How to deal with severe anxiety?

Published on November 9th 2022
Written by Jenna Farmer

Chapters.
1. About | 2. Symptoms | 3. Types | 4. Treatment | 5. Resources

Key Points.

    • Severe anxiety goes beyond the usual stress and worries of day to day life and can impact your ability to do everyday things such as working and socialising.

    • Severe anxiety causes a range of short-term and long-term symptoms that can manifest both physically and mentally.

    • The severity of your anxiety is unlikely to be dictated by the type of anxiety that you have but there are a number of tests that can be used to measure how severe your anxiety is.

    • There are a range of treatments for severe anxiety that you can access by speaking to a doctor and these include an array of therapies and medications.

Photo by Jakub Kriz on Unsplash

Whether you dread a trip to the hospital, hate the thought of large crowds or have worries that you can’t shake, many of us experience anxiety from time to time. In fact, almost 20% of Americans have an anxiety disorder. 

For some people, the symptoms of anxiety can be more overwhelming than for others. When the symptoms of anxiety occur more frequently and seem to have a greater impact on how you live your life, it’s possible that what you’re experiencing is actually severe anxiety.

What is severe anxiety? 🤔

Severe anxiety goes beyond the usual stress and worries of day to day life that come and go. Severe anxiety impacts your ability to do everyday things-such as working and socialising.  “Whilst mild anxiety might mean we notice racing thoughts or a quickened heart rate as we go about our every day, severe anxiety impacts a person’s life and stops them from doing usual activities and may involve panic attacks” says therapist Marianne Rizkallah, who is also Head Music Therapist for North London Music Therapy.

Severe anxiety is far more than fretting: it can cause lots of very real physical symptoms, which aren’t ‘just in your head’ and you may not even realise are due to anxiety. Classic symptoms of severe anxiety include things like a racing heart, headaches, muscle twitches, digestive issues or feeling short of breath. 

Severe anxiety can also cause panic disorder, which impacts 6 million Americans.  Panic disorder is the most severe form of anxiety and is when anxiety causes panic attack; a rush of physical and mental symptoms which come on quickly-such as shortness of breath, sweating and feeling faint.

What are the symptoms of severe anxiety? 🔍

Severe anxiety causes a range of both short-term and long-term symptoms. Mentally, severe anxiety may mean you feel permanently on edge or unable to shrug off feelings of worry or impending doom. Severe anxiety also causes a range of physical symptoms too such as: sweating, racing heart, shakiness and headaches.

Sometimes you may not even realise severe anxiety is causing some of your long-term health issues too: such as insomnia (which often occurs with severe anxiety) or digestive conditions such as IBS. Rates of IBS are higher with people who have anxiety and they are especially high for those who have severe anxiety disorders like panic disorders. 

When severe anxiety happens suddenly, you may also experience a panic attack. Panic attacks may only last a few minutes (although can last longer) but can make you feel as if you are going to collapse (thanks to feeling dizzy or struggling to breathe) or even as if you’re having a heart attack (as it’s common for your heart to race during a panic attack, along with chest tightness or pain).  Panic attacks can be super scary but they’re more common than you think. In fact, 10% of us have had at least one.

Panic attacks associated with severe anxiety cause a huge range of symptoms-you may find yourself sweating more often; struggling with nausea and stomach cramps; having throat and chest tightness and physically trembling.  Because of this, many people with long-term severe anxiety don’t always connect their physical symptoms to their mental health and may seek medical help for these issues (which can then worsen the cycle of anxiety). That’s why it’s so important to get clued up on just how many different ways severe anxiety can manifest itself in your body.

How does severe anxiety differ from other types of anxiety? 🔬

There are several different types of anxiety and the type of anxiety you have doesn’t necessarily tell you how severe it is:

    • Generalised anxiety disorder: this is one of the most common types of anxiety and is when you have long-term anxiety over a range of things, rather than one specific trigger.
    • OCD: Obsessive Compulsive Disorder manifests itself in repetitive behaviour such as hand washing, checking or cleaning to provide reassurance.
    • Social anxiety: anxiety related to social situations and interactions.
    • Panic disorder: a severe type of anxiety with intense fear and frequent panic attacks. 
    • PTSD: where anxiety occurs after being exposed to a disturbing experience.

Whilst some types of anxiety may present more severe symptoms, the label itself doesn’t really tell you how severe your anxiety is-after all, our brains all work differently!

Instead, you’ll likely be asked some questions by your medical team (such as your doctor or therapist) to help assess whether your anxiety is mild, moderate or severe. The GAD7 Anxiety Test Questionnaire is one common questionnaire that your doctor may use to do this. This test looks at a range of self-reporting symptoms over a two week period to decide how much anxiety is impacting your everyday life. Questions may include ‘how often have you had trouble relaxing over the last two weeks’ or ‘How often do you feel afraid something awful might happen?’

Another popular tool for this is the Beck Anxiety Inventory. Whilst the idea of being tested might cause your anxiety to spiral further, it’s important to remember the whole aim of these tools are to figure out how to get you the right support and help. If your doctor does diagnose severe anxiety, you’ll then be in the best possible position to explore a range of treatment options and support networks.

How to treat severe anxiety 🚀

There are a range of effective treatments for severe anxiety, it’s all about finding the one that works best for you (and your brain!). On your first trip to your doctor, they might advise non-medical options in the first instance. These include things like talking therapies (such as cognitive behaviour therapy which helps you challenge those persistent negative thoughts and replace them with more realistic ones) or relaxation therapies. These aren’t quick fixes (getting to grips with anxiety rarely is) but can really help: CBT has found to be effective in helping a wide range of anxiety types. One study found that group CBT therapy had a long-term impact on panic disorder, with 93% participants showing good prognosis when followed up.

If these treatments don’t work or you feel your severe anxiety needs more help, there are a range of medical treatments your doctor may suggest trying, which can be used in conjunction with other strategies you currently have to keep anxious thoughts at bay.

Antidepressants are one type of these (even if you’re not depressed, research has shown these to be super useful at tackling anxiety too). There’s lots of different types of antidepressants and some people need to try a few different kinds until they find the one that works best for them and their body, which might also depend on your current health issues or medication you already take. Antidepressants won’t instantly make your anxiety go away (research has shown the effect may kick in it at around 6-12 weeks) but for some people they can be a useful coping strategy for anxiety. They take some time to work and they don’t mean you’ll never feel anxious again – so it’s important to keep on top of all the other anxiety-busting strategies you already use.

If you are experiencing physical symptoms of anxiety, then beta-blockers may also be prescribed. These won’t take away the anxious feelings but can help quieten the physical symptoms you might get with a panic attack-such as a racing heart or shaking. Beta blockers work by slowing down your heart rate and also blocking hormones such as adrenaline, which trigger our ‘fight or flight’ panic responses. They can be particularly useful if you’re experiencing anxiety at the very thought of getting another panic attack (thus making your anxiety worse) and experiencing these physical symptoms.

Whilst severe anxiety can be really difficult to live with, there is help out there to make things much more manageable. The first step to coping with severe anxiety is to understand and recognise the symptoms so that you can seek support to help you feel in control of your mental health.

Resources for people with anxiety 🆘

There’s lots of different resources you can access if you’re struggling with anxiety:

Resources for those with anxiety in the UK:

Resources for those with anxiety in the US:

The information provided is for educational purposes only, and is not a substitute for professional medical advice.  Consult a medical professional or healthcare provider if you’re seeking medical advice, diagnoses, or treatment.

Anxiety Disorder Statistics, National Alliance on Mental Illness.
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Anxiety-Disorders

 

Marianne Rizkallah, North London Music Therapy.
https://www.northlondonmusictherapy.com/

 

Anxiety Statistics, Anxiety & Depression Association of America.
https://adaa.org/understanding-anxiety/facts-statistics

 

Signs of Anxiety Disorder, NHS.
https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/anxiety-disorder-signs/

 

Symptoms of Generalised Anxiety Disorder in Adults, NHS.
https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/symptoms/

 

Sleep & Anxiety Disorders by Luc Staner, National Library of Medicine.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181635/

 

The link between panic disorder, anxiety, and IBS, Verywell Mind.
https://www.verywellmind.com/irritable-bowel-syndrome-and-panic-disorder-2584207

 

Panic disorder & Panic attacks, WebMD.
https://www.webmd.com/anxiety-panic/guide/mental-health-panic-disorder

 

Generalised Anxiety Disorder Assessment (GAD7), Patient.
https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7

 

Beck Anxiety Inventory, Beck et al. Science Direct.
https://www.sciencedirect.com/topics/medicine-and-dentistry/beck-anxiety-inventory

 

Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence, Kaczkurkin, et al. National Library of Medicine.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/

 

Cognitive behavioural group therapy for panic disorder in a general clinical setting: a prospective cohort study with 12 to 31-years follow-up, Bilet, et al. BMC Psychiatry.
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02679-w

 

Antidepressants may reduce anxiety more than depressive symptoms, University of York.
https://www.york.ac.uk/news-and-events/news/2019/research/anti-depressants-reduce-anxiety

 

Beta Blockers, NHS.
https://www.nhs.uk/conditions/beta-blockers/

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