Anxiety Symptoms and How to Cope with Anxiety (Anxiety Disorders)

What are the symptoms of anxiety, and how do they differ from normal worry? Learn about the causes of anxiety disorders, ways to cope and how therapy helps.

When you get into bed at night, does your mind refuse to go quiet? What will happen at work tomorrow, how will the bills get paid, how will your child do in the exam, what will your mother's test results show... One thought has not finished before the next begins, your shoulders tense up, your stomach ties itself in knots. Anxiety is a natural emotion that all of us experience from time to time; but when it becomes constant, intense and uncontrollable, it can make life seriously difficult. In this article we talk about the symptoms of anxiety, the difference between normal anxiety and an anxiety disorder, the causes of anxiety, the coping strategies you can use in daily life, and how anxiety is approached in therapy.

What Is Anxiety? The Difference Between Normal Anxiety and an Anxiety Disorder

Anxiety is an emotional, bodily and mental response to a danger or uncertainty that may arise in the future. This response is actually protective. The anxiety you feel before an important exam pushes you to study; the unease you feel when crossing the road makes you careful. In other words, to a certain degree, anxiety is an emotion that helps us survive and reach our goals.

The problem begins when anxiety goes beyond this protective function. When anxiety

• is intense out of proportion to the size of the real danger,
• continues all the time even when there is no obvious cause,
• is difficult for the person to control,
• lasts for months,
• clearly affects work, school, relationships and daily life,

we can speak of an anxiety disorder. Anxiety disorders are not a single condition. Generalised anxiety disorder, panic disorder, social anxiety disorder, specific phobias and separation anxiety are the main members of this group. Obsessive compulsive disorder and health anxiety are also problems closely related to anxiety. In this article we focus mainly on general anxiety that spreads across many areas of everyday life and can be described as a state of "worrying about everything".

What Are the Symptoms of Anxiety?

The symptoms of anxiety show up not only in the mind but also in the body and in behaviour. Many people consult different doctors about physical complaints for a long time before realising that these symptoms are linked to anxiety.

Mental Symptoms

• Constant worries that are hard to control
• Chains of thought that begin with "What if...?"
• A tendency to imagine the worst-case scenario
• Difficulty concentrating, the mind going blank
• Difficulty making decisions, intolerance of uncertainty
• Being unable to relax, a feeling of always being on alert

Physical Symptoms

• Muscle tension, especially in the neck, shoulders and jaw
• Headaches
• Nausea, indigestion, bowel problems
• Palpitations, a feeling of shortness of breath
• Sweating, trembling
• Tiring easily, feeling run down
• Difficulty falling asleep, frequent waking or unrefreshing sleep

Emotional and Behavioural Symptoms

• Restlessness, irritability, a short temper
• Avoiding situations that create anxiety
• Constantly seeking reassurance: "Are you sure, there's no problem, is there?"
• Procrastination or, on the contrary, excessive preparation
• Checking everything, being unable to tolerate situations that go off plan

Experiencing a few of these symptoms does not mean you have an anxiety disorder. The duration and intensity of the symptoms, and the extent to which they affect your life, can only be clarified by a specialist assessment. In addition, because thyroid problems, some heart rhythm disorders and other medical conditions can cause symptoms similar to anxiety, a medical assessment is important if you have physical complaints.

What Causes Anxiety?

Anxiety disorders usually develop when several factors come together.

Predisposition and Temperament

Some people are born with a more sensitive temperament; they approach new situations more cautiously and react more strongly to uncertainty. A family history of anxiety disorders can also increase vulnerability.

Early Life Experiences

Growing up in an overprotective or overly critical family environment can strengthen the belief that the world is a dangerous place or that making mistakes is unacceptable. Frequently heard messages such as "Be careful, you'll fall" and "What will people say?" can lower a child's tolerance of uncertainty.

Stressful Life Events

Events such as losing a job, financial difficulties, a break-up, health problems, bereavement or migration can trigger anxiety. In Turkey, the high cost of living, rising rents, uncertainty about job security and the earthquake anxiety that has continued since the 6 February 2023 earthquakes have noticeably increased the daily stress load of many people.

Thought Patterns

There are some thought patterns that are common in people who experience anxiety: exaggerating probabilities, thinking that they would not be able to cope if something bad happened, and believing that worrying is protective. The thought "If I worry, I'll be prepared and bad things won't happen" makes it hard to let go of worry.

The Cycle That Maintains Anxiety

The factors that cause anxiety to start are not always the same as those that keep it going. Behaviours such as avoidance, reassurance seeking, excessive checking and constant information gathering bring relief in the short term. But this relief leads the brain to conclude, "So there really was danger, it's a good thing I escaped." In this way, anxiety grows a little stronger each time. One of the points emphasised most in therapy is this maintaining cycle.

How Do Anxiety Symptoms Affect Daily Life?

Anxiety can seep into almost every area of life. At work, there may be behaviours such as checking the same email again and again for fear of making a mistake, avoiding speaking up in meetings, or turning down promotion opportunities. In the family, constantly trying to reach a spouse or children by phone out of worry that something will happen to them, and restricting their independence, can strain relationships.

Say a mother of two thinks every day when her children go to school, "What if the school bus crashes, what if there's an earthquake?" She cannot put her phone down all day, cannot focus on her work, and feels exhausted by the time the children come home in the evening. People around her say, "Don't think so much", but she cannot stop thinking. This example shows that anxiety is not merely "thinking too much", and how it affects a person's energy, relationships and quality of life.

For many people living in big cities, traffic, crowds, noise and a hectic work pace form a background that feeds anxiety. This way of life, in which there is always something to "catch up with", leaves the body no chance to rest. Among teenagers, the LGS and YKS process (Turkey's national high-school and university entrance exams), family expectations and comparisons on social media are among the main sources of anxiety.

Anxiety is an effort to control the future; yet relief often begins at the point where we accept that we cannot control everything.

Ways of Coping with Anxiety: Tips You Can Apply Yourself

The suggestions below can help you change your relationship with anxiety. These methods are not a substitute for therapy, but they can be useful tools in daily life.

Set a Worry Time

Set aside a fifteen to twenty minute window during the day for your worries. When a worry comes to mind during the day, jot it down and tell yourself, "I'll think about this in my worry time." This method can help limit worries from spreading across the whole day.

Separate Solvable Worries from Unsolvable Ones

Ask yourself, "Is there anything concrete I can do about this right now?" If there is, plan a small step. If there is not, for example because it concerns an uncertain event that might happen in the future, try noticing the worry and bringing your attention back to the present moment.

Work with Your Body

Slow breathing exercises, progressive muscle relaxation and regular physical activity can reduce the physical symptoms of anxiety. Even walks a few days a week can make a difference.

Cut Back on Stimulants

Caffeine, energy drinks and nicotine can make the body more aroused and so increase anxiety symptoms. Taking care of your sleep routine is also an important step in coping with anxiety.

Limit News and Social Media Consumption

Constantly following news about earthquakes, the economy or health can feed anxiety. Following the news at set times of the day and for a limited period opens up some space for your mind to rest.

Notice Reassurance Seeking

Constantly asking those close to you "Nothing will happen, will it?" may soothe you in the short term, but in the long term it keeps anxiety going. You can try noticing this behaviour and gradually reducing how often you do it.

Create Small Pockets of Enjoyment

Anxiety keeps carrying the mind into the future and makes it hard to notice the small beauties the present offers. Creating short periods during the day that belong only to you, for example drinking your morning coffee without looking at your phone, going for a short walk in the evening or listening to music you love, gives your nervous system the message "I am safe right now". These small pockets do not remove anxiety, but they create a counterweight to it.

Approach Yourself with Compassion

Many people who experience anxiety get angry with themselves for being anxious: "Why am I so weak, everyone manages, so why can't I?" This critical inner voice adds shame on top of anxiety. Yet anxiety is not a character weakness, it is a learned pattern of response. Trying to speak to yourself as you would to a close friend going through a hard time is an important part of change.

When Should You Seek Professional Support?

It may be helpful to contact a mental health professional in the following situations:

• If anxiety has lasted for months and you feel tense on most days,
• If you have difficulty controlling your worries,
• If physical symptoms such as sleep problems, muscle tension and fatigue are affecting your life,
• If you have begun to avoid work, school or social activities because of anxiety,
• If you experience sudden, intense attacks of fear,
• If you notice that you are turning to alcohol or other substances to cope with anxiety,
• If anxiety is accompanied by hopelessness, lack of motivation and deep sadness.

If symptoms are severe, an assessment by a psychiatrist may also be considered. If you have thoughts of harming yourself or ending your life, do not wait: call 112 (emergency services) or go to the nearest emergency department. If you experience sudden waves of intense fear, our article on panic attack symptoms may also guide you.

How Is Anxiety Approached in Therapy?

One of the approaches best supported by research for anxiety disorders is Cognitive Behavioural Therapy (CBT). The therapy process is structured around understanding the person's anxiety and building a new relationship with it.

Assessment and Formulation

In the first sessions, we look at when the anxiety began, in which situations it increases, and which thoughts and behaviours keep it going. With this information, a personalised map of the person's anxiety is built.

Psychoeducation

How anxiety works in the body and the mind is discussed. Once the symptoms of anxiety are understood, the fear of them also begins to decrease.

Working with Beliefs About Worry

Beliefs such as "Worrying protects me" or "If I can't control my worries, I'll lose my mind" are questioned. Work is done to increase tolerance of uncertainty.

Exposure and Behavioural Experiments

Avoided situations and thoughts are approached in a controlled way. Behaviours such as reassurance seeking and excessive checking are gradually reduced. Say a person checks every report four or five times before sending it, for fear of making a mistake. In therapy, an experiment can be planned together: checking the report only once, sending it, and then observing what actually happens. Most of the time the feared disaster does not happen; and even if it does, the person sees that they can cope with it. These experiences allow you to learn first-hand that what anxiety says is not always true.

Relaxation and Mindfulness Skills

Breathing exercises, muscle relaxation and the skill of focusing on the present moment strengthen the body's capacity to calm down.

Different forms of anxiety may call for different approaches. For example, if there are unwanted thoughts that come into the mind and repetitive behaviours carried out to neutralise them, you can read our article on obsessive compulsive disorder. For information on how anxiety complaints are worked with, you can look at our anxiety and panic page.

Frequently Asked Questions

Does anxiety go away on its own?

Short-term anxiety linked to a specific source of stress may decrease once the situation is over. However, anxiety that has lasted for months and is affecting life usually does not go away on its own; it can become entrenched as long as the cycle of avoidance and worry continues. In this case, getting support can be helpful.

Can an anxiety disorder lead to physical illness?

Long-term anxiety can occur together with complaints such as problems with sleep and digestion, muscle tension and headaches. If you have physical symptoms, both a medical assessment and psychological support should be considered together.

Do children experience anxiety too?

Yes. In children, anxiety often shows itself as stomach aches, reluctance to go to school, difficulty separating from a parent, sleep problems or angry outbursts. Play and age-appropriate methods are used when working with children.

Is medication needed for anxiety?

This decision is made only by a psychiatrist, after the person's situation has been assessed. In many cases psychotherapy alone is helpful, while in some cases a combination of the two approaches may be recommended; whichever path is suitable, support is available.

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• #generalised anxiety
• #stress
• #coping with anxiety

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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