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The Call-On-Doc Guide to Anxiety

Published on Feb 01, 2024 | 3:41 PM

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Anxiety makes it difficult to relax, often resulting from upcoming events, potential problems that may arise, and things that normally will stress you out. Anxiety disorders not only compound those fears and stressors but also make it exceedingly difficult to relax even when the source has passed or dealt with. The most common mental illness in the United States, anxiety disorders affect over 40 million adults and only 36.9% of known cases seek out treatment despite it being an effective option. (1) 

What are the symptoms of anxiety?

There are a number of different anxiety disorders that commonly affect American adults and youths. When it comes to how they are identified and categorized, each is different based on the symptoms exhibited in the patients that have them. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also referred to as the DSM-5, is used by medical professionals in the United States to identify mental disorders. Two disorders treated by Call-On-Doc found in the DSM-5 include generalized anxiety and social anxiety.

What is the difference between general anxiety and social anxiety?

Social Anxiety Disorder (SAD) is identified by the profound unease or apprehension that arises in social settings where the possibility of scrutiny by others exists. This can manifest during various social interactions, such as conversations or encounters with strangers, while being observed, like during meals, drinks, or tests, and when presenting in front of an audience, be it public speaking, acting, or participating in a sporting event. It's essential to note that for children, this anxiety may specifically emerge in peer settings, whether with or without adults present, or directly with adults. 

Someone with a social anxiety disorder will have a persistent concern about the negative evaluation of their actions, words, or overall appearance, accompanied by a heightened fear of humiliation, embarrassment, rejection, or causing offense. Observable signs of fear or anxiety often manifest in social situations, and in the case of children, physical displays of discomfort such as freezing up, tantrums, crying, and screaming may occur. Reactions to potential social scenarios can lead to outright avoidance or intense fear during their occurrence. 

Instances where a person's quality of life is impacted by social anxiety disorder include avoiding them despite potential professional or personal benefits. This avoidance may extend to skipping dates, avoiding meetings with colleagues or superiors, backing out of networking opportunities, or canceling plans with friends. In addition to that, things like gatherings, dates, interviews, and work on camera can become exceedingly difficult. 

Generalized Anxiety Disorder (GAD) is persistent anxiety and excessive worry with little to no capacity to relieve it, characterized by apprehensive expectations, lasting for a minimum of six months and occurring on most days. The focus of concern revolves around various events or activities, such as performance at work or school. Individuals with GAD experience constant difficulty managing and reducing this overwhelming concern. The anxiety and worry are often accompanied by three or more of the following six symptoms: restlessness or a heightened sense of being keyed up, easy fatigue, challenges in concentration or experiencing a blank mind, irritability, muscle tension, and disturbances in sleep.

In both cases, the general and social anxiety symptoms are generally present in a fashion unrelated to other mental conditions present for six months or more. Additionally, while substances like alcohol or marijuana may play a factor in exacerbating each, the condition should be present in patients considered. (2)(3)

Condition

Social Anxiety Disorder

Generalized Anxiety Disorder

Focus

Fear of judgment in social situations.

Constant, diverse worrying about everything.

Duration

Anxiety duration varies, situational.

Worry persists for at least six months.

Relief

Relief may come in non-social.

Hard to find relief.

Symptoms

Fear, avoidance, physical signs.

Restlessness, fatigue, concentration issues.

Trigger Scope

Fear mainly in social settings, even in personal interactions.

Anxiety spans various life aspects.

Impact

Social impact, specific interactions.

Worry affects daily activities.

As it can put a heavy strain on a person’s mental health, it should be noted that either anxiety disorder left untreated can lead to thoughts of self-harm or suicide. Those with such a symptom should consider the Suicide and Crisis Lifeline 988 when they occur. Featuring personnel who speak both English and Spanish, the hotline is open 24 hours a day, seven days a week, 365 days a year. 
 

What’s the difference between social and generalized anxiety?

When it comes to comparing generalized anxiety disorder and social anxiety disorder, there is no doubt that the two have similarities. Both can lead patients to undoubtedly believe the worst outcome will occur when it concerns situations or events that make them anxious. Both types of patients further exhibit physical symptoms, viewable habits, and behaviors directly linked with either disorder. However, the prominent differences primarily concern what triggers anxiety symptoms with either condition. (4) 

Generalized anxiety and social anxiety are different by way of what makes the patient nervous or what they are fearful of. Whereas social anxiety has everything to do with social interaction, from small talk with a coworker to speaking in front of crowds, generalized anxiety is much broader in that it not only includes an aversion to social interaction but also things like planned events, performing a task that may be important, and so on. (5) Additionally, those with generalized anxiety might feel as though they are in a constant state of worry about something that may not occur or a disaster that might be remotely plausible but has no substantial reason for happening. (6)

What conditions commonly arise with anxiety?

Of the 40 million Americans estimated to have some form of anxiety, 60% of those people are suspected to have an additional anxiety disorder or other mental disorder. (7) There are a number of conditions that occur alongside both social and generalized anxiety, with the most common that Call-On-Doc treats including: 

Depression: Among the estimated number of people who have a comorbid condition with anxiety, depression is the most common mental health condition seen by medical professionals. The same is true for patients with depression, with 45.7% of those polled in a worldwide study also admitting to having an anxiety disorder. (8) Those with symptoms of anxiety and depression should seek medical treatment as they can feed off one another, making the conditions worse. Learn more about depression from The Call-On-Doc Guide to Depression

Insomnia: Insomnia is prominent for those who have anxiety disorders, with surveys indicating that up to 36% of patients with anxiety have insomnia. (9) The symptoms of both tend to compound on one another, with anxiety making sleep more difficult and the lack of sleep caused by insomnia making the worrying and irritability worse. Learn more about insomnia through the CallonDoc Guide to Insomnia.

Panic Disorder: A type of anxiety disorder, around 3% of all Americans have panic disorder, with a greater number going unreported. (10) Characterized by the occurrence of “panic attacks,” the condition not only can make dealing with stress and stressful situations difficult but also is compounded when comorbidity of generalized anxiety or social anxiety. 

Substance Abuse: Those with anxiety run a higher risk of developing an addiction to certain substances like alcohol, marijuana, nicotine, and more. (11) Smoking cessation, alongside other forms of therapy, is often recommended when people seek out anxiety treatment. 

Can anxiety cause chest pain?

Yes, anxiety can cause chest pain. Alongside affecting a person mentally, the condition causes the brain to more quickly activate a person’s fight or flight mode, which results in a faster heart rate. This can equally result in heart palpitations when treatment is not pursued. (13)

Can anxiety cause high blood pressure?

Anxiety can result in spikes or temporary high levels of blood pressure but does not result in constant hypertension by itself. (14) However, leaving the condition untreated will make it a factor for chronically high blood pressure to develop and cause important systems within the body to be prone to greater damage over time. 

Can anxiety cause shortness of breath?

Yes, anxiety can both cause shortness of breath and exacerbate conditions like asthma that feature shortness of breath as a symptom. When a person is anxious, the body's stress response can lead to changes in breathing patterns, including shallow or rapid breaths. This, in turn, can result in the sensation of not getting enough air, contributing to shortness of breath.

Can anxiety cause nausea?

Yes, anxiety can cause nausea and vomiting. When a person experiences anxiety, the body's stress response can lead to various physical symptoms, including changes in the digestive system. Anxiety can stimulate the release of stress hormones, alter gastric motility, and affect the normal functioning of the digestive tract, potentially resulting in nausea. 

Can anxiety cause diarrhea?

Like how it can cause nausea and vomiting, anxiety symptoms can heavily affect the digestive system. As a result, someone with anxiety may be more prone to diarrhea and other gastrointestinal symptoms.

Can anxiety cause headaches?

Those with anxiety will often get headaches, as they are often more prone to developing migraines. Around half of all patients with migraines tend to match the qualifications to be considered for an anxiety diagnosis. (15)

Can anxiety cause acid reflux?

There are numerous studies that indicate those with anxiety run a greater risk of developing GERD or regularly experiencing conditions like heartburn. Habits associated with anxiety, like overeating and lack of sleep, are some of the reasons behind this. 

What triggers anxiety?

Anxiety disorders do not have one direct cause, but a number of suspected factors that result in its development. The following factors are most often recorded when an anxiety diagnosis is explored: 

  • Genetics: There is evidence that genetics play a role in anxiety disorders. Individuals with a family history of anxiety may be more predisposed to experiencing it themselves.
  • Brain Chemistry: Imbalances in neurotransmitters, the brain's chemical messengers, can contribute to anxiety. Factors like irregular serotonin levels are associated with certain anxiety disorders.
  • Environmental Factors: Stressful life events, trauma, or chronic stress can trigger or exacerbate anxiety. Childhood experiences, such as abuse or neglect, may also contribute to the development of anxiety disorders.
  • Personality Factors: Individuals with certain personality traits, such as perfectionism or a tendency to worry excessively, may be more prone to anxiety.

How do doctors diagnose anxiety?

Diagnosing anxiety typically involves a thorough psychological assessment by a healthcare professional. The process is made easy, often feeling more like a conversation with doctors relying on a combination of clinical interviews, self-report questionnaires, and observation of symptoms to evaluate the nature and severity of anxiety. The diagnostic process may include discussions about the individual's medical history, recent life events, and the specific symptoms they are experiencing. (17)

Additionally, doctors will work with you to rule out potential physical causes for the symptoms through medical examinations. The criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are often used to guide the diagnosis of specific anxiety disorders. 

How do you tell your doctor you think you have anxiety?

Be direct. Medical professionals are trained to diagnose and treat you according to your specific needs. They will not only be able to answer questions but also provide a safe place to discuss any concerns. A number of those with anxiety avoid anxiety treatment due to fear of being judged or believing the problem is lesser compared to others present. In such cases, telemedicine providers like Call-On-Doc provide a good outlet to seek out treatment for mental health conditions. 

There is nothing wrong with seeking out treatment, and on the occasion that you do, put forward your regular symptoms, what you feel long-term, and anything you might think is related. Doctors may inquire about what stresses you out, what substances you use, and more. It's important that you share that information so they can produce the best plan to help you.

How is anxiety normally treated?

The treatment of anxiety typically involves a combination of therapeutic approaches and, in some cases, medication. Psychotherapy, particularly cognitive-behavioral therapy (CBT), is a common and effective method. CBT helps individuals identify and change negative thought patterns and behaviors contributing to anxiety. Exposure therapy is often used to gradually confront and desensitize individuals to feared situations. 

Medications, such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, may be prescribed in certain cases to help alleviate symptoms. Lifestyle modifications, stress management techniques, and mindfulness practices can complement formal treatment. 

The approach depends on the specific type and severity of anxiety, with individualized plans crafted in collaboration between the person and their healthcare provider to promote long-term coping strategies and improved well-being. Regular monitoring and adjustments to the treatment plan may be necessary based on individual progress and needs.

Can anxiety be managed?

Along with medication or talk therapy, there are many ways anxiety can be managed through positive lifestyle changes, which include:

  • Regular Exercise: Engaging in regular physical activity has been shown to have significant benefits for mental health. Exercise helps release endorphins, which are natural mood enhancers. Activities like walking, jogging, swimming, or yoga can be effective. Find something you enjoy, and make it a consistent part of your routine.
  • Healthy Diet: A well-balanced diet can positively impact mood and energy levels. Focus on incorporating fruits, vegetables, whole grains, and lean proteins. Omega-3 fatty acids, found in fish, flaxseeds, and walnuts, have been linked to improved mental health. Limit the intake of caffeine, as it can contribute to jitteriness and exacerbate anxiety.
  • Adequate Sleep: Establishing a regular sleep routine is crucial for managing anxiety. Create a calming bedtime routine, limit screen time before sleep, and ensure your sleep environment is comfortable. Quality sleep plays a vital role in emotional regulation and stress resilience.
  • Stress Management Techniques: Learn and practice relaxation techniques to manage stress. Deep breathing exercises, progressive muscle relaxation, meditation, and mindfulness can help calm the mind and reduce anxiety. These practices are often integral components of cognitive-behavioral therapy for anxiety.
  • Limit Stimulants: Caffeine and nicotine are stimulants that can increase feelings of restlessness and anxiety. Consider reducing or eliminating these substances from your diet, especially in the hours leading up to bedtime.
  • Time Management: Organize your schedule to prioritize tasks and break them into smaller, more manageable steps. This approach can help prevent feelings of overwhelm and make it easier to focus on one task at a time.
  • Social Support: Maintain connections with friends and family. Share your thoughts and feelings with those you trust. Social support can provide emotional validation, a sense of belonging, and practical assistance during challenging times.
  • Mindfulness and Meditation: Incorporate mindfulness practices, such as mindful breathing or meditation, into your daily routine. These practices help you stay present, reduce rumination on anxious thoughts, and cultivate a greater sense of calm and self-awareness.
  • Hobbies and Enjoyable Activities: Engage in activities that bring you joy and fulfillment. Whether it's a hobby, creative pursuit, or recreational activity, allocating time for enjoyable experiences can serve as a positive distraction and contribute to overall life satisfaction.
  • Limit Exposure to Stressors: Identify and, where possible, minimize exposure to unnecessary stressors in your environment. This may involve setting boundaries at work, managing time effectively, or reassessing commitments to reduce overall stress levels.

Can you prevent anxiety?

Unfortunately, like other mental disorders, you cannot prevent anxiety outright. However, you can manage it and make it easier to deal with over time. Call-On-Doc offers a stress-free way to connect to medical providers for the treatment of mental disorders and also offers prescription refills and home delivery options for easy anxiety management.

Source:

  1. “Anxiety Disorders - Facts & Statistics.” Anxiety and Depression Association of America, ADAA, 28 October 2022, https://adaa.org/understanding-anxiety/facts-statistics.
  2. Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 16, DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t12/
  3. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.15, DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t15/
  4. Glasofer, Deborah R. “The Difference Between GAD and Social Anxiety Disorder.” Verywell Mind, https://www.verywellmind.com/difference-between-gad-and-social-anxiety-disorder-1393009.
  5. National Collaborating Centre for Mental Health (UK). Social Anxiety Disorder: Recognition, Assessment and Treatment. Leicester (UK): British Psychological Society (UK); 2013. (NICE Clinical Guidelines, No. 159.) 2, SOCIAL ANXIETY DISORDER. Available from: https://www.ncbi.nlm.nih.gov/books/NBK327674/
  6. “Generalized Anxiety Disorder: When Worry Gets Out of Control.” National Institute of Mental Health, https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad.
  7. Goldstein-Piekarski AN, Williams LM, Humphreys K. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders. Transl Psychiatry. 2016 Jun 28;6(6):e847. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931606/. 
  8. Kalin, Ned H. “The Critical Relationship Between Anxiety and Depression.” The American Journal of Psychiatry, 01 May 2020, https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.20030305.
  9. Staner, Luc. “Sleep and anxiety disorders - PMC.” NCBI, Sept 2003, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181635/.
  10. “Panic Attacks & Panic Disorder: Causes, Symptoms & Treatment.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder.
  11. Brady KT, Haynes LF, Hartwell KJ, Killeen TK. Substance use disorders and anxiety: a treatment challenge for social workers. Soc Work Public Health. 2013;28(3-4):407-23. doi: 10.1080/19371918.2013.774675. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775646/. 
  12. van der Meer D, Hoekstra PJ, van Rooij D, Winkler AM, van Ewijk H, Heslenfeld DJ, Oosterlaan J, Faraone SV, Franke B, Buitelaar JK, Hartman CA. Anxiety modulates the relation between attention-deficit/hyperactivity disorder severity and working memory-related brain activity. World J Biol Psychiatry. 2018 Sep;19(6):450-460. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5581282/. 
  13. “Heart Palpitations & Anxiety: Causes, Symptoms & Treatment.” Cleveland Clinic, 23 July 2021, https://my.clevelandclinic.org/health/diseases/21677-heart-palpitations-and-anxiety.
  14. Sheps, Sheldon G. “Anxiety: A cause of high blood pressure?” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/anxiety/faq-20058549.
  15. Kumar R, Asif S, Bali A, Dang AK, Gonzalez DA. The Development and Impact of Anxiety With Migraines: A Narrative Review. Cureus. 2022 Jun 29;14(6):e26419. doi: 10.7759/cureus.26419. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339341/.
  16. Choi JM, Yang JI, Kang SJ, Han YM, Lee J, Lee C, Chung SJ, Yoon DH, Park B, Kim YS. Association Between Anxiety and Depression and Gastroesophageal Reflux Disease: Results From a Large Cross-sectional Study. J Neurogastroenterol Motil. 2018 Oct 1;24(4):593-602. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175551/. 
  17. “Diagnosing Anxiety Disorders.” NYU Langone Health, https://nyulangone.org/conditions/anxiety-disorders/diagnosis.
     

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Wayne C. Hahne,

English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.

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