Understanding And Managing Severe Anxiety

Anxiety disorders are serious mental health conditions that can impact functioning in multiple areas of daily life. Approximately 31% of adults in the US have lived with an anxiety disorder, and 43.2% of those individuals receive mental health treatment. 

When managing anxiety, you may benefit from learning more about how these conditions are addressed. It can also help to know how to alleviate symptoms independently in conjunction with a mental health professional. To start, review the below symptoms of common anxiety disorders.   

About anxiety disorders 

According to the National Institute on Mental Health, “anxiety disorders differ by the objects or situations that induce them, but have features of excessive anxiety and related behavioral disturbances.” Anxiety disorders can interfere with activities in day-to-day life.

However, almost everyone will feel anxious from time to time. Feeling anxious is a normal part of life. It becomes a disorder when it interferes with your daily life or becomes too much to manage. 

Types of anxiety disorders

In the DSM-5, there are ten anxiety disorders that can lead to severe symptoms, including the following: 

• Panic disorder
• Generalized anxiety disorder (GAD)
• Specific phobias
• Social anxiety disorder (previously called social phobia)
• Separation anxiety disorder
• Selective mutism
• Agoraphobia
• Substance or medication-induced anxiety disorder
• Anxiety disorder due to another medical condition
• Other specified anxiety disorder

Note that obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) were previously listed as anxiety disorders in the DSM-4 but are listed under obsessive-compulsive and related disorders and trauma and stressor-related disorders in the DSM-5. Below are a few descriptions of the most common anxiety disorders from the DSM-5. 

Generalized anxiety disorder (GAD) 

Generalized anxiety disorder (GAD) is the most diagnosed anxiety disorder. This condition accompanies symptoms of severe anxiety which may or may not have a cause. With anxiety, you may feel nervous and worried frequently and experience significant functional difficulties in one or more areas of daily life. For a diagnosis of GAD, individuals may be required to experience these symptoms for most days over six months. 

Social anxiety disorder

Social anxiety accompanies symptoms of excessive worry, nervousness, or panic surrounding social interactions. Often arising from fear of judgment, social anxiety can affect your ability to connect with people in everyday situations. Some people with this condition may struggle to leave home or attend social events. Social anxiety can also cause difficulty remembering what to say during high-pressure social situations like interviews.  

Panic disorder

Panic disorder is a condition characterized by frequent panic attacks. Panic attacks are sudden episodes of intense fear that can lead to a sense of impending doom, sweating, chest pains, and irregular heartbeat. These attacks are often short-lived, lasting around ten to 30 minutes. However, they can last longer in severe cases.  

Specific phobias

Specific phobias are fears of a situation, place, object, living being, or concept that incites extreme anxiety, panic, or fear and includes avoidant behaviors. For example, someone with a phobia of needles may avoid getting their blood taken at the doctor, even if they are experiencing a health concern. 

Symptoms of anxiety disorders

Many anxiety disorders have similar symptoms, including the following physical and mental symptoms. 

Mental symptoms

Anxiety disorders are often characterized by consistent nervousness and worry for an extended period (six months for generalized anxiety disorder). However, the exact mental symptoms of anxiety may depend on the specific disorder. Common emotional and cognitive symptoms of severe anxiety include:

• Excessive worry
• Negative thoughts
• Feeling "on edge"  
• Fatigue 
• Difficulty focusing
• Easy irritation 
• Panic or extreme fear
• A sense of impending doom 

Physical symptoms

The physiological symptoms of anxiety can often cause an individual to think that a physical health concern is at play, which may compound their feelings of worry. Some of the most common physical symptoms of severe anxiety include:

• Hot or cold sweats
• Numb or tingling hands and feet
• Shortness of breath
• Increased or irregular heart rate
• Dry mouth
• Nausea
• Tense muscles
• Lightheadedness or dizziness
• Sleep disruptions

Treatment for severe anxiety

If you think you may be living with an anxiety disorder, a healthcare professional can help you develop a plan that addresses your specific symptoms.  Below are the most common forms of anxiety treatment. 

Psychotherapy with a mental health provider 

For many people who are experiencing severe anxiety, a therapist can provide helpful advice, support, and resources. A therapist can also refer you to a psychiatrist if they feel you would benefit from medication. 

Depending on the anxiety disorder you're living with, there are several different therapy methods a mental health professional may utilize, including cognitive-behavioral therapy (CBT), exposure and response prevention therapy (ERP), acceptance and commitment therapy (ACT), and dialectical behavior therapy (DBT). 

Medication

Medication for anxiety comes in numerous forms. Many people can use as-needed anxiety medications, whereas others might use long-term medications they take daily. Consult a medical or mental health professional before starting, changing, or stopping any medication. In most states, therapists do not prescribe or manage medications, so reach out to a psychiatrist or doctor for support.

Can you alleviate anxiety independently?

In addition to a treatment plan developed with a healthcare professional, there are numerous strategies you can implement that may alleviate anxiety symptoms.  

Herbal teas and supplements

Several herbal teas can support relaxation and overall feelings of calm. Herbal tea blends may be found in your local grocery store. Teas that can alleviate anxiety symptoms include chamomile, lavender, and peppermint.   

Several supplements can improve anxiety symptoms, including magnesium, vitamin D, L-theanine, and vitamin C. Talk to your doctor before you add any supplement to your diet, as supplements and vitamins can interact with medications and health conditions. 

Massage therapy

Research has shown that massage therapy can effectively reduce stress and anxiety for many people. One study found that people diagnosed with anxiety disorders showed reduced anxiety symptoms for an extended period after a light touch massage. Consider scheduling a routine massage appointment if you experience stress or anxiety.

Deep breathing exercises

Studies show that deep breathing can significantly decrease anxiety's adverse physical and mental effects. Deep breathing exercises can moderate your heart rate, improve focus, reduce blood pressure, and decrease pain. 

Consider utilizing a technique like box breathing. To start, breathe in for a four-count, hold your breath for a four-count, and breathe out for a four-count. Then, hold your breath again for a four-count. Repeat this process up to four times. 

Diet

Making healthy dietary changes may also help you manage anxiety and stress. Limiting caffeine and alcohol can help you reduce anxiety and feelings of restlessness. Additionally, a diet high in whole grains, nuts, legumes, fruits, vegetables, and fish—which has a proven connection to lower stress—may reduce anxiety.  

Sleep 

Sleep and anxiety have a bidirectional relationship, meaning a lack of sleep can lead to or exacerbate symptoms of anxiety, and the symptoms of anxiety can lead to disruptions in sleep patterns. Increasing the time spent sleeping up to 8-9 hours a night can help you stay health in many areas of your life beyond anxiety symptoms, too. 

To ensure you're practicing healthy sleep hygiene, try to create a restful environment. A restful environment could mean leaving your phone in a different room an hour before bed, using essential oils, or trying blackout curtains. It might also help to develop a consistent nighttime routine that allows you to prepare for sleep. 

Physical activity

There is a significant link between physical activity and reduced symptoms of several different anxiety disorders. Regular exercise can control the nervous system and improve symptoms of anxiety disorders. Consider developing an at-home exercise regimen, walking regularly, or joining a gym. 

It may be helpful to gradually increase your physical activity or find an accountability buddy such as a friend or family member who will help keep you motivated to exercise. 

Seeking counseling with a mental health professional 

There are many options for counseling for anxiety disorders. However, reaching out to a provider, managing appointments, and leaving home for a session can feel overwhelming to many people with anxiety disorders. 

A growing number of studies point to the efficacy of online therapy when treating symptoms of anxiety disorders. In one trial, researchers found that participants in an online cognitive-behavioral therapy program exhibited "significant improvement" in symptoms of generalized anxiety disorder, noting that these results were sustained at one and three-year follow-ups. 

Cognitive-behavioral therapy is a widely utilized modality that helps individuals identify and replace negative thought patterns that may accompany unwanted emotions and behaviors, such as those related to severe anxiety. If you are experiencing severe anxiety, consider working with a licensed mental health professional through an online therapy platform like BetterHelp. With online therapy, you can avoid the added stress of commuting to a therapist's office by participating in sessions remotely through video, voice, or in-app messaging sessions. Online therapy is also an affordable option, with sessions often being under $90 a week.