DEAR MAYO CLINIC: I am 34 and over the past few months have been feeling anxious and worried more often than not. I’ve never had issues with anxiety or depression before, and can’t pinpoint anything that’s led to my anxiety. What causes anxiety? At what point should I see a doctor?
ANSWER: Anxiety often stems from a combination of factors. A person’s individual makeup — your biology and genetics, for example — certainly plays a role. But your circumstances and experiences have an impact, too. Sometimes it can be hard to identify the exact cause of anxiety. The good news is you don’t always need to know what triggered anxiety to have it successfully treated. If anxiety is interfering with your daily life, see your doctor.
A variety of anxiety disorders exist. Some are conditions that have specific triggers and symptoms, such as obsessive-compulsive disorder, post-traumatic stress disorder and phobias. In other cases, though, ongoing anxiety may come from a wide variety of sources. That condition is known as generalized anxiety disorder. It sounds like your situation could fall into this category.
Uncertainty is a big part of anxiety disorders. Of course, uncertainty is part of life. No one really knows how something is going to turn out. Whenever we get into a car, for example, there is always a possibility that the car could break down. But, for the most part, we don’t worry about it. Generally, we accept that things will be OK unless we see a warning sign of danger.
For people with an anxiety disorder, that reasoning is flipped. Instead of feeling everything is OK unless there is a sign of a problem, they look for proof that everything is safe. If that proof is not evident, it’s hard for them to shake their worry or fear.
Anxiety disorders are among the most common mental health disorders in the United States. But they often go untreated. Studies show that only about 30 percent of people with an anxiety disorder get treatment. That’s unfortunate because in many cases, anxiety disorders can be effectively treated.
Being unable to identify what led to anxiety is not necessarily an obstacle. Often it is more important to understand what a person is afraid of, or what is keeping the cycle of anxiety going. Once that’s identified, then the cycle can be broken. One useful way to do that can be through behavior therapy.
When people are anxious, they get caught up in their own thoughts, asking “what if” questions. When they try to turn off those fearful thoughts or push them away, it may help for a moment. But the thoughts creep back in quickly. In behavior therapy, professionals experienced in dealing with anxiety encourage people to face and accept their thoughts. Eventually, those thoughts begin to lose their power. They may still be annoying, but they become less frightening and more manageable. In time, they may go away and the anxiety fades with them.
A core part of many anxiety disorders is feeling hopeless, helpless, or out of control. People feel there’s nothing they can do to make a difference. That can be very upsetting. Therapy for anxiety can help you feel more in control and able to take action to improve your situation. When you feel in control, it can help you feel better overall.
Of course, this is much easier said than done. Most people need professional help to effectively deal with problematic anxiety. For some, behavior therapy alone may not be enough, and medication can be useful in managing anxiety. If you feel anxiety is making your daily life difficult, set up an appointment to see your doctor. He or she can either help with treatment directly or put you in touch with a psychologist, psychiatrist, therapist or counselor in your area that has experience managing anxiety disorders. — Stephen Whiteside, Ph.D., Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.