1. You can’t control it.
Telling yourself to calm down (or having someone tell you to calm down) doesn’t help. Anxiety is a signal from the brain that something is wrong, telling your body to stay alert and protect itself. It’s an automatic emotional function of the brain that’s beyond your own control, Lee explains. Telling yourself to stop being nervous or don’t have a panic attack can actually make anxiety worse. “It’s just like someone can’t tell themselves they are not hungry if they are; if you’re experiencing anxiety, it’s real.” In fact, recognizing and accepting the times you feel anxious can sometimes help you cope, Lee notes.
2. Anxiety wrecks your sleep.
Restless nights are very common for anxiety sufferers, Lee says—and it impacts life in a big way. “When you can’t sleep, it becomes difficult to go to work or family functions because you’re so tired.” Poor sleep can lead to a host of other physical symptoms, such as pain (particularly in pressure points and joints), fatigue, headaches, and weight gain.
3. Anxiety hurts.
We’re talking about actual physical pain. The source can vary depending on the individual, but many people with anxiety suffer from “somatic” symptoms—headaches, muscle pain, rapid heart rate, stomach pain, acid reflux, and excessive sweating, says Royce Lee, MD, a psychiatrist and associate professor of psychiatry at University of Chicago.
Somatic symptoms result from chronic stress. When you’re tense, your body’s sympathetic nervous system goes on high alert: muscles contract, pulse rises, blood pressure soars. In the short term, that’s no problem. But for people with anxiety disorders, the arousal occurs too often or it can be too strong, Lee says, and that leads to physical pain. “The stress response stops being helpful and it gets in the way”—in other words, it hurts.
4. There’s more to anxiety than just stress.
Many of the symptoms of an anxiety disorder overlap with normal reactions to stress—such as changes in appetite, feeling nervous and irritable, trouble sleeping, Lee says. The difference with an anxiety disorder is the size of the person’s response, he explains. “It’s an anxiety disorder when the response is disproportionate to the problem—or if the stress response continues even though the trigger is no longer present.”
5. Meds aren’t always helpful.
The current medications for anxiety are far from perfect. Benzodiazepines (Xanax, Ativan, Valium, and others) are used to treat acute bouts of anxiety. However, they can become less effective with repeated use; worse, they’re addictive for some patients, Lee says. Typically, doctors prescribe the drugs for patients to use in specific stressful situations—for people who suffer anxiety over dental procedures or flying, for example. Antidepressants (Zoloft, Prozac, Paxil, and others) work well for long-term treatment of anxiety—and they’re not addictive. However, they do have side effects, such as upset stomach, decreased sex drive, and weight gain.
6. Sometimes you can’t identify the source.
For some sufferers, anxiety triggers can be obvious; for others, the source can be a mystery, Lee says.
Your brain is constantly processing information about your environment and preparing the body to react to various stimuli, he explains. If you’re afraid of snakes, for example, your brain may trigger an anxious reaction to things like grass and rocks—places where a snake might hide—without you even realizing it. It all happens outside of your awareness, says Lee: “It’s entirely possible for the brain to start the fear reaction based on stimuli in the world that you have barely noticed.”