Welcome to our Health Guide on Anxiety. This guide is designed to help you learn about anxiety disorders. By knowing more, you may feel more comfortable talking with a health professional about your experience and your symptoms.

You will be asked a short series of questions. Your answers will lead to suggested reasons for your anxiety. You may find that the information doesn’t quite fit your circumstances. Feel free to start over, picking different answers to learn about additional types of anxiety.

This guide cannot make a diagnosis and it is not intended to be a substitute for professional evaluation.

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Some people have anxiety all the time. Some have periods of anxiety that come and go.

Are you anxious or worried all the time or almost all the time, or do you have separate periods of anxiety that come on rapidly?

I'm anxious almost all the time.

I have separate periods of anxiety.

Some people have waves of panic, called panic attacks. They have intense fear and some uncomfortable physical symptoms, such as a pounding heart, sweating, trembling, shortness of breath or chest discomfort, stomach distress, lightheadedness or feeling like they're losing control.

Do you think you have panic attacks?

Yes, my symptoms fit this description.

No, I do not have these symptoms.

Some people never have typical panic attacks, but they're uncomfortable or anxious when in certain settings. They might always take stairs to avoid using an elevator or take a longer route to avoid driving through a tunnel.

The fear is not caused by having to perform or socialize.

Please tell us whether there are uncomfortable settings you avoid. (Anxiety about performance and being in social situations are addressed in separate questions.)

Even if you don't get severe anxiety attacks, are you afraid of getting stuck somewhere you can't escape. Do you avoid those situations because you fear becoming anxious (for example, being outside, in a crowd, on a bridge, bus, train or airplane)?

Yes, certain settings scare me and I avoid them.

No, I don't avoid specific settings.

Sometimes anxiety is limited to situations where you have to perform in front of a small or large group. You may dread giving a speech or playing at a music recital.

Is your anxiety limited to times when you're presenting yourself to a group of people (for example, giving a speech or performing a musical instrument)?

Yes, I get particularly anxious when I'm performing.

No, my anxiety is not related to performance.

For some people, it is most anxiety-provoking to enter a social situation, like a party or a work meeting. Even one-on-one encounters with new people can be dreadful.

Do you become particularly anxious when you are in a social setting?

Yes, I am very uncomfortable in social situations.

No, social situations do not particularly bother me.

For some people, a very specific trigger kicks off their anxiety symptoms. They work hard to avoid the scary thing, whether it is a dog, the doctor or flying in an airplane.

The person is afraid of the specific thing. They are not primarily worried about feeling trapped, about performing or being social.

Does your anxiety come on only when you're exposed to a particular situation or a thing you fear (for example, a dog, a doctor's visit, or flying)?

Yes, this applies to me.

No, nothing in particular triggers it.

Your answers do not point to one of the more common categories of anxiety. The problem may be short-lived, or it could be a response to a small change in your circumstances that you're not aware of.

You may want to contact your doctor to review your medical situation. If your anxiety persists, you could benefit from an evaluation by a psychiatrist or other mental health professional.

You may have a specific phobia (sometimes called a "simple" phobia"). This problem can be treated with either behavior therapy or medication. Sometimes it is helpful to combine both treatments.

You may have social anxiety disorder.

A person with social anxiety disorder may find it impossible to be in any public situation because of being irrationally self-conscious. You may have an intense fear of being criticized or negatively evaluated by others. A public situation may cause you to be anxious as you anticipate it. Severe anxiety or even panic may occur once you are in the situation itself.

Anyone may have these fears from time to time, but the disorder can be disabling. Fortunately, the disorder is very treatable. Symptoms can be significantly reduced or even eliminated with some combination of psychotherapy and medication.

You may have performance anxiety.

Performance anxiety is specific to a particular activity, like public speaking, acting, or being in a musical performance. In a sense, it is a form of social anxiety. But sometimes the anxiety-provoking performance is relatively private, such as taking a test.

This anxiety may be a small issue if you are never required to do the activity you fear, but it can be devastating if it blocks your progress in life. A lawyer who can't appear in court or an executive who can't make a public presentation may find it hard to advance. An otherwise talented artist may never succeed if performance undermines the ability to play or act.

This type of anxiety is usually very treatable with either psychotherapy, a medication (sometimes taken just prior to a performance), or both.

Based on your answers, you may have agoraphobia without panic disorder.

Agoraphobia is the fear of any place where it might be difficult to escape -- like being in a theater or a crowded mall, or traveling on a bus or an airplane. People with agoraphobia avoid such situations to avoid the anxiety that goes with them. Fortunately, the anxiety never reaches the level of panic.

Agoraphobia is a very treatable illness. The symptoms or discomfort may improve or be eliminated by psychotherapy alone, or with the addition of antianxiety medication.

Some people have their panic attacks triggered in specific situations that they like to avoid. Anticipating situations like being outside, in a crowd, on a bridge, a bus, train or airplane can be frightening.

Are you afraid of getting stuck somewhere you can't escape because you might have an anxiety attack? And do you avoid those situations?

Yes, this describes me.

No, I do not experience this.

You may have panic disorder.

You may have panic disorder with agoraphobia.

In panic disorder, you have regular panic attacks. Panic attacks can be very disturbing. They include sudden bursts of fear, perhaps accompanied by apprehension or a sense of doom. You may have physical symptoms, such as sweating, dizziness, a rapid heart rate, difficulty breathing, a choking feeling or stomach discomfort. You may shake or tremble, feel out of control, feel unreal or feel like you are dying or going crazy.

Panic disorder sometimes goes with agoraphobia. Agoraphobia is the fear of any place where it might be difficult to escape -- like being in a theater or a crowded mall, traveling on a bus or an airplane. People with agoraphobia avoid such situations because they fear having a panic attack.

Fortunately this disorder is very treatable. The symptoms are usually reduced or eliminated by a combination of psychotherapy and medication.

Some people have intrusive thoughts that make them anxious or they feel compelled to do certain things (like checking if the doors are locked) in order to ward off anxiety.

Do you have repetitive intrusive thoughts you can't get rid of that make you anxious (obsessions) along with feelings of being compelled to do things to reduce your anxiety (compulsions)?

Yes, I do have obsessions and/or compulsions.

No, I do not have obsessions or compulsions.

It is important to know when your anxiety problems started. Please tell us whether your anxiety is a longstanding or more recent problem.

Have you been worried or anxious much of your adult life, or is it a more recent phenomenon?

I have been worried for much of my adult life.

My anxiety started relatively recently.

Sometimes anxiety is a side effect of a medication that you are taking. Here are some drugs or groups of drugs that can cause anxiety:

• stimulants, such as Ritalin or amphetamines.

• caffeine in coffee or tea  -- any over the counter medications have caffeine in them (for example, some cough medicines, NoDoz and Excedrin)

• some decongestants (for example, Sudafed)

• psychiatric medications, including antidepressants

• hormones (for example, thyroid medication or birth control pills)

• asthma medications

• seizure medications.

Have your recently started or increased the dose of one of these types of medications?

Yes, I have.

No, my medications haven't changed.

Anxiety can begin after the death of someone you love or depend upon.

Has someone important to you recently passed away?

Yes, someone important to me recently passed away.

No, I have not experienced a loss recently.

Anxiety can begin after a stressful experience.

Have you recently had a stressful or painful experience, a life-changing event or an important loss?

Yes, this describes my recent situation.

No, this does not describe my situation.

At this time, we need to know if you are a man or a woman. Women can experience new or increased anxiety as they approach menopause.

I am a woman.

I am a man.

Sometimes anxiety can be related to the presence of a medical condition, such as heart disease, hyperthyroidism (an over active thyroid gland), and chronic lung disease.

You will probably need the help of your primary care physician to figure out if you have a medical problem that needs attention.

Do you have or might you have developed a medical illness at the time your anxiety began? Do you think your anxiety is related to developing a new medical condition?

Yes, I think this is possible.

No, this is unlikely.

Some women develop anxiety in the perimenopausal period, usually when a woman is in her late 40s or early 50s. Sometimes the anxiety can precede other symptoms such as irregular menstrual cycles and hot flashes.

Do you think your anxiety may be related to perimenopause?

Yes, this may be true for me.

No, this does not apply to me.

Sometimes anxiety can be related to the presence of a medical condition, such as heart disease, hyperthyroidism (an over active thyroid gland), and chronic lung disease.

You will probably need the help of your primary care physician to figure out if you have a medical problem that needs attention.

Do you have or might you have developed a medical illness at the time your anxiety began? Do you think your anxiety is related to developing a new medical condition?

Yes, I think this is possible.

No, this is unlikely.

Your answers do not point to one of the more common reasons for anxiety. You may be having a time-limited episode of anxiety that will go away soon. Or it could be an adjustment to a small change in your circumstances that you're not aware of.

You may want to contact your doctor to review your medical situation. If your anxiety persists, you could benefit from an evaluation by a psychiatrist or other mental health professional.

Also, consider going through the guide one more time. You may find that you wish to answer one or two questions differently.

Based on your answers, you may have anxiety due to a medical condition.

Anxiety can sometimes be produced by a non-psychiatric physical illness. Heart disease may cause anxiety and dread. An overactive thyroid may cause jitters. Respiratory conditions, like asthma or chronic lung diseases can cause anxiety symptoms. It's important to check your general health with your primary care provider to see if an underlying medical condition can be treated.

Anxiety is sometimes a symptom during the period prior to menopause called perimenopause. Some women will experience depression, irritability or mood swings during this period. Perimenopause symptoms may occur up to 15 years prior to a woman losing her period completely. If these symptoms are more than a small bother, you should talk to your primary care physician, gynecologist or a mental health professional about ways to manage these symptoms.

You will probably need the help of your primary care physician to figure out if you have a medical problem that needs attention.

You may have an acute stress disorder.

A diagnosis of acute stress disorder is made if you have very recently experienced a traumatic event, you keep re-experiencing the trauma, and you avoid reminders of the trauma. Anxiety after trauma is normal. It generally is very helpful to rely upon friends and family for support. It is probably not a good idea to spend too much time reliving the trauma, because that can make you feel worse rather than better. Instead focus on trying to manage your symptoms and maintaining your functioning as much as you can.

But if symptoms last for many months or you can't get on with your life, you may find it helpful to seek treatment through your primary care provider or a mental health professional.

You may be experiencing a grief reaction.

Grief is a painful, but unavoidable part of life. In most instances, the way to cope with it is by leaning on family and friends for emotional support and practical help, or turning to meaningful activities like spiritual practice or hobbies. Most often, grief looks like depression, but anxiety can be a big part of the picture.

When anxiety (or depressive) symptoms are severe, medication can help take the edge off or help you get some sleep. The pain of grief may never go away completely. But if symptoms last longer than six months, it may be worth seeing your primary care provider or a mental health professional to see if ongoing treatment for an anxiety disorder (psychotherapy and/or medication) makes sense.

Ask your primary care doctor if a medication change might be related to your anxiety.

Some people have anxiety problems as a result of a severely traumatic experience.

For the purposes of this question, trauma is defined as an event where you were threatened with death or severe injury, or you were close by when someone else was threatened in this way. As a result of this experience, you would have felt very afraid or helpless. Examples would be frightening wartime experiences or being the victim of a violent crime.

Losses, such as the death of a loved one after a prolonged illness, are very painful and may lead to anxiety, but do not fit the definition for this question. (Experiences of loss and milder forms of trauma are dealt with in another question.)

Have you been exposed to a severe traumatic event or life experience in the past?

Yes, I have experienced severe trauma.

No, I have not experienced severe trauma.

All kinds of drugs and substances can cause anxiety symptoms. The most common one is caffeine. So can cocaine and other stimulants, and hallucinogens like LSD.

Anxiety can come as a result of withdrawing from alcohol or some anti-anxiety drugs.

Please tell us whether there's been any change in your pattern of using alcohol or drugs.

Have you begun to drink more or less alcohol or changed the way you use drugs?

Yes, my alcohol or drug use has recently changed.

Yes, I use alcohol or drugs, but it is no different than ever.

No, I don't use alcohol or drugs.

You may have generalized anxiety disorder.

You may have a substance-induced anxiety disorder, or you may be drinking or using drugs as part of a generalized anxiety disorder.

You may have a substance-induced anxiety disorder, or you may be drinking or using drugs as part of a generalized anxiety disorder.

You may have post traumatic stress disorder (PTSD).

You may have obsessive compulsive disorder (OCD).