Just the Facts: Anxiety in Mental Health

“JUST THE FACTS” is a series focused on substance use and mental health written especially for young adults and their parents. It’s easy to understand and judgment-free, giving young adults just the facts they need to help them make informed choices.

I have friends who say they have anxiety, but I’m not sure what they mean. If I am worried about something, is that anxiety?

Yes and no. We all worry, or feel anxious from time to time about things whether it’s grades, money, friends, or perhaps family issues. Occasional anxiety is a normal feeling of fear or panic.   Afterwards, you calm down and feel better.

But when you’re not in a stressful situation, are you still worried, fearful, or panicky?

So, if any of this sounds familiar it’s probably time to get help.  It’s easier to treat if you start early. If you are in school, start with a counselor, coach, trusted educator, or an adult family member.    In college, most campuses provide mental-health resources where you can get more information. You can also see your doctor or a mental health provider.

There are several options available that can help manage anxiety —  from self-help tools like relaxation therapies and meditation, to talk therapy on its own or combined with medication.

Sometimes I’m literally sweating things, or I just feel sick. Is that anxiety?

Yes, there can also be physical symptoms along with psychological ones.  Those can include:

• Feeling weak or tired.
• Breathing rapidly (hyperventilation), sweating, trembling, or headaches.
• Sleep Issues or insomnia.
• Pounding or racing heart.
• Upset stomach, nausea, or diarrhea.

So it’s probably just anxiety?

While that feeling of anxiety is part of your body’s stress response,  knowing what you are dealing with is why it’s important to seek professional help.  According to the National Alliance on Mental Illness (NAMI), an estimated 40 million adults over the age of 18 in the U.S. have an anxiety disorder. That includes several types of anxiety — each one with different characteristics.

The National Institute of Mental Health defines generalized anxiety disorder (GAD) as displaying excessive anxiety or worry, on most days for at least 6 months.  It can be anxiety or worry about a number of things such as personal health, work, social interactions, and everyday routine life circumstances.  The other types of anxiety disorders include phobias, social anxiety disorder, or panic disorders.

Anxiety disorders can also occur along with other mental health conditions, like depression, eating disorders, or substance use disorder.  This is known as a co-occurring disorder.

Is that really a thing? 

Yes!  9.2 million U.S. adults experienced both mental illness and a substance use disorder in 2018.   In fact, Michael Phelps — the most decorated Olympian of all time — has been open about his own struggles with anxiety, depression, substance use, and thoughts of suicide.

His first DUI arrest made headlines just months after he won six gold medals at the 2004 Summer Olympics. After he won 8 gold medals at the 2008 Beijing Games,  he was briefly suspended after a picture emerged of him smoking from a bong. In 2014, he was arrested again for DUI, then went into treatment for 6 weeks. He continues his therapy to this day.

“I’m going to have depression spells weekly, daily, who knows? Whenever they come on, that’s when they are gonna come on. That’s just who I am and what makes me, me. So honestly I think it’s just being able to step up and talk about it. Be able to understand that it’s okay to not be okay,” said Phelps in a 2019 interview. “Mental health is something that I struggled with and still struggle with daily. There are so many people out there that are going through the same exact thing that I went through, and they think they are alone – but they’re not.”

If I have one disorder, does that mean I will have the other?

Several studies conducted over the past 20 years consistently indicate that anxiety disorders and substance use disorder co-occur more commonly than would be expected.

It’s not uncommon for  people with untreated anxiety to “self-medicate” — using  alcohol or other substances to feel better. While there is no evidence that either relieves anxiety, some people feel  temporary relief from anxiety while under the influence. Either disorder can develop first but to determine if you have or are at risk for multiple disorders, consider talking to a professional.

How do I know if I have co-occurring disorders?

If this is a concern to you – again,  it’s best to talk to a professional. Co-occurring disorders can be difficult to diagnose but it’s possible to treat both disorders, preferably by the same provider.   At one time, the disorders were treated separately — as two separate diagnoses. Now, integrated intervention is considered the best way to get help, where you receive care for both at the same time.

I’m not sure I’m ready to get help.  

Understood, but we’ll let Michael Phelps answer that:  “…It’s not going to go away, that’s Number one, that’s the thing. We can say we’re not able to see a therapist and in a couple of weeks when we have the opportunity to get an appointment, we decide not to because it’s gone. It’s not gone. For me, this is something that is gonna go throughout my whole entire life.”

So if you’ve read this far — you may be interested in learning more.  And remember, “It’s okay not to be okay.”

Learn more about  anxiety disorders at the  National Institute of Mental Health. 

Learn more about co-occurring disorders at the National Institute for Drug Abuse.

If you or someone you know are in crisis or danger, please call the National Suicide Prevention Lifeline at 1-800-273-8255. 

You can also get help by texting the Crisis Text Line: text “HOME” to 741741.