What Is Severe Anxiety?

Most people experience some anxiety. However, severe anxiety can be overwhelming and sometimes debilitating.

Severe anxiety occurs when the body's natural responses to anticipated stress exceed healthy levels. The symptoms—a racing heart, changes in breathing, and headaches—can hinder your ability to carry out day-to-day tasks.

Long-term or recurrent severe anxiety can be a sign of an anxiety disorder. Left untreated, it can lead to chronic health problems, including heart disease.

This article discusses severe anxiety. It explains common anxiety reactions and how the severity can vary. It also offers tips for how to deal with severe anxiety and when to talk to your healthcare provider about it.

What Is Severe Anxiety?

The mind and body naturally perceive and react to potential threats automatically, with the goal of staying safe. This is often helpful and means your body is working the way it should.

Anxiety is a way of preparing for future stress or possible negative experiences.

However, when these feelings include constant worry or a chronic sense of threat or impending dread, it could signal an anxiety disorder.

Severe anxiety symptoms can become a persistent problem. They can interrupt daily functioning, impact quality of life, and become too difficult to manage. Severe anxiety can even bring about suicidal thoughts.

Mild, Moderate, and Severe Anxiety Symptoms

Anxiety, in a broad sense, is very common. In fact, it's the most common type of mental health disorder, with 33% of people being impacted by an anxiety disorder in their lifetime.

Symptoms of anxiety can impact a person's mind, behaviors, and physical well-being. Though anxiety symptoms can be different for each person, worry and avoidance are common.

The actual symptoms of severe anxiety are no different from mild or moderate anxiety. However, severe anxiety symptoms are less likely to be self-manageable.

Worry

In small amounts, as with mild levels of anxiety, worry can actually help you prepare, like when studying for a test or paying your bills before late fees kick in.

However, worrying too much about things that cannot be controlled can have a negative effect on overall well-being and is a sign that anxiety may be more severe.

Avoidance

Severe anxiety often causes avoidance, a type of behavior people use to escape uncomfortable feelings. It can mean physically avoiding something, such as crowds, or declining invitations to events.

In some cases, avoidance can lead to life choices like not preparing for a presentation due to feelings of nervousness. This type of behavior may temporarily circumvent anxiety, but avoidance is not an effective way to overcome it.

When most severe, anxiety-induced avoidance can cause a person to withdraw from stressful interactions, such as socializing, making decisions, or working. It can even lead to isolation. It's common for social isolation itself to lead to anxiety and depression, adding to the problem.

Physical Symptoms

Severe anxiety can lead to physical symptoms. Muscle tension is a natural tightening of muscles when the body experiences stress. A tight jaw and tense abdominal muscles are examples of ways that muscles react to stress and anxiety.

Paying attention to specific ways your body feels when you are calm vs. anxious can help you recognize when you are experiencing anxiety symptoms.

These are common ways anxiety is experienced physically:

• Sweating
• Upset stomach
• Shallow breathing
• Shakiness
• Headache
• Jaw pain
• Eye strain
• Racing heartbeat

People with severe levels of anxiety might experience physical responses more frequently, more intensely, or with a more significant impact.

Long-term impacts from severe levels of anxiety symptoms can result in medical conditions like heart disease, an ulcer, or a lowered immune system.

Types of Severe Anxiety

Severe anxiety is not a formal diagnosis but a level of how serious the symptoms and impact of the anxiety disorder are. Anxiety disorders are categorized into different types based on the specific way symptoms are experienced.

Categories include:

• Separation anxiety disorder
• Selective mutism
• Specific phobia, the most common type
• Social anxiety disorder (social phobia)
• Panic disorder
• Agoraphobia (fear of public or crowded places)
• Generalized anxiety disorder

Each type of anxiety disorder can range from mild to severe and requires different interventions based on the individual and the circumstance.

Anxiety disorders also come about at different points in a person's life, with most developing during childhood and adolescence, and they tend to fluctuate in severity throughout the course of the illness.

For example, separation anxiety disorder and specific phobias tend to arise during childhood, with an average age of diagnosis around 7 years old, while generalized anxiety disorder (GAD) is more common later in life.

When to See a Healthcare Provider

If symptoms of anxiety are impacting your ability to function at work or in your personal life, contact your healthcare provider. Signs that warrant further evaluation include:

• Difficulty controlling your worries or feelings of nervousness
• Excessive worry about everyday things 
• Fatigue or excessive tiredness
• Headaches, muscle aches, stomachaches, or unexplained pains
• Inability to concentrate on tasks
• Irritability or feeling on edge
• Panic attacks
• Restless or inability to relax 
• Trembling, twitching, or startling easily
• Trouble falling asleep or staying asleep
  

Causes of Severe Anxiety

The exact cause of anxiety disorders is unknown. Several factors can play a role, such as genetics and brain chemistry. Stress and your environment can also contribute to the development of severe anxiety.

Situations and events that may trigger an anxiety disorder are unique to individual experiences. These can include:

• Difficult life experiences, such as the death of a loved one
• Family issues
• Financial insecurity
• Having a baby (post-partum anxiety)
  
• Health concerns
• Job loss
• Miscarriage
• Parenting
• Relationship problems, including divorce
  
• Stressful childhood events
• Worries over global issues, such as the COVID-19 pandemic, climate change, or politics
  

Symptoms of anxiety can also be caused by a physical health condition, such as thyroid problems or heart arrhythmia. Alcohol, caffeine, medications, and substance use can also trigger anxiety symptoms.

Risk Factors

Anyone can develop an anxiety disorder, but it is more common in people with the following:

• Childhood shyness or feeling distressed or nervous in new situations
• Exposure to stressful and negative life or environmental events
• A family history of anxiety or other mental disorders
• Traumatic events in early childhood or adulthood
  

Severe Anxiety Diagnosis

Anxiety is one of the most underdiagnosed mental health disorders. Though it is very common, many people do not seek treatment for anxiety. One study found only 20% of people with an anxiety disorder seek help from healthcare providers.

If you're trying to manage severe anxiety alone, it may be time to seek professional care. Your healthcare provider or insurance company can help you to find a mental health professional.

Anxiety disorders can only be diagnosed by licensed mental health professionals. A provider will typically ask a series of questions to determine the type and severity of anxiety you're experiencing.

Anxiety disorders are highly co-occurring, meaning they are often present alongside depression, substance use disorders, and other conditions.

Measuring Anxiety Levels

The fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5) includes diagnostic criteria for anxiety disorders.

Mental health professionals often use measurement scales to determine anxiety levels. These tools can determine how distressing and disruptive your anxiety symptoms are, which allows for a more personalized and effective treatment plan.

Examples of common anxiety-measurement scales include:

• The Generalized Anxiety Disorder Assessment (GAD-7)
• The State-Trait Anxiety Inventory (STAI)
• The Beck Anxiety Inventory (BAI)

These assessments ask questions related to how often anxiety symptoms occur and how disruptive they are. Based on the responses, a determination of mild, moderate, or severe anxiety will be provided.

Severe Anxiety Treatment

Noticing and effectively addressing the feelings that come with anxiety is an important step toward treatment. Even severe levels of anxiety can be treated by working with a mental health professional. Sometimes, medication is recommended along with psychotherapy.

Though the specific treatment plan will depend on the individual needs of the person seeking help, some common treatment approaches include:

• Cognitive behavioral therapy (CBT)
• Psycho-education about the disorder and how to manage it
• Exposure therapy (for specific phobias)
• Mindfulness
• Support groups

Cognitive Behavioral Therapy

Cognitive behavioral therapy is the most highly recommended intervention for overcoming anxiety due to its high level of effectiveness. CBT involves identifying negative thoughts and behaviors that contribute to anxiety with the goal of changing these in more adaptive ways.

Psycho-Education

Along with a formal intervention like CBT, psycho-education is often used to provide information about the nature of anxiety. A therapist will explain how it impacts health, functioning, and experiences, and ways it can be recognized and reduced.

Exposure Therapy

Sometimes, the best way to overcome anxiety, as with specific phobias, is to face the fear directly. With exposure therapy, a person is gradually introduced to the anxiety-causing stressor over time.

Seeing a snake across the room, then being near it, and then touching it is an example of exposure therapy. This type of therapy is done with the support of a qualified mental health professional.

Prior to being exposed to triggers, the therapist will first teach you relaxation techniques and tools for calming your anxiety. Practicing these new skills when calm will help you to implement them once the exposure stage of therapy begins.

Mindfulness

Mindfulness is an evidence-based practice that can be done for severe anxiety. It can help people to overcome racing thoughts or constant worry with a focus on the present.

Research has shown promising results in people with severe anxiety and depression, especially those who haven't responded well to other interventions.

Support Groups

When working through severe anxiety, it's important to have ongoing support. Along with trusted friends, family members, and colleagues, support groups can be an impactful way to connect with others who are experiencing similar symptoms.

A mental health therapist will often provide recommendations for support groups based on the type of anxiety disorder a person is dealing with.

Coping and Prevention

It's important to find ways to cope with anxiety and to incorporate lifestyle practices that can help prevent your symptoms.

There are many ways to keep anxiety in check, including:

• Getting regular exercise
• Getting enough sleep every night
• Relaxation exercises, including deep breathing, mindfulness exercises, and meditation
• Eating healthy, nutritious, and regular meals
• Limiting caffeine intake
• Finding helpful social supports

A good routine can help to support the work that happens in therapy.

Summary

Anxiety is a common mental health concern. Severe anxiety can impact a person's overall well-being, ability to function, and enjoyment of life.

Anxiety disorders can range from mild to moderate to severe. It's important to work with a mental health professional to get an accurate diagnosis and start a treatment plan. With the right support, even severe anxiety can be reduced and managed.