Anxiety is a normal human emotion that everyone experiences from time to time. However, for some people, anxiety can become excessive, persistent, and out of proportion to the situation, leading to significant distress and functional impairment. This is what characterizes an anxiety disorder. Severe anxiety that is left untreated can potentially have serious physical and mental health consequences. In extreme cases, it is possible for anxiety to become life threatening.
What is anxiety?
Anxiety refers to the body’s natural response to perceived threats or danger. When we sense a threat, whether real or imagined, our bodies go into an automatic physiological state of stress or arousal, activating the sympathetic nervous system and triggering the fight-or-flight response. This response prompts the release of stress hormones like cortisol and adrenaline that accelerate heart rate, increase blood pressure, boost energy, and prepare the body to respond to the threat.
Anxiety serves an important adaptive purpose, enabling us to mobilize and take action in the face of danger. However, sometimes the body’s alarm system gets triggered when there is no real threat present. This is when normal anxiety transitions into an anxiety disorder. The anxiety becomes disproportionate, difficult to control, debilitating, and distressing.
Types of anxiety disorders
Some of the most common clinically diagnosed anxiety disorders include:
- Generalized anxiety disorder – Excessive and uncontrollable worry about everyday things
- Social anxiety disorder – Extreme fear of social situations and interactions
- Panic disorder – Recurring panic attacks and fear of future attacks
- Phobias – Extreme fear about a specific object or situation
- Separation anxiety – Severe worry and fear about being away from home or loved ones
- Agoraphobia – Fear of being in public places or situations where escape would be difficult
These disorders differ in terms of the triggers and focus of the anxiety. However, they share many of the same symptoms, including persistent nervousness, muscle tension, sleep disturbances, restlessness, and difficulty concentrating.
Symptoms of severe anxiety
For anxiety to be considered severe, symptoms are frequent and intense enough to cause significant distress or substantially interfere with daily life and functioning. Signs of severe anxiety can include:
- Feeling constantly tense, worried, or “on edge”
- Panic attacks
- Obsessive thoughts and compulsive behaviors
- Nightmares or flashbacks
- Avoidance of certain places or situations
- Inability to tolerate uncertainty
- Difficulty concentrating or mind going blank
- Irritability, anger, restlessness
- Muscle tension, headaches, stomachaches
- Trembling, sweating, dizziness, shaking
- Insomnia or restless sleep
Physical symptoms may arise from the chronic activation of stress hormones and the body being perpetually in fight-or-flight mode. Mental symptoms stem from persistent fear and worry occupying the mind.
What causes severe anxiety?
Like many mental health conditions, anxiety disorders arise from a combination of biological, psychological, and environmental factors. Contributing causes can include:
- Brain chemistry – Neurotransmitter imbalances or hyperactive fear circuits
- Genetics – Family history of anxiety disorders
- Trauma – Past traumatic or abusive experiences
- Stress – High levels of chronic stress
- Substance abuse – Alcohol or drug dependence
- Medical conditions – Thyroid problems, heart conditions, etc.
While the exact causes are unknown, anxiety seems to involve a hypersensitive fear response and problems regulating emotional arousal. Those with anxiety have a lower threshold for perceiving threats and are more reactive to stress. Environmental factors like childhood adversity, trauma, poor coping skills, or substance abuse can further heighten this innate vulnerability.
When does anxiety become severe?
Anxiety exists on a spectrum ranging from mild, transient anxiety to severe, debilitating anxiety. There is no absolute threshold delineating normal anxiety from an anxiety disorder. However, severe anxiety is generally characterized by:
- High frequency – Occurring consistently and persistently over time
- High intensity – Marked physical symptoms and extreme thought distortions
- Significant distress – Causing substantial unhappiness and impairment
- Dysfunctional – Interfering with daily activities and quality of life
- Uncontrollable – Difficult or impossible to manage through coping strategies
Severe anxiety exceeds the level expected for a given situation, cannot be calmed, feels unmanageable, and dominates a person’s life and functioning. Typically professional help is needed to treat severe cases effectively.
Long term effects of untreated severe anxiety
Leaving severe anxiety unchecked can allow symptoms to spiral, leading to detrimental effects on physical and mental health. Potential long term consequences include:
- Worsening anxiety – Symptoms become more frequent and intense over time
- Co-occurring disorders – Depression, substance abuse, eating disorders, etc.
- Cardiovascular disease – Hypertension, heart disease, heart attacks, strokes
- Digestive problems – Irritable bowel syndrome, ulcers, nausea
- Weakened immune system – More frequent colds and infections
- Chronic pain – Tension headaches, body aches, migraines
- Brain changes – Reduced gray matter and altered neural pathways
- Cognitive decline – Impaired memory, concentration, and decision-making
- Sleep disturbances – Leading to fatigue, impaired functioning, and health problems
- Suicidal thoughts – Feeling hopeless, worthless, or like a burden
The cumulative toll of severe anxiety and the associated stress response takes a significant physical and psychological toll if not properly treated.
Can severe anxiety be fatal?
Though rare, there are some ways severe anxiety can potentially be fatal:
Suicide
People suffering from severe anxiety are at higher risk for suicide and suicidal ideation. Anxiety’s effects on brain function combined with feelings of hopelessness may lead some to take their own lives.
Somatic manifestations
In some cases, the physical effects of untreated severe anxiety can be deadly. Sustained stress hormones and cardiovascular strain can lead to heart attacks, strokes, or other fatal conditions.
Anxiety-induced asthma
Asthma attacks triggered by extreme anxiety can potentially be fatal if urgent medical care is not received. Panic attacks and hyperventilation caused by anxiety can prove deadly for those with severe asthma.
Fatal accidents
Severe anxiety can cause such profound distractions and distortions in thinking that fatal accidents may occur, like car crashes due to panicking while driving.
Unhealthy coping behaviors
Some people engage in risky behaviors like drug/alcohol abuse to cope with severe anxiety. Excessive self-medication can lead to accidental overdoses. Those with eating disorders driven by anxiety may die from medical complications.
So while anxiety itself is not directly fatal, extreme cases coupled with certain additional factors can sometimes lead to death. However, with proper treatment and support, the vast majority of severely anxious individuals can regain health and functioning.
Warning signs of dangerous anxiety levels
It is important to recognize when someone’s anxiety has reached critical levels requiring emergency care. Warning signs include:
- Thoughts of death, suicide plans, feeling life’s not worth living
- Intense chest pain, heart palpitations, inability to breathe
- Hyperventilating, gasping for air
- Feeling detached from reality, losing touch with surroundings
- Numbness or loss of sensation in extremities
- Uncontrollable panicking behavior
- High fever, vomiting, severe shaking
- Inability to speak comprehensibly
- Fainting or collapsing
- Unresponsiveness, catatonic state
If someone exhibits these extreme symptoms related to anxiety, call emergency services or drive them to an emergency room immediately. Urgent medical intervention may be needed to stabilize the person and ensure safety.
When to seek help for anxiety symptoms
It is important not to wait until anxiety becomes severe or life threatening to take action. Anxiety symptoms should be addressed when they:
- Are present most days over a period of 6 months or more
- Significantly interfere with work, school, relationships, or daily activities
- Cause substantial distress and diminished quality of life
- Lead to avoidance of certain situations
- Are not attributable to another disorder or medical condition
- Cannot be successfully managed with self-help strategies
Speaking to a doctor or mental health professional for an evaluation is recommended if anxiety symptoms persist beyond 6 months and impact functioning. Early intervention can prevent exacerbation of symptoms and development of complications.
Professional treatment options for severe anxiety
For severe anxiety, professional treatment is often necessary to effectively alleviate symptoms, address underlying issues, and regain life stability. The main treatment options include:
Medication
Medications like antidepressants, anti-anxiety drugs, and beta-blockers can help regulate brain chemistry, reduce anxious thoughts, and control physical anxiety symptoms. These may be prescribed alone or in conjunction with therapy.
Psychotherapy
Talk therapy methods like cognitive behavioral therapy help anxious individuals recognize irrational thoughts, develop coping strategies, manage stress, and overcome fears/triggers. Therapy can rewire anxiety responses in the brain.
Mind-body practices
Meditation, mindfulness, yoga, deep breathing, and guided imagery help calm the body’s stress response. Regular practice dampens anxious reactivity.
Exposure therapy
A behavioral approach involving gradual exposure to feared situations helps desensitize anxious reactions through habituation. It provides a sense of control over anxiety-inducing triggers.
Alternative approaches
Massage, acupuncture, hypnotherapy, and herbal remedies may complement other treatment modalities for anxiety relief in some individuals.
The most effective treatment plans tend to involve multiple coordinated approaches based on each person’s symptoms and needs. With comprehensive treatment, severe anxiety can be successfully managed in most cases.
Strategies for coping with severe anxiety
In addition to professional treatment, there are self-help strategies and lifestyle changes that can aid coping with severe anxiety:
- Learn anxiety management techniques like deep breathing, progressive muscle relaxation, and calming visualization
- Reduce caffeine and refined sugar intake to minimize agitation
- Adopt regular exercise routines to burn off nervous energy
- Practice mindfulness and living in the present moment
- Challenge negative thoughts and catastrophic thinking patterns
- Identify and limit triggers/stressors
- Increase social support and lean on loved ones
- Use grounding strategies when experiencing anxiety spikes
- Establish consistent daily routines for stability
- Make time for enjoyable activities and self-care
Coping strategies help anxious individuals gain a sense of control over anxiety symptoms and establish healthy stress management habits. However, severe anxiety usually requires professional treatment as well.
Helping a loved one with severe anxiety
If you have a loved one suffering from severe anxiety, here are some ways you can help:
- Listen compassionately and validate their experience
- Encourage them to seek professional evaluation and treatment
- Remind them daily that they are stronger than their anxiety
- Help identify triggering situations and work to gently avoid/face them
- Ask how you can best support them in moments of anxiety
- Educate yourself on their anxiety disorder
- Reassure them without reinforcing unrealistic fears
- Inquire about suicidal thoughts if very severe symptoms arise
- Have patience, anxiety can take time to overcome
- Aid their use of prescribed treatments and lifestyle changes
- Express love, acceptance, and hope for recovery
While you cannot cure their anxiety, providing stable support can bolster treatment progress. Let them know you care and want to help. The journey to recovery is gradual but perseverance pays off.
When to consider inpatient treatment programs
Most anxiety disorders can be managed through outpatient services like therapy, medication, and self-help strategies. However, inpatient or residential programs may be appropriate if the anxiety:
- Is completely disabling – Preventing independent functioning
- Puts the person at immediate risk of harm
- Is paired with severe depression or active suicidal intent
- Coincides with severe substance abuse or addiction
- Is unresponsive to exhaustive outpatient treatment efforts
- Requires intensive, multi-modal specialty care
- Would benefit from a highly structured environment providing safety and stabilization
The intensive support and continual access to psychiatric care offered in an inpatient setting can be beneficial when anxiety is profoundly severe and unmanageable in an outpatient setting.
Conclusion
Severe anxiety that persists unabated can have devastating consequences on physical and mental health. While rare, anxiety disorders at the extreme end of the spectrum can also prove fatal in certain scenarios. If anxiety becomes profoundly disabling or poses a self-harm risk, urgent intervention is needed. With comprehensive treatment combining medication, therapy, lifestyle changes, and self-help strategies, most people with severe anxiety can achieve substantial symptom relief and resumed daily functioning. Consistent implementation of healthy coping skills and stress management are key to maintaining ongoing improvement.