Chronic Anxiety: Symptoms And Treatment
Everyone experiences occasional anxiety, but chronic anxiety is different. Chronic anxiety can prevent you from living your life to the fullest, changing how you behave and interact with others and the world around you.
If anxiety seems like your constant companion, you can get help. Start by learning what the symptoms are and exploring your treatment options, such as psychotherapy for anxiety.
What is chronic anxiety?
While there is no official diagnosis for “chronic anxiety,” there are multiple subcategories of anxiety disorders that can affect an individual in the long term.
Symptoms of anxiety can cause significant distress and may be best helped with the assistance of a licensed mental health professional.
Physical symptoms
Chronic anxiety symptoms can manifest physically and may even exacerbate existing physical health conditions such as irritable bowel syndrome. Physical signs and symptoms of anxiety may include:
Rapid heartbeat
Muscle tension
Difficulty breathing
Hyperventilation
Exhaustion
Sleep problems
Muscle tension or muscle aches
High blood pressure
Digestive system problems
Chest or throat tightness or pain
Stomachache or sensation of butterflies in the stomach
Headaches
Chills
Dizziness
Being easily startled
Sweaty palms
Throat constriction
Trembling
Cognitive symptoms
The cognitive symptoms of chronic anxiety often revolve around worrying thoughts. People with chronic anxiety tend to get stuck in a cycle of worry that they have trouble escaping without help. Here are some of the cognitive symptoms to watch for:
Intense stress
Excessive worry
Hyperarousal
Feeling restless
Trouble concentrating
Trouble dealing with uncertainty
Constantly asking, "What if something bad happens?"
Obsession with physical symptoms
Worry about being humiliated
Fear that you can't escape danger
Thinking you're going crazy or having a fear of going crazy
Memory problems
Mood disorders
Emotional symptoms
If you're experiencing chronic anxiety, you may feel many different emotions, including:
Worried
Apprehensive
Distressed
Dread
Nervous
Overwhelmed
Panicky
Uneasy
Fearful or terrified
Jumpy or on edge
Behavioral symptoms
Chronic anxiety can affect an individual’s behavior significantly. A person might avoid situations that they associate with their anxiety symptoms. If they’re in a tense situation that triggers a perceived threat (regardless of whether that perceived threat is reasonable), a person with anxiety may want or try to escape it.
Substance use is often linked to anxiety due to its capacity to dull or alleviate feelings of unease. Eventually, a person with anxiety may put severe limits on their activities, not venturing far from home or any place, person, or object that they perceive as safe.
If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Please see our Get Help Now page for more immediate resources.
Duration and intensity of symptoms
To meet the generalized anxiety disorder diagnosis criteria, you must experience three or more symptoms more days than not for six months or more. The duration and intensity of your anxiety are essential considerations when deciding what to do about your condition.
Anxiety disorder types
There are five major types of anxiety disorders, according to the Department of Health and Human Services:
Social anxiety disorder (SAD) — Also known as social phobia, this type of anxiety disorder is characterized by persistent social anxiety. In its most severe form, SAD can harm a person’s relationships, career prospects, and other aspects of life.
Obsessive-compulsive disorder (OCD) — OCD is an anxiety disorder characterized by recurring, unpleasant thoughts (obsessions) and/or repetitive activities.
Post-traumatic stress disorder (PTSD) — PTSD is a disorder in which a person develops overwhelming anxiety after exposure to a traumatizing experience.
Panic disorder — A panic disorder is an anxiety disorder in which a person regularly suffers sudden and recurrent episodes of intense fear, known as panic attacks. Physical symptoms of these panic attacks include chest pain, heart palpitations, shortness of breath, wooziness, or stomach discomfort. Some evidence indicates panic disorders can develop from PTSD, with the intense fear associated with past trauma leading to panic attacks.
Generalized anxiety disorder (GAD) — GAD is an anxiety disorder characterized by symptoms similar to OCD and panic disorder, seemingly due to no apparent cause.
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) used by the American Psychiatric Association, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are not considered anxiety disorders but mental health disorders. However, this is controversial, and PTSD, in particular, is still considered an anxiety disorder by the HHS and other authoritative outlets.
Besides those five major disorders, there are also two other anxiety disorders that mainly affect children:
Separation anxiety disorder — Separation anxiety disorder is when someone experiences intense anxiety and overwhelming worry related to the prospect of being separated from a loved one or caregiver.
Selective mutism — Selective mutism is an anxiety disorder most common in children. This disorder is characterized by an inability or refusal to speak. Selective mutism usually coincides with social anxiety disorder.
If you are living with an anxiety disorder, you are not alone. According to the Anxiety and Depression Association of America, an estimated 19.1% of the adult U.S. population had some sort of anxiety disorder in the past year. Per the National Institute of Mental Health, 31% of Americans will experience an anxiety disorder at some point in their lives.
Causes of anxiety
There is no one cause of chronic anxiety, but some common factors have been identified. For some people, biological problems contribute to their anxiety. Family background may also play a part, both through genetics and behavior patterns handed down from each generation. Life experiences can also contribute to chronic anxiety.
Chronic depression and anxiety
Depression and anxiety often go hand in hand and can be very difficult to overcome. The depression component is characterized by ongoing symptoms, such as:
Persistent sad, anxious mood
Feelings of hopelessness or helplessness
Pessimistic outlook
Feelings of guilt or worthlessness
Loss of interest in things that were once enjoyable
Low energy
Sleep disturbances, sleeping too much or too little
Eating too much or too little
Unexpected weight loss or weight gain
Restlessness
Irritability
Headaches
Digestive problems
Pain with no identifiable cause
Suicidal thoughts, plans, or attempts
If you have these symptoms along with symptoms of chronic anxiety, seek help. Research has shown that instances of these two conditions occurring together tend to have poorer outcomes.
If you are having suicidal thoughts, it is essential to reach out for help immediately. You can call or text the National Suicide Prevention Lifeline at 988, 24 hours a day, seven days a week, for immediate assistance.
Self-help for chronic anxiety
There are various techniques you can try on your own to help alleviate your anxiety symptoms, including:
Exercise
Yoga
Meditation
Relaxation techniques
Herbal remedies
Spending time with friends and family
Treatment for chronic anxiety
For many people with chronic anxiety, treatment by a doctor or counselor provides the best hope for recovery. If you are experiencing chronic anxiety symptoms, talk to your doctor to figure out a treatment plan that will work for you.
There are many ways to treat anxiety disorders, but most will involve a mix of psychotherapy and anti-anxiety medications to manage stress. Support groups can also be helpful, particularly for those dealing with self-consciousness over having an anxiety disorder.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is the most commonly used psychotherapy for chronic anxiety. CBT is a way of training yourself to identify problematic thoughts, evaluate them, and, if needed, replace them with more rational, helpful thoughts.
CBT is very helpful for anxiety disorders such as:
Separation anxiety disorder
Post-traumatic stress disorder
Obsessive-compulsive disorder
Panic disorder
Generalized anxiety disorder
Social anxiety disorder
CBT can teach you how to manage your anxious feelings and stop worrisome thoughts that can trigger anxiety, as well as learn coping techniques for stress management and to relieve anxiety when it occurs.
Acceptance and commitment therapy
Acceptance and commitment therapy is an approach that involves accepting the existence of troublesome thoughts as well as committing to changing your behavior. In one study, three patients with anxiety were treated with ten sessions of acceptance and commitment therapy. They saw significant improvements in their anxiety levels.
Exposure therapy
Exposure therapy focuses on helping people overcome phobias by exposing them thoughtfully and carefully to their triggers. The idea is that, over time, being exposed to that object will lessen their fear until it eventually goes away.
Get started with therapy
Although medication can help people get their symptoms under control quickly, research indicates that psychotherapy can be more effective than medication for treating anxiety. If you’re looking for a way to help you treat your anxiety symptoms, consider online therapy.
Online therapy has many benefits for people with anxiety. The process is straightforward; just sign up online to be matched with a therapist available to help. With online therapy, you can speak with your therapist from the comfort of your home, and some people report that the distance and space between them and their therapist make it easier to open up.
Research shows that online therapy is effective, too. One study showed that online therapy participants had “significant and clinically meaningful improvements in depression and anxiety scores relative to baseline” at 12 weeks post-intervention sustained at six months. If you’re interested in online therapy to help with your anxiety symptoms, reach out to a BetterHelp therapist to get started.
Takeaway
What are the best coping mechanisms for anxiety?
Coping mechanisms that can help you manage an anxiety disorder effectively include:
- Learning as much as possible about anxiety and related mental health conditions
- Getting physical exercise regularly
- Adopting a healthy sleep schedule
- Practicing mindfulness meditation
- Consuming a healthy, well-balanced diet
- Keeping a journal of your thoughts, feelings, and reflections
- Maintaining active relationships with friends, family, and community members
Finding a qualified mental health provider and receiving therapy may also be a highly effective way of managing your condition. In addition to relieving anxiety, your therapist may also be able to suggest other evidence-based coping strategies.
What happens to people with chronic anxiety?
Outcomes for people with anxiety disorders can vary a great deal depending on various genetic and environmental factors. The severity of an individual’s symptoms may also factor into their prognosis, as well as their level of social support and — perhaps most importantly — whether or not they receive treatment. Untreated chronic anxiety can make it hard to manage daily life, leading to strained relationships, missed opportunities, and diminished life satisfaction.
On the other hand, people who receive timely treatment for anxiety often experience significant improvement. Therapy, medication, or some combination of both can greatly relieve symptoms of this serious illness and lead to substantially increased well-being.
How can you learn and implement calming skills to reduce overall anxiety and manage anxiety symptoms?
There are many places online where you can learn some helpful strategies to lower your anxiety level and decrease your symptoms. Mental illness nonprofits like the Anxiety and Depression Association of America (ADAA) or Mental Health America (MHA) host a variety of free online resources on managing generalized anxiety disorder and other mental health conditions. You may also be able to find useful information from government agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA).
When practicing these skills, it’s often important to be realistic about your expectations and compassionate with yourself. It may take time to develop consistent, positive habits like meditation or regular exercise. You may also need to try out many different relaxation techniques, such as sensory grounding or diaphragmatic breathing, before finding the ones that work for you.
Instead of criticizing and judging yourself when you run into difficulties, you might want to try to remember that you’re working to overcome a deeply ingrained habit of excessive anxiety. It’s normal to need time before you start seeing results. But by continuing to practice daily, educate yourself, and try new methods, you should be able to develop a useful tips of anxiety coping skills.
It may also be easier to learn effective anxiety reduction techniques with the guidance of a trained therapist. Online therapy is often an excellent way to begin your mental health journey if you don’t currently have a counselor.
What is it like to live with chronic anxiety?
Life with chronic anxiety is often quite stressful. Many people describe feeling constantly on edge, as though they’re always expecting something terrible to happen. Others may feel disproportionate levels of worry and fear about low-stakes situations or small mistakes. These can be characteristics of generalized anxiety disorder (GAD), which is what many people think of first when they hear the term “anxiety”.
Some anxiety disorders may involve more targeted fears. For example, panic disorder is often marked by persistent worries about having a debilitating panic attack. Other individuals may have specific phobias about things like heights, flying, or enclosed spaces.
Regardless of the specific focus of your worries, anxiety disorders can often lead to a sense of physical and emotional fatigue. Some people with these conditions may also struggle with focus because they’re frequently distracted by anxious thoughts. Chronic anxiety may also prompt people to steer clear of certain situations because they’re concerned it will trigger their anxiety. However, this type of avoidant behavior can often worsen anxiety disorders in the long run.
What happens if chronic anxiety is left untreated?
Untreated anxiety can have a variety of long-term negative outcomes, including diseases resulting from chronic stress. If symptoms of anxiety aren’t addressed, they may also lead to an increased risk of suicide.
Readers who are experiencing suicidal thoughts can reach helpful and compassionate volunteers 24/7 at the Suicide & Crisis Lifeline. You can chat online or call the lifeline by dialing 988.
Other potential negative outcomes of untreated anxiety disorders include:
- Damage to interpersonal relationships due to stress and irritability
- Unhealthy substance use behaviors
- Missing out on enjoyable or profitable experiences because of avoidant behavior
- Delayed career advancement due to impaired performance
- Social isolation
Does chronic anxiety get better?
A 2022 meta-analysis of clinical research suggests that symptoms of GAD and other anxiety disorders do sometimes improve on their own. In most cases, though, there’s only a small level of improvement. Only around 15% of untreated individuals studied showed a clinically significant decrease in anxiety throughout the study. Some conditions, such as specific phobia or panic disorder with agoraphobia, did not appear to get better on their own.
Research into this area is still relatively new, so further discoveries may change our understanding of the prognosis of untreated anxiety. Still, current evidence suggests that most people are unlikely to see much improvement in their anxiety unless they receive treatment.
Will my chronic anxiety ever go away?
It’s difficult to predict the outcome of any specific individual’s mental illness. However, studies suggest that, with treatment, many people can receive substantial relief from anxiety disorders. For example, the authors of a 2018 meta-analysis reported that slightly more than half of patients receiving cognitive-behavioral therapy (CBT) experienced remission, meaning that they no longer met the criteria for diagnosis of an anxiety disorder.
Even people who don’t achieve full remission with mental health care may drastically improve their ability to manage their anxiety disorders and function well in everyday settings. Pursuing treatment could help you greatly reduce the level of worry and fear you experience. You can also learn effective coping skills to help you enjoy life and pursue your goals even during the times when you do feel anxious.
How do I know if my anxiety is chronic?
According to the American Psychological Association, chronic anxiety is a state of worry, apprehension, or tension that is pervasive and persistent. In other words, you may have chronic anxiety if you feel worried all the time despite a lack of actual danger.
Others may define a chronic mental illness as one in which some symptoms persist for years despite treatment. If you receive help for your anxiety disorder but still have frequent anxious feelings that require active management, you could be considered to have a chronic condition.
How long does it take to treat chronic anxiety?
The necessary length of treatment for chronic anxiety disorders can vary depending on the treatment method selected. In many cases, the first-line treatment is cognitive behavioral therapy (CBT), which has a typical course of 6-20 weekly sessions. Some patients and providers may opt for intensive CBT (I-CBT), which involves longer and more frequent sessions and may be completed significantly sooner.
For those receiving pharmacological treatment, the first-line recommended medications are selective serotonin reuptake inhibitors (SSRIs) — although they were developed to treat depression, there’s evidence that they can also function as anti-anxiety medications. The effects of SSRIs may not be felt for 2-4 weeks, and it usually takes 6-8 weeks for them to be fully effective. To avoid the risk of relapse, experts recommend continuing to take medication for 12 months even after anxiety symptoms fade.
These treatment lengths are guidelines and averages. Some individuals may recover faster, while others may take more time. Certain people may need to try several different medications or types of psychotherapy before finding the one that works for them. It’s common for treatment to take longer when a patient has other mental health concerns in addition to anxiety.
How long does it take for chronic anxiety to occur?
The typical age of onset can vary between different anxiety disorders. A 2017 research review found that generalized anxiety disorder (the most common cause of chronic feelings of anxiety) most commonly begins between ages 21 and 35. Older onset is not uncommon, though there’s a substantial drop in prevalence past age 50.
Some anxiety disorders tend to begin earlier. The typical age of onset for social anxiety disorder is 13 years old, while specific phobias and separation anxiety disorder often show up around age 7. Panic disorder is most likely to occur around age 24.
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