Anxiety disorders: Is it really all in your head?

Everyone experiences some anxiety at some point. Negative emotions often serve an important purpose. They are the brain's way of getting ready to deal with stressful situations or escaping danger. For example, anxiety before exams could make you study more and lead you to perform better on a test.

For some people, anxiety can be severe and out of proportion to the actual danger or situation. This can cause more harm than good. People with anxiety disorders have intense, persistent worry and fear about everyday situations. These feelings can interfere with daily activities, are difficult to control and can last a long time. These people may avoid places or situations to prevent these feelings. In these instances, it's important to talk to your health care team about treatment.

People with anxiety disorders often feel that their concerns are not taken seriously or that "it's all in their heads." This minimizes their pain and discomfort, and leaves psychiatric and associated medical conditions unaddressed.

It should be noted that the statement "it's all in your head" is not entirely wrong. Psychiatric distress often manifests physically. Anxiety begins in the brain, but it manifests as various symptoms.

Mental symptoms of anxiety

Many symptoms of anxiety cannot be seen by others and offer no outward signs of distress. Since people can't read the minds of others, concerning thought processes and worries need to be shared to be understood.

Some common mental symptoms of anxiety include:

• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Trouble concentrating or thinking about anything other than the present worry
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety

Physical symptoms of anxiety

The brain is a powerful organ and the central command center for the rest of the body. When anxiety hijacks this central command system, the anxiety has free reign to cause havoc in the different organ systems. This can create actual physical symptoms, even though there is nothing wrong with the organ itself.

Anxiety can feel like you are having a heart attack, asthma, acid reflux, insomnia or a stroke.

Some common physical symptoms of anxiety include:

• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Sweating
• Trembling
• Feeling weak or tired
• Having trouble sleeping
• Experiencing gastrointestinal problems
• Avoidance behaviors

The good news is that various approaches can be used to manage anxiety disorders.

Medications can help with short- and long-term symptom control. Cognitive behavioral therapy, which teaches your brain to change thought patterns can help. Also, many nonmedication ways of managing anxiety can be used, like reducing stress, exercising, practicing breathing exercises and yoga techniques.

So if you hear "it's an anxiety disorder," don't despair or think no one is taking you seriously. Your health care team is available to help you alleviate symptoms and gain back control over anxiety.

Patrick Bigaouette, M.D., is a psychiatrist in Psychiatry & Psychology in Mankato, Minnesota.