Anxiety

Anxiety is a general feeling of being worried. Everyone experiences anxiety from time to time as a result of life experiences, but those with generalized anxiety disorder feel anxious frequently or excessively, not necessarily as a result of a particular situation.

Signs and Symptoms

• Muscle tension, trembling
• Fast heartbeat (tachycardia)
• Fast or troubled breathing (dyspnea)
• Dizziness or impaired concentration
• Palpitations
• Sweating
• Fatigue
• Irritability
• Sleep disturbances

What Causes It?

Anxiety can result from many specific causes, such as an underlying medical condition or drugs you are taking. However, there may be no specific cause. Factors such as genetics and early life experiences may play a role.

What to Expect at Your Provider's Office

Your healthcare provider will talk to you about when you feel anxious, what it feels like, and your medical history. He or she will give you a physical examination and may take blood or urine samples for laboratory tests. In some cases, you will have an electrocardiogram (EKG) to rule out heart problems.

Treatment Options

Treatment Plan
Sometimes anxiety has a specific physical cause. A treatment plan can be made once the cause is identified. However, there are a variety of ways to treat anxiety that has no physical cause. Short-term counseling can boost your self-esteem and help you learn coping strategies and problem solving techniques. Your healthcare provider may also suggest trying a method of relaxation such as deep breathing techniques. In some cases, your healthcare provider will prescribe drugs to help you until you have mastered these techniques.

Drug Therapies

Prescription
Antianxiety Medications

• Benzodiazepines — a group of drugs that help to reduce anxiety and have sedating properties; may cause drowsiness, constipation, or nausea; do not take if you have narrow-angle glaucoma, a psychosis, or are pregnant

Antidepressant Medications

• Tricyclic antidepressants — a group of drugs that relieve depression (which can accompany anxiety); these medications tend to have numerous side effects

Complementary and Alternative Therapies

Mind-body techniques, nutrition, and herbs may be an effective way to treat anxiety. Progressive muscle relaxation, diaphragmatic breathing, biofeedback, meditation, and self-hypnosis can help you relax and reduce your anxiety. Talk with your health care provider about these techniques.

Nutrition

• Avoid caffeine, alcohol, sugar, refined foods, and cut down on foods that are known to cause allergies (common food allergens are dairy, soy, citrus, peanuts, tree nuts, wheat, fish, wheat, fish, eggs, corn, food colorings, and additives). Fresh vegetables, whole grains, and protein nourish the nervous system, so eat more of these.
• Calcium (1,000 mg per day), magnesium (400 to 600 mg per day), and B complex (50 to 100 mg per day) help support the nervous system and minimize the effects of stress.

Herbs
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

A tea (3 to 4 cups per day) or tincture (10 to 20 drops four to six times per day) from the following herbs will help to reduce anxiety and strengthen the nervous system.

• Kava kava (Piper methysticum) for mild to moderate anxiety.
• St. John's wort (Hypericum perforatum) for anxiety associated with depression.
• Passionflower (Passiflora incarnata) for anxiety with insomnia.
• Oatstraw (Avena sativa) nourishes the nervous system.
• Lemon balm (Melissa officinalis) for anxiety with depression and heart palpitations.
• Lavender (Lavandula angustifolia) for nervous exhaustion and restoring the nervous system.
• Skullcap (Scutellaria lateriflora) relaxes and revitalizes the nervous system.

Kava kava (100 to 200 mg two to four times a day) and St. John's wort (300 mg two to three times per day) may be taken as dried extracts to maximize effectiveness in moderate anxiety.

Essential oils of lemon balm, bergamot, and jasmine are calming and may be used as aromatherapy. Place several drops in a warm bath or atomizer, or on a cotton ball.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of anxiety based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Aconitum - for anxiety accompanied by irregular or forceful heartbeat, shortness of breath, or fear of death
• Arsenicum album - for excessive anxiety that has no clear cause and is accompanied by restlessness, especially after midnight; also for perfectionists, including children, who worry about everything
• Phosphorus - for an impending sense of doom and anxiety when alone; also for impressionable adults and children who are easily influenced by the anxiety of others
• Lycopodium - for performance and other types of anxiety in those who are insecure, yet hide their low self-esteem with arrogance and bravado; also for children with anxiety accompanied by bedwetting
• Gelsemium - for performance anxiety resulting in diarrhea, headache, dizziness, weakness, shakiness and trembling, or trouble speaking
• Argentum nitricum - for performance anxiety (such as before tests in school-age children) with rapid heart rate, feeling of faintness, diarrhea, or flatulence

Acupuncture
Many people report feeling less stressed after receiving acupuncture therapy. This finding has led researchers to speculate that acupuncture may have some beneficial effect when used to treat anxiety directly. In a study of 55 healthy volunteers, acupuncture applied to a "relaxation" point in the ear led to a greater reduction in anxiety than sham acupuncture (needling inactive points). Acupuncturists treat people with anxiety based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of anxiety, a qi deficiency is usually detected in the kidney or spleen meridians. In addition to performing needling techniques, acupuncturists may also employ lifestyle and breathing techniques as well as herbal and dietary therapy.

Massage
Therapeutic massage can be helpful in reducing anxiety and alleviating stress.

Following Up

Follow your health care provider's instructions, and practice relaxation techniques as needed.

Special Considerations

Be sure to tell your health care provider if you are pregnant. Call your provider if you experience any significant side effects from prescribed medications.

While the herbal tea suggested above is safe during pregnancy, you should avoid the dried extracts of kava kava and St. John's wort if you are pregnant.

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