Like many working Americans, I’ve always had a full plate. When I was 30, I quit my job as an attorney to write full-time, working 50-hour weeks to get my business off of the ground. By the time I was in my early 40s, with two little kids, I was juggling career, children and everything else. I thrived on chaos.
But by my late 40s, something shifted. I found myself worrying all of the time — about my kids, my marriage (our relationship had been strained for years), my career. About getting older. School shootings. The environment. About… well, everything.
I felt a continual sense of dread. I couldn’t sleep. I’d go hours without eating because I felt vaguely nauseated and would then stress-eat an entire bag of Cheetos. I drank too much wine at night to try to shut my brain off, yet did not sleep well.
There’s a difference between feeling anxious or overwhelmed about some event and the kind of anxiety that can be disturbing, even disabling.
I tried journaling, talking to friends, prayer, running, yoga. Nothing helped for long. After yet another tear-filled conversation with my mom, I finally agreed to talk to a psychiatrist.
“It sounds like you have anxiety,” the doctor said, after I downloaded the way I’d been feeling for months.
“Well, doesn’t everyone?” I replied.
But as I learned, there’s a difference between feeling anxious or overwhelmed about some event (a big job interview or the birth of your first grandchild) and the kind of anxiety that can be disturbing, even disabling.
Here’s a closer look at this common condition and how to know what’s normal — and what may signal the need for help:
Normal Anxiety and Anxiety Disorders
Life itself produces some anxiety, even fear. And that’s not necessarily bad, says Dr. Michael S. Ziffra, an assistant professor of psychiatry and behavioral sciences at the Feinberg School of Medicine at Northwestern University in Chicago.
“On some level, anxiety has positive qualities,” he says. “It can motivate you to make change or alert us to something going on. The emotion of anxiety itself isn’t necessarily a bad thing.”
However, “it’s important to distinguish between feeling anxious, which is a normal emotion, and having an anxiety disorder, which is the term for anxiety that is clinically significant in some way,” Ziffra continues. “Anxiety disorders are pretty common. If you lump them together, the prevalence over the course of a lifetime is that one-quarter to one-third of people will have one at some point during their lifetime.”
In fact, according to the National Institute of Mental Health, about 1 in 5 adults has been dealing with an anxiety disorder in the last year.
Common Anxiety Disorders
The most common anxiety disorders include:
- Generalized anxiety disorder. Symptoms include excessive anxiety or worry most days for at least six months, with the anxiety interfering with daily life.
- Panic disorder. People with panic disorder have recurring, unexpected panic attacks or periods of intense fear. People with the condition can develop agoraphobia, a condition in which a person fears and avoids places or situations that might cause him or her to panic or feel trapped.
- Phobia-related disorders. People with a specific phobia have an out-of-proportion fear in response to a particular situation (like flying) or object (like snakes). People with social anxiety disorder have intense fear related to interacting with others. And people with agoraphobia have fear related to leaving their homes, which can manifest as fear of being in open spaces, being in a crowd or using public transportation.
According to a 2017 study by researchers at Erasmus Medical Center in the Netherlands, the age of onset for anxiety disorders depends on the disorder. Several of them, including social anxiety disorder, tend to emerge when people are children. Other disorders, like agoraphobia and panic disorder typically start in early adulthood, while generalized anxiety disorder may emerge even later in life.
It’s not clear why some people are more likely to develop an anxiety disorder than others, though women are about twice as likely to have one as men. A family history of anxiety and other mental illness, a stressful childhood and even some health conditions can raise the risk of developing one. Some are short-lived, with treatment; others can be chronic, with fluctuating symptoms.
How Do You Know When You Need Help for Anxiety?
So how do you draw the line between what’s normal anxiety or fear (like when you’re white-knuckle driving in heavy traffic in a downpour) and what’s a sign of excessive anxiety? It’s a question of how much it is impacting your life.
If you’re unable to leave the house, for example, or you’re unable to eat, sleep or concentrate, and this goes on for longer than several weeks, it’s time to talk to a doctor.
“The big distinguishing feature is that it’s causing significant functional impairment in some way,” Ziffra says. “That’s what you’re looking for. Is it impairing you from doing your job? Is it affecting your family, your social connections? Is it affecting your sleep or your eating or your ability to concentrate?”
Treating Anxiety Disorders
There are generally three avenues of treatment when it comes to anxiety disorders — medication (usually antidepressants), therapy or both. Psychotherapy involves working with a psychologist, social worker or therapist to learn about ways to better understand anxiety and manage your symptoms.
Other, supplemental strategies, like getting regular exercise, making sleep a priority and reaching out for social support, can also help. Meditation can help you learn to relax and quiet your mind.
People suffer for months or even years with crippling anxiety, but anxiety disorders are very treatable, Ziffra says. Reach out for help if your anxiety has spiraled to the point where it’s affecting your life.
In retrospect, I wish had done that earlier. I just didn’t want to admit that I couldn’t fix the problem on my own. I felt weak, especially when my boot-strapping didn’t help. But taking a selective serotonin reuptake inhibitor (a medication known as an SSRI used for anxiety and depression) got my racing thoughts under control to the point where I could eat and sleep normally again.
Seeing a wonderful therapist helped me identify some major stressors I could (and did) change. It was still a challenging few months, but today, I feel like myself again.
My only regret? That I waited so long to get help.
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