Impact Of Anxiety Disorder

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 20, 2021

It’s been long known that anxiety and stress cause an increase in activity in the fear center of the brain (the amygdala and other parts of the brain) and a decrease in activity in the executive function parts of the brain (the prefrontal cortex and others).

However, this is the first time brain scans have been used to examine how emotion-regulation circuits are changed by anxiety and chronic stress in children.

The takeaway, however, is not that the brain is malfunctioning or damaged in some way due to anxiety, but that the brain is responding the way it’s supposed to when we think we are in danger. This change in brain function is an integral part of the body’s survival mechanism.

We explain this change in brain function in more detail in our “Stress Response” article.

We can remedy this change by behaving calmly instead of anxiously. As we use calming behavior, the executive function parts of the brain increase in activity, and the fear center decreases. Thus, restoring our ability to regulate our emotions.

So, it’s not that we can’t regulate our emotions when we’re anxious, but a matter of learning how so that we can gain more control over our emotions when we are anxious.

Recovery Support members can read the articles “Hyperstimulation And Its Effects,” “The Rational Brain And The Emotional Brain,” and the “Natural Ways To Shift The Body Out Of ‘Emergency Mode’” in chapter 14 for more information about how anxiety changes brain function and how to regain emotional control.

You can read the press release about this research below:

Stanford study finds stronger one-way fear signals in brains of anxious kids

Signals from the brain’s fear center make it more difficult for anxious and stressed children to regulate their emotions, a first-of-its-kind brain scanning study from Stanford shows.

In chronically stressed or anxious children, the brain’s fear center sends signals to the decision-making part of the brain that make it harder to regulate negative emotions, according to new research from the Stanford University School of Medicine.

The findings, which was published April 21 in Biological Psychiatry, come from the first study to use brain scans to examine how emotion-regulation circuits are changed by anxiety and chronic stress in children. The children studied were 10 or 11 years old, a developmental stage when vulnerability to mood-regulation disorders, such as anxiety and depression, becomes entrenched.

The study used functional magnetic resonance imaging to examine the nature of the signals between two parts of the brain: the amygdalae, almond-shaped nerve clusters on the right and left sides of the brain that function as its fear centers; and the dorsolateral prefrontal cortex, a brain region involved in executive functions such as decision making and emotion regulation.



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“The more anxious or stress-reactive an individual is, the stronger the bottom-up signal we observed from the amygdala to the dorsolateral prefrontal cortex,” said the study’s senior author, Vinod Menon, PhD, the Rachael L. and Walter F. Nichols, MD, Professor and professor of psychiatry and behavioral sciences. “This indicates that the circuit is being hijacked in more anxious children, and it suggests a common marker underlying these two clinical measures, anxiety and stress reactivity.”

Victor Carrion, MD, a co-author of the study and professor of child and adolescent psychiatry, said, “This study shows that the communication between our emotional centers and our thinking centers becomes less fluid when there is significant stress. You want that connection to be strongly signaling back and forth. But stress and anxiety of a certain level seem to interrupt that process.”

Carrion is the director of the Stanford Early Life Stress and Pediatric Anxiety Program, and is the John A. Turner, MD, Endowed Professor for Child and Adolescent Psychiatry. Lead authorship of the paper is shared by researcher Stacie Warren, PhD, and postdoctoral scholar Yuan Zhang, PhD.

Kids react to images

The study included 45 students in a California community with predominantly low-income residents who often face high levels of adversity. All 45 children had their anxiety levels and stress responses measured using standard behavioral questionnaires. Although their exposure to stress was potentially high, none were diagnosed with mood disorders.

To test how the children’s brains responded as they were trying to regulate negative emotions, the scientists conducted functional MRI scans while the study participants looked at two types of images, neutral and aversive. Neutral images showed pleasant scenes, such as someone taking a walk, whereas aversive images showed potentially distressing scenes, such as a car crash.

The children received instructions about responding to each image. For all the neutral images and half the aversive images, they were asked to look at them and respond to them naturally, rating their emotional state on a numerical scale after seeing each one. They were asked to look at the other half of the aversive images and try to reduce any negative reactions they had by telling themselves a story to make the pictures seem less upsetting — a story such as, “This car crash looks bad, but the people in the vehicles weren’t hurt.” After the kids tried to modify their emotional reaction, they again rated their emotional state on the numerical scale.

As the researchers expected, the children reported less negative emotions after being asked to reappraise their reactions to aversive images.

Using the brain-scan data, the researchers tested the strength and direction of interactions between the amygdala, the fear center, and the dorsolateral prefrontal cortex, the reasoning center, while the children viewed the images. Although the children with different levels of anxiety and stress reactivity reported similar reductions in their negative emotions when asked to reappraise the aversive images, their brains were doing different things.

More stress leads to less control of emotional reaction

The more anxious or stressed the child, the stronger the directional signals from the right amygdala to the dorsolateral prefrontal cortex. No such effects were seen in the reverse direction — that is, there was no increase in signaling from the dorsolateral prefrontal cortex to the amygdala. Higher levels of anxiety were associated with less positive initial reactions to aversive images, less ability to regulate emotional reaction in response to aversive images, and more impulsive reactions during reappraisal of aversive images. Higher stress reactivity was linked with less controlled, more impulsive reactions when reappraising aversive images, suggesting that the dorsolateral prefrontal cortex is less able to carry out its job.

Not only do the findings reveal how the brain can be changed by anxiety, they also act as a baseline for future studies to test interventions that may help children manage their anxiety and stress responses, the scientists said.

“We need to be more mindful about intervening,” Menon said. “These results show that the brain is not self-correcting in anxious children.”

“Thinking positively is not something that happens automatically,” Carrion said. “In fact, automatically we think negatively. That, evolutionarily, is what produced results. Negative thoughts are automatic thoughts, and positive thoughts need to be practiced and learned.”

The paper’s other Stanford co-authors are former research assistants Katherine Duberg and Sarah-Nicole Bostan; postdoctoral scholar Percy Mistry, PhD; Weidong Cai, PhD, clinical assistant professor of psychiatry and behavioral sciences; former postdoctoral scholar Shaozheng Qin, PhD; and former staff researcher Aarthi Padmanabhan, PhD.

This work was completed in partnership with the Ravenswood City, Alum Rock and Orchard school districts and Pure Edge Inc., which provides mindfulness curricula for children, and supported by the Lucile Packard Foundation for Children’s Health, the National Institutes of Health (grants EB022907, NS086085 and MH121069), the Stanford Maternal Child Health Research Institute and the Stanford Institute for Computational & Mathematical Engineering.

Media Contacts

ERIN DIGITALE
Tel 650-724-9175
digitale@stanford.edu

MARGARITA GALLARDO
Tel 650-723-7897
mjgallardo@stanford.edu

impact of anxiety disorder imageThe impact of anxiety disorder is often far more significant than many people realize.

Over the years, I’ve heard many anxiety disorder sufferers say, “People who don’t suffer with anxiety disorder have no idea what I go through. Since most of them only see my outward appearance, they often assume I’m managing fine, which means to them that anxiety disorder can’t be that difficult to live with. If they only knew!”

As an ex-anxiety disorder sufferer, I empathize with that statement. During my 12-year battle with anxiety disorder, there were many, many days where it took everything I had just to make it through the day. Yet, I kept up a brave front as often as I could. Most people who knew me back then had no idea I was struggling with anxiety disorder…and so badly.

Even though we might look fine on the outside, for many anxiety disorder sufferers, there is a horrendous battle raging inside – physical, mental, emotional, and even spiritual.

Here is a brief glimpse into my experience with anxiety disorder:

I suffered with anxiety disorder for 12 and a half years (late fall of 1974 to spring of 1986). During that time, I became almost completely housebound, missed a lot of work, had thousands of panic attacks, and experienced all of the symptoms we mention at our website with many to severe degrees.

The vast majority of those days were filled with intense symptoms, intense and uncontrollable fear, and frustration. My life was consumed with fear, feeling terrible, and trying to figure out why.

24/7 dizziness, nausea, bloating, diarrhea, trembling, burning skin, numbness and tingling, twitching, hot and cold flashes, feeling like I was going to lose it and go mad, crazy thoughts, thoughts of suicide, vomiting, dry heaving, sensory anomalies, tunnel vision, heart palpitations, shortness of breath, feeling like I was going to pass out, crying for no reason, depersonalization, body and brain zaps, insomnia, intense fatigue yet overly stimulated at the same time, confusion, difficulty thinking, difficulty talking, neck and head tension, racing heart, shooting pains, weak legs, and so on.

 On those nights I could sleep, I’d wake up the next day with symptoms raging again. Day after day, week after week, month after month, and year after year, my life was a living hell with little reprieve.

Numerous trips to the emergency department and countless trips to the doctor. Medication after medication. And yet, my suffering continued.

I felt trapped in a pit of fear and symptoms with no way out. Many days were unbearable.

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So many people suffer like I did…or worse.

For example, here are some quotes from some of the comments we’ve received in our discussions and emails from website visitors, Recovery Support members, and therapy clients:

“I first came to Anxietycentre.com around April 2018, and I arrived as an absolute mess. I was in a sheer state of 24/7 terror that never seemed to relent. My symptoms included (by not limited to) obsessive terrifying thoughts about my "condition," burning sensation on my skin down my back and neck, a lump in my throat, constant state of fear (e.g., like something really bad was about to happen to me), tinnitus, pain in my fingers and groin, insomnia, confusion and poor memory, rapid swings in emotion and mood, and an incredibly debilitating tight-chested feeling that was with me every moment of the day. It's nearly impossible to convey the exact experience with words...” – Damien S.

Read Damien's complete anxiety disorder recovery story.

“Struggling with anxiety and all that it entails sucks. There are no two ways around it. It festers and grows like a fungus. For me, it started off with a panic attack about 7 years ago. Terrifying would be an understatement. I continued to bear the brunt of an illness I didn’t understand which added to my life of panic and uncertainty. The weeks of anxiety turned into months and quickly the years passed by. Life had, seemingly out of the blue, become a painful struggle. The good times didn’t seem that good and the bad times sure were awful and often scary. I was an emotional mess when I found the Anxiety Centre in 2010.” – Chris.

Read Chris's anxiety disorder testimonial.

“Last November 21st, I fell rapidly into a terrifying pit of symptomatic high anxiety with most of the symptoms of anxiety mentioned on the website. I knew I had been stressed with money worries and a new two-year course I had started, but this felt like I was in a 24-hour living hell. It took me 4 months to even accept this was anxiety. And like most, I visited the doctor many times and had all the neurological tests done. I just couldn't believe this was just elevated stress! I also thought it must be the beginning of a severe mental illness that would never go away. I didn't even want to write this testimonial at first as I got better, for fear of jinxing myself or speaking too soon. But I can honestly say that with the combination of in depth information on the website, Jim's super kind voice on the Skype chats, and my no nonsense, practical, and reassuring counsellor, I have finally found my way out of what I would describe as the worst phase of my life.” – Caron

Read Caron's complete anxiety disorder testimonial.

“I’ve been to the hospital and doctor so many times, I’ve lost count.” – Sherry

“My life has been a living hell. I can’t eat, sleep, look after my children, or do anything anyone living a normal life can do. I feel completely devastated!” - Terry

“One morning in May 2006, I woke up in tears. What I felt that morning was so new to me, it was such a great amount of fear that it came out in a huge panic attack. This anxiety attack lasted what seemed like hours, I had never felt so anxious in my whole life. This kept with me for a year and a half. I quit my job (doctor’s order), rented out my apartment, grabbed my puppy, and moved back in with my parents within 3 days of that morning. I felt like a complete failure. I sat in my bed in my old room and just thought to myself, ‘You’ve really done it this time, 26 years old and back at square one, with the parents, and jobless.’” – K.D.

Read K.D.'s complete anxiety disorder recovery testimonial.

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What is anxiety?

Anxiety is defined as a state of apprehension, uncertainty, and fear resulting from anticipation of a realistic or imagined threatening event or situation.[1][2]

What anxiety isn’t

Anxiety isn’t caused by a biological problem with the brain, chemical imbalance in the brain, or by genes. Anxiety is a natural response to believing you could be in danger.

 Everyone experiences anxiety from time to time. This is normal.

What is anxiety disorder?

Anxiety becomes a disorder when it and its symptoms interfere with a normal lifestyle.[3] The higher the severity of anxiety, the greater the impact.

 Anxiety disorder isn’t a medical term and shouldn’t be misinterpreted as a medical diagnosis or disease. Anxiety disorder is a label used to describe when anxiety becomes problematic.[4]

 Anxiety disorder is not just feeling anxious from time to time. For many people, it can be a horrendous daily experience that never lets up.

 Anxiety disorder is the ongoing, day after day hardship of living life anxiously.

Degrees Of Anxiety Disorder Severity

There are different degrees of anxiety severity. For instance:

Early-stage or onset anxiety disorder

This degree of anxiety is characterized by sporadic episodes of anxiety that might or might not be accompanied by light to moderate symptoms.

 Even though these episodes occur from time to time, they are mildly distressing, have minimal impact on the person’s lifestyle, and generally subside when the reason for the anxiousness has passed.

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Mild severity

Mild anxiety is characterized by frequent episodes of mild anxiety, which might or might not be accompanied by mild to moderate symptoms.

 This degree of anxiety is mildly distressing, somewhat restrictive, and has a minimal impact on the person’s lifestyle.

 This degree of anxiety typically subsides when the reason for the anxiousness has passed.

 People with this degree of severity often begin to become concerned about their anxiety, how it feels, and the impact it is beginning to have on their lifestyle.

 They might also begin to research about anxiety online or make a trip to the doctor for more information. Some people inquire about medication to help manage symptoms during times of anxiousness.

Moderate severity

Anxiety at this degree of severity is more complex, more impacting, and more frequent. This degree of anxiety is often accompanied by more noticeable symptoms.

 There is moderate lifestyle impairment, and everyday tasks can become difficult and restricted.

 Those at this degree of severity often become concerned about how they feel and how their anxiety is impacting their lifestyle.

 Many people in this category make repeated trips to the doctor in hopes of finding answers and some relief. Some people have made a few trips to the emergency department at the hospital because of concern about their symptoms.

 Doctors often recommend therapy and offer medication to help manage symptoms at this degree of severity.

High anxiety

This degree of severity is characterized by frequent or persistent anxiety that is accompanied by symptoms that can be dramatic, persistent, and seem entrenched.

 Lifestyle is significantly impaired, and repeated trips to the doctor often prove fruitless.

 Many people at this stage have started medication, are already on medication, or have tried and stopped medication, yet their symptoms persist to varying degrees.

 High anxiety disorder sufferers are typically worried about their symptoms, worried about how anxiety is affecting their lives, and worried about the prognosis of overcoming it.

 Many people at this degree of severity feel their condition is becoming out of control.

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Very high anxiety

Anxiety severity at this degree is characterized by intense and persistent anxiety, severe and persistent symptoms, and significant lifestyle impairment.

 People with this degree of anxiety have visited their doctor and emergency departments countless times in the search for help and symptom relief.

 Most people in this category are on or have tried one or more medications.

 Very high anxiety disorder sufferers are typically consumed with worry about their symptoms, how anxiety is affecting their lives, and if they will ever overcome it.

 Many people in this category have difficulty functioning in day-to-day activities, have difficulties at work or can’t work, have lost their jobs, and are concerned about losing their spouses and families.

 Many people in this category become or almost become housebound, believe their condition is out of control, and often feel hopeless.

 High degree and very high degree anxiety disorder is a tough place to find oneself. The amount of lifestyle impairment is often beyond comprehension.

Statistics

Percentage of people who have anxiety disorder

percentage of anxiety disorderApproximately 20 percent of Americans have anxiety disorder.[5] It’s thought that this number is much higher (approximately 30 percent) since many people don’t report their issues with anxiety.

 Approximately 33.7 percent of Americans will have an anxiety disorder at some point in their lives.[6] Some researchers believe this number is closer to 50 percent.

Most people have moderate and above degrees of anxiety disorder

anxiety disorder degrees of severity imageAccording to the National Institute of Mental Health (NIMH), 43.5 percent of anxiety disorder sufferers have early-onset to mild anxiety, 33.7 percent have moderate anxiety, and 22.8 percent have high to very high degree anxiety.[5]

 In an online poll we conducted, 18 percent of respondents categorized their anxiety as early-onset to mild, 27.5 percent reported moderate anxiety, and 54.5 percent reported high to very high degree anxiety.

93 percent take medication93 percent of anxiety disorder sufferers in Canada said they are taking, or have taken a medication for their anxiety.[7]

However, many people don’t find medication helpful, find that medication has made their condition worse, or are on multiple medications yet still experiencing some symptoms. Medication rarely produces complete or lasting symptom relief.

 Medications also produce side effects that can be worse than the benefit.

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Economic toll

Anxiety disorder not only takes a toll on the person, but it also exacts a heavy toll on the economy.

 For instance, mental health problems and illness cost the Canadian economy at least $50 billion each year.[8] Mood and anxiety disorders are the most common mental health disorders in Canada.

Medical system toll

In 2011, $42.3 billion was spent on providing treatment, care, and support services for people with mental health problems.[7]

 58 percent of ER visits for heart concerns are related to anxiety and not to medical problems with the heart.[9]

The toll on the ability to work

50 percent of anxiety disorder sufferers reported having to modify their work or schedule to remain working.[5]

 35 percent had to stop working altogether.[5]

 Overall, anxiety disorder can take a heavy toll on a person’s life.[10][11][12]

Anxiety disorder symptoms

Because of the tight mind/body connection, anxiety affects the mind and the body.

 Visit our “Stress Response” and “Hyperstimulation” articles for more information about the many ways anxiety can affect the body.

 Anxiety symptoms can occur occasionally, intermittently, or persistently. As the degree of anxiety disorder increases, so do the type, number, severity, persistence, and duration of symptoms:

 Here is a small sampling of symptoms anxiety disorder sufferers can experience:

 To name a few.

 Visit our “Anxiety Symptoms” article for a more comprehensive list of symptoms, including descriptions and treatment options.

 Again, you can visit our “Stress Response” and “Hyperstimulation” articles for more information about how anxiety affects the body and mind.

 As I mentioned, I experienced all of the symptoms we mention in our Anxiety Symptoms article, with the majority to severe degrees. Most of those symptoms occurred simultaneously, with one on top of the other, or they changed and shifted where a new set of symptoms replaced the existing symptoms.

 For years, my days were filled with strong physical, mental, and emotional distress. Looking back, I don’t know how I made it through all of that suffering and hardship.

 Many people with anxiety disorder are or have endured something similar.

 Furthermore, many people who experience anxiety disorder also feel weak, ashamed, and inferior for having to struggle with anxiety disorder. Many also feel alone and without hope.

 To say suffering with anxiety disorder was truly difficult is an understatement. For me, it felt like hell every day. Many of those who have experienced anxiety disorder in the upper ranges of severity understand.

 Visit Jim Folk’s personal story for a better glimpse into how anxiety disorder can affect a person’s life.

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Treatment

Fortunately, there is hope and relief. Even though anxiety disorder can be extremely debilitating and cause significant lifestyle impairment, it can be overcome with the right information, professional help, support, and effort.

 There is a lifeline out of the pit of struggle. But, it’s typically challenging work and lots of it.

 Overcoming anxiety disorder is not easy. It requires doing a lot of work in a lot of areas. With the right help, support, and effort, however, we can succeed and return to a life free of anxiety disorder.

 Anxiety disorder sufferers aren’t asking for pity. They also are asking that you make their lives better. All they want is to be understood and supported as they work to overcome it.

 Hopefully, this brief glimpse into how anxiety disorder can affect a person will encourage you to support and assist those you know that struggle with anxiety disorder.

 Your understanding, support, and encouragement could make a world of difference to someone who is struggling (or silently struggling) with anxiety disorder or working to overcome it.

 Yes, we can overcome anxiety disorder and live normal lives without the bother of problematic anxiety. The road to recovery is well-known and well-traveled. Your support and encouragement can be an invaluable help to a family member, friend, or co-worker who is struggling with anxiety issues.

 Sadly, in many cases, your support might be the only support they get. You might be surprised the difference you can make on their road to lasting anxiety disorder wellness.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our Anxiety Articles page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including The Impact Of Anxiety Disorder.

References

1. Folk, Jim. “The Stress Response.” Anxiety Attacks, Anxietycentre.com, 2020, https://www.anxietycentre.com/anxiety-disorders/symptoms/stress-response/

2. "Understanding the Stress Response - Harvard Health." Harvard Health. N.p., n.d. Web. 23 May 2016.

3. “Anxiety Chest Pain: Symptoms, Home Remedies, and More.” American Psychological Association, American Psychological Association, 2019. https://www.apa.org/topics/anxiety/

4. Shelder, Jonathan. “A Psychiatric Diagnosis Is Not a Disease.” Psychology Today, Sussex Publishers, 27 July 2019. https://www.psychologytoday.com/us/blog/psychologically-minded/201907/psychiatric-diagnosis-is-not-disease

5. National Institute of Mental Health. "Any Anxiety Disorder." Retrieved 8 June 2020, https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml

6. Bandelow, Borwin, and Michawlis, Sophie. "Epidemiology of anxiety disorders in the 21st century." Dialogues in Clinical Neuroscience, Sep 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610617/

7. Government of Canada. "Mood and anxiety disorders in Canada." Retrieved 8 June, https://www.canada.ca/en/public-health/services/publications/diseases-conditions/mood-anxiety-disorders-canada.html

8. Mental Health Commission of Canada. "Making the Case for Investing in Mental Health in Canada." 2017. https://www.mentalhealthcommission.ca/sites/default/files/2017-05/Overview_on_Mental_Health_Data_in_Canada.pdf

9. Musey, Paul, et al. "Anxiety about anxiety: a survey of emergency department provider beliefs and practices regarding anxiety-associated low risk chest pain" BMC Emergency Medicine, 14 Mar 2018, https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-018-0161-x

10. Wong, Nina, et al. "Quality of Life Impairments among Adults with Social Phobia: The Impact of Subtype." Journal of Anxiety Disorders, 10 Sep 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254860/

11. Mendlowicz, Mauro, and Stein, Murray. "Quality of Life in Individuals With Anxiety Disorders." The American Journal of Psychiatry, May 2000, https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.157.5.669

12. Sherbourne, Cathy, et al. "The Effects of Multiple Anxiety Disorders on Patient Functioning and Well-Being." RAND, 2010, https://www.rand.org/pubs/research_briefs/RB9525.html