Anxiety: Causes, Symptoms & Treatment

What is Anxiety?

Anxiety is a natural response of the body designed to help you function in extreme situations. In people with anxiety disorder, this legitimate and evolutionary fear that exists in every person is amplified, to the point of disrupting their lifestyle and daily functioning.

Anxiety is often accompanied by avoidance: in order to avoid provoking the extreme and irrational fear, we try to avoid coping with the triggering situation, cause or object that causes the fear response.

One of the main characteristics of anxiety is consistent and paralyzing symptoms such as muscle tension, indigestion, difficulty breathing, fatigue and much more.

Anxiety is one of the most common issues in the field of mental health, affecting all groups of people.

According to the National Institute of Mental Health, over 30% of the population suffers from an anxiety disorder during their lifetime. Anxiety also accompanies other mental health problems with high frequency.

Another study on comorbidity found that almost 50% of patients diagnosed with major depression also had at least one anxiety disorder. Only 35% of them had no other mental disorders.

Causes of Anxiety

How Does Anxiety Develop?

Anxiety disorder is not a genetic problem that you were born with, but rather the result of poor habits that is treatable. The development of an anxiety disorder starts at a very young age, in our childhood and at home. If you grew up with at least one parent who was often anxious or intolerant of emotions, such an experience would affect your own emotional habits and tolerance, and contribute to the development of your own anxiety.

  • A worried or anxious parent who has difficulty trusting the child only conveys to the child the message that, in time of doubt or uncertainty, they are unable to trust themselves.
  • The child constantly hears how weak they are in the face of a dangerous world, how many bad things can happen, and how much they don’t have the ability to deal with “dangers”. The parents keep warning them to be careful, so they end up being careful all the time, of everything, continuously.
 

As a result, such an individual on the one hand is growing up constantly looking for ways to evade danger, maintain certainty, and try to control their external situations. On the other hand, when this individual doubts their ability to cope they are filled with anxiety and worries about potential terrible and catastrophic consequences. These thoughts take on a life of their own and often make it impossible to think of anything else.

Hence the road to a world of anxiety is short, since there are a lot of uncertainty and “what if’s” that we all have to deal with in life. Being deprived of the skills to deal with uncertainty or a lack of control in life only increases our anxiety, and causes normal and unavoidable situations to feel unbearable or courting disaster. This is the basic underlying mechanism that results in an anxiety disorder.

The first lesson of the Healthy Mindset Toolkit explains how our ability to learn to deal with our fears  when we’re young affects the chances of developing an anxiety disorder. If you’re curious to learn more, sign up for the first lesson free.

What Are The Consequences Of Anxiety?

Common Symptoms of Anxiety

How To Recognize Anxiety?

Anxiety disorders mostly include obsessive or negative thoughts about yourself or the world, unpleasant and even painful physical symptoms, behaviors of escape or avoidance that impair functioning, and emotional feelings that reach high levels of intensity and frequency. As the anxiety persists it may feel like your energy is running out and your levels of motivation and desire in life are decreasing.

Common to all anxiety disorders is the irrational and practically crippling fear, which increases our motivation to avoid the situations which trigger the anxiety. The cycle of avoidance and physical symptoms that accompany anxiety significantly impair our lifestyle and normal daily functioning. There are quite a few symptoms of anxiety, and they can be broadly divided into categories. However, it is important to remember that anxiety symptoms vary from person to person and some of the symptoms listed here may not be present for everyone.

Anxious Thoughts

Anxious Feelings

Anxious Behaviors

Anxious Physical Sensations

Anxious Dysfunction

Can I Check My Own Anxiety Levels?

Only a mental health professional can unequivocally diagnose mental health problems.

But if you have a suspicion about your emotional state or have recognized  within yourself some of the common symptoms of anxiety, this questionnaire can enable you to get an idea of the severity of the problem and a possible need for treatment.

Additional Anxiety Disorders

Anxiety Attack (Panic Attack)

An anxiety attack or panic attack is a period of time of at least ten minutes in which a person experiences long moments of severe terror and deep fear for their life, often for no apparent logical reason.

If a person suffers from repetitive anxiety attacks, they may be diagnosed with what is known as panic disorder. However, isolated anxiety attacks can occur as well.

Panic attacks can be accompanied by severe physical symptoms: abnormal heart rhythm, respiratory problems, dry mouth, involuntary tremors, excessive sweating, chest tightness, gastrointestinal problems, irrational and constant fear of death, and more.

Social Anxiety

Social anxiety is characterized as an extreme and irrational fear of situations that carry the potential for criticism or rejection by other people.

This intense anxiety about being rejected by society or receiving criticism from others leads to extreme emotional reactions and a noticeable impairment in daily functioning.

People who suffer from social anxiety are afraid to interact with people in certain situations and avoid social exposure. The phenomenon impairs the individual’s quality of life and daily functioning, and often also causes depression.

Specific Phobias

A phobia is a state of extreme, excessive and irrational fear of an object or situation that is not usually definitively dangerous. This is a very common disorder.

An individual suffering from a phobia may disrupt his life and engage in acts of avoidance and distancing to avoid encountering the trigger for his fears.

The physical symptoms of phobia are reminiscent of an anxiety attack in that the individual experiences severe distress, physical symptoms associated with life threatening situations, and the impairment of functioning and quality of life.

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is considered the most common anxiety disorder. According to health statistics, between 4-8% of the adult population suffer from GAD.

The main characteristic of GAD is the constant preoccupation with worrisome thoughts (which raise the level of stress and anxiety) during many hours of the day, regardless of the external situation, and persistently over time (at least several months).

The physical symptoms that accompany Generalized Anxiety Disorder include fatigue, difficulty concentrating, weakness, irritability, chest pains, and more. GAD is also often accompanied by sleep disorders.

Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is a disorder in which intrusive thoughts (“obsessions”) cause a person to feel anxious and stressed.

To calm these upsetting thoughts, an individual suffering from OCD repeatedly and compulsively performs  behavioral and/or mental rituals (“compulsions”) in an attempt to neutralize the obsessions and to “ensure” that nothing bad will happen.

Over time these rituals can get worse and eventually take up hours out of the day of an individual with OCD, to the point that they know their behavior is irrational or exaggerated, but nevertheless are unable to stop themselves. OCD can create an emotional burden of general anxiety, specific fears, depression, self-disgust, shame, guilt and more.

Posttraumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) can develop after an individual has experienced a traumatic event and their perception of the event conflicts with their worldview.

Many aspects of the emotional and physical experience which occurred during the traumatic event remain with them even after the event itself is over and can reoccur in full force as a result of various triggers, both external triggers present in the world around them and internal triggers such as memories.

PTSD shares many features with other anxiety disorders, including the symptoms with which it presents, and also the great distress and significant impairment to one’s lifestyle and quality of life.

What Is The Treatment For Anxiety?

There are various options for treating anxiety that include psychodynamic (psychoanalytic) therapy, Cognitive Behavioral Therapy (CBT), and medication. Most studies have found that patients who underwent either CBT alone or CBT combined with medication experienced the most significant improvement.

Today it has been widely demonstrated in hundreds of studies that anxiety disorders can be treated in a relatively short time through treatment that addresses the patterns of thinking and behavior which result in high levels of anxiety. CBT teaches the patient “tools” to identify and change unhealthy habits in real-time in order to lower their anxiety levels. CBT has been shown in research to be effective for the entire spectrum of anxiety disorders, including phobias (such as fear of driving, fear of roaches), social anxiety, panic attacks, OCD, post-trauma, as well as for eating disorders, anger management problems, sleep disturbances, and more.

How Does Cognitive Behavioral Therapy (CBT) Work?

Cognitive Behavioral Therapy (CBT), which has been proven in hundreds of research studies to be highly effective, focuses on two major areas of habitual functioning: cognitive and behavioral.

Treatment – How to Stop Anxious Thoughts and Over-worrying:

Tolerance of anxiety: Because cognitive symptoms of anxiety are born out of difficulty in dealing with uncertainty and a lack of control, low self-esteem, and fear of catastrophic events, we must learn how to tolerate the uncomfortable thoughts and feelings of anxiety, and set boundaries to deal with them better.

Exposures: A classical treatment methodology that is common in the world of CBT and proven in the treatment of various disorders is called the method of exposure, or Exposure Response Prevention (ERP). Exposure is a gradual and controlled process which aims to increase one’s tolerance for situations that cause anxiety until it subsides, and to prevent reactions that only exacerbate the symptoms of anxiety.

What do we learn during exposures?

  1. The most important thing we learn during exposures is that even when we do not engage our anxious thoughts or respond to “what if” questions but rather passively let our thoughts come and go – the feelings of anxiety diminish on their own with the passing of time.
  2. Equally important, we learn that the feelings of anxiety are not dangerous or life-threatening. They are uncomfortable but temporary.
  3. We also learn that it is possible to tolerate our impulses to respond to our anxiety without heeding those impulses. There is no obligation to obey the impulse to avoid, escape, control, eat, perform a compulsion, etc.


The process is reminiscent of a child who is afraid to sleep in the dark. If his parents let him sleep with them, he’ll calm down for the moment, but continue to be scared of sleeping in the dark. There is no actual coping but only a temporary solution to his fear of the dark. But if his parents return him to his room to cope with his fear, eventually he will succeed in staying on his own and discovering that there is no real danger, and that the feeling of fear subsides with time. By sending him back to his room his parents have promoted a habit of tolerating and coping with anxiety rather than believing his fears or heeding his impulse to escape the fearful situation.

During CBT there are exposure sessions to anxiety-provoking triggers, and tasks are given with the aim of coping with the triggers. For example – when anxiety arises, you are given a task to try to postpone any immediate response and instead to wait and see what happens.

As part of the treatment, we learn to conduct a rational assessment that aims to prevent extreme reactions to a situation, and to restore a sense of calm. Ultimately, the idea is to teach us to trust ourselves and our ability to deal with any situation that may arise, even when there is an element of uncertainty.

Core Belief Therapy:

The symptoms of anxiety stem from deep inner beliefs (or Core Beliefs) that “I can not trust myself if I am not 100% sure. Something may be wrong with me. Something bad may happen”. (As a result of these inner beliefs, we worry or think obsessively about “what if”, and try to compensate by achieving certainty or control of a situation.) Therefore part of the treatment addresses our inner beliefs and deeper thought processes.

  1. In order to address the underlying beliefs that feed into our anxiety, we must first recognize the beliefs when they arise. Once we realize that we are in the midst of a negative thought, CBT provides us the tools to challenge these thoughts in real time. Various techniques enable us to stop negative thoughts, exchange them for healthier ones, obtain a respite from them, let go and relax. 
  2. In addition, we learn how to improve our self-confidence in areas where it is lacking. For example, if you have learned and accepted all your life that you are “not good enough” – this perception is re-examined, is it objectively true? Was it ever true? Or was it possibly a self-fulfilling prophecy? … Or we might conduct a “rational test” in the face of difficult situations to discover in fact how dangerous the world really is to the point that we have to worry. What disaster awaits us that justifies worrying for much of our day? As these core beliefs are questioned and examined, we begin to discover the capacity to deal with life’s challenges without needing to worry about them or ourselves. Ultimately we learn to start trusting ourselves more, and to let go of the need to address our anxiety and the need to resolve uncertainty. This confidence makes it possible for us to deal successfully with fears even in situations where we have no control over current and future events.
  3. These skills make it possible to discover that we have the ability to cope with situations which carry an element of uncertainty, lack of control, or that provoke anxiety. During the treatment process we come to understand that perhaps we had the capability to cope all along, and it was the negative belief itself – that we could not cope or that something was wrong with us – which created a negative self-fulfilling cycle exacerbating the anxiety and our lack of confidence. Once we accept our anxiety in all its manifestations (thoughts, physical sensations, behaviors, affect on functioning) as natural and not as a threat, the anxiety along with its unwanted symptoms subside much faster and reoccur less and less. In addition we feel more confident in the face of situations that may arouse our anxiety.

CBT is generally short (3-6 months on average), effective, focused and goal-oriented. Dr. Ohad has developed an online course based on the CBT method to teach individuals how to deal with anxiety on their own. Experience the first lesson of the course free >

What do Dr. Ohad's patients say?

Therapy changed my life and gave me the tools to realize that anything can be improved

I came to treatment due to problems with anxiety accompanied by physical complaints like elevated heartrate, sweating, and the like.

CBT gave me practical tools that helped me understand the physical sensations can be controlled and reduced. In addition I was given tools to challenge my negative and pessimistic thoughts, as well as to gain the ability to redirect myself to more positive thoughts. Also, the treatment helped raise my self-confidence.

CBT changed my life a lot, made it easier for me on all levels and gave me tools to cope, and to realize that anything can be improved. I also received issues to work on during the week  in between sessions.

Roy

I managed to reach a level of zero anxiety attacks

Therapy for my anxiety helped me a lot. I managed to reach a level of zero anxiety attacks and received tools to deal with my thoughts that turned into emotions.

Once I started practiced with the exercises I received I got to a point where I was able to control the physical sensations and I started to feel more confident. I learned that once I have the tools to deal with my anxiety I’m able to deal with everything else in my life!

The results speak for themselves !!!!!!!

Shira

I improved my self-confidence and learned tools for dealing with anxiety

I started therapy because of anxiety attacks that caused breathing difficulties that scared me and bothered me a lot. Not only did the symptoms go away in a few sessions but I improved my self-confidence and learned tools for dealing with difficulties and anxiety.

I learned that feelings of anxiety should not always be taken for granted and one can easily refute the thought that the situation is dangerous and requires “fight or flight”. I learned that even if the feeling does not go away it is not really dangerous, and that it’s actually when we don’t avoid an anxious situation that the anxiety will subside.

I want to thank you for your excellent treatment that has improved my life in many ways, and I recommend treatment to anyone who does not want feelings of fear to dominate their life.

Naomi

My life has changed for the better including my quality of life

I started CBT due to recurrent anxiety attacks and social anxiety.

In short time Dr. Ohad was able to get me to rethink my way of dealing with things, to see myself as a valuable person, to think in a healthy and conscious manner less affected by stress, and to learn amazing tools that helped me tremendously to overcome anxiety and fears, increase my self-confidence and decrease the stress in all areas of life.

My life has changed for the better including my quality of life which is so much higher, a huge thank you for that!

Mira

Want to stop your anxiety on your own?

Learn the tools you need to reduce your anxiety
and get back in control of your life.