by persistent and excessive anxiety and worry about activities or events, even ordinary and routine ones.

The worry is out of proportion to the actual circumstance, is difficult to control and affects how one feels physically.

It often occurs together with other anxiety disorders or depression. Other common anxiety disorders are:

-agoraphobia, a type of disorder in which one fears and often avoids places or situations that might make one feel trapped, helpless or embarrassed;

-an anxiety disorder due to a medical condition, which includes symptoms of intense worry or panic that are directly caused by a physical health problem,

-selective mutism, a consistent inability of children to speak in certain situations, e.g. at school;

-separation anxiety disorder, a childhood disorder characterised by excessive anxiety for the child’s developmental level and related to separation from parents or other parental figures;

-social anxiety disorder (social phobia), which involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others;

-specific phobias, characterised by high anxiety when exposed to a specific object or situation and a desire to avoid it;

-substance-induced anxiety disorder, in which symptoms of intense anxiety or panic are the direct result of drug abuse, taking medication, exposure to a toxic substance, or drug withdrawal.

The causes of anxiety

Anxiety is a very complex condition, the causes of which are not entirely known.

However, it is likely to result from the interaction of several factors: environmental, genetic and chemical.

Life experiences such as traumatic events seem to trigger anxiety disorders in people who are already prone to this problem.

In some cases, anxiety may be linked to an underlying health problem, such as heart disease, diabetes, thyroid problems, chronic obstructive pulmonary disease (COPD), asthma, drug abuse or abstinence, alcohol withdrawal, irritable bowel syndrome.

Sometimes, the origin of anxiety is the use of certain drugs.

Anxiety risk factors

The following factors can increase the risk of developing an anxiety disorder

trauma: children who have experienced abuse or trauma or who have witnessed traumatic events have a higher than normal risk of developing an anxiety disorder at some point in their lives. Adults who experience a traumatic event may also develop these problems;
stress over an illness: suffering from a fragile or precarious health condition or a serious illness can cause considerable worry;
accumulation of stress: a major stressful event (such as bereavement) or many minor stressful events added together can trigger excessive worry;
certain personalities: people with certain personality types (e.g. very vulnerable, sensitive, fragile) are more prone to these disorders;
other mental health disorders: people with other disorders such as depression often also have an anxiety disorder;
familiarity: having blood relatives with an anxiety disorder increases the risk;
drugs and alcohol: the use, abuse or withdrawal of drugs or alcohol can cause or worsen anxiety.

Who can diagnose anxiety

In the presence of suspicious symptoms, the doctor may refer the patient to a neurologist, a psychiatrist and/or a psychotherapist.

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These figures, after a careful anamnesis, i.e. an in-depth interview with the person to find out about the symptoms experienced and his or her personal and family medical history, might prescribe a series of tests and examinations to better investigate the situation.

For example, they might conduct a physical and neurological examination, request blood or urine tests to rule out underlying medical conditions that might have contributed to the present manifestations.

They will also use various tests and anxiety scales to assess the level of tension and worry felt by the patient.

Anxiety, the remedies

The two main treatments for these disorders are psychotherapy and drug therapy.

Often, a combination of the two is used.

It may take some trial and error to find out which treatment works best for the individual.

Pharmacological therapy involves the use of medication to alleviate symptoms.

Depending on the type of disorder present and the individual situation, different molecules can be used, such as antidepressants, anti-anxiety drugs, sedatives.

Psychotherapy involves working with a therapist to reduce the symptoms experienced.

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