Women & Anxiety
Women and Anxiety
Experiencing feelings of anxiety happens to most people at some point in life. Nervousness before a big interview, in certain social gatherings, or prior to a test in school are all normal occurrences of ‘anxiety’. However, when these feelings of nervousness, irritability, being ‘on edge’ dominate most of your days and waking hours—you may have an anxiety disorder.
You aren’t alone. There are about 40 million adults in the United States with an anxiety disorder, according to the Anxiety and Depression Association of America (ADAA). That’s more than 18% of the population. Anxiety in women is higher than it is for their male counterparts. Women have twice the increased chance of having an anxiety disorder in their lifetime as compared to men.
If you are living with an anxiety disorder you may feel hopelessness and despair on a day-to-day basis. Days with less anxiety give you hope that maybe the anxiety is subsiding, but for anyone with an anxiety disorder, these days often fade quickly and are replaced with more anxiety-filled days. Whether you’ve been living with anxiety issues for years, months, or weeks, it’s vital for you to know that anxiety disorders are treatable. In fact, most people can be effectively treated with professional care and manage their symptoms of anxiety.
The Face of Anxiety Disorders in Women
Anxiety is defined as feelings of worry, nervousness, or unease. Anxiety disorders are defined as a mental health disorder characterized by feelings of worry, anxiety, or fear that interferes with daily activities such as work, school, and family responsibilities. There are several different types of anxiety disorders, but first, let’s look at some of the most common overall symptoms.
Millions of Americans and people worldwide—both male and female—suffer from an anxiety disorder. However, how these anxiety symptoms present varies between genders. There are some overall symptoms of anxiety that characterize anxiety disorders:
- Experiencing nervousness, tension, or the inability to be still
- Having trouble focusing or maintaining attention
- Feeling controlled by thoughts of worry
- Avoiding or wanting to avoid things or situations that cause anxiety
- Experiencing a sense of doom or danger when there is no threat
- Racing heart (increased heart rate)
- Breathing rapidly or hyperventilating
- Sleeping problems or inconsistencies
- Having shakiness or trembling
- Having stomach issues
- Feelings of weakness or fatigue
These feelings and symptoms can be different from one person to the next. Some will experience a few of these anxiety symptoms, others will experience most of them. Experiencing these uncomfortable symptoms once in a while is common. But experiencing them on a more regular, even daily, basis signals a possible anxiety disorder.
When someone with an anxiety disorder is having a particularly difficult time and in the midst of an anxiety attack, a well-meaning friend or family member may tell them to “just relax” or “calm down” or “it’s not a big deal”. Despite the good intentions of this person, for anyone who has an anxiety disorder, this can sometimes increase the anxiety symptoms or attack. Women or men with anxiety disorders know that just relaxing or calming down doesn’t happen as easily for them as it does for others.
If you are a woman with an anxiety disorder or living with symptoms of anxiety, you know first-hand how difficult it can be to simply relax. And you also know this is really what you’d like to do more than anything else—experience the feeling of peace of mind and serenity. Many people with anxiety not only suffer from the daily uncomfortable and often debilitating symptoms of anxiety, they also experience other physical and mental health issues from the ongoing anxiety.
Health Issues from Anxiety Disorders in Women
As if the feelings associated with any anxiety disorder aren’t difficult enough to try to manage, ongoing anxiety can cause health issues. There are several health issues, both physical and mental, that are more commonly found in women that can be exacerbated with anxiety.
- Stomach or gastrointestinal issues such as irritable bowel syndrome (IBS)
These issues, particularly IBS, are common in women with anxiety disorders. Two-thirds of individuals with IBS are referred for the care of mental health issues, most often anxiety. Often, one makes the other worse, and women find themselves in a never-ending cycle between the two. Although treatment for one can help the other, you must treat both to regain both physical and mental health.
- Chronic Pain
An article in Harvard Health reports that 65% of people seeking treatment for depression or anxiety also experience some type of ongoing pain issue. Mental health issues, like anxiety disorders, add to the intensity of pain and also increase a person’s risk for disability.
- Headaches and Migraines
Another type of chronic pain is headaches and migraines. Rates of anxiety amongst those suffering from migraines are higher. What’s more, about 70% of migraine sufferers are female.
- Heart Disease
Asthma is another condition that worsens anxiety and vice versa. When a person is having an asthma attack they can also experience an anxiety attack. And when someone is having an anxiety attack it can lead to an asthma attack. Studies show that stress and anxiety are linked to asthma attacks.
Anxiety and depression are linked. It’s been said that anxiety is the cousin of depression. They are closely related. The ADAA reports that half of those diagnosed with depression are also diagnosed with an anxiety disorder.
- Substance Use Disorder (SUD)
It is common for people living with an anxiety disorder to also have a SUD. Which began first may be difficult to unravel, however, it’s essential to treat both at the same time for sustained recovery. The National Institute on Drug Abuse (NIDA) reports 7.7 million of the 20.3 million American adults with a SUD also have a co-occurring mental health issue. Anxiety disorders are one of the most common co-occurring disorders.
Issues like IBS, chronic pain, depression, and SUD can often make anxiety disorders worse and vice versa. For this reason, it’s crucial to treat these co-occurring conditions simultaneously. Seeking treatment at a reputable addiction treatment facility with expertise in co-occurring disorders as well as one with medical staff is a key to recovery.
Understanding Types of Anxiety Disorders in Women
Anxiety is a term often used to describe several different anxiety disorders or associated symptoms of anxiety attacks in women. There are several major types of anxiety disorders. Each of these disorders has some of the same and some different characteristics.
Generalized Anxiety Disorder (GAD)
Women with generalized anxiety disorder have excessive and out of proportion worry and fear. This is usually on a day-to-day basis for at least six months. Topics of worry may include family, money, health, etc. This ongoing fear and anxiety manifest in physical issues such as stomach problems and muscle tension. It is also often accompanied by depression.
Symptoms of GAD may include:
- Fatigue (easily and often)
- Concentration issues
- Restlessness or edginess
- Worrisome feelings
- Sleep problems (falling asleep, staying asleep, not feeling rested after sleep)
- Muscle tension and pain
The U.S. Office on Women’s Health reports women are twice as likely as men to have panic disorders. Women with panic disorder may be overcome with fear or terror in a matter of minutes when there is no real threat or danger. These anxiety attacks in women or panic attacks occur repeatedly. Some attacks are brought on for no apparent reason while others happen due to triggers. These attacks often leave the person having anxiety about when and where the next panic attack will occur.
Symptoms of panic attacks (associated with panic disorder) may include:
- Out of control feelings
- Impending disaster or danger feelings
- Heart changes such as palpitations, increased heartbeat, racing heart
- Excessive sweating, shakiness, or trembling
- Shortness of breath or perception of shortness of breath
Social phobias or social anxiety disorder are characterized by being anxious, worried, and overly self-conscious in social settings. Social anxiety symptoms in women often happen in social, work, and school environments. These fears about how one is perceived and evaluated by others can lead to complete avoidance of these situations. Of the estimated 7.1% of adults in the U.S. with this anxiety disorder, women were more frequently diagnosed with it.
Symptoms of social phobias may include:
- Extreme fear of the situation associated with the phobia
- Immediate anxiety when faced with the situation
- Actively avoiding the fear-inducing situation
- Excessive anxiety endured when the person is in the situation
These anxiety disorders symptoms include experiencing acute and extreme fears over an object or situation. Phobia-related anxiety disorders often lead to panic attacks when the person encounters the object or situation. Examples are fear of heights, water, closed-in or tight spaces, certain animals, or specific situations.
Symptoms of phobia-related disorders may include:
- Extreme fear of the object associated with the phobia
- Immediate anxiety when faced with the object
- Actively avoid the fear-inducing object
- Excessive anxiety endured when the person encounters the object
If you relate to any of the symptoms of these different anxiety disorders, you aren’t alone. Treatments for anxiety disorders vary and often involve a combination of medication and therapy. These treatments are often effective in treating anxiety disorders.
There are also conditions that are commonly associated with anxiety disorders.
Post-traumatic stress disorder (PTSD)
PTSD is a disorder in which people experience anxiety and flashbacks accompanied by intense emotional and physical responses. These episodes are usually triggered by something that reminds the person of the traumatic experience or event they either experienced or witnessed.
Obsessive-compulsive disorder (OCD)
This anxiety-related disorder impacting 2.2 million U.S. adults is characterized by obsessive thoughts which lead to repetitive behaviors.
This disorder, most common in children, is when they refuse to speak in certain situations, like school, but speak normally in other settings.
Prevalence of Anxiety Disorders in Women
Anxiety disorders are found in both men and women. Women, overall, have higher rates of anxiety than men. In fact, women are diagnosed more frequently than men with each of the anxiety disorders discussed.
Understanding why women have higher rates of these sometimes debilitating anxiety disorders can be vital for proper treatment approaches. Research has revealed there are gender differences in rates of anxiety disorders between males and females. However, more research is needed in this area to better tailor treatment for anxiety in both genders.
Data currently suggests a few reasons for this increased rate of anxiety disorders amongst women. According to research published by the Psychiatric Clinics of North America, women were more prone to have anxiety from environmental factors. Lifetime adversity, trauma, and the exacerbation of symptoms with their menstrual cycles were found to be key factors.
The World Health Organization (WHO) reports that women across the globe are disproportionately impacted by certain conditions that lead to an increased risk of mental health issues including anxiety disorders.
- Gender-based violence
- Socioeconomic disadvantage
- Low income
- Income inequality
- Lower social status and ranks
- Ongoing responsibility for the care of others
- Experiencing hormonal changes such as those during the menstrual cycle, postpartum, and menopause
In addition, the high rates of sexual violence against women directly correlate to the high rates of post-traumatic stress disorder (PTSD) in women. The WHO reports that women are the largest single group impacted by PTSD.
Brain chemical differences between men and women may also play a role in women having higher rates of anxiety disorders than men. The fight or flight response in women is not only activated more easily but also remains activated for longer. This is due, in part, to estrogen and progesterone action.
The ADAA also reports that recent research reveals that the female brain produces serotonin at a slower rate than the male brain. Research also shows that women are more sensitive and reactive to low levels of the stress response hormone, corticotropin-releasing factor (CRF), potentially putting them at a greater risk for stress-related issues such as anxiety.
One important fact to consider when looking at the higher incidence of anxiety disorders amongst women is gender bias. When it comes to diagnosing anxiety disorders, doctors are more likely to diagnose women with depression and anxiety than men. This holds true even when both present with the same symptoms.
Research also shows that women are more likely than men to report mental health concerns to their primary care providers. However, men are more likely than women to report substance abuse issues to specialists. Primary care providers do not specialize in mental health issues and the treatments they give women are not always what they need. Often women are only given medications.
These factors mentioned are unique to women, however, there are additional factors putting both men and women at risk for developing anxiety disorders.
Risk Factors for Anxiety Disorders
There are certain risk factors impacting both genders when it comes to developing anxiety disorders.
- Being exposed to traumatic, stressful, or negative events during childhood or even later in life
- Having family members with anxiety or depression
- Having excessive stress related to an illness, death, job loss, or ongoing worry
- Living with other mental health disorders such as depression
- Having a co-occurring alcohol or substance use disorder
There are also some physical illnesses and medical causes that can contribute to a person’s increased risk of an anxiety disorder.
- Thyroid problems
- Chronic pain
- Heart disease
- Respiratory issues
- Withdrawal from or misuse of drugs
- Alcohol withdrawal
- Withdrawal from certain medications like anti-anxiety medications such as benzodiazepines (benzos)
Sometimes, the very medications used to treat anxiety disorders can exacerbate them. Benzodiazepines, or benzos as they’re often called, can be highly addictive. Benzos include Xanax, Valium, Klonopin, Librium, Ativan, etc.
If a person is taking benzos to treat anxiety they can become addicted. This is called comorbidity. Comorbidity occurs when a person has two or more disorders at the same time. These two conditions which occur together can cause the other to worsen.
For example, if a person with an anxiety disorder also has an alcohol use disorder (AUD), when they drink it can make them feel more anxious. Or, as in some cases, when they are withdrawing from alcohol or hungover it may worsen their anxiety. And the reverse is also true. As the individual’s anxiety worsens, they may drink more alcohol to help calm their nerves or self medicate.
This is also referred to as co-occurring or dual diagnosis. It’s imperative when you seek treatment for either substance use or alcohol use disorder and suspect (or know) you have a co-occurring disorder like anxiety, to choose a treatment center with expertise in treating both.
Mental health conditions that commonly are found to co-occur with anxiety disorders in addition to substance use and alcohol use disorders are:
- Eating disorders
- Bipolar disorders
- Sleep disorders
- Adult ADHD
- Body dysmorphic disorder (BDD)
- Chronic stress
It’s vital to know that you can get help and manage both anxiety and any one of these other co-occurring conditions. You don’t have to find a way to do it on your own.
Many people with co-occurring disorders, such as anxiety and AUD or SUD, want to know which came first; the substance or alcohol use disorder or the other mental health issue. In some cases, it’s clear to see but in others, it’s more complex. However, there are many instances of both men and women “self-medicating” to treat anxiety disorders which then leads to dependence.
Anxiety and Self-medicating
Anyone who lives with anxiety knows how terrible the symptoms can be. Living day-to-day with nervousness, fear, feeling on edge, and experiencing the other physical issues like sweating and shaking can be exhausting. It’s normal to want to do whatever it takes to be rid of these feelings.
At a certain point, many, without even knowing they are doing it, begin to self-medicate. Whether through alcohol or misusing prescription benzos, the use of these substances can initially seem to “take the edge off”. But what first may seem to help can sometimes actually lead to a dependence on that substance. Then, in turn, you not only have an anxiety disorder but also an alcohol use disorder or substance use disorder.
Women with anxiety disorders are reported to be two to three times more likely than the general public to also have a substance use or alcohol issue at some points in their lives. In addition, 20% of Americans with an anxiety or other mood disorder also have a co-occurring substance or alcohol use disorder.
If you have co-occurring conditions, it’s essential when seeking treatment for either to find a treatment facility, preferably an addiction treatment center, specializing in treating co-occurring issues.
Prescriptions for Benzodiazepines: From Use to Abuse
Many individuals struggling to live with the exhausting symptoms from anxiety disorders seek help from their primary care physician. Often, benzos are prescribed. According to the National Center for Health Statistics, benzos are prescribed at about 66 million doctors appointments each year in the United States.
This number continues to grow. A report in JAMA Network Open revealed prescriptions for benzos during outpatient visits doubled from 2003 to 2015. In addition, as women are more likely to see their primary care doctors for anxiety and depression, they are also the group most prescribed benzos.
So just what are benzos and how do they help anxiety? Benzodiazepines, or benzos, are a type of medication in the sedative-hypnotics class or a type of tranquilizer. Acting on the GABA receptors in the brain, they essentially help the brain and central nervous system to slow down and “relax”. Benzos are the most frequently prescribed medications to treat anxiety disorders.
When it comes to benzos and women, it’s important to understand that even though these anti-anxiety medications are often prescribed by well-meaning physicians, they are highly addictive. Each year more women begin taking benzos and each year more become dependent or addicted to them.
As with any medication, there are side effects. The following are side effects of benzos:
- Memory loss
- Appetite changes
- Weight gain
- Balance issues
- Dry mouth
- Loss of sex drive
While these side effects may seem mild and worth the inconvenience to be rid of the debilitating symptoms of anxiety, there are other more serious side effects to consider. It’s also crucial to understand that benzos act much like opioids in their sedative effect and are also highly addictive.
Serious side effects of benzos include:
- Dependence and abuse
- Lowered heart rate
- Respiratory depression
- Movement disorders
- Withdrawal symptoms
- Decreased blood pressure (severely lowered)
- Rapid heart rate
Benzos are intended for short-term use, however, long-term use has been found to be increasing. This is a result of dependence on the drug and the inability to stop using them. Tolerance is also common with benzos. This means that you need to take more of the drug to get the same effect. This increases the chances of overdose.
It’s essential to note that anyone who is taking benzos should not attempt to stop doing so “cold turkey”. It is vital to be under supervised medical care in order to safely stop taking benzos no matter how long you have been taking them. Withdrawal from benzos can be fatal.
Long-term use of benzos can result in overdose and death. The National Institute on Drug Abuse (NIDA) reports an eight times increase in overdose deaths from benzos. That amounts to around 12,000 deaths each year from benzos.
Women are leading these deaths. The Centers for Disease Control and Prevention (CDC) reported an 830% increase for mortality in women from benzo-related causes for women between the ages of 30 and 64.
If you or a loved one are taking benzos, either with or without a prescription and think you may be dependent, finding an addiction treatment center experienced in treating benzo addiction is crucial.
As the increase of prescriptions to benzos and death rates from them rise, many in the medical community have become alarmed. Some professionals are concerned that with the primary focus on the opioid epidemic, benzo addiction is going unnoticed. It’s urgent to find other solutions to anxiety, chronic pain (for which benzos are also commonly prescribed), and insomnia other than these highly-addictive drugs. It’s also imperative to increase awareness and understanding of this dangerous trend.
For those women living with anxiety disorders, benzos may seem like the only way to ease the pain. However, there are other safer, effective ways to overcome and manage anxiety disorders. If you think you have become addicted to benzos, alcohol, or any other substance, there is help. The choice isn’t either living with the addiction or living with life-robbing anxiety. You can reclaim your life and live in serenity and happiness.
Addiction treatment centers with experienced professionals who can not only diagnose but effectively treat both addiction and anxiety can help. Each day women and men take that first brave step and ask for help. Although recovery from any addiction can be difficult, with the right support, resources, and treatment, it is possible. On the other side is a life of peace and serenity—a life you deserve.
If you are a woman with anxiety or anxiety disorder symptoms, it’s important to realize benzos aren’t the only way to treat these issues. In fact, they can cause more problems than they solve.
Treatment for Women with Anxiety Disorders
Effective treatment for anxiety disorders comprises multiple components. Therapy and medications are the most commonly used approaches. When seeking treatment for anxiety disorders, a psychotherapist should be consulted.
Psychotherapy has been found to be successful in helping to manage anxiety disorders. There are different types of psychotherapy. One of the most effective in helping to treat anxiety disorders is cognitive-behavioral therapy or CBT.
Cognitive-behavioral Therapy (CBT)
CBT involves examining an individual’s way of thinking and responding. They learn different ways to behave and react in anxiety-producing situations or around objects that trigger anxiety. CBT is also helpful for individuals with social anxieties. This type of therapy can also be effective for the practice and learning of new social skills that can be applied in daily life.
Exposure therapy is sometimes used in conjunction with CBT. Exposure therapy involves facing or confronting underlying fears related to a person’s anxiety. The goal is to help people engage in the situations or activities they have been avoiding due to anxiety.
Both of these therapies, but primarily CBT, can be conducted in group or individual therapy sessions. With CBT, homework is often assigned between sessions.
Medications Used to Treat Anxiety Disorders
Medications are also sometimes used in conjunction with CBT and exposure therapy. Luckily, benzos aren’t the only type of medication used to treat anxiety disorders effectively. In fact, there are other medications that are more appropriate for long-term treatment of anxiety.
There are four major groups of medications used to treat anxiety disorders.
1. Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs work to relieve symptoms by blocking the reabsorption of serotonin by certain cells in the brain. This, in turn, leaves more serotonin in the brain to improve the mood. Side effects associated with SSRIs are mild but include sleep issues, weight gain, and sexual issues.
2. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
This medication has a dual-action which works with anxiety disorders. It both increases levels of neurotransmitters serotonin as well as prohibits reabsorption. Side effects include upset stomach, insomnia, headache, sexual issues, weight gain, and small blood pressure increase.
3. Tricyclic Antidepressants
Effective in the treatment of some anxiety disorders this drug began being prescribed when concerns were raised about benzodiazepines being over-prescribed. The side effects associated with tricyclic antidepressants are severe and include constipation, urinary issues, dry mouth, blurry vision, and hypotension. Hypotension is a drop in blood pressure when standing.
This class of drugs should be used only for short-term situations. As mentioned the risk of dependence on benzos is high with these addictive drugs. The side effects include drowsiness, lack of motor control, memory loss, slurred speech, blurred vision, as well as tolerance and dependence.
Professional psychotherapists and psychiatrists are the best medical professionals to advise which medications are best for each person with an anxiety disorder. Medications should always be taken with caution and follow all warnings by your physician and pharmacist.
It can be dangerous to mix medications with alcohol or other drugs—prescription or otherwise. This practice may also exacerbate anxiety symptoms rather than ease them.
Treatment for Co-occurring Disorders
Co-occurring disorders such as alcohol use disorder and anxiety disorders or anxiety disorders and a substance use disorder are common. In fact, the NIDA reports that these co-occurring disorders make-up nearly 40% of all substance use issues.
Effective treatment for co-occurring disorders must simultaneously address the substance or alcohol issues as well as the other mental health issues like anxiety disorders. There are addiction treatment centers with vast experience and success in treating co-occurring disorders. However, many living with a dual diagnosis like this don’t get the help they need.
Statistics show that only 9.1% of the 7.7 million U.S. adults with an AUD or SUD and another mental health issue received treatment for both the substance issue and the mental health problem. Many times if a proper assessment is not given at the beginning of treatment, mental health issues can mask substance use issues and vice versa. That’s why if you think you or a loved one has a co-occurring disorder, it’s imperative to seek treatment at an addiction treatment center capable and experienced in treating both.
Many people, including women with anxiety disorders, take the first step, and reach out for help. This sometimes difficult step towards recovery often opens the door to a life free from the painful symptoms of both anxiety disorders and substance use issues.
Support Groups and Alternative Treatments for Anxiety Disorders in Women
Finding the right treatment center that addresses the specific anxiety disorder as well as any co-occurring issues like substance abuse, eating disorders, or other mental health problems is essential for building a solid foundation in recovery.
Therapy and medications, either alone or combined, are found to be extremely helpful in managing both anxiety disorders and substance use issues. There are also approaches that complement these treatments.
Many addiction treatment centers include these program options. Yoga, meditation, 12-Step groups, nutrition, spiritual groups, and more. These support programs can prove to be helpful additions to psychotherapy and medication treatment. They can be easily incorporated into your life once you leave treatment and help tremendously to reduce anxiety disorder symptoms in women and men.
Effective and comprehensive treatment for women with anxiety disorders, as well as those with co-occurring issues, is needed today more than ever. As the responsibilities on women continue to grow, so too do the rates of anxiety disorders and substance use disorders. If you are a woman struggling with either of these issues—or both—you don’t have to push forward alone anymore.
Caron is here for you with expertise in treating co-occurring disorders as well as programs specifically tailored to meet the unique recovery needs of women. Reclaim your life and peace of mind today.