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Anxiety Disorders

(Chronic Free-Floating Anxiety)
  • Definition

    Anxiety is a state of dread, tension, and unease. It is considered a normal response to stress or uncertain situations. Feeling anxious for long periods of time or at intense levels may mean that you have an anxiety disorder. You may be diagnosed with an anxiety disorder if the anxiety:
    • Occurs without an external threat (called "free-floating" anxiety)
    • Is excessive or unreasonable for the situation or threat
    • Negatively affects how you function during the day
    The most common types of anxiety disorders are:
    Anxiety may occur with other conditions, such as alcohol use disorder, drug abuse, and depression.
  • Causes

    Anxiety disorders may result from a combination of factors, such as:
    • Genetics
    • Factors in the environment
    Chemical imbalances in the brain may also play a role.
  • Risk Factors

    Anxiety disorders are nearly twice as common in women than in men. Other factors that may increase your chance of anxiety disorders include:
    • Family member with anxiety disorders
    • Stressful life events
    • Poor coping strategies
    • History of physical or psychological trauma
    • Chronic medical illness
    • Substance abuse
    • History of self-harm as a teenager, with or without suicidal intent
  • Symptoms

    Psychological symptoms may include:
    • Worry or dread
    • Intrusive or ruminative thoughts
    • Sense of imminent danger or catastrophe
    • Fear or panic
    • Restlessness
    • Irritability
    • Impatience
    • Uncertainty
    • Trouble concentrating
    Physical symptoms may include:
    • Headache
    • Fatigue
    • Chest pain
    • Rapid heartbeat
    • Sweating (especially the palms)
    • Dry mouth
    • Flushing or blushing
    • Muscle tension
    • Shortness of breath
    • Feeling lightheaded or fainting
    • Difficulty sleeping
    • Shaking
    • Choking sensation
    • Abdominal discomfort
    • Nausea or vomiting
    • Diarrhea
    • Feeling of "butterflies" in the stomach
    • Sexual difficulties
    • Tingling sensations
    • Nail biting or other habitual behavior
    Symptoms of Anxiety
    Physiological effects of anxiety
    Copyright © Nucleus Medical Media, Inc.
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical and psychiatric exam will be done. Conditions with similar symptoms will be evaluated. Blood and urine tests may be done.
    Your doctor will ask questions about your:
    • Use of alcohol and drugs
    • Mental health history
    • Family's mental health history
    You may be referred to a psychotherapist for further evaluation.
  • Treatment

    Effective treatment usually involves a combination of interventions, including:
    Lifestyle Changes
    • Get sufficient rest and sleep.
    • If you smoke, talk to your doctor about ways to quit.
    • Reduce or eliminate caffeinated beverages.
    • Excess alcohol use can make anxiety worse—drink alcohol in moderation.
    • Avoid using drugs.
    • Reduce exposure to stressful environments.
    • Exercise regularly.
    Relaxation Techniques
    • Practice deep breathing and meditation.
    • Learn how to do progressive muscle relaxation.
    • Work with a massage therapist.
    • Engage in pleasurable activities.
    • Do yoga.
    Social Support
    • Have a strong support system of family and friends.
    • Seek therapy to improve your coping skills.
    • Join a support group.
    This therapy addresses thoughts, feelings, and behaviors that play a role in anxiety. It helps you work through traumas and conflicts.
    Cognitive behavioral therapy (CBT) can help you identify negative thought patterns and behaviors. Over time, you can learn to retrain your thinking. This will help you respond better to stress and anxiety.
    CBT has been very effective in children and teens.
    For severe anxiety or anxiety disorder, medications may include:
    • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants
    • Buspirone
    • Benzodiazepines
    Talk to your doctor about the risks and benefits of these medications. Some types may cause dependence.
  • Prevention

    To help reduce your chance of anxiety:
    • Be aware of situations, occupations, and people that cause you stress.
    • If unavoidable, confront and overcome situations that provoke anxiety.
    • Find a relaxation technique that works for you. Use it regularly.
    • Develop and maintain a strong social support system.
    • Express your emotions when they happen.
    • Challenge irrational beliefs and thoughts that are not helpful to you.
    • Correct misperceptions. Ask others for their points of view.
    • Work with a therapist.
    • Avoid using nicotine or other drugs. If you drink alcohol, drink only in moderation. Moderation is (one drink or less per day for women and two drinks or less per day for men.

    Anxiety and Depression Association of America

    Mental Health America


    Canadian Psychiatric Association

    Canadian Psychological Association


    Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: Updated December 23, 2014. Accessed January 26, 2016.

    Generalized anxiety disorder. EBSCO DynaMed website. Available at: Updated December 23, 2015. Accessed January 26, 2016.

    Generalized anxiety disorder (GAD). National Institute of Mental Health website. Available at: Accessed January 26, 2016.

    12/4/2009 DynaMed's Systematic Literature Surveillance Javnbakht M, Hejazi Kenari R, Ghasemi M. Effects of yoga on depression and anxiety of women. Complement Ther Clin Pract. 2009;15(2):102-104.

    9/12/2012 DynaMed's Systematic Literature Surveillance Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.

    11/6/2014 DynaMed's Systematic Literature Surveillance Mars B, Heron J, Crane C, et al. Clinical and social outcomes of adolescent self harm: Population based birth cohort study. BMJ. 2014;349:g5954.

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