Health Essentials from Cleveland Clinic

We all feel fear, worry and stress at times. And sometimes those feelings overwhelm us. So if that is a common human experience, how do you know whether your anxiety is “normal,” or whether you may have an anxiety disorder?

Clinical psychologist Joseph Rock, PsyD, says it all depends upon the frequency and extent of your anxiety.

Defining anxiety vs. worry

Most people feel fear or even brief panic when confronted with a threat: When someone swerves their car into your lane or you turn around in a store and your toddler is out of sight, for instance.

In those situations, you may notice you have a physical response, like a racing heart, sudden perspiration or a knot in your stomach.

Anxiety is similar, but it comes from a perceived threat rather than an immediate threat, Dr. Rock says. The symptoms for anxiety vary from person to person and with the cause of the stress.

Dr. Rock breaks anxiety down into common anxiety disorders, with varying symptoms, including:

• Panic disorder. You may experience extreme panic or panic attacks. It may feel like heart palpitations or pounding, shortness of breath or choking.
• Phobias. Your anxiety peaks when you encounter certain things, such as small spaces, social situations or leaving your house. Here, you may experience nausea, sweating or trembling.
• Obsessive compulsive disorder. You have fears — of germs, for instance — that cause you to compulsively perform rituals, such as constant hand-washing.
• Post-traumatic stress disorder. A traumatic event triggers this type of anxiety. You may experience panic attacks or more general symptoms like sleep problems, muscle tension or constant worry.
• Generalized anxiety. Consistent anxiety that hangs around and isn’t triggered by particular causes characterizes this anxiety type. Here, you might experience any of the above symptoms at any time. Dr. Rock says it’s like “always feeling a little revved up and not in a positive, exciting way.”

When to consider talking to your doctor

There are a few factors that separate typical anxiety from a more serious issue you might seek treatment for, Dr. Rock says. Factors to consider include:

1. Intensity. Does your anxiety cause significant discomfort or intolerable symptoms?
2. Duration. Do your symptoms linger beyond the anxiety-inducing experience (e.g., you’re stressed out about a test and the stress lingers all day or even into the next day)?
3. Interference. Does your anxiety reduce your ability to function so that you can’t work or do other tasks?
4. Triggers. Do you have triggers that render you helpless? Do you have so many triggers that you stop doing things like leaving your home or driving on the freeway?
5. Affect on your life overall. Consider how the anxiety is affecting all areas of your life, such as work and relationships. How would your life look if you didn’t have the anxiety? Would it be significantly different?

“You really have to think about how much it affects your functioning,” Dr. Rock says. “You can avoid some triggers: If you’re afraid of lions, don’t go to the zoo. But if you are afraid of people, that’s more of a problem.”

How treatment works

If you decide to seek treatment, you may start with your primary care provider, Dr. Rock says. Most doctors can help you get a good idea of how severe your anxiety is. They then may recommend medication, therapy or both.

Two types of medication may help control your symptoms:

• Daily. You can take some medications regularly to prevent anxiety.
• As needed. You can take other drugs only when an episode occurs.

Your doctor also may refer you to a psychiatrist who can help manage your medication.

Working with a psychologist can help you learn how to prevent anxiety in the first place. He or she is likely to use cognitive behavioral therapy to help you better understand your anxious moments and learn coping strategies.

You can often learn to manage anxiety with fewer than a dozen sessions. And combining medication and therapy is often highly effective at reducing anxiety, Dr. Rock says.

If your anxiety is having a detrimental effect on your life, talk with your doctor about your specific needs. Awareness and management are important, Dr. Rock says.

“You may not need medication or therapy for life,” he says. “But addressing the issue is important, because some anxiety can get worse over time if not treated.”