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Alternative Names Return to topAnxiety; Feeling uptight; Stress; Tension; Jitters; Apprehension
Definition Return to top
Stress can come from any situation or thought that makes you feel frustrated, angry, or anxious. What is stressful to one person is not necessarily stressful to another.
Anxiety is a feeling of apprehension or fear. The source of this uneasiness is not always known or recognized, which can add to the distress you feel.
Considerations Return to top
Stress is a normal part of life. In small quantities, stress is good -- it can motivate you and help you be more productive. However, too much stress, or a strong response to stress, is harmful. It can set you up for general poor health as well as specific physical or psychological illnesses like infection, heart disease, or depression. Persistent and unrelenting stress often leads to anxiety and unhealthy behaviors like overeating and abuse of alcohol or drugs.
Emotional states like grief or depression and health conditions like an overactive thyroid, low blood sugar, or heart attack can also cause stress.
Anxiety is often accompanied by physical symptoms, including:
Sometimes other symptoms accompany anxiety:
Anxiety disorders are a group of psychiatric conditions that involve excessive anxiety. They include generalized anxiety disorder, specific phobias, obsessive-compulsive disorder, and social phobia.
Causes Return to top
Certain drugs, both recreational and medicinal, can lead to symptoms of anxiety due to either side effects or withdrawal from the drug. Such drugs include:
A poor diet -- for example, low levels of vitamin B12 -- can also contribute to stress or anxiety. Performance anxiety is related to specific situations, like taking a test or making a presentation in public. Posttraumatic stress disorder (PTSD) develops after a traumatic event like war, physical or sexual assault, or a natural disaster. People with generalized anxiety disorder experience almost constant worry or anxiety about many things on more than half of all days for 6 months. Panic disorder or panic attacks involve sudden and unexplained fear, rapid breathing, and increased heartbeat.
In very rare cases, a tumor of the adrenal gland (pheochromocytoma) may be the cause of anxiety. The symptoms are caused by an overproduction of hormones responsible for the feelings of anxiety.
Home Care Return to top
The most effective solution is to find and address the source of your stress or anxiety. Unfortunately, this is not always possible. A first step is to take an inventory of what you think might be making you "stress out":
Then, find someone you trust (friend, family member, neighbor, clergy) who will listen to you. Often, just talking to a friend or loved one is all that is needed to relieve anxiety. Most communities also have support groups and hotlines that can help. Social workers, psychologists, and other mental health professionals may be needed for therapy and medication.
Also, find healthy ways to cope with stress. For example:
When to Contact a Medical Professional Return to top
Your doctor can help you determine if your anxiety would be best evaluated and treated by a mental health care professional.
Call 911 if:
Call your health care provider if:
Ask your pharmacist or health care provider if any prescription or over-the-counter drugs you are taking can cause anxiety as a side effect. Do not stop taking any prescribed medicines without your provider's instructions.
What to Expect at Your Office Visit Return to top
Your doctor will take a medical history and perform a physical examination, paying close attention to your pulse, blood pressure, and respiratory rate.
To help better understand your anxiety, stress, or tension, your doctor may ask the following:
Diagnostic tests may include blood tests (CBC, thyroid function tests) as well as an electrocardiogram (ECG).
If the anxiety is not accompanied by any worrisome physical signs and symptoms, a referral to a mental health care professional may be recommended for appropriate treatment.
Psychotherapy such as cognitive-behavioral therapy (CBT) has been shown to significantly decrease anxiety. In some cases, medications such as benzodiazepines or antidepressants may be appropriate.
References Return to top
Muller JE, Kohn L, Stein DJ. Anxiety and medical disorders. Curr Psychiatry Rep. 2005 Aug;7(4):245-51.
White KS, Farrell AD. Anxiety and Psychosocial Stress as Predictors of Headache and Abdominal Pain in Urban Early Adolescents. J Pediatr Psychol. 2005.
Lubit R, Rovine D, Defrancisci L, Eth S. Impact of trauma on children. J Psychiatr Pract. 2003; 9(2): 128-138.
Ahmed SM, Lemkau JP. Psychosocial influences on health. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 4.Update Date: 12/15/2008 Updated by: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.