Anxiety: What Is It And Do You Have it?

What is Anxiety?

There are as many definitions of anxiety as there are potential reasons to be anxious.  One definition of anxiety is that it is “A painful or apprehensive uneasiness of mind usually over an impending or anticipated ill. It is a fearful concern, marked by physiological symptoms, by doubt concerning the nature of the threat and by self-doubt concerning one’s capacity to cope with it.”

Another definition of anxiety is “ that it is a psychological, physiological, and behavioral state induced in animals and humans by a threat to well-being or survival, either actual or potential. It is characterized by increased arousal, expectancy, autonomic and neuroendocrine activation, and specific behavior patterns. The function of these changes is to facilitate coping with an adverse or unexpected situation. Pathological anxiety interferes with the ability to cope successfully with life challenges.”

Some common symptoms associated with anxiety include:

  • panicky feelings
  • racing heart and chest discomfort
  • dizziness or light-headedness
  • feelings of bewilderment and unreality
  • scary, uncontrollable thoughts
  • nausea, upset stomach, diarrhea
  • hot and cold flashes
  • numbness or strange aches and pains,
  • muscle tension
  • feelings of depression and hopelessness

Common worries people with anxiety have include the following:

  • having a heart attack
  • going insane
  • losing control
  • embarrassment
  • death
  • illness
  • hurting themselves or someone else
  • fainting
  • difficulty breathing

The Neurobiology of Anxiety

The following describes what happens in the brain and the body when a person experiences anxiety.  The experience of anxiety primarily arises from the limbic system of the brain (often called the emotional brain). In simple terms, the limbic system is comprised of the thalamus, the hypothalamus, the hippocampus and the amygdala.  Each part of the limbic system plays a role in generating anxiety, but it begins in the thalamus which is a relay station for incoming information about the external world. The thalamus takes information from our senses (sight, sound, touch, taste, and smell) and assesses it for possible danger.  This information then travels through the brain down what is often referred to metaphorically as either the low road or the high road.

The low road refers to circuitry involving the amygdala which is the early warning or alarm station of the brain.  This part of the brain operates unconsciously.  It is an automatic response to what is perceived as immediate danger. The high road circuitry involves another part of the brain referred to as the cortex, the part of the brain that is needed for conscious thought, the formulation of ideas and the attribution of meaning.  The part of the cortex which is significant to anxiety is the prefrontal cortex which processes information, maintains conscious attention, forms behavioral responses and makes meaning of sensory experience.

When danger is perceived by either road, the brain mobilizes its response to the stress.  This response is often described as “fight, flight or freeze”.  It involves the hypothalamus-pituitary-adrenal (HPA) axis which is the brain system that initiates the stress response to prepare the body to respond to a stressor. The hypothalamus initiates the response by releasing a peptide called corticotropin release factor to the pituitary gland.  The pituitary in turn releases adrenocorticotropin to the adrenal gland which releases adrenalin and cortisol.  The HPA axis starts the sympathetic nervous system arousal which results in increased heart rate and respiration and the redirection of blood flow.  This response also uses up neurochemicals such as serotonin, dopamine and norepinephrine.

Thus when the stress response is initiated, it causes changes in neurochemicals, breathing, blood flow and motor responses.  These responses are meant to be short-term reactions to danger in the environment, but they can be initiated not only by actual dangers but also by thoughts of danger and particularly thoughts that have been associated with danger in the past.  When an experience has been associated with danger in the past, even the anticipation or thought of that experience can trigger the stress responses described above.  One of the greatest factors determining whether a stress response will be initiated is the meaning attributed to the potentially threatening experience.  When stressors (be they internal or external) are constant, the stress response described above functions continuously and anxiety results.

An Anxiety Self Test

If you are curious about whether you may be experiencing anxiety, take this quick self test.

1. Are you troubled by the following?

Repeated, unexpected panic attacks during which you suddenly are overcome by intense fear or discomfort for no apparent reason; or the fear of having another panic attack
Yes / No

Persistent, inappropriate thoughts, impulses, or images that you can’t get out of your mind (such as a preoccupation with germs, worry about the order of things, or aggressive or sexual impulses)
Yes \ No

Powerful and ongoing fear of social situations involving unfamiliar people
Yes \ No

Excessive worrying (for at least six months) about events or activities
Yes \ No

Fear of places or situations where getting help or escape might be difficult, such as in a crowd or on a bridge
Yes / No

Shortness of breath or a racing heart for no apparent reason
Yes / No

Persistent and unreasonable fear of an object or situation, such as flying, heights, animals, blood, etc.
Yes No

Inability to travel alone
Yes No

Spending more than one hour a day doing repetitive actions (hand washing, checking, counting, etc.)
Yes / No

Experience or witnessing a traumatic life-threatening or deadly event or serious injury (such as military combat, violent crime, or serious accident)
Yes / No

2. More days than not, do you experience the following?

Feeling restless
Yes / No

Feeling easily tired or distracted
Yes / No

Feeling irritable
Yes / No

Tense muscles or problems sleeping
Yes / No

Your anxiety interfering with your daily life
Yes / No

3. Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate anxiety disorders.

In the last year have you experienced changes in sleeping or eating habits?
Yes / No

More days than not, do you feel sad or depressed?
Yes / No

More days than not, do you feel disinterested in life?
Yes / No

More days than not, do you feel worthless or guilty?
Yes / No

4. During the last year, has the use of alcohol or drugs…

Resulted in your failure to fulfill responsibilities with work, school, or family?
Yes / No

Placed you in a dangerous situation, such as driving a car under the influence?
Yes / No

Gotten you arrested?
Yes / No

Continued despite causing problems for you or your loved ones?
Yes / No


The more times you answered yes on the anxiety disorder quiz, the more likely it is you may suffer from an anxiety disorder.

Sections one and two of the anxiety disorder test above are designed to indicate an anxiety disorder, while sections three and four screen for conditions that may complicate anxiety disorders – such as depression or substance use.

Anxiety: What Is It And Do You Have It