Some degree of anxiety when under stress is expected. Anxiety is your body’s way of communicating that something either makes you feel temporarily unsafe or stressed. Your body responds to anxiety in many different ways, causing more numerous and intense symptoms as the level of anxiety increases. The founder of psychiatric nursing, Hildegard E. Peplau, described 4 levels of anxiety: mild, moderate, severe and panic. Each level of anxiety can be experienced differently.
Mild anxiety is common in everyday life. At this level, you’re likely open-minded, although stressed. You might experience this level of anxiety as you await a job performance review or if you're lost in a new city. Symptoms might include fidgeting, irritability, sweaty palms and heightened senses. Mild anxiety is typically motivational, meaning it helps you focus on seeking a solution to the challenge you face. For example, if you're lost in a new place, you might look for a safe place to ask for directions. Once you get your bearings, your anxiety will likely dissipate quickly. This is typical of mild, situational anxiety.
At a moderate level of anxiety, you're likely to focus exclusively on the stressful situation directly in front of you and ignore other tasks. Say you've taken a child to the playground and lose sight of him. You might experience a faster heartbeat, dry mouth, sweating and stomach pain or nausea. Your speech may be rapid and high-pitched, and your hand and arm movements are likely more exaggerated. Nervous habits, like biting your nails or wringing your hands, are common. Your singular focus is likely where the child might be. Once you find him playing with other children, your symptoms subside.
With severe anxiety, symptoms intensify and others develop, such as a pounding heartbeat, chest pain, headache, vomiting or diarrhea, trembling, scattered thoughts, erratic behavior and a sense of dread. Learning a loved one has been in an accident or died unexpectedly, or the unexpected loss of employment, are examples of situations that can provoke these symptoms. With severe anxiety, your ability to focus and solve problems is impaired, which can lead to further anxiety. You may not even be able to recognize or take care of your own needs. Attempts of others to redirect your attention are likely to be unsuccessful.
Panic-level of anxiety is the most disruptive and challenging, as it overwhelms your capacity to function normally. You may experience an inability to move or speak, but sometimes the opposite is true. Some people take off running or find it impossible to sit or stay still. Your ability to think rationally will likely be impaired, and your perceptions might be distorted. You might not identify danger or understand your needs in the moment. Extreme life stressors can provoke these types of reactions, such as being victim of a crime or living through a disaster.
Coping and Precautions
The complexities of life can cause anxiety in anyone. At the mild and moderate levels, it may help to discuss the anxiety-provoking situation with someone you trust. Engaging in a relaxing activity, like a workout or meditation, can also help. Severe and panic levels of anxiety might require you to enter into a less stressful environment, or seek professional help.
All levels of anxiety can be normal in specific situations and for brief periods. However, frequent or persistent anxiety that causes distress and interferes with your daily functioning might indicate an anxiety disorder. If you're having difficulty with anxiety, talk with your doctor or a mental health professional.
- Psychiatric-Mental Health Nursing, 5th Edition; Sheila L. Videbeck
- American Psychiatric Association: Help With Anxiety Disorders
- Psychiatric-Mental Health Nursing: An Interpersonal Approach; Jeffrey S. Jones, et al.
- Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition; American Psychiatric Association
- Varcarolis' Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 7th Edition; Margaret Jordan Halter