Anxiety: Constant Worry, Racing Heart, Causes and When to Be Seen

What it involves

MedlinePlus describes anxiety as a feeling of fear, dread, and uneasiness that can cause sweating, restlessness, tension, and a rapid heartbeat. It says anxiety can be a normal reaction to stress, but for people with an anxiety disorder the fear is not temporary and can be overwhelming.

Who this is for

• Patients who worry about ordinary things almost every day and cannot turn it off
• Patients who have had sudden episodes of intense fear with a pounding heart or shortness of breath
• Patients who avoid places or activities because of fear
• Patients with physical symptoms such as dizziness or chest tightness who want to know whether anxiety could be involved

What to expect

• Questions about your symptoms, when they started, and what makes them better or worse
• A physical exam and, if needed, lab tests to make sure a different health problem is not the cause
• A talk about caffeine, other substances, and medicines that can make symptoms worse
• A plan that may include a referral to a mental health professional for therapy, medicine, or both

Types of anxiety disorders

MedlinePlus names three common groups. Generalized anxiety disorder involves excessive worry about ordinary issues such as health, money, work, and family, almost every day for at least 6 months. Panic disorder involves panic attacks, which are sudden, repeated periods of intense fear when there is no danger and can last several minutes or more. Phobias are intense fears of something that poses little or no actual danger, including social situations. Each has different symptoms and needs.

How anxiety shows up in the body

MedlinePlus says anxiety disorders share anxious thoughts that are hard to control, physical symptoms such as a pounding or rapid heartbeat, unexplained aches and pains, dizziness, and shortness of breath, and changes in behavior such as avoiding everyday activities. Because those physical symptoms overlap with heart and lung problems, a provider looks at both. See the heart palpitations guide and the dizziness guide for what else can cause them.

Causes and risk factors

The cause is unknown, according to MedlinePlus. Genetics, brain biology and chemistry, stress, and environment may all play a role. It lists shyness in new situations, traumatic events, and a family history of anxiety or other mental disorders as risk factors, as well as some physical health conditions such as thyroid problems or an irregular heartbeat. It adds that caffeine, other substances, and certain medicines can make symptoms worse.

How it is diagnosed

MedlinePlus says a provider asks about symptoms and medical history, may do a physical exam and lab tests to make sure a different health problem is not the cause, and, if there is no other problem, arranges a psychological evaluation. The primary care provider may do it or refer you to a mental health professional. If thyroid problems are a possibility, the thyroid care page describes how the practice approaches them.

Treatment options

The main treatments, per MedlinePlus, are psychotherapy, medicines, or both. It describes cognitive behavioral therapy, which teaches different ways of thinking and behaving, as one option, along with acceptance and commitment therapy. Medicines include anti-anxiety medicines and certain antidepressants, and you may need to try more than one to find the right fit. Support groups and stress management techniques may also help. A provider can talk through which route suits you.

Anxiety, sleep, and the chest

Anxiety and poor sleep tend to feed each other, and the insomnia guide covers the common causes. Chest pain is never something to assume is anxiety, and the chest pain guide explains when to call 911 instead of booking a visit. If you feel unsafe or are thinking of harming yourself, call 911 or call or text 988, the Suicide and Crisis Lifeline.

Sources

• MedlinePlus — Anxiety
• MedlinePlus — Mental Health