Alternate Names: Feeling uptight; Stress; Tension; Jittery
Considerations: Stress is not a disease and is a normal part of everyone’s life. Stress is not necessarily good or bad; however, reactions to stress can vary considerably, and some of these reactions are undesirable. The most frequent undesirable reaction is anxiety.
Anxiety is often accompanied by twitching or trembling, muscle tension, headaches, sweating, irritability, fatigue, nightmares, memory problems, sexual impotence, sleeplessness, dry mouth, or difficulty swallowing.
The degree of anxiety is much more a function of the individual than the degree of stress. The risk of anxiety increases with stress, a family history of neurosis, fatigue or overwork, or the recurrence of situations that have been previously stressful or harmful.
Insomnia and an inability to concentrate are common symptoms of anxiety which can lead to a vicious cycle that makes the problem worse. The symptoms are effects, not causes. Focusing on the insomnia or on the lack of concentration as the problem is not the solution.
Common Causes:
- actual danger
- physical and emotional stress
- grief (such as from death of a loved one or loss of a job)
- drugs including caffeine, cold remedies (Cough/Cold Combinations - oral), sympathomimetics, decongestants (Antihistamines and Decongestants - oral), bronchodilators, tricyclic antidepressants, and thyroid supplements
- withdrawal from drugs
- poor diet
- hyperventilation syndrome
- hyperthyroidism
Home Care: Finding the cause of the anxiety is a required first step in resolving a problem with stress.
Avoid becoming dependent on "mood-altering" drugs when confronted by life’s problems. These drugs will not provide a permanent solution or even a long-lasting one. While no special diet is required, avoid caffeine and other stimulants and avoid alcohol.
Find someone who will listen to you and counsel with you about your problems. Very often, supportive family or nursing care can help relieve anxiety. A calm, quiet atmosphere and comfortable environment is recommended.
Verbally express feelings and concerns. Most communities have several resources that can help with problems of anxiety. Ministers, social workers, friends, neighbors, and family may each play a therapeutic role.
Learn techniques, including biofeedback and relaxation therapy, to reduce muscle tension. Biofeedback is a process of monitoring body functions (such as the tightness of certain muscle groups) and altering these functions through relaxation.
Follow a regular energetic fitness routine using aerobic exercise if possible.
Avoid focusing on the effects of anxiety (such as insomnia or inability to concentrate). If the anxiety is cured, the insomnia and lack of concentration will resolve themselves.
Call If:
- you are unable to work because of anxiety, self-treatment has failed, or the cause of the anxiety is unknown.
- there is a sudden feeling of panic.
- problems cannot be resolved without outside, professional help.
A mental health care professional may be appropriate to consult. Remember, your primary health care provider is an additional resource but is not necessarily the first or the best place to seek help for these problems.
What To Expect: The medical history will be obtained and a physical examination performed.
Medical history questions documenting anxiety, stress, or tension in detail may include:
- What other symptoms are also present?
- What physical symptoms develop that make you feel anxious?
- What physical symptoms do you have that you are worried about?
- What makes the anxiety better?
- What makes it worse?
A general physical examination will be performed. The level of consciousness will be assessed and behavior noted.
If the anxiety is not accompanied by other physical signs and symptoms, a psychological cause may be suspected. A referral for psychiatric evaluation may be necessary.
Diagnostic tests may include lab studies to rule out medical conditions, such as hyperthyroidism, that produce anxiety.
After seeing your health care provider:
You may want to add a diagnosis related to anxiety to your personal medical record.
