What Is Severe Anxiety?

Anxiety disorders can cause mild to severe symptoms, but treatment is available

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Severe anxiety occurs when the body's natural responses to stress exceed healthy levels and interrupt your ability to function and carry out typical day-to-day tasks. While most people experience some anxiety, as with a new experience or challenge, severe anxiety can be overwhelming.

Severe anxiety symptoms may be immediate, with a racing heart, changes in breathing, or a headache. Long-term, or chronic, severe anxiety disorder can lead to conditions including heart disease or gastrointestinal (GI) issues.

This article explains how the severity and type of anxiety reaction can vary, depending on the person and the situation. It will help you to know more about how to deal with severe anxiety, and when a diagnosis and professional care may be needed.

If you or a loved one is struggling with severe anxiety, contact the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.

What Is Severe Anxiety?

Anxiety is related to the body's natural way of responding to stressful events and circumstances. When a stressor is present, the mind and body perceive it as a potential threat and react automatically, with the goal of staying safe.

This is actually helpful and means your body is working the way it should. Anxiety is a way of preparing for or anticipating future stress or possible negative experiences.

It's when these feelings include constant worry, or a chronic sense of threat or impending dread, that an anxiety disorder may be at work.

Severe anxiety symptoms can become a persistent problem. They can interrupt daily functioning, impact quality of life, and become too difficult to manage. Severe anxiety can even bring about suicidal thoughts.

Anxiety in a broad sense is very common. In fact, it's the most common type of mental health disorder, with 33% of people being impacted by an anxiety disorder in their lifetime.

Mild, Moderate, and Severe Anxiety Symptoms

Several reactions come with anxiety. Symptoms can impact a person's mind, behaviors, and physical well-being. Though anxiety symptoms can be different for each person, worry and avoidance are common. These symptoms also may lead to physical responses.

Worry

In small amounts, as with mild levels of anxiety, worry can actually be helpful and motivating, like when preparing for a test to avoid anxious feelings about failing.

However, worrying too much about things that cannot be controlled can have a negative effect on overall well-being and is a sign that anxiety may be more severe.

Mindfulness Can Help To Reduce Worry

Mindfulness is one evidence-based practice that can be done for severe anxiety. It can help people to overcome racing thoughts or constant worry, with a focus on the present. Research has shown promising results in people with severe anxiety and depression, especially those who haven't responded well to other interventions.

Avoidance

Severe anxiety often includes avoidance, a type of behavior people use to escape uncomfortable feelings. It can mean physically avoiding something, such as crowds, or by declining invitations to events.

In some cases, avoidance can lead to life choices like not preparing for a presentation that brings about feelings of nervousness. It may seem a good way to limit feelings of anxiety, but avoidance is not an effective way to overcome it.

Noticing and effectively addressing the feelings that come with anxiety is an important step toward learning to cope with it.

When most severe, anxiety-induced avoidance can cause a person to withdraw from social interactions and become isolated. But it's common for social isolation itself to lead to anxiety and depression, adding to the problem.

Physical Symptoms

Severe anxiety can lead to physical symptoms. Muscle tension is a common way that many people experience anxiety. It is a natural tightening of muscles when the body experiences stress. A tight jaw and tense abdominal muscles are examples of ways that muscles react to stress and anxiety.

Paying attention to specific ways your body feels when you are calm vs. anxious can help you to recognize when you are experiencing anxiety symptoms.

Common ways anxiety is experienced physically are through:

  • Sweating
  • Upset stomachs
  • Shallow breathing
  • Shakiness
  • Headaches
  • Jaw pain
  • Eye strain
  • Racing heartbeats

Long-term impacts from severe levels of anxiety symptoms can result in medical conditions like heart disease, gastrointestinal issues, and a lowered immune system.

Severe Anxiety Attacks

Sometimes, the sweats, jaw tension, and other physical responses occur without your awareness. People with severe levels of anxiety might experience these symptoms more frequently, more intensely, or with a more significant impact. The actual symptoms might not be different from mild or moderate levels of anxiety, but severe anxiety symptoms are less likely to be self-manageable.

Severe Anxiety Diagnosis

Anxiety is one of the most underdiagnosed mental health disorders. Though it is very common, many people do not seek treatment for anxiety. One study found only 20% of people with an anxiety disorder seek help from healthcare providers.

Like other mental health disorders, anxiety disorders can only be diagnosed by licensed mental health professionals. There really is no "severe anxiety test," and they'll typically ask a series of questions to determine the type and severity of anxiety you're experiencing.

They will do this by referencing the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5). Keep in mind that anxiety disorders are highly co-occurring, meaning they are often present alongside depression, substance use disorders, and other conditions.

For extreme cases of severe anxiety, it's likely that anti-anxiety medication will be prescribed by a psychiatrist along with therapy.

Measuring Anxiety Levels

Mental health professionals often use measurement scales to determine anxiety levels. These tools can determine how distressing and disruptive your anxiety symptoms are, which allows for a more personalized and effective treatment plan.

Examples of common anxiety-measurement scales are:

  • The Generalized Anxiety Disorder assessment (GAD-7)
  • The State-Trait Anxiety Inventory (STAI)
  • The Beck Anxiety Inventory (BAI)

These assessments ask questions related to how often anxiety symptoms are experienced and how disruptive they are. Based on the responses, a determination of mild, moderate, or severe anxiety will be provided.

Causes of Severe Anxiety

Severe anxiety can occur for a number of reasons, each of which is unique to individual experiences. Stressful events during childhood, trauma, and difficult experiences throughout life, such as death and divorce, can lead to anxiety.

In other cases, the anxiety may be related to a broader situation experienced personally. For example, the COVID-19 pandemic or concerns over climate change can lead to anxiety.

Though it is difficult to determine who will be most at risk for developing an anxiety disorder, those with a close family member who suffers from an anxiety disorder are three to five times more likely to develop an anxiety disorder themselves.

Types

Severe anxiety is not a formal diagnosis, but a level of how serious the symptoms and impact of the anxiety disorder are. Anxiety disorders are categorized into different types, based on the specific way symptoms are experienced. These categories include:

Each type of anxiety disorder can range from mild to severe, and require different interventions based on the individual and the circumstance.

Anxiety disorders also come about at different points in a person's life, with most developing during childhood and adolescence, and they tend to fluctuate in severity throughout the course of the illness.

For example, separation anxiety disorder and specific phobias tend to arise during childhood, with an average age of diagnosis being 7 years old, while generalized anxiety disorder (GAD) is more common later in life.

When Is Anxiety an Emergency?

Severe anxiety can lead to chest pain, shortness of breath, lightheadedness, and other symptoms. Some of these symptoms are common to other serious health conditions and should be evaluated. If your anxiety is so severe that it prompts thoughts of suicide or self-harm, seek professional help immediately.

Severe Anxiety Treatment

Even severe levels of anxiety can be treated by working with a mental health professional. Sometimes, medication is recommended along with psychotherapy.

Though the specific treatment plan will depend on the individual needs of the person seeking help, some common treatment approaches include:

When Anxiety's Getting Worse

If you're trying to manage severe anxiety alone, it may be time to seek professional care. Your healthcare provider or insurance company can help you to find a mental health professional. If you're already receiving treatment but feel anxiety is getting worse, tell your provider right away. It may be necessary to change your current medication or type of therapy.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is the most highly recommended intervention for overcoming anxiety, due to its high level of effectiveness. CBT involves identifying negative thoughts and behaviors that contribute to anxiety with the goal of changing these in more adaptive ways.

Psycho-Education

Along with a formal intervention like CBT, psycho-education is often used to provide information about the nature of anxiety. A therapist will explain how it impacts health, functioning, and experiences, and ways it can be recognized and reduced.

Exposure Therapy

Sometimes, the best way to overcome anxiety, as with specific phobias, is to face the fear directly. With exposure therapy, a person is gradually introduced to the anxiety-causing stressor over time.

Seeing a snake across the room, then being near it, then touching it is an example of exposure therapy. This type of therapy is done along with large amounts of supportive and relaxation techniques.

Support Groups

When working through severe anxiety, it's important to have ongoing support. Along with trusted friends, family members, and colleagues, support groups can be an impactful way to connect with others who are experiencing similar symptoms.

A mental health therapist will often provide recommendations for support groups based on the type of anxiety disorder a person is dealing with.

Coping With Severe Anxiety

Anxiety can be very disruptive. Even with professional treatment, it's important to find ways to cope and manage anxiety symptoms at home. There are many ways to keep anxiety in check, including:

  • Getting enough regular exercise
  • Getting enough sleep every night
  • Doing relaxation exercises, including deep breathing, mindfulness exercises, and meditation
  • Eating healthy, nutritious, and regular meals
  • Limiting caffeine intake
  • Finding helpful social supports

A good routine can help to support the work that happens in therapy and keep severe anxiety symptoms under control.

Summary

Anxiety is a very common mental health concern. Severe anxiety can impact a person's ability to function, their enjoyment of life, and overall well-being.

Anxiety disorders can range from mild to moderate to severe, so it's important to work with a mental health professional to get an accurate diagnosis and start to work on a treatment plan. With the right support, even severe anxiety can be reduced and managed.

A Word From Verywell

Managing anxiety isn't easy. If you are struggling with severe anxiety, just getting through the day can be exhausting. Know that you are not alone and that there are treatment options that can help.

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