Everyone knows ordinary anxiety: butterflies before a first date, tension when the boss is angry. It can be useful, pushing us to study or prepare. But when anxiety is constant and disrupts several areas of life, it's an anxiety disorder, an illness rather than just "nerves," which can damage relationships if left untreated. It often runs in families ("my sister's nervous, just like Mom") and is accepted as unchangeable, though therapy can treat it.
What it looks like. Lisa, a young mother of two, describes days of worrying over small decisions such as dinner or a friend's gift, being unable to switch off even during intimacy, trouble falling asleep, inability to concentrate on reading or a movie, a racing heart before guests arrive, and panic if her daughter is ten minutes late. An anxiety disorder means fear and tension without apparent reason, constant anticipation that something will go wrong, exaggerated health fears ("Is this stomachache cancer?"), fear of losing money or a job, and a sense of impending disaster. People with it always find something to worry about, can't relax even in sleep, and may wake at night. Physical symptoms include trembling, neck and back pain, headaches, irritability, shortness of breath, nausea or diarrhea, fatigue, and bouts of sadness and crying. Those who've had it since childhood often think "that's just who I am," but psychotherapy is usually very effective within months.
Panic attacks
Panic attacks strike suddenly with uncontrollable terror. Symptoms include a pounding heart, chest pain, dizziness, nausea, flushed cheeks, heat in the face, shortness of breath, feeling out of control, fear of dying and sweating. People may feel they're having a heart attack or losing their mind, though it passes in minutes. The author cites about six million Americans affected, more often women. People start avoiding places where an attack happened (elevators, driving, going out alone) and become dependent on family. About a third develop agoraphobia, fear of crowded public places. Psychotherapy, sometimes with medication, helps people recover in a relatively short time.
Phobias
Phobias are irrational fears of specific situations, objects or animals. Martín, 27, avoids all travel because he feels trapped and out of control once a plane's door closes. Others fear heights, stairs, tunnels or traffic jams, sometimes selectively (afraid of the tenth floor but not of skiing a mountain, of a mouse but not a tiger). People know the fear is irrational but can't face it, and exposure can trigger a panic attack. Phobias often run in families and may start in childhood or adolescence; adult-onset phobias tend to persist longer. The author estimates about 20% of adults have a specific phobia, and some hold back their careers and lives to avoid triggers. Psychotherapy and relaxation exercises help a great deal.
Children
When children have anxiety, panic attacks or phobias, treat them early, because these problems worsen rather than resolve on their own. Parents may shrug it off ("he's just like his father"), but anxiety causes school problems through poor concentration, restlessness, irritability and sleep trouble, and keeps a child from enjoying childhood.