Many people suffer from anxiety silently. It may show as excessive worrying, bodily sensations or both. It can affect one’s life to such an extent that leaving the house or speaking to others becomes difficult, if not impossible. Different forms of psychotherapy can help reduce and even eliminate excessive anxiety. In some cases, medication can provide extra support.

Often, anxiety is a signal of other emotions underneath it and that something or some things in life may not be aligned with one’s needs, values, and aspirations. This may be a work situation or a relationship. An important goal of therapy can be to make things work again.

Many people suffer from anxiety in silence. This often masks the suffering on the inside and the debilitating quality of anxiety. Often people feel helpless. They don’t know what to do, they feel trapped in a box by their own anxiety, which limits life more and more. There are many approaches that can be helpful against anxiety, such as psychotherapy, counselling, meditation, certain forms of exercise, and in specific cases also medication.

Anxiety is your body’s and your brain’s natural response to stress. Anxiety is not the same as fear, which is targeted at something specific. For example, one can be afraid of snakes or a specific outcome of a situation. Anxiety, on the other hand, is when there is the uncertainty itself one is afraid of. Anxiety can lead to reduced enjoyment in life, and in more extreme cases avoidance. For example, one might be anxious about social situations, and so avoid being around people. avoiding people, however, can cause a painful dilemma, in which one actually wants to be with people but at the same time feels too anxious to do so.

Anxiety disorders are very common, and they can affect anyone at any age. Women tend to be more often diagnosed with an anxiety disorder than men, but it may also be that women seek out help earlier.

Anxiety and Depression

Anxiety and depression quite often tend to go together. This does not mean one cannot experience them separately, but there is a significant correlation between the two. Heightened anxiety, for example, may worsen depressed feelings. On the other hand, anxiety can even be a symptom of depression. Diagnostically, it is important to keep them apart, if possible.

Many of the same treatment approaches help against both depression and anxiety. For example, enough sleep, stress reduction, better strategies for fulfilling wants, needs and aspirations, healthy and supportive relationships, and someone to discuss problems with, such as a therapist or close understanding friends, can all help against depression and anxiety. Important is that in at least the more severe cases one seeks out professional help, because the earlier these conditions are treated, the quicker they are to go away and to stay away.

Therapy and counselling can also be helpful in milder cases of anxiety and depression. One does not even have to be anxious or depressed to benefit from counselling. Very often we use strategies and interaction patterns in daily life that we have learned and acquired a long time ago, but which might not be as effective anymore. Therapy can help identify and replace them with better working ones.

Some Background on Anxiety

Anxiety is an emotion characterized by an unpleasant state of inner turmoil, often accompanied by nervous behaviour, such as pacing back and forth, somatic complaints, and rumination. [1] Unlike anxiety, fear is a response to a real or perceived threat [2]. Fear, on the other hand, is the expectation of a future threat. [3] Usually, in anxiety, there is a sense of existential fear or imminent doom. Frequent is a fear of death. [2] When anxiety is experienced regularly the individual may suffer from an anxiety disorder. [3]

Physical Symptoms of Anxiety

Anxiety is often accompanied by muscular tension [3] restlessness, fatigue and problems in concentration. The physiological symptoms of anxiety may include:[5][6]

  • Neurological, as headache, paresthesias, vertigo, or presyncope.
  • Digestive, as abdominal pain, nausea, diarrhoea, indigestion, dry mouth, or bolus.
  • Respiratory, as shortness of breath or sighing breathing.
  • Cardiac, as palpitations, tachycardia, or chest pain.
  • Muscular, as fatigue, tremors, or tetany.
  • Cutaneous, as perspiration, or itchy skin.
  • Uro-genital, as frequent urination, urinary urgency, dyspareunia, or impotence.

People facing anxiety may withdraw from situations which have provoked anxiety in the past.[4] Furthermore, anxiety has been linked with physical symptoms such as Irritable Bowl Syndrome (IBS) and can heighten other mental health illnesses such as OCD and panic disorder.

Distortions in Thinking

Cognitive distortions such as overgeneralizing, catastrophizing, mind reading, emotional reasoning, binocular trick, and mental filter can result in anxiety. For example, an overgeneralized belief that something bad “always” happens may lead someone to have excessive fears of even minimally risky situations and to avoid benign social situations due to anticipatory anxiety of embarrassment. Such unhealthy thoughts can be targets for successful treatment with cognitive therapy.

Psychodynamic Explanations

Psychodynamic theory posits that anxiety is often the result of opposing unconscious wishes or fears that manifest via maladaptive defence mechanisms (such as suppression, repression, anticipation, regression, somatization, passive aggression, and dissociation) that develop to adapt to problems with early objects (e.g., caregivers) and empathic failures in childhood. For example, persistent parental discouragement of anger may result in repression/suppression of angry feelings which manifests as gastrointestinal distress (somatization) when provoked by another while the anger remains unconscious and outside the individual’s awareness. Such conflicts can be targets for successful treatment with psychodynamic therapy.

Where does it come from?

Anxiety disorders are partly genetic but may also be triggered, due to drug use, including alcohol and caffeine, as well as withdrawal from certain drugs. They often occur with other mental disorders, particularly major depressive disorder, bipolar disorder, certain personality disorders, and eating disorders. The term anxiety covers four aspects of experiences that an individual may have: mental apprehension, physical tension, physical symptoms and dissociative anxiety.[7] The emotions present in anxiety disorders range from simple nervousness to bouts of terror.[8] There are other psychiatric and medical problems that may mimic the symptoms of an anxiety disorder, such as hyperthyroidism. Common treatment options include lifestyle changes, therapy, and medications. Medications are typically recommended only if other measures are not effective.[9] Anxiety disorders occur about twice as often in females as males and generally begin during childhood.[10] As many as 18% of Americans and 14% of Europeans may be affected by one or more anxiety disorders. [11]

Social Anxiety

Social anxiety varies in degree and severity. For some people, it is characterized by experiencing discomfort or awkwardness during physical social contact (e.g. embracing, shaking hands, etc.), while in other cases it can lead to a fear of interacting with unfamiliar people altogether. Those suffering from this condition may restrict their lifestyles to accommodate the anxiety, minimizing social interaction whenever possible. Social anxiety also forms a core aspect of certain personality disorders, including avoidant personality disorders. [12] Humans generally require social acceptance and thus sometimes dread the disapproval of others. Apprehension of being judged by others may cause anxiety in social environments.[13] Anxiety during social interactions, particularly between strangers, is common among young people. It may persist into adulthood and become social anxiety or social phobia. “Stranger anxiety” in small children is not considered a phobia. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety. People with social phobia usually do not fear the crowd but the fact that they may be judged negatively. [14]

If you want to read more about anxiety, you may be interested in the following articles:

Angst vor der Arbeit: Viele Menschen sind betroffen

Von Bauchgrummeln bis zum gelben Schein: Der Gedanke an Arbeit löst bei vielen Sorge aus. Die Psychologin Beate Muschalla erklärt, ab wann das gefährlich ist und was gegen Ängste helfen kann.

Rebecca Morgan: My widowed mum of seven built a modelling empire in the ’70s — ‘She used her fear to propel herself’

Starting a modelling agency was never the intention for Rebecca Morgan’s mother, the legendary agent Nanette Morgan, known to her family and friends as Nan. For the mother of seven — six girls and one boy — working outside of the home was not part of the plan.

Debunking the Social Media & Teen Anxiety Myth

Contrary to popular belief, a six-year study reveals that increased use of social media platforms like Instagram, Snapchat, and TikTok does not lead to higher rates of anxiety and depression among young people. Following 800 children from age 10 to 16, the study found that symptoms of mental health issues remained stable irrespective of social ...

Case report: Anxiety and depression as initial symptoms in a patient with acute hypoxia and patent foramen ovale

The prevalence of patent foramen ovale (PFO) is 15–35% among adults. The role of right-to-left shunting through the PFO, anxiety, depression, and hypoxemia in the systemic circulation remains poorly understood. Herein, we present the case of a 52-year-old woman with no heart or lung disease, who was admitted due to anxiety for 5 months and had ...

Incongruent gestures slow the processing of facial expressions in university students with social anxiety

In recent years, an increasing number of studies have examined the mechanisms underlying nonverbal emotional information processing in people with high social anxiety (HSA). However, most of these studies have focused on the processing of facial expressions, and there has been scarce research on gesture or even face-gesture combined processing in HSA individuals. The present ...

Conquering Orgasm Anxiety

Orgasms are one of the most pleasurable experiences that one can have during sexual activity. However, for some people, the thought of experiencing an orgasm can cause immense anxiety. It is a common issue called orgasm anxiety, which can hinder one’s ability to enjoy intimacy to the fullest. If you are one of those people, ...

Anxiety and the Brain: The Forebrain’s Role in Social Decisions Unveiled

Researchers discovered that anxious individuals utilize a less optimal region of the forebrain when navigating socially challenging situations compared to their non-anxious counterparts. This was determined through brain scans that mapped regions active during simulated social scenarios.

Don’t Let Others Fear You

Throughout evolution, humans have developed a natural inclination to be cautious and apprehensive in various situations. Our minds are equipped with multiple hair-trigger systems that continuously scan for potential threats. However, if we assert ourselves and meet our personal needs, we are less likely to react impulsively towards others. Remember, cultivating self-assurance and fulfilment promotes ...

The Booming Business of American Anxiety

Americans are increasingly anxious, and a flurry of companies and opportunistic entrepreneurs aim to fill the demand for relief.

8 Tips To Beat Your Dating Anxiety And Ace Your Next Date

Dating anxiety is complex and multifaceted, here’s how you can keep calm.

For This Venture Capitalist, Research on Aging Is Personal; ‘Bob Has a Big Fear of Death’

Robert Nelson has invested hundreds of millions in Altos Labs, a biotech company working on ways to  rejuvenate cells and eliminate disease

Native Hawaiians fear Maui wildfire destruction will lead to their cultural erasure

Hawaiians are still grappling with the emergency caused by wildfires that destroyed Lahaina, but Indigenous leaders are thinking about the future of the community and how to rebuild.

How to Face and Not Fear Intrusive Thoughts

Struggling with intrusive thoughts? Here are three steps that can help you regain control and minimize their impact on your mental well-being.

The Fear of Sharks

Did you know that more than half of all Americans experience a certain level of fear when it comes to sharks? It might seem irrational, but there are both logical and irrational reasons behind it. Great White Sharks specifically tend to strike terror even though actual attacks are quite rare. This fear stems from their ...

How Parents Can Help Their Kids With School Anxiety

How parents can anticipate the possibility of school anxiety, open up communication channels, and prepare some de-escalation methods in case they are needed.


[1] Davison, Gerald C. (2008). Abnormal Psychology. Toronto: Veronica Visentin. p. 154. ISBN 978-0-470-84072-6.

[2] American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. p. 189. ISBN 978-0-89042-555-8.

[3] Bouras, N.; Holt, G. (2007). Psychiatric and Behavioral Disorders in Intellectual and Developmental Disabilities (2nd ed.). Cambridge University Press.

[4] World Health Organization (2009). Pharmacological Treatment of Mental Disorders in Primary Health Care (PDF). Geneva. ISBN 978-92-4-154769-7.

[5] Testa A, Giannuzzi R, Daini S, Bernardini L, Petrongolo L, Gentiloni Silveri N (2013). “Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases” (PDF). Eur Rev Med Pharmacol Sci (Review). 17 Suppl 1: 86–99. PMID 23436670.

[6] Diagnostic and Statistical Manual of Mental DisordersAmerican Psychiatric Associati. (5th ed.). Arlington: American Psychiatric Publishing. 2013. pp. 189–195. ISBN 978-0890425558.

[7] Phil Barker (7 October 2003). Psychiatric and mental health nursing: the craft of caring. London: Arnold. ISBN 978-0-340-81026-2. Retrieved 2010-12-17.

[8] Patel, G; Fancher, TL (Dec 3, 2013). “In the clinic. Generalized anxiety disorder.”. Annals of Internal Medicine. 159 (11): ITC6–1, ITC6–2, ITC6–3, ITC6–4, ITC6–5, ITC6–6, ITC6–7, ITC6–8, ITC6–9, ITC6–10, ITC6–11; quiz ITC6–12. doi:10.7326/0003-4819-159-11-201312030-01006. PMID 24297210.

[9] Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE (June 2005). “Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication”. Arch. Gen. Psychiatry. 62 (6): 617–627. doi:10.1001/archpsyc.62.6.617. PMC 2847357. PMID 15939839.

[10] Öhman, Arne (2000). “Fear and anxiety: Evolutionary, cognitive, and clinical perspectives”. In Lewis, Michael; Haviland-Jones, Jeannette M. Handbook of emotions. New York: The Guilford Press. pp. 573–93. ISBN 978-1-57230-529-8.

[11] Scarre, Chris (1995). Chronicle of the Roman Emperors. Thames & Hudson. pp. 168–9. ISBN 978-5-00-050775-9.

[12] Stephan, Walter G.; Stephan, Cookie W. (1985). “Intergroup anxiety”. Journal of Social Issues. 41 (3): 157–175. doi:10.1111/j.1540-4560.1985.tb01134.

[13] Thomas, Ben; Hardy, Sally; Cutting, Penny, eds. (1997). Mental Health Nursing: Principles and Practice. London: Mosby. ISBN 978-0-7234-2590-8.

[14] Settipani, Cara A.; Kendall, Philip C. (2012). “Social Functioning in Youth with Anxiety Disorders: Association with Anxiety Severity and Outcomes from Cognitive-Behavioral Therapy”. Child Psychiatry & Human Development. 44 (1): 1–18. doi:10.1007/s10578-012-0307-0. PMID 22581270.

© Christian Jonathan Haverkampf. All rights reserved.

Psychotherapeutic Counselling, Communication-Focused Therapy. Dublin, Ireland.

This article is solely a basis for academic discussion and no medical advice can be given in this article, nor should anything herein be construed as advice. Always consult a professional if you believe you might suffer from a physical or mental health condition.

Trademarks belong to their respective owners. They have not been checked.

1 thought on “Anxiety”

  1. The most aggravating thing is when people make it sound so simple, like “everyone has anxiety, you just need to calm down and be positive. It’s not that serious.” Every day, there are some things that give me anxiety and cause me to worry about all the things that could go wrong. My therapist advised me not to listen to those folks or to express my emotions to them.

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