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Anxiety is a natural human response to stress, characterized by nervousness and uncertainty. Unfortunately, as a college student, you are likely to experience these emotions frequently because of your course load, work-study, leadership positions, social scene, or other obligations. You may feel anxious about an exam, a date, a big tournament game, or a study abroad trip. This anxiety is linked to a specific event or circumstance. It may not feel good, but it does benefit you. Anxiety acts as a warning or motivator; it reminds you to prepare for what’s ahead. It’s important to pay attention to feelings of anxiety. It’s the body’s way of dealing with traumatic events, uncomfortable social situations, and everyday concerns.

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What if my anxiety is constant and not linked to an event?

For some people, anxiety isn’t linked to any big stressor or situation. It is constant, overwhelming, and debilitating. It may last more than six months and it could worsen over time. These feelings of excessive dread and worry could harm your schoolwork, your performance at your job or work-study, and your friendships or romantic relationships. If your anxiety is pronounced enough to interfere with daily experiences, you may have an anxiety disorder.

Are there different types of anxiety disorder?

The National Institute of Mental Health has identified three types of anxiety disorders:

• Generalized anxiety disorder (GAD) affects over 3% of Americans in any given year. People with GAD do worry about situations and stressors in their life, as everyone else does, but the level of their anxiety surpasses the gravity of the situation. Often, they are unable to look past their everyday concerns about school, work, or money. Sometimes, they may feel upset, but can’t pinpoint the cause. They may struggle to relax, at which point anxiety starts to interrupt their daily lives and affect their physical health. Headaches, stomachaches, difficulty sleeping, and an inability to focus are common in people with GAD. There is no known cause of generalized anxiety disorder—though in some cases it may be hereditary and in others it may be brought on by trauma—but it influences the parts of the brain that control fear and anxiety.
• Panic disorder is a psychiatric disorder characterized by sudden strikes of fear and worry, called panic attacks. Inducing uncontrollable anxiety, these attacks also cause physical reactions. During a panic attack, one may experience difficulty breathing, feelings of choking, sweating, hot flashes or chills, numbness, stomachache, or chest pain, including a racing heart rate, which could feel like a heart attack. Not everyone who experiences a panic attack has panic disorder. In fact, some people may have one panic attack and never have another. People suffering from panic disorder have recurring attacks. The fear of another panic attack may be disabling. Some people with panic disorder avoid situations that may spark an attack. For nearly one-third of them, this means never leaving the house alone or at all. At this point, the panic disorder has progressed into agoraphobia, characterized by the fear of open or enclosed spaces, the fear of leaving the house, the fear of crowds, and/or the fear of using public transportation. It is hard to estimate the number of people suffering from panic disorder because not everyone who has recurring panic attacks seeks medical treatment. The Anxiety and Depression Association of America estimates the number to be between six and ten million.
• Phobia-related disorders are those that involve fear or anxiety about specific objects or situations. The fear is disproportionate to the actual danger or threat that could be caused by the object or situation, and because of this, people with phobia-related disorders actively work to avoid their fears.
  • Separation anxiety disorder is diagnosed in individuals who feel acute anxiety when separated from someone whom they care about. Typically, this anxiety stems from a fear that something will happen to the other individual when they are not together. People with separation anxiety may take steps to avoid separation or avoid being alone and have a physical reaction to separation or the thought of separation. While more common in children, adults can also suffer from separation anxiety disorder.
  • Social anxiety disorder is diagnosed in people who suffer from a severe, irrational fear of judgment in social situations. It’s not that people suffering from social anxiety don’t want to be around people; rather, they may feel so stressed and self-conscious that they can’t focus on making friends or talking to another person. They may anticipate they’ll feel embarrassed or worry they’ll offend someone. Their fears, which are seemingly unfounded, affect their ability to make friends and hold a conversation, especially because they tend to avoid group situations. When they do find themselves in a social situation, their anxieties may manifest physically: blushing, sweating, trembling, feelings of nausea, etc. More than 15 million Americans have social phobia. It often develops in late childhood or early adolescence, but many people do not seek help until much later.
  • Specific phobias are intense fears of relatively common objects or occurrences, like blood, flying, elevators, heights, or animals (commonly dogs, spiders, and snakes). Upwards of 20 million people in the United States are affected by specific phobias, women more so than men. People with phobias may go out of their way to avoid specific situations despite realizing that their fear is unfounded or unreasonable; for example someone afraid of elevators may elect to take the stairs everywhere they go, regardless of the height of the building.

How are anxiety disorders diagnosed?

While anxiety disorders are easy to treat with professional help, they don’t always get diagnosed. Some people may never mention their symptoms to friends, family, or a doctor. They may be ashamed of the stigma or they may brush the signs off, thinking that it’s just part of being an introvert or a worrier.

Other times, anxiety disorders go hand in hand with other conditions like chronic physical illnesses, depression, PTSD, and substance abuse. In these cases, it may be difficult to separate one from the other, so the anxiety disorder may not be overt. When it comes to treatment, the National Institute of Mental Health recommends first treating the coexisting condition, then treating the anxiety.

If you think you could be suffering from an anxiety disorder, it is important to speak with your doctor. Your primary care doctor may do a comprehensive checkup to make sure that the anxiety is not associated with any other physical illness. At that point, your doctor may refer you to a mental health specialist for treatment.

How are anxiety disorders treated?

If you have suffered from severe anxiety for as long as you can remember, you may be surprised to learn that anxiety is treatable. That’s great news. You don’t have to feel this way forever. Doctors treat anxiety with prescription medication and therapy. One or both could work for you.

If your primary care physician referred you to a counselor or a psychiatrist, you may need to build a relationship with the specialist before he or she can determine the best treatment options for you. You should feel comfortable with all of your doctors, mental health care professionals included. You may wish to try several providers until you click with one.

Because anxiety affects people differently, your course of treatment will be unique to you. Anxiety disorders are generally treated with either therapy, medication, or both. Your doctor may recommend that you learn techniques for managing stress, get regular aerobic exercise, or attend a support group for people suffering from anxiety as well.

Providing psychotherapy to individuals suffering from anxiety is common. Psychotherapy is essentially talk therapy. It can be uncomfortable to talk to someone about your fears, your feelings, and the manifestation of your anxiety, but doing so will help a doctor better understand your situation and your needs. Once your needs are assessed, a therapist will determine their approach.

You may be asked to participate in exposure therapy, in which you will learn to confront your fears instead of avoid them. Exposure may be real (if you’re afraid of cars, you may be instructed to get into a car), or imagined (you are instructed to imagine your fears and speak about them). Over time, exposure therapy can lessen the intensity of phobias.

Cognitive behavioral therapy is also frequently used to combat anxiety. This type of therapy doesn’t rely on exposure, but changing the way you think about and react to a situation, essentially rewiring your brain to create a more positive outcome. Your therapist may choose not to rely solely on one type of therapy, but to use a combination of techniques. Treatment plans are as varied as the people whom are being treated.

If your anxiety is symptomatic, a doctor may choose to prescribe a medication (typically antidepressants or benzodiazepines) to help reduce your symptoms. It’s unlikely that medication will cure your anxiety, though it will likely keep the worst of it at bay. Always take medication as prescribed, not just when you’re having a bad day. These types of medication are intended to be used continuously; if you stop taking medication without being told to do so by a doctor, your symptoms will likely return.

Remember, neither medication nor therapy will cure you of anxiety overnight. Be patient and be sure to communicate any concerns or observations with your specialist. You may wish to write down information about new medications (dosage, side effects, benefits) and any types of therapy that you try (behavioral therapy, support groups, meditation). This information will help your specialist determine what’s working and what’s not.

Your thoughts and feelings are invaluable to providers who want to help you improve your treatment. Many medications are available to treat anxiety, so if something is not working for you, your provider can help you switch to something that will benefit you.

What resources exist for individuals suffering from anxiety?

For everyone:

• Crisis Support Services
  • Call 1-800-273-8255 toll-free or text “CARE” to 839863.
  • Helpline is open 24 hours a day, seven days a week.
• Crisis Text Line
  • Text "HOME" to 741741.
  • Text line is open 24 hours a day, seven days a week.
  • Texts are confidential.
• National Institute of Mental Health
  • Call 1-866-615-6464 toll-free.
  • Helpline is open Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
  • Online chat is available Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
• National Suicide Prevention Lifeline
  • Call 1-800-273-8255 toll-free or chat with an online representative.
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential.
• The Samaritans
  • Call 212-673-3000 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential and anonymous. Caller ID is not used.

For Spanish speakers:

• Crisis Support Services
  • Call 1-888-628-9454 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
• National Institute of Mental Health
  • Call 1-866-615-6464 toll-free.
  • Helpline is open Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
  • Online chat is available Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
• National Suicide Prevention Lifeline
  • Call 1-888-628-9454 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential.

For teens and adolescents:

• Thursday’s Child
  • Call 1-800-872-5437 toll-free.
  • Helpline is open 24 hours a day, seven days a week.

For LGBT+ youth:

• The Trevor Project
  • Call 1-866-488-7386 toll-free.
• • Helpline is open 24 hours a day, seven days a week.
  • Chat with a counselor 24 hours a day, seven days a week.
  • Text "START" to 678678 to text with a counselor 24 hours a day, seven days a week.

Page last updated: 03/2019