Anxiety, Explained

By: Rochelle Perper, Ph.D. | January 10, 2020

What is anxiety?

You know that feeling of fear on the first day at your new job? That’s anxiety. Do you recall that apprehension you felt before speaking in public? That’s anxiety. Remember that uncomfortable feeling when moving to a new town? That’s anxiety…and all forms of it represent normal and healthy responses to stress. Yet anxiety exists as the most common mental health concern. So, why do so many of us feel this way when its effects can range from mild to severe emotional impairment?

Whether mild or severe, we recognize anxiety by its physical symptoms that include, among many things, racing heart, tense muscles, stomach ache, feeling of pins and needles, cold hands and feet, dry mouth, and difficulty shifting our focus and attention.

Anxiety represents our body’s natural response to a perceived threat. When confronted by something that scares us, our brain releases adrenaline (epinephrine) — a naturally occurring hormone — throughout the body. Adrenaline prepares the body to face the threat by fighting or to escape the threat by fleeing, the so-called ‘fight or flight’ response. These bodily sensations prepare you to fight or flee the threat, thus representing — from an evolutionary perspective — a wonderfully adaptive human response to perceived dangers but misery for us as we endure it in real time.

When our body activates the fight-or-flight response with adrenaline, our hearts race, breathing speeds up, and blood vessels widen, all to make sure that plenty of oxygen gets to our muscles. Additional blood flow and oxygen tenses our muscles making our bodies ready for action. Other systems not needed for fighting or fleeing shut down, such as digestion. Our peripheral vision narrows and blood flows away from our limbs but toward the torso to protect vital organs.

What causes anxiety?

A single or particular cause of anxiety probably does not exist. The interplay of multiple factors including environment, genetics, unique physiology and early development all play significant roles in the development of anxiety.

Some people may tend toward anxiety due to their early development and upbringing. Research reveals a genetic element as well. For some, a traumatic or major provoking event, even chronic stress, can lead to the onset of anxiety. Continual chronic stress can cause the brain to exist in a constant state of fight or flight, having been “taught” to be in persistent hypervigilance.

Genetics also plays a significant role in the development of anxiety. If you have a parent with anxiety, you are more likely to be anxious yourself. Women are up to two times more likely than men to have an anxiety disorder. Anxiety also seems to have something to do with the balance of neurotransmitters or chemicals in the brain. Similar to depression, research shows that too little serotonin can lead to anxiety. Other neurotransmitter culprits include norepinephrine, dopamine, and GABA.

When anxiety becomes a problem

Statistics show that a third of people suffer with anxiety at some point in their lives. Although a normal response to danger, anxiety becomes a problem when it dominates or interferes with your life.

Modern life has evolved us past the need to fight or flee when we feel threatened. Today, we worry more about things like taxes, relationships, a deadline, or public speaking than a lion attack. We can’t fight or flee our way out of doing taxes, and yet our brain sends the same body signal to release adrenaline. In other words, our bodies respond the same way whether we are chased by a lion or stuck in traffic.

The fight-or-flight response seems unnecessary in our modern lives yet the physical after-effects of increased adrenaline remain. The more we perceive threats in our daily lives, the more adrenaline is released and the worse these symptoms become. This can lead to an anxiety disorder.

What are the different forms of anxiety?

Anxiety manifests itself differently in different people in different ways and patterns.

    • The term Generalized Anxiety represents a prevailing condition as opposed to intermittent or intense bouts of anxiety called Panic attacks.
    • Similar to panic attacks, a Phobia exists when a certain, specific, fearful situation leads to acute anxiety.
    • Social Anxiety represents the anxious discomfort in social situations.
    • Anxiety is the most common element in Post Traumatic Stress Disorder and Obsessive-Compulsive Disorder.
    • Anxiety often finds itself as a feature of Depression or can accompany a Major Depressive episode.
    • Clinical anxiety presents a greater challenge to reason their way out of feeling anxious. Why? Because the prefrontal cortex — the part of the brain responsible for logical thought — is “hijacked” by the emotion center of the brain and the reason why some anxieties have an irrational appearance or make no sense to others.

What can we do about anxiety?

Answer: Get a formal diagnosis as the best first thing to do. Work with a professional San Diego Psychologist to help you understand your concerns. Ruling out other possible explanations for what you experience is of the utmost importance.

Fortunately, several methods exist to reduce or eliminate anxious symptoms including:

    • Exercise and Nutrition
    • Psychotherapy
    • Psychotherapy and Medication
    • Mindfulness Therapies

Exercise and Nutrition

If you think you experience anxiety, you can start right away to ease your symptoms now with exercise and nutrition.

    • Eliminate your intake of processed foods and sugars. Eat regularly and drink enough water. By eating a balanced, healthy diet we maintain even blood sugar levels, which significantly contribute to a feeling of calm. Not skipping meals and staying hydrated helps to avoid the jitters, which often worsen underlying anxiety.
    • Create movement in your day and engage in the physical activities that you enjoy. These help your brain release hormones such as serotonin that helps elevate your mood. Getting blood flow to your limbs will release some of the physical fight-or-flight response and help you access the mental clarity that follows exercise to reason through your fears.
    • Reduce, or eliminate your intake of caffeine, and other stimulant drugs known to lead to anxious feelings, such as cocaine or ecstasy, prescription drugs like Ritalin or Adderall taken incorrectly or without a prescription, including some over-the-counter medications containing pseudoephedrine. Talk with your doctor or pharmacist if you have questions about pseudoephedrine.


Psychotherapy or “talk therapy” is the most effective way of reducing or eliminating anxiety and the most common treatment. Action-oriented therapies such as Cognitive Behavioral Therapy (CBT) teach tools and strategies to help you manage anxiety by evaluating negative thoughts and behavior patterns. Your San Diego Psychologist will help you learn ways to manage anxious thoughts and break down associations.

Psychotherapy and Medication

Research shows the most effective and successful treatment includes a combination of medication and therapy. Antidepressants represent the most commonly used medications for anxiety disorders to increase production of neurotransmitters like serotonin and keep it in the brain longer. Psychiatrists can also prescribe anxiolytics, or antianxiety medications. When taken appropriately with monitoring by your doctor, these medications help to manage high levels of anxiety most commonly experienced during panic attacks. Your San Diego Psychiatrist will work collaboratively with you to determine the best treatment option.

Mindfulness therapies

Mindfulness-based practices such as meditation, breathing exercises, and visualization have been scientifically shown to reduce anxiety and help you feel calmer. Mindfulness groups are a valuable opportunity to learn these skills to reduce stress and find support during your recovery. Therapy Changes has included such useful programs in its repertoire of services.

Say goodbye to anxiety

Freedom from anxiety is possible, especially if you seek professional help. Feelings of isolation can make the experience of anxiety worse, and yet most people who experience anxiety attempt to get through it themselves. As our society evolves and we continue to take steps to overcome stigma, seeking mental health counseling shows as a sign of strength. If you suffer from anxiety, reach out and ask for help.

We can and will get through this together. Be well!


Image: Michael Matti on flickr and reproduced under Creative Commons 2.0

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