7 symptoms of anxiety

The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists ten different anxiety disorders, each one slightly different and specific, such as social anxiety and panic disorder. In this article, I'm going to focus on generalised anxiety disorder only.

The DSM lists the required symptoms to receive a formal diagnosis of generalised anxiety disorder (GAD). In 2006 Spritzer et al. developed the GAD-7 scale, designed to screen for generalised anxiety. The seven questions in the GAD-7 questionnaire cover the symptoms of generalised anxiety disorder specified in the DSM and give a final score to determine whether the anxiety you feel is mild, moderate, or severe.

Anxiety symptoms

The DSM lists the first symptom of GAD as excessive worry about many different things, more often than not. You have felt this excessive worry for at least six months and find it difficult to control. As well as the feeling of excessive worry, you find yourself with at least three other physical symptoms from a list of four; restlessness, fatigue or sleep difficulties, difficulty concentrating or focusing, irritability and/or tension in your muscles.

The symptoms should create enough distress to stop you from functioning as you consider typical and not relate to another medical condition or substance use.  

How do you know if you have anxiety?

Many people find themselves here when they begin to question whether what they feel and may have felt for many years, if not a lifetime, is normal.

Personally, I do not like the word normal, there is no normal. Every being exhibits different behaviours, experiences different feelings, and likes or dislikes different things. There is no normal behaviour in the home or treatment of others. 

Believing in a normal might create more problems as you place a greater expectation on yourself to cope when you assume your experience is normal.

If you feel that your feelings – emotional and physical - prevent you from living your best life but you have found yourself unable to know the cause, anxiety is most definitely a consideration.

But how to know if you have anxiety?

The GAD-7 questionnaire is a good place to start your exploration of anxiety. It is not conclusive but does report a sensitivity of 89%. 

When answering the questions in the GAD-7 questionnaire you should focus on the previous two weeks and the regularity of the symptom. Score yourself 0 for ‘not at all’, 1 for ‘several days’, 2 for ‘more than half the days’ and 3 for ‘nearly every day’.

When you total your score, 5 – 10 represents mild anxiety, 10 – 15 represents moderate anxiety, whilst 15 – 21 represents severe anxiety.

GAD-7 questions

• Feeling nervous, anxious or on edge?    
• Not being able to stop or control worrying?         
• Worrying too much about different things?          
• Trouble relaxing?           
• Being so restless that it is hard to sit still?           
• Becoming easily annoyed or irritable?     
• Feeling afraid as if something awful might happen?         
• What are the symptoms of anxiety?

Just like ‘normal’, everyone experiences anxiety differently. Your heart may pound out of your chest like someone else’s, but you shiver and they flush. It is difficult to determine your anxiety by asking someone else how they feel.

The GAD-7 questionnaire alongside the symptom list in the DSM will help you determine whether what you feel is anxiety. If the feelings are typical of your life forever you might find it harder to work out whether you have the symptoms or not. It is difficult to know whether your sleep is typical or disturbed when it has never been any different.

There are further physical symptoms of generalised anxiety not listed in the DSM or covered in the GAD-7 questionnaire. These symptoms are more typical and covered in some of the other anxiety disorders such as panic disorder, however, my experience through speaking about experiences of anxiety with many people is that they are prevalent in GAD too.

At times you might find yourself with any of the following physical symptoms:

• shaking
• digestive/stomach problems
• dizziness
• tiredness
• a noticeably strong, fast or irregular heartbeat (palpitations)
• aching
• dry mouth
• unusual sweating
• breathing difficulties
• headache
• pins and needles

Some of these symptoms are representative of other disorders and I advise a consultation with your GP before assuming anxiety.

However, when you recognise that what you have been contemplating for a while is probably true and you have symptoms of anxiety, some hypnotherapy sessions will help understand the neuroscience of your autonomic nervous system and why your body is in an anxious state.

You will learn tools to manage the anxiety and techniques to calm your body and even eliminate the anxious feelings in some circumstances.

References 

• A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7 | Anxiety Disorders | JAMA Internal Medicine | JAMA Network
• GAD-7 Anxiety Test Questionnaire | Patient