Anxiety: More than being on edge

Feeling anxious is a normal response to life’s challenges or major decisions. These sometimes uncomfortable, unsettling feelings tend to resolve as you work through the situation.

But for people with an anxiety disorder, the worries and distress don’t go away as easily. In fact, they may grow severe enough to disrupt daily activities and relationships. For example, James Tevlin (@thankful), who owned a construction company, was doing something routine 20 years ago — crossing a bridge he’d crossed many times near his home — when fear suddenly overtook him.

“I had this incredible sense of my vehicle being crushed,” he says. “It was like if I didn’t get to the other side, I would be thrown overboard.”

It’s important not to minimize feelings of anxiety when they occur — help is available. In older adults, the most common anxiety disorder is generalized anxiety disorder. This is marked by excessive anxiety or worry across different areas, such as relationships, finances and health. Common symptoms include fatigue, difficulty concentrating, irritability, sleep problems, and feelings of restlessness, tension or being on edge.

Other anxiety disorders include:

• Panic disorder — This involves recurrent panic attacks — sudden periods of intense, unexpected fear. Typical signs and symptoms include a pounding or racing heart, sweating, shaking, sensations of shortness of breath, and a feeling of impending doom or an urgent need to escape.
• Phobias — These stem from an intense fear and avoidance of something specific, such as an object, animal, situation or environment.
• Social anxiety disorder — Also known as social phobia, this condition involves a significant fear of social or performance situations due to worries of embarrassment, negative judgment or rejection. The condition may lead to avoidance of social settings and difficulty forming or keeping relationships.

Sometimes, more than one anxiety disorder may be present — or anxiety disorders may be paired with another mental health condition, such as depression, post-traumatic stress disorder (PTSD) or substance misuse. This can compound symptoms and worsen quality of life.

For Tevlin, that crushing fear of crossing a bridge spread to other routine activities. Soon, he feared flying. He feared driving down any road without a shoulder. His world caved in on him. “That initial anxiety exploded,” he says. Tevlin became oversensitized to things he had done for many years.

“I realized that trying to deal with what was going on by myself was not working,” he says. “I was slipping into adding more anxieties into my life and things I felt I could no longer do.” He saw a psychiatrist, which led to regular one-on-one counseling meetings and, later, participation in group therapy. He found it hard to make progress with therapy, so he eventually stopped. But the medication prescribed improved his condition dramatically.

“That seemed to help me to stop slipping and to begin having the courage to build on small victories and once again enable me to participate in life,” he says of the medication.

Looking for more stories about overcoming health struggles? Find them, along with dozens of health tips, with a subscription to the Mayo Clinic Health Letter.