让我们来谈谈焦虑

When’s the last你躺在床上醒着,愿你旋转的thoughts to quiet down? Or the last time you felt your heart race so hard you thought your chest might burst? If this happens to you often, you’ve come to the right place.

Anxiety

Our Pro Panel

Our experts have all the details you need to understand the causes, symptoms, and treatments for anxiety disorders.

埃里克•Rafla-Yuan医学博士

Clinical Professor in the Department of Psychiatry

University of California San Diego

San Diego, CA

安德鲁·普莱纳，M.D.

综合精神科医生，创始人和总监;创始人

#samevee scent联盟;区域精神病学

Windermere, FL

Jennifer L. Payne, M.D.

Director of the Women's Mood Disorders Center and Associate Professor of Psychiatry

Johns Hopkins School of Medicine

Baltimore, MD

Anxiety is a daily reality for millions of people—who feel just like you do right now. Here, we share the reality of coping with anxiety, as well as expert advice from top doctors, the most successful treatments, and body-calming lifestyle changes. With the right treatment, our experts say people can bring your anxiety down to a level that is manageable, perhaps even helpful (yes, you read that right), rather than painful and disabling.

What Is Anxiety, Really?

Anxiety can show up in your body as a racing heartbeat, or in your mind as racing thoughts that are hard to quiet. It can make it tough to fall asleep at night, or give you a sick stomach when you wake up in the morning. Feeling anxious is a normal part of being human—and we can feel “anxious” about things that are good or bad. (Ever felt a little anxious or nervous while packing up for a much-anticipated trip? Or before meeting up with a date?)

“Anxiety” is, in fact, a useful, basic human response that is partially responsible for the survival of our species! A natural vigilance against potential danger keeps us from falling off a cliff or being bitten by an aggressive animal. It’s also a useful motivator that helps give us energy and alertness during work or school deadlines, sporting events, and other stressful moments that require vigilant awareness and stamina.

Feeling some worry, nervousness, and anxiety is especially normal when there are major changes or challenges going on in your life like starting a new job, entering a relationship, or moving homes. And some people tend to be a little more prone to anxiety than others. Because the unknown can mean potential danger, anxious brains sometimes interpret anything “new” as dangerous.

问题是,这些情绪通常一旦消退problem is solved or a stressful moment passes. In other words, typical, everyday anxiety, even for those who experience it more often than average, is uncomfortable but temporary.

For people suffering from anxiety disorders, however, that’s not the case. For these folks, some form of nervousness, agitation, or fear is persistent—at times overwhelming—and can greatly interfere with their daily lives.

在任何年龄，任何年龄段都可以发生焦虑症。它们是美国最常见的心理健康问题。估计19％的美国人有焦虑症，约占7％的孩子。大多数情况下，焦虑症症状开始出现在你打到的21岁之前。这个伞下有许多条件下降：

Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD)—the most common anxiety disorder—feel “excessively” anxious or worried most days, for a period of six months or more. These worries make handling and succeeding in relationships, friendships, school, or work harder, and can sometimes cause people to withdraw from socialization and normal everyday tasks. Nearly 7 million American adults have GAD; and women are nearly twice as likely to be diagnosed with it than men.

Generalized anxiety disorder is the most common type of anxiety issue, but there are many other conditions, including:

Panic Disorder and Panic Attacks

恐慌的攻击是极端恐惧的一集，突然突然撞击并迅速升起。恐慌攻击通常会导致“厄运”的感觉摇晃或颤抖，出汗，赛马心跳或心悸，以及失控的感觉。攻击可以毫无注意到，或者被一个人已经害怕的东西被踢掉。那些有恐慌障碍的攻击性攻击，并且可以花很多时间担心当下一个会击中。估计有2％至3％的美国人口报告恐慌症each year.

Social Anxiety Disorder

我们大多数人都感到紧张地结识新人或在公共场合发言。但是，具有社交焦虑症的人们对公共或社会情况或工作场所或学校互动的兴趣感到强烈担心 - 有时会避免他们摆脱恐惧。

Phobia-related Disorders

A phobia is a severe and often overwhelming fear of or aversion to a thing or situation that is generally thought to be pretty safe or neutral by other folks. Phobias last for a long time, and can cause very intense reactions such as nausea, dizziness, fainting, sweating, and rapid heartbeat. Some common phobias are fear of heights, flying, blood, or animals like snakes or spiders.Agoraphobiacreates powerful fear around things like crowds, standing in line with others, leaving the house, or being on a bus, train, or other public transportation.

Separation Anxiety Disorder

This is most often seen in children, but teens and adults can suffer from separation anxiety disorder, too. People with this condition have intense fear around being away from their loved ones and worry that something terrible will happen to their family or friend while they’re apart. Separation anxiety can also cause nightmares and physical symptoms like headaches and stomach pain.

Selective Mutism

People with selective mutism seem unable to speak in some public situations such as at work or school—even though they talk plenty when they’re at home or with people they know and feel comfortable with.

其他指定或未指明的焦虑症

Significant and disruptive disorders and phobias that don’t fit neatly into any of the other diagnoses are often grouped under these terms.

What Causes Anxiety?

与涉及大脑和神经系统的许多医疗问题一样，医生究竟不知道是什么导致焦虑。它可能是许多事情的组合，包括遗传，脑化学和过去创伤体验。

遗传学

Anxiety disorders are known to run in families, just like other medical conditions such asdiabetes,沮丧, and autoimmune disorders. Studies suggest that about 33% of a person’s risk of developing generalized anxiety disorder is predicted by their genes.

Brain Chemistry

Neurotransmitter chemicals in the brain such as dopamine and serotonin are important in regulating mood. Imbalances or disruptions in these and other neurotransmitters is associated with anxiety and depression.

创伤

像攻击，离婚等情境一样强烈消极或创伤体验可以引发焦虑症。

Personality and Parental Modeling

自然谨慎或害羞的人似乎具有更高的焦虑障碍风险，以及与父母长大的人，具有焦虑的倾向。

焦虑的症状是什么？

因为每个人有时会经历焦虑，因为你经历的是焦虑症，可能很难知道。此外，特定障碍的症状彼此不同。
But one common thread that runs through all anxiety disorders is a persistent feeling of worry or fear in situations that may not typically be perceived as very threatening by other folks. Some other common emotional or psychological symptoms to look out for:

• 易怒

• 不安的感觉

• Being ever-watchful of danger

• Feelings of dread or impending doom

Anxiety also causes many physical symptoms, a fact that surprises many people. Some of the physical symptoms are so intense that people may undergo lots of medical testing only to find that their physical symptoms go away once they’re treated for anxiety. Some of the physical symptoms of anxiety include:

• Trouble falling or staying asleep

• Racing heartbeat or palpitations

• Nausea

• Shaking or twitching

• head

• 疲劳

• 腹泻

• Frequent urination

• Numbness or tingling, often in the hands, feet, head, neck, or face

• Shortness of breath

How Do Doctors Diagnose Anxiety?

你may worry that a medical doctor will tell you that your feelings of fear and dread are “all in your head.” But if anxiety is getting in the way of your relationships with friends or family, or interfering with your ability to go to work, eat or sleep normally, it’s time to make an appointment.

General practitioners see anxiety disorders in their medical practices every single day—after all, more than 40 million Americans suffer from them. And if your particular provider doesn’t seem to be taking your symptoms seriously, don’t hesitate to get a second opinion or ask for a referral to a psychiatrist for further evaluation. Your wellness is worth it!

When you get to your appointment, here are the three main steps your doctor will likely take to officially diagnose you with an anxiety disorder:

Physical Examination

你r doctor will want to rule out other conditions such as heart problems, and may even order a simple test to check levels of thyroid hormone and other substances in your blood. She’ll also want a complete list of all medications or supplements you take on a regular basis, since side effects of some medications and supplements can mimic the symptoms of anxiety, or cause actual anxiety as a side effect.

Family History

Because anxiety disorders tend to run in families, your doctor will want to know about mental health conditions in close relatives such as parents, siblings, and grandparents.

Psychological Evaluation

你r doctor will ask for a detailed description of the frequency and severity of your symptoms. She may also give you a formal or informal screening questionnaire for anxiety that includes questions about specific anxiety symptoms and how they affect your life. If the doctor suspects an anxiety disorder, they may discuss treatments such as medication and psychotherapy or refer you to a psychologist or psychiatrist for additional care.

What Are the Best Treatments for Anxiety?

People with anxiety disorders often use a combination of psychotherapy and medication to help alleviate symptoms. There are complementary medicine approaches that may help, too.

心理治疗

研究表明了某些类型的talk therapyto be very effective at helping people with anxiety disorders feel better, including:

• Cognitive-behavioral therapy (CBT)

• Dialectical-behavioral therapy (DBT)

• Acceptance and commitment therapy (ACT)

• 基于过程的疗法（PBT）

These types of therapy offer specific tools, such as worksheets, mental tools, and deep breathing, that address the underlying causes of anxiety and teach people how to cope.

Medication

虽然药物无法治愈焦虑，但它们可以帮助减少或控制症状。一些用于焦虑症的最常见的一些包括：

Antidepressants:尽管如此，抗抑郁药也会通过帮助您的大脑更好地利用情绪稳定化学品来治疗焦虑。选择性血清素再摄取抑制剂（SSRIS），如Zoloft（肉嘌呤）和paxil（帕罗西汀）和血清素 - 去甲肾上腺素再摄取抑制剂（Snris），如Cymbalta（Duloxetine）和Esfexor（Venlafaxine），通常用于治疗焦虑。

焦化性：These anti-anxiety medications target certain brain chemicals in order to calm the brain and reduce agitation and excitability. They’re often taken on a daily basis, but sometimes they are prescribed to be taken only in moments of extreme anxiety. Some of the most common ones are:

• Ativan (lorazepam)

• Klonopin（Clonazepam）

• Librium (chlordiazepoxide)

• Valium (diazepam)

• Xanax（Alprazolam）

Beta-blockers:These blood-pressure lowering drugs target racing heartbeat, shaking, and trembling, and can be used to help keep physical symptoms of anxiety under control.

CBD焦虑, and Other Supplements:CBD oil, also known as cannabidiol, is a non-intoxicating extract of the cannabis (or marijuana) plant that is also sometimes used to help with symptoms of anxiety. There isn’t enough evidence on safety and efficacy of CBD for doctors to routinely recommend it to their anxiety patients—and some people find that cannabis products make their symptoms worse. But if you do decide to try CBD, be sure to get it from a reliable manufacturer, since, like all supplements, CBD isn’t regulated by the FDA. Some doctors also support the use of the amino acid L-Theanine as an anxiolytic as well as a sleep aid.

Where Can I Find Anxiety-Related Communities?

焦虑可以让你想拉开并孤立自己。但事情是，开放并与获得它的人在一起，有助于更多的是netflix和一个温暖的毯子。随着治疗和药物，寻找支持性的人 - 在线和现实生活中与他们联系起来 - 是照顾好自己的关键部分。
这是在哪里开始。

Top Anxiety Support Groups and Nonprofits

Anxiety Sisters.A nonprofit formed by two women with anxiety disorders, Anxiety Sisters offers peer support, e-courses, and a well-loved podcast to help women with anxiety feel less alone and learn new ways to get the treatment and support they need.

National Alliance on Mental Illness (NAMI).与NAMI在线留言板上的其他焦虑患者连接，并通过NAMI连接每周或每月恢复组。NAMI PEER-TO-PEER会话还为具有特定心理健康状况的成年人提供了八个免费课程。

Anxiety and Depression Association of America (ADAA).This nonprofit offers new research, monthly webinars from mental health experts, educational infographics and stats, and a Find-a-Therapist database you can search by disorder. The ADAA is dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders. There’s also (free) support available on the ADAA Online Peer-to-Peer Support Group or support group iOS app for iPhone.

Meet Our Writer

Sunny Sea Gold

Sunny is a health journalist with deep expertise in women's and children’s health who has written for some of the largest and most well-known print and digital publications in the United States. She’s also the author of the book食物：好女孩的药物, and writes essays and reported pieces on body image, eating disorders, parenthood, and mental health. She lives in Portland, OR, with her husband and two daughters.

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