Everyone gets anxious, restless, and frazzled. But if you constantly feel worried, tense, or on edge, you may have an anxiety disorder. Anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time.
Doctors make a diagnosis of generalized anxiety disorder (GAD) when patients have anxiety symptoms much of the time for more than six months. Symptoms can include intense, hard-to-control worry and at least three of the following: irritability, sleep disturbance, fatigue, muscle tension, difficulty concentrating, and restlessness.
Examples of other anxiety disorders include:
- Agoraphobia
- Panic disorder
- Separation anxiety disorder
- Social anxiety disorder (social phobia)
- Specific phobias
According to the Mayo Clinic, you can have more than one anxiety disorder.
Research shows that a combination of environmental and genetic factors likely increase a person’s risk for developing an anxiety disorder, notes the National Institute of Mental Health (NIMH). Like so many health conditions, anxiety appears to run in families.
Anxiety may be caused by stress, whether from a major life event or the accumulated effect of small everyday stressors. Anxiety can also come with medical conditions, such as heart disease, diabetes, asthma, or thyroid disorders, that need treatment. There’s a clear link between caffeine and anxiety, and also alcohol and anxiety. And certain medications may cause anxiety. In this case, avoiding caffeine and alcohol or changing medications may reduce the anxiety. It’s important to note that while all these things (medications, substances, stress) can cause anxious feelings, they may involve different medical diagnoses.
Some anxiety is normal, but if you suffer from severe anxiety or are worrying too much, it’s important to talk with a mental health specialist about your symptoms. Psychologists focus more on psychotherapy and are not medical doctors. Psychiatrists are medical doctors who specialize in mental health treatment. Both psychologists and psychiatrists can diagnose and treat anxiety disorders with psychotherapy, and psychiatrists can also prescribe medications. Psychologists in a few states may have the ability to prescribe medication, but this is not common or widespread.
Additionally, if you have anxiety with suicidal thoughts, seek emergency medical treatment immediately or call 988.
Could any of the following be causing your anxiety?
Heart Problems Can Cause Anxiety
If you’ve ever had a panic attack, you’re familiar with the way your hands get clammy, you can’t catch your breath — and your heart feels like it’s going to pound right out of your chest. While a panic attack is not a heart attack, there’s a relationship between heart problems and anxiety.
Indeed, about 5 percent of American adults have generalized anxiety disorder, but the incidence is higher in people diagnosed with coronary artery disease (11 percent) or with heart failure (13 percent), according to research from 2016. Evidence also shows that anxiety can be brought on after a heart attack, stroke, or heart failure, notes the Centers for Disease Control and Prevention (CDC).
The connection appears to go both ways: People who experience long-term anxiety may experience increased heart rate and blood pressure, reduced blood flow to the heart, and heightened levels of the stress hormone cortisol — over time, all this can lead to heart problems, says the CDC.
Anxiety Disorders Are Linked to Alcohol and Drugs
There is a strong link between alcohol and anxiety. Research shows that people with anxiety disorders are 2 to 3 times more likely to have problems with drugs and alcohol at some point in their lives than the general population. But that’s not all: Alcohol and drugs can often cause panic attacks, according to the Anxiety and Depression Association of America (ADAA).
People with social anxiety, in particular, may turn to alcohol in order to lessen their symptoms, but alcohol can actually make anxiety worse. About 20 percent of people with social anxiety disorder also have an alcohol or substance abuse disorder, notes the ADAA. No matter which problem comes first, the combination of drugs, alcohol, and anxiety can become a vicious cycle.
Caffeine and Anxiety Make You Feel Jittery and Nervous
Caffeine is a stimulant — and that can be bad news for someone with anxiety. Caffeine’s jittery effects on your body are similar to those of a frightening event. That’s because caffeine stimulates your “fight or flight” response, according to a 2006 study, and research from 2018 has shown that this can make anxiety worse and can even trigger an anxiety attack.
Other research suggests that while caffeine can increase alertness, attention, and cognitive function, overdoing it can increase anxiety, particularly in people with panic disorder and social anxiety disorder. And as with the symptoms of anxiety, one too many cups of joe may leave you feeling nervous and moody, and can keep you up at night.
RELATED: 11 Benefits of Going Caffeine Free
Medications Can Trigger an Anxiety Attack
Certain medications have some ugly side effects — and can cause anxiety symptoms or an anxiety attack. Prescription medications to watch out for include thyroid drugs and asthma drugs, while over-the-counter decongestants have been known to cause anxiety symptoms in some people. If you suddenly stop taking certain medications sometimes used to treat anxiety, such as benzodiazepines, withdrawal may cause added anxiety.
Weight Loss Supplements Can Have Anxiety-Producing Side Effects
Many over-the-counter (OTC) weight loss supplements come with anxiety-producing side effects. Use of St. John’s wort may lead to insomnia, and green tea extracts (which claim to suppress appetite) contain plenty of caffeine. Guarana, an ingredient in some OTC diet products, can contain up to 4 times as much caffeine as coffee beans. And beware of any product containing ephedra — it can cause increased heart rate and anxiety. The U.S. Food and Drug Administration (FDA) banned the sale of dietary supplements containing ephedra in 2004.
Are Anxiety Symptoms Related to Your Thyroid Gland?
The thyroid is a butterfly-shaped gland in the front of your neck that produces thyroid hormones. These hormones are important for regulating your metabolism and energy levels. But if your thyroid produces too much, it can cause anxiety symptoms, such as nervousness, irritability, heart palpitations, and sleeplessness. Hypothyroidism (in which your thyroid produces too little of the needed hormones) has also been linked to anxiety disorders. If you have anxiety symptoms along with swelling in your neck, weight loss, weakness, fatigue, or heat intolerance, ask your doctor to check your thyroid gland.
Stress Can Worsen Anxiety Symptoms
Stress and anxiety often go hand in hand — stress can be what causes anxiety symptoms, and anxiety can make stress worse. When you’re overly tense, you may also turn to other behaviors that make anxiety worse, such as smoking, abuse of drugs, or abuse of alcohol. Remember that stress and anxiety are often accompanied by physical symptoms, such as stomachache, headache, dry mouth, dizziness, and sweating.
If you have unexplained symptoms of anxiety, talk with your doctor. Anxiety disorders are treatable.
RELATED: How Are Anxiety Disorders Treated?
Seth Gillihan, PhD
Medical Reviewer
Chris Iliades, MD
Author
Chris Iliades, MD, is a full-time freelance writer based in Boothbay Harbor, Maine. His work appears regularly on many health and medicine websites including Clinical Advisor, Healthgrades, Bottom Line Health, HeathDay, and University Health News. Iliades also writes a regular blog for The Pulse, a website for fetal health and pregnancy.
Iliades is board-certified in Ear, Nose and Throat and Head and Neck Surgery. He practiced clinical medicine for 15 years and has also been a medical director for diagnostic research and a principal investigator for clinical research before he turned to full-time medical writing.