Nerves or Something More? A Quick Guide to Anxiety Disorders

By: Jennifer Yen Clark, MD
You know the feeling: sweaty hands, pounding heart, shaking, lightheadedness, and butterflies in your stomach. Whether it’s speaking in public, going to a job interview, traveling alone for the first time, or proposing marriage, we have all known what it’s like to feel nervous. For some of us, it’s having an irrational fear of something small, like heights or spiders. For others, it’s the pressure of performing at work or in social situations. With all of our lives becoming more demanding and fast-paced than they have ever been, it’s no shock to anyone to learn that anxiety is part of our daily lives.

With that said, there are many aspects of anxiety that impact your ability to function in ways that can be extremely difficult to manage. Unlike the occasional sleepless nights at home or the bad day at work, there are instances in which your day-to-day stress develops into something more serious. Most people can identify what it feels like to be anxious. Whether it’s the physical symptoms that we have (listed above) when we have stage fright or the feeling of drowning under a mountain of responsibilities, we can readily state that we are feeling out-of-sorts. However, those same symptoms can be the early warning signs of a developing anxiety condition, something that should be caught early and receive intervention before it becomes incapacitating.

Many patients walk into my office telling me that they “just need stress management,” “just can’t seem to sleep,” or “just feel really angry all the time.” None of them come in saying they need help with anxiety, but in many cases, that’s exactly what they need. Although there is a biological, or genetic, component to anxiety disorders that can be inherited through generations of the same family, it is not the only factor that plays into an individual developing a disorder. People who tell me they have an “anxious personality” report that it is not their tendency to worry that disrupts their lives, but rather their inability to control all the chaos around them. In reality, however, some of the most common symptoms of anxiety are things people chalk up to stress.

What kinds of anxiety can you have?
Anxiety disorders are quite common and come in a variety of forms. There is the constant worry and perseverative thinking that comes with Generalized Anxiety Disorder, and there are the phobias (Agoraphobia, Social Phobia, and Specific Phobias) that cause the sufferer to have excessive and out of proportion anxiety to certain situations. There is Separation Anxiety Disorder, which can occur even in adulthood, and Selective Mutism, in which the anxiety causes a child to become mute around others. Some of the worst symptoms are associated with Panic Disorder, in which the attacks can be so severe that the person cannot bear to leave the house.

How can you tell that you might have anxiety?
Those with anxiety disorders often complain of difficulty shutting their minds down at night, constantly worrying and going over what’s in the past and the future. They wake up multiple times a night for no reason and have a hard time going back to bed. When they wake up, their minds are immediately worrying and obsessing, and they spend their days irritated with everyone that crosses their path and wanting to be left alone. Despite isolating themselves in their office or cubicle, they often find themselves spending more time worrying about what they have to get done than actually doing any of it. They forget to eat their lunch or snacks, and by the end of the day, they go home feeling tense and achy all over. When it is time to go back to bed, the entire cycle starts all over again. This happens day after day, week after week, until these individuals can’t remember what it was like not to feel like this.
to bed. When they wake up, their minds are immediately worrying and obsessing, and they spend their days irritated with everyone that crosses their path and wanting to be left alone. Despite isolating themselves in their office or cubicle, they often find themselves spending more time worrying about what they have to get done than actually doing any of it. They forget to eat their lunch or snacks, and by the end of the day, they go home feeling tense and achy all over. When it is time to go back to bed, the entire cycle starts all over again. This happens day after day, week after week, until these individuals can’t remember what it was like not to feel like this.

How bad can anxiety get?
For a lot of people, the anxiety seems to appear abruptly, in a near incapacitating way. One of my patients came in and told me that he was sitting in traffic one day and, out of the blue, he suffered severe pressure in the chest difficulty breathing, he felt dizzy, his limbs went numb, and he was convinced that he was having his first heart attack. Another told me that despite having been a social butterfly for most of her life, she found herself standing in a crowd watching everything in tunnel vision and hearing things as if she was under water. In each case, the person sought out medical evaluation and treatment only to be told there was nothing physically wrong with them. In fact, what they were experiencing were anxiety attacks and panic attacks that later became more and more frequent. By the time both of these individuals came to see me, they were terrified of the next attack and barely left home. They were constantly in fear of having an attack in public and could no longer perform at work. In most cases of panic symptoms, the person has had low levels of anxiety for much longer, but something in their environment or situation can cause a spike in their anxiety to the point where an attack is triggered.

What can I do if I think I have anxiety?
There are several ways to approach a possible anxiety disorder. First, ask yourself how long you have had the anxiety, what makes it worse, and what makes it better. If you are able to identify what is causing the anxiety and have the ability to bounce back from feeling nervous or worried fairly easily, you’re probably fine to just work on scheduling down time to decompress and use coping skills, such as deep breathing, visualization, or deep muscle relaxation. If you find that you apply all the techniques you can think of and are still anxious, or you’re in a situation you cannot control and do not foresee an immediate end to, consider seeking out a therapist or life coach to support and guide you. If your symptoms are severe enough that they are causing you to have severe anxiety or panic attacks or you are unable to function at work or take care of yourself at home, then consider getting an evaluation from a qualified mental health professional like a psychiatrist. If need be, medication may be recommended, with regular follow-up and monitoring to determine the efficacy of treatment.

What to remember
Anxiety disorders can be tough to deal with, but it doesn’t mean you can’t reduce or resolve your symptoms with help from others. There are many ways to address anxiety, including the use of coping skills, individual therapy, and relaxation training, and if all else fails, medication. Identifying the anxiety early is crucial to treatment, and being willing to admit that things are out of your control could be the most important step towards getting better. As long as you take care of your mind, you’ll be able to enjoy the excitement in your life without getting wrapped up in the chaos.

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Jennifer Yen Clark, MD graduated from the University of Texas Medical School in Houston and went on to complete residency training in general psychiatry at UT Medical School. She then completed fellowship training in child and adolescent psychiatry from Baylor College of Medicine. She is currently splitting her time between her private practice, Serenity Behavioral Health, and academics as Clinical Assistant Professor of Psychiatry and Behavioral Sciences at Baylor College of Medicine.

Dr. Yen Clark is also the author of a young adult novel series entitled The Avalon Relics, under her pen name of J.L. Clark. The series follows a teenage girl named Sophia as she discovers a realm of magic, intrigue, and romance. She hopes to send a message of empowerment and acceptance through her writing, while entertaining her audience with a journey through a hidden world of wonder and fantasy.

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