"I'm worried. I just know something bad is going to happen."

What is anxiety?

Symptoms of anxiety include:

• Unpleasant emotions like anxiety, apprehension, and panic;
• Behaviors like escaping or avoiding uncomfortable situations, checking and re-checking to prevent mistakes, worry, repeatedly asking others for reassurance;
• Cognitions (thoughts) like, "I'm going to fail," "Bad things are going to happen," "I won't be able to cope," as well difficulty making decisions, difficulty concentrating, frightening nightmares or daydreams;
• Physical symptoms like fatigue, palpitations, sweating, hot flashes or cold chills, butterflies, nausea, headaches, muscle tension, loss of appetite.

Symptoms of anxiety occur in many disorders, including panic disorder and agoraphobia, social phobia, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, depression, bipolar disorder, hypochondriasis, and schizophrenia. Anxiety symptoms can also result from medical problems. Anxiety is normal and appropriate when life stresses are high. Common symptoms that accompany anxiety include depression, a tendency to overuse alcohol or other substances, and marital and other interpersonal problems.

Cognitive-behavioral model of anxiety
Several cognitive-behavioral models of anxiety have been proposed and are supported by data from scientific studies. In the most important model, which was developed by Dr. Aaron T. Beck at the University of Pennsylvania, anxious emotions result from distorted thinking and dysfunctional behaviors that are activated by triggers, which are often stressful life events. Thus, for example, after encountering a major traffic jam and arriving late for work, a person might have the thought, "I'm going to lose my job," and this thought might cause emotions of fear and anxiety, and behaviors of worry and asking the boss for reassurance that he is not angry about the lateness. Other cognitive-behavioral models point to other factors that can cause or contribute to anxiety, including overwhelming or intractable life problems, poor problem-solving skills, the loss of important sources of pleasure and satisfaction, and difficulty modulating and regulating emotions. All of the models also allow for a role for biological factors as causing and maintaining anxiety.

Cognitive-behavior therapy for anxiety
Cognitive-behavior therapy for anxiety is so-named because it emphasizes teaching the anxious person to identify and take steps to gradually change the thinking (cognitions) and behaviors that cause and maintain anxious emotions, with the notion that if the cognitions and behaviors change, the emotions will also change. Cognitive-behavior therapy for anxiety typically involves taking steps to approach feared situations rather than to escape or avoid them. Although escape and avoidance behaviors are helpful in the short term by reducing anxiety and distress, in the long term they feed the problem. Therapy may also focus on helping the anxious person develop and use skills to solve overwhelming life problems, find new or regain old sources of pleasure and satisfaction, and regulate emotions.

Additional resources

Web links:
The Anxiety Disorders Association of America
The Association for Behavioral and Cognitive Therapies
Freedom from Fear

Books:
For links to purchase these books and others, please go to Self-Help Books for Adults

Bourne, E. J. (2005). The anxiety and phobia workbook 4th edition. Oakland, CA: New Harbinger Press.

Burns, D. D. (1989). The feeling good handbook: Using the new mood therapy in everyday life. New York, NY: William Morrow and Company.

Foa, E. B., & Wilson, R. (1991). Stop obsessing! How to overcome your obsessions and compulsions. New York, NY: Bantam.

Markway, B. G., Carmin, C. N., Pollard, C. A., & Flynn, T. (1992). Dying of embarassment: Help for social anxiety and phobia. Oakland, CA: New Harbinger Press.

Schwartz, J. M. (1996). Brain lock: Free yourself from obsessive-compulsive behavior. New York, NY: ReganBooks.

Zuercher-White, E. (1995). An end to panic: Breakthrough techniques for overcoming panic disorder. Oakland, CA: New Harbinger Press.