Anxiety: Understanding It and Treating It

• By:  Ben Korman
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As a busy adult in this hustle-and-bustle society, I often struggle to find time to talk to my mother. But when we do connect over the phone, we try to make it count. “How are you feeling?” she asks me. “Mentally? How about physically?”

And I’ll respond, “Oh, mom! Aren’t you aware that mental and physical health are intimately connected through the complex physiological framework that is the human body?!”

Okay, maybe not quite like that. But the distinction between mental and physical health isn’t always as clear as a concerned mother might like it to be. Mental and physical health are interdependent — especially when it comes to anxiety.

This is true even when we just look at the symptoms of anxiety. Some are emotional, such as feeling tense, anticipating worst-case scenarios and struggling to concentrate. Others are physical, ranging from muscle tension, headaches or mild tremors up to a pounding heart, insomnia or constant fatigue.

Anxiety Is Hard on Your Body: Get Treatment

According to the Anxiety and Depression Association of America (ADAA), anxiety disorders are the most common form of mental illness in the U.S., with 19% of adults over age 18 suffering from it. And although anxiety is highly treatable, two-thirds of anxiety sufferers don’t receive any treatment for it.

That’s doubly bad. First, without treatment, some types of anxiety are unlikely to go away. Second, allowing anxiety to flourish can have adverse effects on your physical health.

Anxiety is your body’s reaction to both psychological and physical stress. This stressed feeling is how our body gets put on a heightened state of alertness. When our neurotransmitters communicate anxiety to our brains, it causes our breathing rate to increase, our muscles to tense up, and blood to divert from abdominal organs and to the brain. This hyper-alert state is useful in an emergency, but if the body is on hyper-alert too much over too long a period of time, it really takes a toll and can trigger a vast array of medical conditions.

Some stress is part of our lives — and certain kinds of anxiousness may be a normal, healthy response. But it takes work and help from a clinician to keep stress and anxiety from taking over and reaching potentially damaging levels. To better identify mental health risks, the U.S. Preventive Services Task Force recommends screening adults 18 to 64 years for anxiety — including people who are pregnant or postpartum. By addressing anxiety sooner, you can reduce your risk — and, of course, quell mom’s concerns.

Insights from an Anxiety Expert

Dr. Alicia Kaplan, a psychiatrist with the Allegheny Health Network (AHN) who frequently works with patients dealing with anxiety, notes that sometimes the symptoms of anxiety waver on the thin line between emotional and physical. She also points out that these symptoms are not always consistent over time.

“Sometimes these symptoms are short term, as in situationally induced panic symptoms,” she says. “But they can also be longer term when present in chronic worry with muscle tension, or with significant panic disorder.”

Panic disorder is characterized by recurring panic attacks, one of the most frightening (and most physical) symptoms of anxiety. Sufferers of panic disorder often describe not being able to breathe, a pounding heart, dizziness and other symptoms that can be very disturbing. According to Dr. Kaplan, the core of panic disorder lies in the catastrophic misinterpretation of physical sensations, leading to fears of dire consequences such as a serious medical event or loss of control. This "fear of fear" then becomes a central driver of avoidance behaviors, shrinking one's world to feel safety and causing significant distress.

Anxiety is not the only type of problem in which mental and physical symptoms tend to meld together. And certain types of disorders sometimes coexist. This is often the case with irritable bowel syndrome, for example, which may occur side by side with panic disorder, generalized anxiety disorder or obsessive compulsive disorder.

Dr. Kaplan says that one type of symptom can drive other symptoms in a cycle that can be hard to break. For example, worries, obsessions or panic symptoms can exacerbate existing gastrointestinal distress. In turn, the physical discomfort causes more emotional anxiety. Mental illness can feed physical illness, and vice versa.

Anxiety Can (and Should) Be Treated

The good news is that anxiety, which is often the root condition of other disorders, can be very treatable. So if you’re suffering from anxiety, what are some ways you can fight it?

“Exercise is often very helpful for anxiety, as it helps relieve muscle tension and is a healthy outlet for nervous energy,” says Dr. Kaplan. “Relaxation techniques are also useful in maximizing our response to stress.”

In addition, she recommends:

• Doing activities that you find relaxing, such as listening to music, doing yoga or meditating
• Eating right, especially limiting yourself to small but frequent meals that include whole grains, fruits and vegetables
• Avoiding caffeine, alcohol or nicotine — we often turn to these substances when our anxiety levels are high, but they can actually make the anxiety worse
• Getting enough sleep (7 to 9 hours per night, ideally); a lack of sleep gives your mind the chance to dwell on your anxiety
• Using your support system — simply talking to a friend or family member about your feelings can be a huge stress reducer

Those are all important “self-help” options. But keep in mind that in some situations, you may need help that goes beyond what you can do on your own.

“If we find that anxiety or stress are interfering too much with our functioning — for example, at work, home or other areas such as relationships — or causing marked distress, then seeking out professional help can be very beneficial,” Dr. Kaplan explains.

Especially if you’re experiencing the physical side of anxiety, there may be an underlying health condition that requires professional help. One’s primary care physician can rule out medical causes and determine the most appropriate course of action which may include referral for specialty assessment for anxiety with treatment considerations of cognitive behavioral therapy, biofeedback, medication management, or a combination approach for anxiety.

When dealing with either the physical or mental side of anxiety, it’s helpful to remember that you’re not alone. Many people deal with this at some point in their lives. There are good resources (including, but not limited to, your mom) to help you get through any rough patches.

You can find more information about anxiety and the resources available to help manage it on the ADAA’s website. As always, it’s also a good idea to discuss any symptoms you’re experiencing with your doctor, who will be able to refer you to other resources and professional support.