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Signs and Symptoms of Anxiety Disorders

By Friedemann Schaub, M.D., Ph.D. ; Updated August 14, 2017

Anxiety can appear so abruptly and with such intensity that it makes you feel as if you are being attacked by an outside force. To better understand and demystify this emotion, let’s have a closer look at the neurophysiological pathway to learn how anxiety is created.


Anxiety can get stimulated by something “scary” you notice in your environment, such as a loud noise at night, an unexpected bill or an angry boss. The emotion can also get sparked internally by a dream, a negative thought or a body sensation. Sometimes these external or internal stressors can be so sudden and fleeting that you are not even able to consciously compute them, although they have been registered by your nervous system. All you notice is that you are anxious for no apparent reason.

Brain Response

The anxiety triggers activate the amygdala, an almond-shape group of cells that are part of the brain’s limbic system and play a significant role in emotional responses and long-term memory. The amygdala, which has also been called “the anxiety switch,” evaluates whether the information it receives could be related to any dangerous or threatening events from the past. The more memories that are associated with fear and anxiety, the more readily the amygdala will raise alarm.

Stress Hormone Release

As soon as your brain considers a situation potentially perilous, the hypothalamus and the pituitary gland stimulate the release of stress hormones, such as adrenaline and cortisol, to prepare your body for an appropriate flight, flight or freeze response.

Physiological Responses

Stress hormones increase your heart rate, breathing, blood sugar level, perspiration and blood circulation to the muscles. As a result you feel hot, sweaty and tense; your heart is pounding and you are breathing faster; you may start trembling, shaking or even experiencing chest pain. These physiological reactions can be so sudden, uncomfortable and overwhelming that they themselves can trigger additional anxiety. This is the reason people can become more afraid of their own anxiety compared to perceived external threats.

This neurophysiological pathway is designed by nature to protect you from danger and keep you safe. In other words, anxiety is a normal feeling with an important purpose. However, when even the smallest triggers cause the anxiety pathway to overreact regularly, you are dealing with an anxiety disorder. The distinguishing factors between a normal level of anxiety or an anxiety disorder are whether your feelings cause you suffering or dysfunctional behavior or interferes with your daily life.

Typical Symptoms of Anxiety Disorders

  • Excessive worrying and racing thoughts - Overwhelmed and difficulty concentrating - Overanalyzing past or present challenges and ruminating about the worst-case scenario - Hypervigilance and trying to micromanage others and your outside circumstances - Feelings of powerlessness and inability to make decisions - Growing difficulties with work and relationships due to insecurity, doubt and fear - Seeking distractions in addictive behaviors, such as gambling, eating, sex or work - Self-medicating with alcohol, nicotine or other drugs - Trouble falling asleep or waking up in the middle of the night feeling wired and unable to relax again - Physical symptoms like high blood pressure, irregular heartbeat, chronic pain, and weight fluctuation

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