What Is Severe Anxiety?

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Most people feel anxious from time to time. Anxiety is part of the body's natural stress response. Small amounts of anxiety can help prepare for future uncertainty or discomfort. Though most people experience tolerable amounts of anxiety, like when taking on a big project or trying a new experience, the degree of severity and type of reaction can vary from person to person and from situation to situation.

Anxiety can range from mild to severe. When anxiety interferes with normal functioning, becomes a persistent problem, or becomes too difficult to manage, it could be a sign of a more concerning issue, an anxiety disorder.

Severe anxiety is often debilitating and significantly interrupts a person's ability to function and carry out typical day-to-day tasks. This is different from the typical anxiety most people feel when they are unsure or worried about something. Severe anxiety can even bring about suicidal thoughts.

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.

Cropped shot of a woman sitting on a sofa and feeling anxious

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What Is 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 things are working the way they should. Anxiety is a way of preparing for or anticipating future stress or possible negative experiences.

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.

Severe anxiety symptoms are burdensome and concerning for those who experience them. They can interrupt daily functioning and impact enjoyment of life. For those who suffer from severe anxiety, the effects can be debilitating.

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, they are commonly experienced as worry, avoidance, and 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 Reduce Worry

Mindfulness is a great way to overcome racing thoughts or constant worrying by keeping your mind on the present moment. For example, try looking around and naming all the things you see in a certain color. Be sure to take a deep breath in between each object you find.

Avoidance

Avoidance is a type of behavior people use to escape the uncomfortable feelings that come from anxiety. Avoidance can mean physically avoiding something, such as crowds, or avoiding by not attending to something, such as not preparing for a presentation that brings about feelings of nervousness.

Although it may seem like avoidance is a good way to lessen the discomfort of feeling anxious, avoidance is not an effective way to overcome ongoing anxiety. 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.

Physical Symptoms

Anxiety symptoms can also occur physically. Muscle tension is a common way many people experience anxiety. It is a natural tightening of muscles when the body experiences stress.

Raising your shoulders, clenching your jaw, making fists with your hands, and tensing your abdomen are examples of ways our muscles react to stress and anxiety. When you notice this happening, try intentionally relaxing the affected muscles.

Other common ways anxiety is experienced physically are through sweating, upset stomachs, shallow breathing, shakiness, headaches, jaw pain, eye strain, and a racing heart. Long-term impacts from severe levels of anxiety symptoms can result in physical ailments, like heart disease, gastrointestinal issues, and a lowered immune system.

Sometimes, these physical responses can occur without our realizing that the cause is anxiety. Paying attention to specific ways your body feels when you are calm vs. anxious can help you recognize when you are experiencing anxiety symptoms.

People with severe levels of anxiety might experience these symptoms more frequently, more intensely, or with a more significant impact. Though the actual symptoms might not be different from mild or moderate levels of anxiety, severe anxiety symptoms are less likely to be self-manageable.

Diagnosing Anxiety

Anxiety is one of the most underdiagnosed mental health disorders. Though it is very common, many people do not seek treatment for anxiety. Like other mental health disorders, anxiety disorders can only be diagnosed by licensed mental health professionals.

According to one study, only 20% of people with an anxiety disorder seek help from healthcare providers.

During a therapy session, a mental health provider will typically ask a series of questions to determine the type and severity of anxiety you're experiencing. A mental health practitioner will determine the exact type of anxiety disorder you have by referencing the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5). For extreme cases of anxiety, medication will likely be prescribed by a psychiatrist along with therapy.

Anxiety disorders are highly co-occurring, meaning they are often present along with one or more additional mental health disorders, such as depressive disorders and substance use disorders.

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

Causes

Anxiety can occur for a number of reasons, each of which is unique to individual experiences. 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.

Other reasons a person might develop an anxiety disorder are usually related to having a negative life experience, such as stressful events during childhood, trauma, and stressful experiences throughout life, such as death and divorce.

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:

  • Separation anxiety disorder
  • Selective mutism
  • Specific phobia
  • Social anxiety disorder (social phobia)
  • Panic disorder
  • Agoraphobia (fear of public or crowded places)
  • Generalized anxiety disorder

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. The most common type of anxiety disorder is specific phobia, an intense fear of something that poses little to no actual harm.

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:

  • Cognitive behavioral therapy (CBT)
  • Psycho-education about the disorder and how to manage it
  • Exposure therapy (for specific phobias)
  • Support groups

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, 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 for longer and longer periods. 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 the support of 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

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

Finding a good routine can help support the work that happens in therapy and keep symptoms under control.

Summary

Anxiety is a very common mental health concern that effects many people every day. Severe anxiety can impact a person's ability to function, their enjoyment of life, and overall well-being. As anxiety disorders can range from mild to moderate to severe, 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, let alone seeking support. Know that you are not alone and that there are treatment options that can help. Talk to your doctor or contact your health insurance for a list of recommended mental health professionals near you.

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