INSIDE THE MIND Anxiety disorders have been linked to health conditions like irritable bowel syndrome. High Anxiety ABOUT ONE IN FIVE OF US HAS AN ANXIETY DISORDER—BUT MANY GO UNDIAGNOSED AND UNTREATED. HERE’S HOW TO IDENTIFY THE PROBLEM AND GET THE HELP YOU NEED. » BY DIANA KELLY LEVEY rom the time she was a to help her deal with the panicky, child, Tara Mandarano worst-case feelings she was always felt a little anxious. experiencing, and medication after F But when she became she stopped breastfeeding her baby pregnant with her daughter, her at four months. “I stopped constantly anxiety reached new heights. having dreams that my baby was “I started to worry about everything, somehow lost in my bed, or that she incessantly. I was terrified I would had stopped breathing, or that I would lose my baby. I would sit in the accidentally drop her.” bathroom in the dark, sobbing, and Anxiety disorders like the one my husband would have to comfort Mandarano experienced are me and try to talk me down from extremely common among men and whatever catastrophic thoughts I women of all ages and backgrounds. was having,” recalls the 41-year-old Anxiety disorder is the most Ontario, Canada–based writer. common mental illness in the U.S., Mandarano finally got the help experienced by about 19 percent of she needed when she was diagnosed adults in the past year, according with perinatal generalized anxiety to the National Institute of Mental disorder, a mental health condition Health. And an estimated 31 percent that affects 8 to 10 percent of women of adults will cope with an anxiety during pregnancy and 4 to 10 percent disorder at some point in their lives. postpartum. She received treatment In fact, you’ve likely felt anxious throughout her pregnancy and into at some point in your life, whether her postpartum period, including it was a nervous feeling before a cognitive behavioral therapy (CBT) big test or an interview, or some 20 MENTAL HEALTH 21 INSIDE THE MIND excitement and uneasiness before a first date. “It’s important to remember that anxiety as an emotion is totally normal—and in fact, it’s essential for survival,” says Dana Dorfman, PhD, who treats patients at a private practice in New York City. “It’s not always Stress and pathological. Anxiety is only problematic when it interferes with relaxation one’s functioning in [his or her] home or work life.” techniques, ● The Rise of Anxiety meditation, Anxiety disorders can be grouped into several categories, including yoga and generalized anxiety disorder (GAD), panic disorder, social anxiety acupuncture disorder, obsessive compulsive disorder, post-traumatic stress may all help to disorder and specific phobias. And it seems like we are feeling more treat anxiety anxious, more often. A 2018 survey from the American Psychiatry disorders. Association found 40 percent of Americans say they felt more Women are twice anxious than they did the previous as likely as men to that can influence anxiety include year. That followed a 36 percent be affected with the death of a loved one, a serious increase from 2016 to 2017. generalized anxiety illness or financial stress. Finally, disorder, which But while these disorders affect there can also be some learned often co-occurs with millions of Americans, only 36 major depression. behavior involved. “Anxiety is very percent of those with a disorder ‘emotionally contagious,’” says receive treatment, according to the Dorfman. “So if you’re around Anxiety and Depression Association a lot of anxious people, there’s a of America (ADAA). Much of that there’s less shame around struggling symptoms must be severe enough or ‘What if I seem awkward at the upbringing and what you’ve learned mirroring quality that happens. may have to do with an ingrained bias with anxiety as a lifestyle condition to interfere with your personal or party?” Here, the core fear is around throughout your life, and it’s not Oftentimes people are at greater against receiving help. “It may be a versus as a sign of that [someone is] professional life. negative evaluations from others. just your biology, but it’s really risk for becoming anxious when challenge for someone to be willing permanently damaged or weak.” Anxiety also comes in many forms, Obsessive-Compulsive Disorders how they interact with each other,” they are around other people to accept it as a condition to manage, including the following: (OCD) are often associated with says Kissen. who are anxious.” versus a deep character flaw,” says ● Defining the Generalized Anxiety Disorder obsessive hand-washing or needing Genetics, or having a family Sometimes, anxiety may seem Debra Kissen, PhD, executive director Different Disorders (GAD) is characterized by what feels things to be symmetrical, but this history of anxiety, plays a big part like it crops up out of nowhere. “I’d and owner of the Light On Anxiety Like most mental illnesses, in order like out-of-control worries, says chronic disorder has more to do in anxiety disorders. “If a parent been told I might have anxiety after CBT Treatment Center in Chicago for someone to be diagnosed with an Kissen. “When you hear someone with order (which might surface in or sibling suffers from anxiety, it going to a couple of walk-in clinics and co-chair of the ADAA. anxiety disorder, there are specific saying, ‘I just can’t stop worrying,’ or your career or physical appearance) significantly increases one’s genetic for chest pain in my early 20s, and I But a growing awareness about criteria that they need to exhibit— ‘I spent all night worrying about my as well as recurring thoughts and predisposition,” says Dorfman. was having panic attacks somewhat anxiety disorders may be helping especially for insurance to pay for finances or health’—those are signs of repetitive behaviors. “OCD-related Trauma—either ongoing stresses regularly for years, but I didn’t get more people get the help they need. treatment. Those symptoms may generalized anxiety.” disorders that we see a lot of include or having experienced trauma as a help for it until age 27,” says Lauren “There’s more education, include excessive anxiety Social Anxiety Disorder is where perfectionism or needing things child or having witnessed a traumatic Coffin, a 31-year-old baker/cake consumer awareness, and worry, worry that the core characteristic is fear of to be just right,” says Kissen. event—can also make you more likely decorator and writer in Boston. “For more of a dialogue is difficult to control, negative evaluation or judgment. “It to develop anxiety as an adult. reasons I still don’t really know, my on mental health in No. 1 feelings of restlessness, might look like the person has a lot ● Who’s More Prone Working an extremely stressful anxiety flared up in my mid-20s and general in society,” Anxiety disorders being easily fatigued, of worries and anxiety or stress, but A number of factors play a part job, and not managing those worries simply didn’t stop. I even ended up says Kissen. “For are the most common irritability and sleep what they’re really worried about are when it comes to developing an in a healthy way, may also be a in the hospital. I think what made anxiety specifically, mental illness in disturbances. These things like, ‘What if I do a bad job?’ anxiety disorder. “It’s not just your contributing factor. Other stressors the difference that time was that the U.S. 22 MENTAL HEALTH 23 INSIDE THE MIND It usually takes around four weeks for an SSRI to start to work; if you need help in the meantime with ANATOMY OF severe panic or anxiety attacks, AN ANXIETY ATTACK you might also need a fast-acting caused it and could be a downward spiral. medication like a sedative or a It’s not just your mind racing; all your wondering, “Why is my Your fingertips benzodiazepine like Klonopin, Xanax bodily systems body freaking out all might get cold as or Valium, says Dorfman. “They can react when you start of a sudden?” blood moves away work within 30 minutes or so, but the to panic. Here’s what may from the periphery effects may only last for a few hours.” happen inside your to the core. These have a tendency to be more “An anxiety or panic body when an anxiety You might become habit-forming and are a “quick fix” attack is simply your attack strikes: nauseous or Your heart rate experience other but don’t necessarily address the root sympathetic nervous system activating the speeds up as you gastrointestinal of the problem, she adds. fight-or-flight response start to breathe faster distress as blood flow Coffin—who was diagnosed of the body,” says in an effort to pump leaves the stomach and with generalized anxiety disorder Debra Kissen, PhD. “It’s more blood and oxygen heads to large muscle and panic disorder—says she an adaptive response to your major muscles groups so you are benefited from a combination of that you have when to help you to run ready to flee or fight. treatments, including CBT and you’re facing an from or fight this Your pupils may “immediate threat.” dilate, so you can taking benzodiazepine. “It got me immediate threat, like if you were in a Some people might see more of any down to having a panic attack only burning building or a feel like they’re perceived threats. once or twice a year. It was a massive loved one was about to suffocating and their You might feel improvement, but it took months of get hit by a car.