What are the Symptoms of Anxiety Disorder? A Detailed Look at Physical and Mental Signs

Anxiety disorder is a mental health condition characterized by strong anxiety or fear that affects daily life. Unlike temporary worries or nervousness, this anxiety can be persistent or manifest as uncontrollable panic in specific situations.
These symptoms can sometimes be accompanied by physical discomfort and interfere with various aspects of life, including work, school, and relationships. However, anxiety disorder is a condition that can be improved with proper understanding, coping strategies, and professional support.
This article explains the symptoms of anxiety disorder in detail, from physical and mental signs to the characteristics of different types. If you are struggling with symptoms yourself or know someone who is, we hope this article serves as a first step and encourages you to consider consulting with a professional.

What is Anxiety Disorder? Overview and Mechanism

Anxiety disorder is a general term for mental illnesses that have anxiety and fear as core symptoms. While anxiety and fear are typically natural emotions that help us avoid danger or alert us, in anxiety disorders, these emotions are excessively strong, persistent, or uncontrollable compared to the actual danger. This condition significantly interferes with daily life and social functioning.

The development of anxiety disorder is believed to be influenced by a complex interplay of various factors. Imbalances in brain neurotransmitters (such as serotonin, norepinephrine, and GABA) and dysfunction in areas like the amygdala (involved in emotions, especially fear) and the prefrontal cortex (involved in thinking and judgment) are suggested.
Also, genetic factors, childhood experiences, personality traits (such as sensitivity and proneness to worry), stress, and environmental factors (such as relationships and changes in work) are also thought to play a role.

The difference between ordinary anxiety and anxiety disorder lies in the severity, duration, and impact on daily life. For example, feeling nervous before an exam is natural anxiety, but if you constantly feel intense anxiety even in everyday situations unrelated to exams, or if anxiety prevents you from being in front of others, it could be anxiety disorder.

Common Symptoms Shared Across Anxiety Disorders

While there are several types of anxiety disorders, there are common physical and mental symptoms observed in many of them.

Physical Symptoms

Anxiety affects not only the mind but also the body in various ways. The following are common physical symptoms seen in anxiety disorders:

• Palpitations, Increased Heart Rate: A feeling of the heart pounding or a rapid pulse.
• Shortness of Breath, Feeling of Suffocation: Feeling breathless, the sensation of not being able to get enough air, or hyperventilation (overbreathing).
• Sweating: Prone to sweating in the palms or underarms, or experiencing cold sweats.
• Trembling, Shaking: Shaking of hands or voice, or fine trembling of the body.
• Nausea, Abdominal Discomfort: Stomach upset, nausea, abdominal pain, or diarrhea.
• Dizziness, Lightheadedness: Feeling dizzy, faint, or like you might collapse.
• Muscle Tension: Stiffness in the shoulders or neck, a feeling of tension throughout the body.
• Insomnia, Sleep Disturbances: Difficulty falling asleep, waking up multiple times during the night, or not feeling well-rested.
• Fatigue: Feeling tired even after adequate rest, or feeling heavy.
• Headache: Can experience tension-type headaches, a band-like tightness around the head.

These physical symptoms occur due to excessive activation of the autonomic nervous system by anxiety and fear. When symptoms are severe, they can further increase anxiety, leading to worries like “Is something seriously wrong with me?”

Mental Symptoms

Anxiety disorder also affects thoughts, emotions, and behavior. The following are common mental symptoms seen in anxiety disorders:

• Excessive Worry, Anticipatory Anxiety: Worrying excessively and persistently about future events or various things. Thoughts like “What if…?” become difficult to shake off. Anticipatory anxiety, the fear of having another anxiety attack, is particularly characteristic of panic disorder.
• Restlessness, Feeling Edgy: Finding it difficult to sit still, constantly feeling the need to be doing something, or feeling fidgety and unsettled.
• Difficulty Concentrating: Finding it hard to focus on what’s in front of you due to being preoccupied with anxiety or worries, and experiencing increased forgetfulness.
• Irritability, Increased Sensitivity: Becoming easily annoyed or emotional over minor things.
• Feeling of Tension: A constant feeling of physical tension, unable to relax.
• Racing Thoughts: Anxious thoughts repeating in the mind, feeling trapped in a cycle.
• Avoidance Behavior: Beginning to avoid situations or places that cause anxiety or fear. This can lead to restrictions in daily life.

These mental symptoms arise when anxiety and fear affect thought processes and emotional regulation. When anxiety becomes severe, it can become difficult to make rational judgments or may lead to extreme behavior.

Symptoms of Different Types of Anxiety Disorders

Anxiety disorders are classified into several types based on the object or situation that triggers anxiety and fear. Each type has characteristic symptoms.

Symptoms of Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is characterized by excessive and persistent worry about various events in daily life (such as work, school, health, finances, family) rather than specific objects or situations. This worry is difficult to control and often lasts for at least six months.

The main symptoms of GAD are as follows:

• Excessive worry about various things (worry is not limited to specific objects)
• Finding it difficult to control worry
• Restlessness, tension, or feeling edgy
• Fatigue, feeling easily tired
• Difficulty concentrating, the feeling of the mind going blank
• Irritability, increased sensitivity
• Muscle tension (such as stiffness in the shoulders or neck)
• Sleep disturbances (difficulty falling asleep, waking up during the night, not feeling well-rested)

People with GAD are in a constant state of worrying that “something bad might happen.” This worry is incessant and can be physically and mentally exhausting.

Symptoms of Panic Disorder

Panic disorder is characterized by recurrent, unexpected panic attacks, which are sudden periods of intense fear or discomfort. Panic attacks can occur not only in specific situations but also unexpectedly while relaxing or during sleep.

Specific Symptoms of Panic Attack

A panic attack is a sudden onset of intense fear or discomfort that typically peaks within 10 minutes. During an attack, at least four of the following symptoms appear abruptly:

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feeling of being choked
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Derealization (feelings of unreality) or depersonalization (being detached from oneself)
• Fear of losing control or going crazy
• Fear of dying
• Paresthesias (numbness or tingling sensations)
• Chills or hot flashes

These symptoms are very intense, and during an attack, individuals experience intense fear like “I might die,” “I’m having a heart attack,” or “I’m losing my mind.” After experiencing a panic attack, they often develop strong anticipatory anxiety, the fear of having another attack, and may begin to avoid places or situations where attacks have occurred (leading to the development of agoraphobia).

Symptoms of Social Anxiety Disorder (SAD)

Social Anxiety Disorder (SAD), formerly known as social phobia, is characterized by intense fear or anxiety in social situations where one might be scrutinized or evaluated by others (such as public speaking, talking to strangers, eating in public, writing in front of others). This fear is based on the dread of being embarrassed, humiliated, or negatively evaluated by others.

The main symptoms of SAD are as follows:

• Experiencing intense anxiety or fear in specific social situations
• Avoiding social situations that cause anxiety or fear, or enduring them with intense anxiety
• Anxiety or fear that is excessive and out of proportion to the actual threat
• Anxiety or fear that causes significant distress or impairment in social, occupational, or other important areas of functioning

Physical symptoms accompanying SAD often include blushing, sweating, trembling, stuttering, nausea, and palpitations. The appearance of these physical symptoms itself can create a vicious cycle that further increases anxiety.

Symptoms of Specific Phobia

Specific phobia is a disorder characterized by intense fear or anxiety about a specific object (such as animals, insects) or situation (such as heights, enclosed spaces, flying, certain sounds). When faced with the feared object or situation, individuals experience a strong anxiety response, sometimes approaching a panic attack. Avoiding the feared object can interfere with daily life.

The main symptoms of specific phobia are as follows:

• Experiencing significant fear or anxiety when exposed to a specific object or situation
• Avoiding the feared object or situation, or enduring it with intense anxiety
• Fear that is excessive and out of proportion to the actual danger posed by the object or situation
• Fear or avoidance behavior that causes significant distress or impairment in daily life

Common specific phobias include acrophobia (fear of heights), claustrophobia (fear of enclosed spaces), animal phobias (dogs, snakes, spiders, etc.), natural environment phobias (thunderstorms, darkness, etc.), and blood-injection-injury phobia. A characteristic of blood-injection-injury phobia is the possibility of fainting as a response to fear.

Symptoms of Agoraphobia

Agoraphobia is an intense fear of situations or places where escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (such as incontinence, vomiting, falling). Agoraphobia is commonly seen in individuals with a history of panic disorder, but it can also develop in those without such a history.

Situations that people with agoraphobia tend to fear include:

• Using public transportation (trains, buses, airplanes, etc.)
• Being in open spaces (parking lots, marketplaces, bridges, etc.)
• Being in enclosed places (shops, theaters, cinemas, etc.)
• Standing in line or being in a crowd
• Being outside the home alone

Because people with agoraphobia tend to avoid these situations, it can become difficult to leave the house, leading to significant restrictions in daily life.

Symptoms of Separation Anxiety Disorder

Separation Anxiety Disorder is characterized by excessive anxiety or fear concerning separation from attachment figures (such as parents or spouses) that is inappropriate for the developmental level. It is most commonly diagnosed in childhood, but it can also occur in adulthood.

The main symptoms of Separation Anxiety Disorder are as follows: (Focusing on adulthood)

• Excessive anxiety or worry about separation from attachment figures or about harm befalling attachment figures
• Reluctance or refusal to go to places (such as work, school, or on trips) associated with separation from attachment figures
• Strong resistance to being alone without attachment figures nearby
• Difficulty sleeping away from attachment figures or being unable to sleep without them nearby
• Nightmares involving separation
• Complaints of physical symptoms (such as headaches, stomachaches, or nausea) when separation is anticipated

In adulthood, separation anxiety disorder can manifest as excessive anxiety about separation from a partner or one’s own children. This can interfere with work and other activities.

Symptoms of Selective Mutism

Selective Mutism is a disorder characterized by a consistent failure to speak in specific social situations (such as school, work, or in front of certain friends or relatives) despite being able to speak in other situations (such as at home). This is different from mere shyness and is a state where the individual is unable to speak due to anxiety.

The main symptoms of Selective Mutism are as follows:

• Consistent failure to speak in specific social situations (but speaks in other situations)
• The failure to speak has lasted for at least one month (not limited to the first month of school)
• The failure to speak interferes with educational or occupational achievement, or with social communication
• The failure to speak is not due to a lack of knowledge of or comfort with the spoken language required in the social situation, and is not better explained by another mental disorder

Children and adults with selective mutism may have a lack of expression or appear stiff in situations where they cannot speak. Although they may want to speak, they are unable to due to anxiety.

About Severe Anxiety Symptoms

When anxiety symptoms become severe, the impact on daily life can be immeasurable. It may become difficult to continue with work or school, or individuals may become housebound and socially isolated. Furthermore, intense anxiety and despair can lead to suicidal thoughts in some cases.

Severe anxiety symptoms are debilitating and can increase the risk of developing other mental illnesses such as depression, as well as physical conditions such as high blood pressure and heart disease. It is extremely important not to dismiss it as just a matter of willpower but to seek appropriate medical care. In particular, if there are thoughts of wanting to die, or impulses to harm oneself or others, these are signs of high urgency.

Characteristics of Anxiety Symptoms in Women

Statistically, anxiety disorders tend to be diagnosed more often in women than in men. Possible reasons for this include fluctuations in hormone levels (during puberty, pregnancy/postpartum period, menopause, etc.) and social factors (gender roles, burden of childcare and eldercare, etc.).

While there are no clear gender differences in the symptoms themselves, some reports suggest that women may experience physical symptoms more intensely than men. Furthermore, hormonal fluctuations during the menstrual cycle can affect the severity of anxiety symptoms. Anxiety during pregnancy and the postpartum period is particularly concerning as it can affect the health of both mother and child and requires special attention.

Differences Between Anxiety Disorder and Depression Symptoms and Comorbidity

Both anxiety and depression are conditions that involve mental distress, but their symptoms differ. Anxiety disorder is centered around excessive worry and fear about the future, while depression is characterized by low mood, loss of interest or pleasure, and lack of motivation.

However, anxiety and depression very often occur together. It is not uncommon for individuals with anxiety disorder to develop depression or for individuals with depression to also experience strong anxiety. When both symptoms are present, they can exacerbate each other. For example, anxiety might prevent someone from going out, which in turn leads to further worsening of their mood.

When both symptoms are present, diagnosis and treatment can become more complex. A doctor will carefully determine which symptom is more dominant or if both need to be treated simultaneously. Distinguishing between anxiety and depression and determining the presence of comorbidity is difficult without professional expertise, so it is important to consult a medical professional rather than self-diagnose.

Anxiety Disorder Symptoms: When to Seek Medical Attention

Anxiety and worry are emotions everyone experiences, but the following are signs that indicate you should consider seeking medical attention (from a psychiatrist or psychosomatic medicine specialist):

• Symptoms have been ongoing for a long time: If intense anxiety or physical symptoms have persisted for several weeks or months.
• Daily life is being affected: If symptoms are causing significant disruption to your life, such as being unable to go to work or school, difficulty concentrating, impaired social relationships, or being unable to leave the house.
• Feeling unable to control it: If you try to suppress anxiety or worry but cannot, and it escalates further.
• Physical symptoms are severe and distressing: If palpitations, shortness of breath, dizziness, etc., occur frequently and physical discomfort persists.
• Worried about having another illness: If you are concerned about physical symptoms but tests at internal medicine clinics show no abnormalities.
• Suffering alone: If you are unable to talk to anyone and are struggling on your own.
• Having suicidal thoughts: If you are having thoughts of wanting to die.

If you notice these signs, gather the courage to consult with a professional. Seeking appropriate support early is a shortcut to recovery.

Diagnosis Methods for Anxiety Disorder

Anxiety disorder is diagnosed by a doctor (a psychiatrist or psychosomatic medicine specialist). Diagnosis is primarily based on the patient’s history (interview).

During the interview, the doctor will ask in detail about the following:

• What symptoms are present (physical and mental symptoms)
• When the symptoms started, their frequency and intensity
• Whether symptoms worsen in specific situations
• How the symptoms affect daily life (work, school, relationships, etc.)
• Whether you have experienced mental health problems in the past
• Whether there is a history of mental illness in the family
• Current living situation and stress levels
• Alcohol or drug use
• Presence of physical illnesses and current medications

If necessary, psychological tests (such as questionnaires or projective tests) may be conducted. Physical examinations, such as blood tests, may also be performed to rule out the possibility that anxiety symptoms are caused by a physical illness (such as hyperthyroidism).

Diagnosis is made based on international diagnostic criteria (such as DSM-5 or ICD-10). These criteria consider factors such as whether specific symptoms have persisted for a certain period and if they are causing impairment in daily life. Diagnosis requires specialized knowledge, so it is important to consult a specialized medical institution.

Main Treatments for Anxiety Disorder

Treatment for anxiety disorder primarily includes medication and psychotherapy. In many cases, these treatments are combined.

Medication:
Various types of medications are used to relieve anxiety symptoms.

• SSRI (Selective Serotonin Reuptake Inhibitors) and SNRI (Serotonin and Norepinephrine Reuptake Inhibitors): Effective for both anxiety disorder and depression, they are often the first-line treatment for anxiety disorders. They work by adjusting the activity of neurotransmitters like serotonin and norepinephrine in the brain, improving anxiety and low mood. It may take several weeks for the effects to appear.
• Benzodiazepine Anxiolytics: Have a rapid effect and are effective in temporarily suppressing severe anxiety or panic attacks. However, due to the risk of dependence, they are not recommended for long-term use and are often used as as-needed medication.
• Other Medications: Beta-blockers (to suppress physical symptoms like palpitations and tremors), non-benzodiazepine anxiolytics, and antipsychotics may be used as adjuncts if necessary.

It is important to take medication correctly according to the doctor’s instructions. Do not adjust the dose or stop taking it on your own.

Psychotherapy:
This type of therapy aims to change patterns of anxiety and fear or to teach coping strategies for symptoms.

• Cognitive Behavioral Therapy (CBT): A therapy that aims to reduce anxiety by working on thought patterns (cognitions) and behavioral patterns that trigger anxiety. For example, it may involve gradually exposing oneself to feared situations (exposure therapy) or practicing changing negative thoughts to more realistic ones. CBT is an evidence-based treatment for anxiety disorders and is a recommended therapy.
• Other Psychotherapies: Morita therapy or interpersonal therapy may also be used depending on individual circumstances.

Combining medication and psychotherapy can be expected to yield better results. The choice of treatment is decided in consultation with a doctor, considering the type and severity of symptoms, and the patient’s preferences.

Coping with Anxiety Disorder Symptoms and Self-Help Strategies

In addition to receiving professional treatment, self-care and coping strategies that can be practiced in daily life can also help alleviate anxiety symptoms.

Daily Life Strategies

• Relaxation Techniques: Incorporating deep breathing, abdominal breathing, progressive muscle relaxation, or meditation into your daily routine can help relax the body and calm the mind.
• Moderate Exercise: Making exercise that you enjoy, such as walking, jogging, or yoga, a habit can reduce stress and improve mood.
• Sufficient Sleep: Ensuring quality sleep by maintaining a regular sleep schedule and optimizing your sleep environment is crucial.
• Balanced Diet: Eating a nutritionally balanced diet and reducing consumption of caffeine and alcohol can also help alleviate anxiety symptoms. Caffeine and alcohol can exacerbate anxiety.
• Stress Management: It is important to identify the causes of stress and find ways to cope with them, or to make time for hobbies and refreshing activities.
• Thought Recording: Recording the situation, thoughts, emotions, and physical symptoms when you feel anxious can help you understand your anxiety patterns and find clues for coping strategies.
• Challenging Anxious Thoughts: When faced with unrealistic worries like “What if…?”, practice asking yourself questions like “How likely is that really?” or “Are there other possibilities?” to find more realistic ways of thinking.

Approaches Other Than Professional Treatment

• Support Groups: Sharing experiences and supporting each other with people who are struggling with similar anxiety symptoms can alleviate feelings of isolation and help maintain a positive outlook.
• Peer Support: Support from peer supporters (individuals with lived experience) can provide empathy and understanding, leading to hope for recovery.

These coping strategies can enhance the effectiveness of professional treatment and help prevent symptom recurrence. You don’t need to start everything at once. Try incorporating what you can, little by little.

Is It Possible to Live a Normal Life While Having Anxiety Disorder?

While the definition of “normal life” varies from person to person, it is definitely possible to live a fulfilling life that is authentic to you while having anxiety disorder. With proper diagnosis, appropriate treatment, and self-care, many people can learn to control their symptoms.

As symptoms improve, you may become able to challenge situations you previously avoided, or resume work or relationships. While it may be difficult for anxiety to disappear completely, it is possible to manage anxiety and work towards your goals.

What’s important is not to suffer alone but to seek support from professionals and those around you. Understanding based on accurate information and a spirit of not giving up will pave the way to recovery.

Conclusion

The symptoms of anxiety disorder are highly diverse, both physically and mentally, and their severity can be difficult for others to fully understand. Physical symptoms like palpitations and shortness of breath, and mental symptoms like excessive worry and fear, can significantly impact daily life.

This article has explained the common symptoms of anxiety disorder and the characteristic symptoms of different types, including Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Specific Phobia, Agoraphobia, Separation Anxiety Disorder, and Selective Mutism. We also discussed the risks of severe symptoms, characteristics in women, the link with depression, when to seek medical attention, diagnosis and treatment methods, and self-help strategies you can practice.

If you or a loved one is struggling with anxiety symptoms, the first step is to be aware that these symptoms might be due to an anxiety disorder. Then, gather the courage to consult with a professional, such as a psychiatrist or psychosomatic medicine specialist. A professional can understand your difficulties and propose an appropriate diagnosis and treatment plan.

Anxiety disorder is not a special condition; it is a state of mind that anyone can experience. With appropriate support, symptoms can improve, and it is entirely possible to regain a life that is authentic to you. Don’t suffer alone; please consult with a professional.

Disclaimer: This article is for informational purposes only and does not provide medical advice. For your symptoms, always consult a specialized medical institution and follow the doctor’s instructions. The author and publisher assume no responsibility for any consequences resulting from actions taken based on the information in this article.