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You may start by seeing your family doctor or a general practitioner to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying illness that may need treatment.

However, you may need to see a specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health providers can diagnose anxiety and provide counseling (psychotherapy).

Here’s some information to help you get ready for your appointment, and what to expect from your doctor or mental health provider.

What you can do

Prepare and take this information with you:
•A list of your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
•What’s caused you stress. Include any major life changes or stressful events you’ve dealt with recently. Also note any traumatic experiences you’ve had in the past or as a child.
•Any other health problems you have. Include both physical conditions and mental health issues.
•A list of all medications you’re taking. Write down the doses, and include any vitamins or supplements.
•Questions to ask your doctor. Prepare a list of questions ahead of time to make the most of limited time with your doctor.

For anxiety, some basic questions to ask your doctor include:
•What’s the most likely cause of my anxiety?
•Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
•Do I need medical tests or other tests?
•Are there any restrictions or steps I need to follow?
•Should I see a psychiatrist, psychologist or other mental health provider?
•Would cognitive behavioral therapy help me?
•Would medication help? If so, is there a generic alternative to the medicine you’re prescribing?
•Do you have any printed material that I can take home? What websites do you recommend?

Don’t hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor will do a physical exam and ask you a number of questions, such as:
•Exactly what are your symptoms, and how severe are they?
•Have you ever had a panic attack?
•Do you avoid certain things or situations because they make you anxious?
•Have your feelings of anxiety been occasional or continuous?
•When did you first begin noticing your feelings of anxiety?
•Does anything in particular seem to trigger your feelings of anxiety or make them worse?
•What, if anything, seems to improve your feelings of anxiety?
•What traumatic experiences have you had recently or in the past?
•What, if any, physical or mental health conditions do you have?
•Do you take any prescription drugs?
•Do you regularly drink alcohol or use illegal drugs?
•Do you have any blood relatives with anxiety or other mental health conditions such as depression?

RISK FACTORS

These factors may increase your risk of developing an anxiety disorder:
•Being female. Women are more likely than men to be diagnosed with an anxiety disorder.
•Childhood trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life.
•Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.
•Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, ongoing worry about finances or a death in the family.
•Personality. People with some personality types are more prone to anxiety disorders than are others. In addition, some personality disorders, such as borderline personality disorder, may be linked to anxiety disorders.
•Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
•Drugs or alcohol. Drug or alcohol use or abuse can cause or worsen anxiety.

COMPLICATIONS:

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical health conditions, such as:
•Depression (which often occurs with anxiety disorder)
•Substance abuse
•Trouble sleeping (insomnia)
•Digestive or bowel problems
•Headaches
•Teeth grinding (bruxism)

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Common anxiety signs and symptoms include:
•Feeling apprehensive
•Feeling powerless
•Having a sense of impending danger, panic or doom
•Having an increased heart rate
•Breathing rapidly (hyperventilation)
•Sweating
•Trembling
•Feeling weak or tired

Several types of anxiety disorders exist:
•Panic disorder involves panic attacks — repeated episodes of sudden, unexplained feelings of intense anxiety and fear or terror. You may have feelings of impending doom, shortness of breath, heart palpitations or chest pain.
•Agoraphobia is anxiety about, or avoidance of, places or situations where you might feel trapped or helpless if you start to feel panicky.
•Specific phobias are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
•Social anxiety disorders (social phobias) involve irrational anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being viewed negatively by others.
•Obsessive-compulsive disorder (OCD) includes persistent, recurring thoughts, images or impulses (obsessions) or an irresistible desire to perform irrational or seemingly purposeless acts or rituals (compulsions). Often it involves both obsessive and compulsive behavior.
•Post-traumatic stress disorder (PTSD) includes the feeling that you’re re-experiencing an extremely traumatic event. It causes intense emotions and physical reactions along with a desire to avoid anything that might remind you of the event.
•Acute stress disorder includes symptoms similar to those of PTSD that occur immediately after an extremely traumatic event.
•Generalized anxiety disorder includes persistent and excessive anxiety and worry about small or large concerns. This type of anxiety disorder often begins at an early age. It frequently occurs along with other anxiety disorders or depression.
•Anxiety disorder due to a medical condition includes prominent symptoms of anxiety that are directly caused by a physical health problem.
•Substance-induced anxiety disorder is characterized by prominent symptoms of anxiety that are a direct result of abusing drugs, taking medications or being exposed to a toxic substance.
•Separation anxiety disorder is a childhood disorder characterized by anxiety related to separation from parents or others who have parental roles.
•Anxiety disorder not otherwise specified is a term for prominent anxiety or phobias that don’t meet the exact criteria for any of the other anxiety disorders but are significant enough to be distressing and disruptive.

When to see a doctor

See your doctor if:
•You feel like you’re worrying too much and it’s interfering with your work, relationships or other parts of your life
•You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety
•You think your anxiety could be linked to a physical health problem
•You have suicidal thoughts or behaviors (seek emergency treatment immediately)

Your worries may not go away on their own, and they may actually get worse over time if you don’t seek help. See your doctor or a mental health provider before your anxiety gets worse. It may be easier to treat if you address it early.

DEFINITION

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive worry and irrational fear about everyday situations. These feelings interfere with daily activities, are difficult to control and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include social anxiety disorder (social phobia), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), specific phobias and separation anxiety disorder.

Treatment may include a type of psychotherapy that teaches you to view and respond to challenging situations in a more effective way (cognitive behavioral therapy), lifestyle changes and, if needed, medications. Sometimes, anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help.

As with many mental health conditions, the exact cause of anxiety disorders isn’t fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to becoming anxious. Inherited traits also are a factor.

MEDICAL CAUSES

For some people, anxiety is linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators that you have a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order lab tests and other tests to look for signs of a problem.

Physical problems that can be linked to anxiety include:
•Heart disease
•Diabetes
•Thyroid problems (such as hypothyroidism or hyperthyroidism)
•Asthma
•Drug abuse
•Alcohol withdrawal
•Withdrawal from anti-anxiety medications (benzodiazepines)
•Rare tumors that produce certain “fight-or-flight” hormones
•Muscle cramps or spasms
•Tingling, burning or prickling sensations that may have no apparent cause

It’s more likely that your anxiety may be due to an underlying medical condition if:
•Your anxiety symptoms started after age 35
•You don’t have any blood relatives (such as a parent or sibling) with an anxiety disorder
•You didn’t have an anxiety disorder as a child
•You don’t avoid certain things or situations because of anxiety
•No events have occurred in your life that were triggered by significant anxiety
•Medications used to treat feelings of panic (such as benzodiazepines) don’t ease your anxiety symptoms

If you’re regularly having trouble either falling or staying asleep (insomnia), make an appointment with your doctor. Treatment is available — but it depends on what’s causing your insomnia. Sometimes, an underlying medical or sleep disorder can be found and treated, a much more effective approach than just treating the symptom of insomnia itself.

Behavior changes learned through cognitive behavioral therapy are generally the best treatment for persistent insomnia. However, there are times when prescription sleeping pills may be helpful. Although sleeping pills don’t treat the underlying cause of your sleeping problems, they may help you get some much needed rest.

Today’s prescription sleeping pills don’t carry the same level of risks of dependence and overdoses as sleeping pills of the past. But risks remain — especially for people who have certain medical conditions, including liver or kidney disease. Always talk with your doctor before trying a new treatment for insomnia.

Here’s information on some of the most common types of sleeping pills used today.

Types of prescription sleeping pills

Prescription sleeping pills are available to help you fall asleep easier, stay asleep longer — or both. Before prescribing a medication to help you sleep, your doctor will ask you a number of questions to get a clear picture of your sleep patterns. He or she may also order tests to rule out any underlying conditions that may be causing difficulty sleeping.

To reduce the risk of side effects and of becoming reliant on drugs to sleep, your doctor likely will prescribe medications for two to four weeks. If the first medication you take doesn’t work after the full prescribed course, call your doctor. You may need to try more than one prescription sleeping pill before finding one that works for you.

Some prescription sleeping pills are available as generic drugs, which are typically less expensive than are brand-name drugs. Ask your doctor whether there is a generic version available of the medication he or she prescribes. Insurance companies may have restrictions on which sleeping pills are covered, and they may require that you try other approaches to your insomnia first.

Sleeping pills that help you fall asleep

The following prescription medications are used mainly to help you fall asleep.

Drugs that help you fall asleep

Drug May not be safe if you: Considerations
Eszopiclone (Lunesta) Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.
May be used for a longer period of time than zolpidem or zaleplon.

High-fat meals may slow your absorption of the drug and make it less effective.
Stopping the drug suddenly may cause symptoms of withdrawal, such as anxiety, unusual dreams, nausea and vomiting.
Ramelteon (Rozerem)
Are pregnant or breast-feeding.

Have a history of kidney or respiratory problems, sleep apnea, or depression.

Have a liver disease.

May interact with alcohol.

High-fat meals may slow your absorption of the drug and make it less effective.
A manufactured drug similar to melatonin. Not likely to be habit-forming.
Triazolam (Halcion)
Are pregnant or breast-feeding.
Have a history of drug abuse, depression or respiratory conditions.
May interact with grapefruit juice, alcohol and many medications.

Can be habit-forming. Seldom prescribed by sleep specialists.
Drug must be stopped gradually.
Zaleplon (Sonata)
Have severe liver problems.

Are pregnant or breast feeding.
Have a history of depression, liver or kidney disease, or respiratory conditions.
May interact with other medications.

Can be habit-forming.

High-fat meals may slow your absorption of the drug and make it less effective.

Very short acting, so can be taken in the middle of the night following precautions from your doctor.

Zolpidem (Ambien, Edluar) Have a history of depression, liver or kidney disease, or respiratory conditions.
May become less effective over time.

Sleep behaviors, such as sleep-driving and sleep-eating may occur.

Sleeping pills that help you stay asleep

The following prescription medications are used to help you get to sleep and stay asleep.

Drugs that help you stay asleep

Drug May not be safe if you: Considerations
Estazolam Are pregnant, breast-feeding, or are an older adult.
May interact with many other medications.
Can be habit-forming.
Eszopiclone (Lunesta) Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.
High-fat meals may slow absorption of the drug and make it less effective.
Stopping the drug abruptly may cause symptoms of withdrawal such as anxiety, unusual dreams, nausea and vomiting.
Temazepam (Restoril)
Have a history of severe depression, substance abuse, lung disease, or kidney or liver problems.

Are pregnant or breast-feeding.

May interact with alcohol and many medications.
Can be habit-forming.
Zolpidem (Ambien CR)
Have a history of depression, liver or kidney disease, or respiratory conditions.

Are pregnant or breast-feeding.
This extended-release formula may be used for a longer period of time than regular zolpidem or zaleplon.
Doxepin (Silenor)
Have a history of glaucoma, trouble urinating (urinary retention) or heart disease.
May cause weight gain.