Anxiety : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 18/06/2022

Anxiety is a negative emotional state, expressed by a feeling of uncertainty, the expectation of bad events. It manifests itself internally as a feeling of anxiety, an experience of excitement, and an unpleasant foreboding of impending disaster. External signs of anxiety - absent-mindedness, restlessness, obsessive movements, a suffering facial expression. A survey, observation, and psychodiagnostic tests are used for diagnosis: questionnaires, and projective techniques. Symptomatic care includes psychotherapy, pharmacotherapy, and relaxation techniques.

General characteristics

Anxiety is expressed as a vague vague fear about possible future events. Often it occurs for no reason, that is, in situations where there is no real danger. A person anticipates trouble but does not know how to avoid or overcome it. Internal tension is partially reduced by motor activity, so restless people cannot sit still, walk around the room, bite their nails, aimlessly turn on the screen of a mobile phone several times, and perform other seemingly meaningless actions.

The expectation of trouble makes you concentrate on finding ways to solve or avoid future problems. There is a distraction, some detachment from reality. Thinking becomes selective: a person pays attention to events associated with a disturbing situation, ignoring all others. In this way, he confirms that his experiences are justified. Sometimes the feeling of anxiety intensifies to a state of anxiety, and disorders of perception of time, space, people, and actions develop.

Subjectively, anxiety is felt as anxiety - a combination of fear, sadness, shame, and guilt for no reason. During the most acute experiences, physiological changes begin to be realized: rapid heartbeat, increased sweating, nausea, dizziness, and headaches. If there is no understanding of the connection between anxiety and physical ailment, a person looks for the cause of discomfort by contacting somatic doctors - therapists, neurologists, and cardiologists.

The thinking of a restless person is directed from the past to the future - an unfavorable or dangerous event is extracted from memories, and then something similar is predicted. At the same time, previous experience can be old or just happened, personal or someone else's. For example, after reprimanding the boss, the discomfort increases every time you come to the workplace since there is a chance to meet the boss. Similarly, anxiety can develop before flying in an airplane if a movie about a plane crash has been watched before.

Speaking of anxiety for no reason, it is worth noting that, as a rule, there is a reason, but it is not recognized or is assessed by others as insignificant. The key function of anxiety is to encourage actions that increase the likelihood of a favorable outcome of events, preventing potentially dangerous behavior. The biological basis of this experience is the mobilization of psychophysiological processes to overcome a possible traumatic situation. The negative effect of anxiety is a feeling of fear that prevents effective activity.


Reasons for concern

Depending on the cause of anxiety, three types of it are distinguished: adaptive, primary, and secondary. In a situation of immediate danger, conflict, or acute stress, anxiety develops as a reaction to the mobilization of the body: all systems are activated, preparing for fight or flight. Primary true anxiety, developing into anxiety, is observed in neuroses, secondary - in some somatic and mental diseases, taking medications, narcotic drugs.

Adaptive response

In contrast to pathological anxiety for no reason, with real danger, an adaptation reaction develops. It is manifested by the activation of physiological systems - increased breathing, increased heart rate, a rush of blood to the muscles, and mental readiness to escape or fight. Stress factors, a threat to life or health provoke a feeling of anxiety, and aggression, anxiety. Such adaptation reactions are triggered in the following cases:

  • Strict upbringing. Within families where parents cultivate conscientiousness, adherence to principles, and a sense of duty, the child does not have the freedom to express naturally existing fears and aggression. The suppression of these emotions leads to the consolidation of anxious and suspicious character traits, which are manifested by the fear of being open, obsessive fears, doubts, and uncertainty. A person is formed with an increased level of anxiety, anxiety.
  • The unpredictability of the behavior of others. The state of constant adaptive readiness is necessary when interacting with unbalanced, emotionally unstable people, or strangers. The feeling of anxiety is constantly present in children whose parents often change the rules of behavior (yesterday it was impossible to eat sweets, today you can). Other examples are speaking in front of an unfamiliar audience, and talking to a hot-tempered boss. Stress prepares the psyche to quickly choose a response.
  • Danger situations. With a real threat to well-being, the concern arises for a reason. When the outcome of the situation is dangerous (injury, serious illness, death), fear appears. If different outcomes are possible, a feeling of anxiety is formed. Examples: waiting for the result of a medical examination in the presence of symptoms of the disease, involuntary participation in hostilities, and terrorist acts.
  • Conflict situations. A clash of interests and different points of view is stressful. The psyche goes into a state of readiness for a quick reaction of defense, attack, or avoiding the conflict. The feeling of anxiety allows you to keep a high level of tension. The more significant areas of life are affected by the confrontation, the more likely the development of a neurotic disorder with anxiety.

Primary concern

Persistent anxiety for no reason contributes to the emergence of anxiety - the dominant symptom of neurotic disorders. The development of neurosis occurs when situational anxiety manifests itself frequently, begins to spread to an ever wider range of events, and is felt almost constantly. Often a person understands that there are no reasons for such experiences, but he cannot change his condition. The feeling of anxiety is characteristic of patients with the following neuroses:

  • Generalized anxiety disorder. In patients with this disease, anxiety and restless experiences are stable. Emotional tension has no connection with real events. Fears are general: fear of an accident, illness (in the absence of symptoms), or sudden death. People report a "bad feeling", a constant expectation of bad news. Generalized anxiety is more common in women, accompanied by autonomic disorders - trembling, dizziness, nausea.
  • panic disorder. Patients suffer from recurring panic attacks - sudden fear, and physical discomfort for no reason. Panic attacks last from 5 to 20 minutes, accompanied by shortness of breath, heart palpitations, and chest pain. Anxiety is felt before an attack when panic approaches. It is associated with the inability to control the attack and the fear of death.
  • Phobias. Phobic disorders are characterized by a persistent intense fear of specific objects or situations. Experiences are intense, often occur in the absence of a real threat, and are uncontrollable. They are due to the potential for the development of a frightening situation or meeting with the object of fear. Common options are claustrophobia, feeling intense fear at the thought of meeting a dog, climbing to a height, and using a public toilet.
  • PTSD. Post-traumatic stress - the consequences of a traumatic event (war, violence) with re-experiencing what happened in dreams and thoughts, mental numbness, and increased excitability. Anxiety often develops in the first stage, when a high focus on the trauma is maintained. Patients mentally return to the past and are poorly adapted to real life.
  • Psychosomatic disorders. In somatoform disorders, health concerns dominate - patients complain of somatic ailments, but medical examinations do not confirm the presence of the disease. A complex of experiences is formed, due to increased attentiveness to the signals of the body, and the lack of a diagnosis.
  • Obsessional neurosis. Obsessive-compulsive neurosis is represented by obsessive thoughts and repetitive actions that relieve mental discomfort. The person is concerned about the presence of disturbing thoughts, and the inability to control them. The most common variant of obsessional neurosis is the idea of ​​the contagiousness of surrounding objects and frequent washing of hands.

secondary anxiety

The experience of anxiety without a cause is a symptom of mental disorders or somatic diseases, a side effect of drugs, and the result of taking psychoactive substances. In all these cases, the feeling of anxiety arises secondarily, not due to external events and their evaluation, but due to physiological changes. Anxiety develops when certain areas of the brain are affected, with biochemical changes with increased production of neurotransmitters and hormones. The symptom is characteristic of several diseases, such as:

  • Depression. The physiological basis of anxiety and depressive disorders is a violation of the metabolism of serotonin and dopamine. A deficiency of these compounds in the areas of the brain responsible for emotional reactions is manifested by a state of depression, unreasonable anxiety, and restlessness. The trigger for depression can be an external negative event or directly biochemical changes (hereditary, provoked by diseases).
  • Schizophrenia. Restless thoughts are typical of the paranoid form of schizophrenia. They are caused by delusions and hallucinations: ideas of persecution, suggestions by voices of various violent acts. In addition, concern about one's condition is observed in patients in the initial stages of schizophrenia, when for no reason there is a feeling of disorientation in one's personality and environment.
  • Organic brain damage. Anxiety symptoms are found in diseases affecting the functioning of the reticular formation, namely, the activity of the blue spot. Axons from this nucleus ascend to the upper layers of the cerebral cortex, the cerebellar cortex, the hippocampus, and other structures involved in the formation of emotions. Lesions of these parts of the brain are represented by vascular, traumatic, tumor, and neurodegenerative pathologies.
  • Endocrine diseases. Hormonal shifts are often accompanied by the development of psycho-emotional disorders. Mood disturbances are diverse and manifest without a reason. The most common depressive states with anxiety, anxiety, and fear. They are provoked by an increase in thyroid hormones and the adrenal cortex. They are observed in thyrotoxicosis, hypercortisolism syndrome, and Itsenko-Cushing's disease.
  • Taking psychostimulants. Psychostimulant drugs, including narcotic drugs, have a stimulating effect on the nervous system. They increase the transmission of neurosignals in various parts of the brain, causing restless thoughts, panic, and sometimes hallucinations, illusions, psychosis. The most pronounced persistent symptoms of psycho-emotional disorder are the result of long-term drug use.


A persistent feeling of anxiety can be a symptom of somatic or mental illness. Psychiatrists, psychotherapists, and psychologists are engaged in the diagnosis of this condition. When a patient contacts specialists, a clinical survey is initially conducted, during which the duration of the emotional disorder, the frequency and severity of anxiety states, and possible causes are specified. In addition to the conversation, the following diagnostic methods are informative:

  • observation. Patients are characterized by restlessness, emotional instability, and absent-mindedness. It can be difficult for them to distract from their own experiences, and to concentrate on the words of the doctor. During the consultation, they often change the position of the body for no reason and touch objects with their hands (clasps of clothes, a phone, a bag). Compulsive actions designed to reduce stress are possible.
  • Psychodiagnostic questionnaires. To determine the level of anxiety, special psychological tests are used: the Taylor Explicit Anxiety Scale, the Spielberger Anxiety Scale, and the Kondash Socio-Situational Fear Scale. The results make it possible to quantify how expressed the feeling of anxiety, worry, and fear.
  • Projective tests. To reveal the emotional state hidden or denied by the patient, projective research methods are used: drawing tests, and tests of interpretation of unstructured drawing material. Examples of such techniques are drawing a person, the Rorschach test, and TAT. Based on the results, it is possible to determine the presence of anxiety and suggest its origin.

If restless thoughts and experiences exist for no reason, the patient is referred for a consultation with a neurologist, or endocrinologist. Narrow specialists determine the presence or absence of endocrine and neurological diseases as a factor in the development of emotional disorders. A survey is performed with the specification of somatic complaints (pain, malaise), examination, laboratory blood tests for the content of hormones, instrumental studies of the brain, and the blood vessels that feed it.


The therapeutic process begins with a conversation with a doctor, during which the specialist talks about ways to treat the underlying disease and eliminate anxiety. Methods of symptomatic treatment are selected individually, taking into account the cause and severity of the emotional disturbance, and the patient's attitude towards it. For neurotic disorders, psychotherapy sessions are more appropriate, with secondary anxiety caused by a somatic disease, pharmacotherapy.

Relaxation techniques are effective in relieving anxiety



Feelings of anxiety are effectively corrected with a combination of cognitive-behavioral therapy techniques. In the first stage - the stage of mental elaboration - the psychotherapist discusses with the patient the causes of anxiety, and situations that provoke emotional tension. He teaches to identify physical discomfort, and changes in thoughts when experiencing anxiety. At the stage of behavioral correction, the exposure method can be used, when the patient creates a vivid mental image of a dangerous situation, while simultaneously applying relaxation and deep breathing techniques, visualizing a successful outcome of the event.

Severe forms of anxiety disorders, accompanied by pronounced autonomic reactions and a sense of fear, require a slightly different sequence of psychotherapy. First, the patient is taught self-control: restoring normal breathing, distraction, and switching attention. When a person becomes able to independently avoid attacks of fear and panic, they move on to the stage of behavioral therapy.

Medical therapy

Medications are prescribed for severe anxiety against the background of a mental disorder, neurological or endocrine disease. Drug correction allows you to control the symptom, even if it occurs without an obvious cause. Its advantage lies in its rapid action - improvement occurs before the patient feels the positive effects of psychotherapy or other main treatment. The use of tranquilizers - anti-anxiety drugs is widespread. Additionally, antidepressants and herbal remedies with a calming, sedative effect are prescribed.

Relaxation Techniques

Mild forms of anxiety are eliminated through the regular practice of physical and mental relaxation. Training in relaxation techniques is more successful in group classes that combine breathing exercises and auto-training. Patients develop muscle feeling and master progressive relaxation, abdominal breathing, and applied relaxation. Through the control of muscle tension and the breathing cycle, emotions and thoughts are correct. Breathing yoga can be considered an alternative to psychotherapeutic group methods.

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