Dealing With Your Own Anxiety

Sources for this article include , (U.S. Department of Veterans Affairs), (the Anxiety and Depression Association of America) and Other sources included the U.S. Department of Health and Human Services, “Identifying and Addressing Family Caregiver Anxiety” by Karen O Moss, PhD, RN, CNL; Colleen Kurzawa, MSN, RN, MFA; Barbara Daly, PhD, RN, FAAN; and Maryjo Prince-Paul, PhD, RN, FPCN. The article “Hidden from view” in Breathe magazine, issue 57, also provided insight.

Are caregivers vulnerable to anxiety?

More than one in five Americans today are caregivers, providing care and support to an adult or child with special needs. That is 21.3 percent of the population.

A study of family caregivers cited above found roughly 38 percent find their situation extremely stressful. Caregivers are a vulnerable population for psychological distress, including anxiety. In fact, the caregiver’s anxiety can even exceed the levels that their loved one’s experience. This study covered caregivers of people with cancer and dementia, but I’m sure the statistics for families dealing with mental illness are similar or even worse.

How anxious are you feeling? Are you managing too many responsibilities? Strain because you can’t control your own life? Fear for a loved one’s well-being? Deal with financial and healthcare coverage stressors? As a caregiver, you may spend many more hours a week providing care than in a regular job. Caregivers report employment problems, health issues, lack of sleep and little time to do the things they enjoy. 

What is anxiety?

Anxiety is the most common form of mental illness in the U.S., affecting 14% of the population. That includes 18% of adults and 8% of children and teenagers. (These figures are from the National Institutes of Health.)

It is a common emotional response to a perceived threat, often accompanied by tension, worried thoughts and physical changes like high blood pressure and insomnia.

Severe and persistent anxiety typically has these aspects:

  1. Extreme fear and dread, even when there is nothing to provoke it
  2. Emotional distress that affects daily life
  3. A tendency to avoid situations that bring on anxiety

How is anxiety different for mental health caregivers?

As we see above, anxiety can be extreme fear without reason. Caregivers for people with mental illness have plenty of reasons to experience fear and ongoing grief, including:

  • Fear of living life without the personality we loved.
  • Grief over our loved one’s lost potential and possible future.
  • Fear of being overwhelmed by the issues surrounding mental illness.
  • Fear of future pain.
  • Fear of losing your own identity and life.
  • Grief over lost plans for retirement.

Once my primary care doctor said to me: “If you weren’t anxious, I’d be worried that you didn’t understand the situation you are in.”

While some caregivers probably do have generalized anxiety disorder, many caregivers are just plain anxious. The study I read was focused on caregivers for people with cancer and dementia, but many of the aspects are the same.

I once attended a retreat for mothers of children with severe mental illness led by Kay Warren. She said: “We receive wounds of many sorts. Some forms of pain and loss we just don’t get over. A soul wound damages the architecture of the soul. What is grief, if not love persevering? The “natural order of things” and the depth of the love impact the grief.”

What are the symptoms of anxiety?

sleepless man

Signs and symptoms of anxiety are similar to the symptoms of depression. They can co-exist.  Among caregivers, the symptoms are:

Neurological: Trembling/shaking, restlessness, headaches, dizziness, apprehension, numbness, tingling, fatigue, poor concentration, nervousness.

Cardiac: Increased pulse rate, chest pain or discomfort, palpitations.

Respiratory: Dyspnea

Digestive: Diarrhea, loss of appetite, nausea, dry mouth, indigestion.

Mood: Nervousness, irritability.

Musculoskeletal: Muscle tension.

Sleep: Insomnia

Skin: Sweating

Urinary: Frequency, urgency.

Do you have high functioning anxiety?

Daily anxiety can affect your health long before it affects your productivity. High functioning anxiety means that you suffer internally from anxiety without it affecting your productivity. People with high functioning anxiety may become more irritable, withdraw socially or self-medicate through alcohol use.

See if these questions reflect things happening to you:

  • Do you worry every day?
  • Are you a perfectionist?
  • Do you suffer from sleep disturbances and muscle tension most of the time?
  • Do you find that your mind is always “on the go,” preventing you from living in the present moment?
  • Are you tired or mentally exhausted most of the time, even after a good night’s sleep?
  • Do you sometimes forget what you were saying or doing?

How to manage your anxiety

Be sure that your doctor knows that you are a caregiver for a person with mental illness so they can test for and monitor anxiety. Many caregivers do not seek out help for anxiety because they are concentrating on their loved ones, giving themselves little or no care.

Remind yourself it’s normal to have fears and anxious thoughts in our situations.

Talk to others who understand. Sharing your fears to a support group helps us realize we are not alone. Therapy can help with marital problems, changed relationships or family issues as a result of the change.

Take care of your body. Caregivers should exercise, get enough sleep, eat healthy meals, take their own medications and get regular check-ups. Walking, biking, yoga, swimming and running can reduce anxiety.

Rest in God. God wants you to experience his compassion during this time. Jesus himself was overwhelmed and deeply shaken as he faced his coming suffering and death at Gethsemane. He said, in Mark 14, “My soul is overwhelmed with sorrow to the point of death.” He knows.

Increase your times of prayer, maintain regular church and small group attendance, and read uplifting materials. “Humble yourselves, therefore, under God’s mighty hand, that he may lift you up in due time. Cast all your anxiety on him because he cares for you.” (1 Peter 5:6-7)

So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand. (Isaiah 41:10)

Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid. (John 14:27)

Managing Depression and Anxiety

Families who have one or more members with severe, persistent mental illness face unique challenges. Complex family dynamics, social isolation and often unpredictable behavior can take their toll. Other ways that mental health issues impact families include:

  • The family may change its rules or patterns.  The ill person may no longer do chores, and the family may withdraw from social situations.
  • Friends may withdraw from the family.
  • Everyone is walking on eggshells around the person.
  • Family members vent their frustration on non-ill family members.
  • Parents may be stricter with non-struggling children.
  • Family members may blame themselves.
  • Family members may become resentful of the ill person for the disruption the illness has caused.
  • Family members may be ashamed of the ill person’s struggle.

Under these circumstances, the primary caregiver or other family members may develop depression and anxiety. This also impacts the entire family. In fact, the additional stress can be overwhelming. But there is hope. The ideas below come from people who have lived experience, as well as NAMI, Mental Health America and the Veterans Administration.

When You Are Struggling

Learn all you can. If you develop depression or anxiety, learn all you can about the illnesses. Taking good care of yourself is critical to caring for your loved ones. Connect with other people experiencing these issues in support groups or meetings. Attend local mental health conferences and conventions. Build a personal library of useful websites and helpful books. Learning is an active thing you can do that gives you a feeling of control where control is possible. Ideally, you should learn about your loved one’s illness as well as depression and anxiety.

Recognize early symptoms. Identify possible warning signs and triggers that may aggravate your depression or anxiety symptoms. With this knowledge, you can recognize an emerging episode and get the help you need as soon as possible. Don’t be afraid to ask your friends and family for help—they can help you monitor your symptoms and behavior.

Partner with your health care providers. Give your health care provider all the information he or she needs to help you recover—including any reactions to medications, your symptoms or any triggers you notice. Develop trust and communicate openly.

Know what to do in a crisis. Be familiar with your community’s crisis hotline or emergency walk-in center. Know how to contact them and keep the information handy.

Avoid drugs and alcohol. These substances can disturb emotional balance and interact with medications. You may think using alcohol or drugs will help you “perk up,” but using them can hinder your recovery or make symptoms worse.

Eat well and exercise. To relieve stress, try activities like centering prayer, meditation, yoga or Tai Chi.

Deal with unresolved grief.  Do you have a mixture of persistent feelings of sadness, anger and frustration about your loved one’s mental illness?  Seek more help if you know that you are still grieving over the illness.

Helping Another Family Member  

In these circumstances, some family members may develop depression or anxiety. This is a heavy load for a caregiver dealing with another loved one with mental illness. Getting support is essential for you to continue be helpful. Some suggestions include:

Be proactive in keeping the family as strong as possible.

  • Eat, sleep, connect with other people and turn to God.
  • Take a break when needed.
  • Go places as a family even if the ill person does not go.
  • Encourage all family members to continue with regular activities.
  • Know some days are better than others, and all things pass.
  • Consider family therapy.

Learn more about your loved one’s condition. Learning about depression and anxiety will help you better understand and support your loved one.  They do not need to “hit bottom” to get better. In many cases, hitting bottom means suicide.

Communicate.  Speak kindly and honestly. Don’t scold or blame people with depression or urge them to “try harder” to “just be happy.” Instead, make specific offers of help and follow through with those offers. Tell the person you care about them. Ask them how they feel and truly listen.

React calmly and rationally. You can’t fix the person, but you can walk with them through this time. Even if your family member or friend is in a crisis, it’s important to remain calm. Listen to their concerns and make them feel understood—then take the next step toward getting help.

Find emotional support from others. Share your thoughts, fears and questions with other people who have loved ones with similar conditions. If they won’t get help, you should.

Schedule pleasant events and encourage an increased activity level.  Assist your loved one in making plans at specific times and dates to do something pleasant … a walk in the park, a movie, etc.

Correct unhelpful thinking. Help your loved one challenge thoughts about how things “should” be.  You need to learn about cognitive distortions and how to gently help a loved one to understand them.   I recommend reading  “Feeling Good: The New Mood Therapy” or “The Feeling Good Handbook,” both by David D. Burns.

Dealing With Anxiety

Note: The information in this post comes from NAMI, Mental Health America and the Veterans Administration.

Anxiety is the most common form of mental illness in the U.S., affecting 14% of the population before the pandemic. The KFF Health Tracking Poll from June 2020 reported that the number had risen to 40% of adults during 2020. Typically, the National Institutes of Health reports that 18% of adults and 8% of children and teenagers have anxiety.

Anxiety disorders are a group of related conditions, each with unique symptoms. All the types of anxiety disorders do have three major things in common:

  1. Extreme fear and dread, even when there is nothing to provoke it
  2. Emotional distress that affects daily life
  3. A tendency to avoid situations that bring on anxiety

Anxiety also can be an early warning sign of a relapse in other forms of mental illness, including schizophrenia.


People suffering from anxiety disorders typically experience one or more of the following symptoms:

  • Mood and thinking:  Worry or concern, fear, irritability, or difficulty concentrating.
  • Behavior:  Avoidance of feared situations, escape from unpleasant situations, trembling, and agitation (such as pacing)
  • Increased arousal: Perspiration, heart palpitations, muscular tension, butterflies in stomach, mild nausea, dizziness, shortness of breath, headaches, sweating, tremors or twitches, frequent urination, diarrhea, insomnia and fatigue

The most common types of anxiety disorders include:

Generalized Anxiety Disorder (GAD)

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

Social Anxiety Disorder

More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Panic Disorder

This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.


We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions. To avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

Causes of Anxiety Disorders

Scientists believe that many factors combine to cause anxiety disorders:

  • Genetics.  Studies support the evidence that anxiety disorders “run in families,” as some families have a higher-than-average amount of anxiety disorders among relatives.
  • Environment. A stressful or traumatic event such as abuse, death of a loved one, violence or prolonged illness is often linked to the development of an anxiety disorder.


Physical symptoms of an anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab tests. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation.


Because different anxiety disorders have their own distinct symptoms, each type has its own treatment plan. Common types of treatment include:

Helping Ourselves

Leading a balanced lifestyle helps us manage symptoms. The suggestions from people who have lived experience with anxiety are similar to those who live with depression:

Learn all you can. Learn about your loved one’s mental illness, our own anxiety, and the many treatment options available. Connect with other people experiencing anxiety in support groups or meetings. Attend local conferences and conventions. Build a personal library of useful websites and helpful books. Learning is an active thing we can do that gives us a feeling of control.

Recognize early symptoms. Identify possible warning signs and triggers that may aggravate your symptoms.

Partner with your health care providers. Give your health care provider all the information he or she needs to help you recover—including any reactions to medications, your symptoms or any triggers you notice. Develop trust and communicate openly.

Avoid drugs and alcohol.

Get physically healthy.

Anxiety is common. Especially in difficult times. As a caregiver of a person with a mental illness, you are likely to experience it occasionally. Be sure to take it seriously. You have to help yourself first before you can help the people you love.