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What is Anxiety?

Revital Ordan, psychiatric nurse, Director of Ambulatory Mental Health Services, Mental Health Division, Ministry of Health;  Dr. Mili Bar Shaked, psychiatrist, Deputy Hospital Director, Be'er Sheba Mental Health Center
4 September 2025

Anxiety is an excessive feeling of fear that arises in the context of dealing with certain situations, or as a way of coping with a wide variety of life situations, or as a compulsive and excessive worry about the future. A feeling of anxiety can also appear without any specific trigger.

Anxiety disorders are the most common of mental disorders. At any given time in the Western world, about 19% of the population is dealing with an anxiety disorder of some kind.

There are several types of anxiety disorders, characterized by symptoms lasting at least 6 months and emotional symptoms such as experiencing tension, distress, discomfort, restlessness, and repeated and obsessive thoughts about the object or situation. In addition, there are also physical symptoms such as muscle tension, increased heart rate, and sweating or trembling, along with difficulty sleeping and fatigue over time. In addition, in most anxiety disorders there are also behavioral symptoms, such as avoidance or over-preparation for negative events.

Anxiety disorders are a general term for a variety of conditions in which people experience feelings of fear that are inconsistent with the actual situation they are in. Anxiety is a feeling of fear or worry about the future, which can be expressed in feelings of tension and discomfort, nervousness, physical sensations such as muscle aches, headaches and stomachaches, and behaviors such as avoiding or preparing for negative events. People with anxiety disorders experience excessive, uncontrollable and often chronic feelings of fear and worry. In most cases, the feelings of fear and anxiety are disproportionate to the actual situation, and when experienced with high intensity and over time, they can significantly interfere with mental well-being and daily functioning.

Anxiety disorders are the most common mental disorders in adults and children, and are more common among women. At any given time in the Western world, about 19% of the population is dealing with an anxiety disorder of some kind.

Common symptoms of anxiety

The common symptoms are often emotional, physical and behavioral. Sometimes people with anxiety disorders tend to think that they have a physical problem due to the physical symptoms and often visit their primary physician. They usually experience these symptoms for a long period of time.

Emotional and cognitive symptoms

Restlessness, tension, distress and discomfort, along with repeated and obsessive thoughts about the object or situation.

Physical symptoms

Muscle tension, increased heart rate, sweating or trembling, there may be stomach, muscle and headache pain, along with difficulty sleeping and fatigue over time.

Behavioral symptoms

Mainly avoiding certain situations or over-preparing for negative events.

Types of anxiety disorders

People with anxiety disorders experience excessive fear or worry about a specific situation (such as a phobia of dogs or social situations). In other cases, such as an anxiety attack or panic disorder, it can be said that the anxiety stems from the experience of the anxiety attack itself or from the fear of experiencing another attack. In contrast, generalized anxiety disorder is characterized by excessive worry and persistent and daily nuisance from different areas of life and certain situations. Coping with an anxiety disorder increases the risk of depression, drug use, and suicidal thoughts and behaviors.

There are several types of anxiety disorders, which are characterized by symptoms that last at least 6 months:

An exaggerated fear of experiencing an actual or perceived separation from significant others or people who are perceived as significant. The anxiety can manifest itself in a variety of ways and situations, including: Fear of losing contact with a significant figure or that this person will be harmed, such as from illness or death; fear of experiencing an event that causes separation from a significant figure, such as getting lost, being reluctant or avoiding leaving the house, for example, to school, work, or elsewhere; fear of being alone or without a significant figure at home or in other settings; fear or avoidance of sleeping away from home or not near a significant figure; recurring nightmares about separation and physical symptoms such as headaches or stomachaches when separation occurs. A diagnosis of separation anxiety is made when the fear, anxiety, or avoidance persists for at least 4 weeks in children and adolescents and at least 6 months in adults.

Inability to speak in certain social situations where speaking is expected, such as standing in front of the class at school. The disorder impairs academic or occupational achievement or social communication. The diagnosis of selective mutism is given when it lasts at least one month.

Disproportionate fear and anxiety that appear when exposed to certain objects or situations, such as fear of heights or elevators, leading to a feeling of immediate distress up to a panic attack or extreme avoidance of them. In the case of a specific phobia, a diagnosis is given when the anxiety or avoidance lasts 6 months or more. In children, the fear and anxiety may be expressed in crying, tantrums, freezing, or clinging to a significant figure.

Fear and worry about social situations that may cause avoidance or a feeling of embarrassment or rejection. Examples of such social interactions include having a conversation, eating or drinking in front of people, and performing or standing in front of people. The person fears that they will act in a way that will reveal the symptoms of anxiety and therefore be embarrassed or feel rejected. In children, anxiety can also occur in settings with a group of their peers, and not just in interactions with adults. Anxiety may manifest itself in crying, tantrums, freezing, clinging, shrinking, or avoiding speaking in social situations. A diagnosis of social anxiety is given when the anxiety or avoidance lasts for 6 months or more.

Recurrent and unexpected panic attacks that occur at least once a month, a panic attack that is accompanied by ongoing worry about further attacks and their consequences, or a significant behavioral change such as avoiding situations associated with the attack. A panic attack is a sudden wave of intense fear or restlessness that reaches a peak within minutes. During a panic attack, at least 4 of the following symptoms will appear: Rapid heartbeat, sweating, trembling, shortness of breath, feeling of shock, chest pain, stomach pain or nausea, dizziness, unsteadiness or fainting, chills or fever, numbness or tingling, feeling of derealization or feeling of depersonalization, fear of losing control or "going crazy" and fear of death.

Fear, anxiety and avoidance of situations and places from which the person experiences they will have difficulty in escaping or getting help if necessary. Agoraphobia is characterized when the fear and anxiety appear in at least two of the following situations: Using public transportation – cars, buses or planes; being in open areas such as markets or bridges; being in closed places such as cinemas; standing in line or in a crowd and being alone outside the home. A diagnosis of agoraphobia is given when the anxiety or avoidance lasts for at least 6 months.

Excessive, irrational, and uncontrollable anxiety and worry about a number of events or activities such as school or work performance, relationships, etc. The anxiety and worry are manifested by at least three of the following symptoms (in children – one symptom): Restlessness or a feeling of being on edge, worry, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance. In most cases, a diagnosis of generalized anxiety disorder is given when the anxiety lasts for 6 months or more.

Risk factors for anxiety disorders

Like other mental disorders, anxiety disorders also arise from a combination of biological factors – genetic, social, and psychological. Alongside these factors, there are also coping with stressful situations, life crises, and exposure to difficult experiences, such as traumatic events, as well as the use of psychoactive substances, which lead to an increased risk of developing anxiety disorders.

Anxiety disorders are particularly related to and affected by physical health. The physical effects of anxiety include overstimulation of the sympathetic system, for example, muscle tension, increased heart rate and blood pressure, along with a decrease in the parasympathetic system responsible for calming, resting, and body preservation. Alongside the direct effects of nervous activity and mental distress on physical health, in many cases we see the use of addictive and psychoactive substances such as cigarettes, drugs, and alcohol. As a result, dealing with an anxiety disorder increases the risk of physical illnesses such as heart, skin, and immune system diseases. In addition, people who suffer from physical illnesses may experience anxiety disorders due to the implications of the illness on their quality and life expectancy, decreased functioning, and coping with other significant losses.

Seeking diagnosis and treatment

If you or someone close to you is experiencing symptoms of anxiety, it is important to contact your primary physician or a mental health professional – they will be able to perform a clinical diagnosis and assessment according to the criteria and symptoms described in each type of anxiety disorder. The diagnosis and treatment method are based, among other things, on:

  • The reported symptoms, their intensity, and their duration.
  • The way in which the symptoms affect functioning in a variety of areas of life.
  • A comprehensive examination of the mental state and the involvement of concomitant physical illnesses.
  • Assessment of the social situation, including coping with stressful situations, resilience factors, and support factors.
  • The course of the development of the disease and a family history of anxiety or depression.

After the assessment, you can discuss with your healthcare provider the appropriate treatment options. It is worth knowing that treatments for anxiety disorders are considered effective and have high success rates.

Assisted in writing the article: Lior Guri, master's degree student in Psychology, Mental Health Division, Ministry of Health

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