Anxiety and Panic: Gaining Control Over How You're Feeling What is anxiety? Anxiety can be a normal "alarm system" alerting you to danger. Imagine coming home and finding a burglar in your living room. Your heart beats fast. Your palms get sweaty. Your mind races. In this situation, anxiety can provide an extra spark to help you get out of danger. In more normal but busy situations, anxiety can give you the energy to get things done. But sometimes anxiety can be out of control, giving you a sense of dread and fear for no apparent reason. This kind of anxiety can disrupt your life. Are there different types of anxiety? Yes. Anxiety can be a general feeling of worry, a sudden attack of panicky feelings, a fear of a certain situation or a response to a traumatic experience. What is generalized anxiety disorder? Generalized anxiety disorder is ongoing worry or fear that isn't related to a particular event or situation, or is out of proportion to what you would expect--for instance, constantly worrying about a child who is perfectly healthy. Symptoms of generalized anxiety disorder include muscle tension, trembling, shortness of breath, fast heartbeat, dry mouth, dizziness, nausea, irritability, loss of sleep and not being able to concentrate. What is panic disorder? Panic disorder is another type of anxiety. It occurs when you have repeated periods of extreme panic, called panic attacks. Suppose one day you're getting out of your car to go to work. Suddenly, your chest feels tight. Your heart races. You begin to feel dizzy and faint. You start to choke. You feel as if the end is near. Was it all in your head? No. Most likely, you had a panic attack. Panic attacks last about 5 to 30 minutes and may include any of the symptoms listed in the box below. Panic attacks can lead to phobias if they aren't treated. Panic attack symptoms Feeling like you're going to choke Chest pressure or chest pain Pounding heart Racing pulse Dizziness or lightheadedness Shortness of breath or tightness in the throat Sweating Trembling or shaking Nausea Tingling or numbness in the hands or feet Hot flashes or chills Sense of unreality or dreamlike sensations Fear of losing control, doing something embarrassing, going "crazy" or dying What is a phobia? A phobia is an extreme, unreasonable fear in response to something specific. Examples include fear of crowds, bridges, snakes, spiders, heights, open places or social embarrassment. A phobia is only considered a problem when it keeps you from living a normal life. An example is being afraid to leave home because you are afraid of having a panic attack or of not being able to escape if an attack starts. This fear is called agoraphobia. What causes anxiety disorders? Suppose the fire alarm goes off in your home. You race around frantically to find the fire. Instead, you find that there is no fire--the alarm just isn't working properly. It's the same with anxiety disorders. Your body mistakenly triggers your alarm system when there is no danger. This may be due to a chemical imbalance in your body. It may also be related to an unconscious memory, to a side effect of a medicine or to an illness. Can anxiety disorders be treated? Yes. Talk to your family doctor if you think you have an anxiety disorder. He or she can help you form a plan to develop skills to cope with your anxiety. Your doctor may also suggest counseling and prescribe medicine if needed. The following are some tips on coping with anxiety: Control your worry. Pick a place and time to do your worrying. Make it the same place and time every day. Spend 30 minutes thinking about your concerns and what you can do about them. Try not to dwell on what "might" happen. Focus more on what's really happening. Then let go of the worry and go on with your day. Steps to deep breathing Lie down on a flat surface. Place one hand on your stomach, just above your navel. Place the other hand on your chest. Breathe in slowly and try to make your stomach rise a little. Hold your breath for a second. Breathe out slowly and let your stomach go back down. Learn ways to relax. These may include muscle relaxation, yoga, or deep breathing (see box to the right). Muscle relaxation is simple. Start by choosing a muscle and holding it tight for a few seconds. Then relax the muscle. Do this with all of your muscles. Try starting with your feet muscles and working your way up your body. Exercise regularly. People who have anxiety often quit exercising. But exercise can give you a sense of well-being and help decrease feelings of anxiety. Get plenty of sleep. Avoid alcohol and drug abuse. It may seem that alcohol or drugs relax you. But in the long run they make anxiety worse and cause more problems. Avoid caffeine. Caffeine is found in coffee, tea, soft drinks and chocolate. Caffeine may increase your sense of anxiety because it stimulates your nervous system. Also avoid over-the-counter diet pills, and cough and cold medicines the contain a decongestant. Confront the things that have made you anxious in the past. Begin by just picturing yourself confronting these things. By doing this, you can get used to the idea of confronting the things that make you anxious before you actually do it. After you feel more comfortable picturing yourself confronting these things, you can begin to actually face them. If you feel yourself getting anxious, practice a relaxation technique or focus on a simple task, such as counting backward from 100 to 0. Although feelings of anxiety are scary, they won't hurt you. Label the level of your fear from 0 to 10 and keep track as it goes up and down. Notice that it doesn't stay at a very high level for more than a few seconds. When the fear comes, accept it. Wait and give it time to pass without running away from it. Use medicine if it helps. Your doctor may give you medicine to help reduce your anxiety while you learn new ways to respond to the things that make you anxious. Many types of medicine are available. Your doctor will decide which medicine is right for you. Talk about your anxiety with your doctor. Your doctor can help you make a plan to cope with anxiety. "Talk therapy," or counseling, can help you learn to express your needs and wants so you can feel more in control and hold in less of your anger and anxiety. The most important thing is to take action. Any action you take will help you gain a sense of control over your anxiety. Other Organizations National Institute of Mental Health http://www.nimh.nih.gov 888-8-ANXIETY (888-8-269-4389)