• Anxiety Disorders

    (Chronic Free-Floating Anxiety)


    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 abuse , drug abuse , and depression .


    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 more common in females. Factors that may increase the risk 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


    Psychological symptoms may include:
    • Worry or dread
    • Obsessive or intrusive 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.


    You will be asked about your symptoms and medical history. A psychiatric exam will be done. A physical exam may also be done. You may be referred to a psychotherapist for further evaluation.


    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.
    • 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:
    • Benzodiazepines
    • Buspirone
    • Antidepressants such as tricyclic antidepressants and selective serotonin reuptake inhibitors [SSRIs]


    To help prevent anxiety, consider taking the following steps:
    • Avoid 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 .


    Anxiety and Depression Association of America http://www.adaa.org

    Mental Health America http://www.nmha.org


    Canadian Psychiatric Association http://www.cpa-apc.org

    Canadian Psychological Association http://www.cpa.ca


    Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Published August 12, 2010. Accessed November 10, 2014.

    Generalized anxiety disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 29, 2014. Accessed November 10, 2014.

    Generalized anxiety disorder (GAD). National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml. Accessed November 10, 2014.

    12/4/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Javnbakht M, Hejazi KR, et al. 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 http://www.ebscohost.com/dynamed: 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 http://www.ebscohost.com/dynamed: Mars B, Heron J, et al. Clinical and social outcomes of adolescent self harm: Population based birth cohort study. 2014;349:g5954.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.