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Anxiety Disorders

Overview

 

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help.

 

How common are anxiety disorders?

 

Anxiety disorders are some of the most common mental health conditions:

  • Specific phobias affect up to 12% of the U.S. population.
  • Social anxiety disorder affects about 7% of the U.S. population.
  • Generalized anxiety disorder affects about 3% of the U.S. population.
  • Agoraphobia affects up to 1.7% of the U.S. population.
  • Separation anxiety disorder affects about 4% of children, 1.6% of adolescents and up to 1.9% of adults.
  • Selective mutism is the least common anxiety disorder. It affects between 0.47% and 0.76% of the U.S. population.

 

Symptoms

 

Common anxiety signs and symptoms include:

Psychological symptoms may include:

  • Feeling panic, fear, dread and uneasiness.
  • Feeling on edge or irritable.
  • Uncontrollable, obsessive thoughts.
  • Difficulty concentrating.

Physical symptoms may include:

  • Restlessness.
  • Heart palpitations.
  • Shortness of breath.
  • Muscle tension.
  • Cold or sweaty hands.
  • Dry mouth.
  • Nausea.
  • Numbness or tingling in your hands or feet.
  • Difficulty falling asleep or staying asleep (insomnia).

It’s important to talk to your healthcare provider or a mental health professional if you frequently experience these symptoms.

Several types of anxiety disorders exist:

  • Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
  • Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
  • Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
  • Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.
  • Post-traumatic stress disorder (PTSD). A traumatic event triggers this type of anxiety. You may experience panic attacks or more general symptoms like sleep problems, muscle tension or constant worry. These attacks associated with PTSD can come up out of nowhere, even when the cause is unidentified, but they’re often rooted in a past traumatic experience.
  • Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
  • Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.
  • Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
  • Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
  • Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
  • Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

When to see a doctor

See your doctor if:

  • You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life
  • Your fear, worry or anxiety is upsetting to you and difficult to control
  • You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety
  • You think your anxiety could be linked to a physical health problem
  • You have suicidal thoughts or behaviors — if this is the case, seek emergency treatment immediately

Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early.

 

Causes

 

The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

  • Heart disease
  • Chemical imbalances
  • Diabetes
  • Brain changes
  • Thyroid problems, such as hyperthyroidism
  • Genetics
  • Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
  • Environmental factors
  • Drug misuse or withdrawal
  • Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
  • Chronic pain or irritable bowel syndrome
  • Rare tumors that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications.

It's possible that your anxiety may be due to an underlying medical condition if:

  • You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder
  • You didn't have an anxiety disorder as a child
  • You don't avoid certain things or situations because of anxiety
  • You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety

 

Risk factors

 

These factors may increase your risk of developing an anxiety disorder:

  • Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.
  • Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.
  • Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances.
  • Personality. People with certain personality types are more prone to anxiety disorders than others are.
  • Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.
  • Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
  • Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

 

Complications

 

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

  • Depression (which often occurs with an anxiety disorder) or other mental health disorders
  • Substance misuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Headaches and chronic pain
  • Social isolation
  • Problems functioning at school or work
  • Poor quality of life
  • Suicide

 

Prevention

 

Currently, there’s no known way to prevent anxiety disorders. But you can lessen many of the related issues with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to your life.

  • Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
  • Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.
  • Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.

 

Diagnosis

 

If you or your child are experiencing symptoms of an anxiety disorder, see a healthcare provider. They’ll start with a medical evaluation. They’ll do a physical exam and ask about your medical history, any medications you’re taking and if any of your family members have been diagnosed with an anxiety disorder.

There aren’t any blood tests or imaging scans that can diagnose anxiety disorders. But your provider may run some of these tests to rule out physical conditions that may be causing your symptoms, like hyperthyroidism, for example. If there isn’t an underlying physical cause, your provider may refer you to a mental health professional.

A mental health professional, such as a psychologist or psychiatrist, will do an interview or survey, asking questions about your symptoms, sleeping habits and other behaviors. They use criteria in the American Psychiatric Association’s DSM-5 to make diagnoses of anxiety disorders.

To help diagnose an anxiety disorder, your mental health provider may:

  • Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
  • Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.

 

Treatment

 

The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Psychotherapy

“Psychotherapy,” also called talk therapy, is a term for a variety of treatment techniques that aim to help you identify and change unhealthy emotions, thoughts and behaviors. A mental health provider talks through strategies to help you better understand and manage an anxiety disorder. Approaches include:

  • Cognitive behavioral therapy (CBT): This is the most common type of psychotherapy to help manage anxiety disorders. CBT for anxiety teaches you to recognize and identify thought patterns and behaviors that lead to troublesome feelings. You then work on changing the thoughts and your reactions to triggering situations.
  • Exposure therapy: This is a type of therapy in which a mental health provider creates a safe environment to expose you to your fears. Fears may be things, situations and/or activities. Exposure therapy helps show you that you’re capable of confronting your fears. You’ll learn to attach new, more realistic beliefs to the things you’re afraid of. You’ll become more comfortable with the experience of fear.

Medications

Two types of medication may help manage your symptoms:

  • Daily. You can take some medications regularly to prevent anxiety as a whole.
  • As-needed. You can take medications only when an episode occurs to lessen how your body reacts to specific moments that trigger your anxiety. This is perhaps most helpful when providing clarity to a specific situation or managing physical symptoms of anxiety like muscle tension, nausea and stomach ache in the moment they happen.

Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues.

For example:

  • Antidepressants: While they mainly treat depression, these medications can also help with anxiety disorders. They adjust how your brain uses certain chemicals to improve mood and reduce stress. Antidepressants may take some time to work, so try to be patient. SSRIs and SNRIs are the go-to types of antidepressants for anxiety. Tricyclic antidepressants are another option, but they cause more side effects.
  • Benzodiazepines: This class of medications may decrease your anxiety, panic and worry. They work quickly, but you can build up a tolerance to them. They also have addiction potential, so you have to take them cautiously. Your healthcare provider may prescribe a benzodiazepine for the short term, then taper you off. Benzodiazepines that can help treat anxiety disorders include alprazolam, clonazepam, diazepam and lorazepam.
  • Beta-blockers: These medications can help reduce some of the physical symptoms of anxiety disorders, like rapid heartbeat, shaking and trembling. They don’t treat the psychological aspects of anxiety disorders.

Your healthcare provider will work with you to find the right medication combination and dosage. Don’t change the dose or stop taking medications without talking to your provider first. They’ll monitor you to make sure the medicines are working without causing negative side effects.

 

Lifestyle and home remedies

 

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

  • Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
  • Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
  • Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
  • Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
  • Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
  • Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

 

Alternative medicine

 

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

 

Coping and support

 

To cope with an anxiety disorder, here's what you can do:

  • Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
  • Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
  • Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
  • Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
  • Socialize. Don't let worries isolate you from loved ones or activities.
  • Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.

 

Preparing for your appointment

 

You may start by seeing your primary care provider. He or she may refer you to a mental health professional.

What you can do

Before your appointment, make a list of:

  • Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
  • What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
  • Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
  • Any other health problems you have. Include both physical conditions and mental health issues.
  • All medications you're taking. Include any medications, Vitamins, herbs or other supplements, and the doses.
  • Questions to ask your doctor to make the most of your appointment.

Some basic questions to ask your doctor include:

  • What's the most likely cause of my anxiety?
  • Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
  • Do I need any tests?
  • Should I see a psychiatrist, psychologist or other mental health provider?
  • What type of therapy might help me?
  • Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
  • In addition to treatment, are there any steps I can take at home that might help?
  • Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, such as:

  • What are your symptoms, and how severe are they? How do they impact your ability to function?
  • Have you ever had a panic attack?
  • Do you avoid certain things or situations because they make you anxious?
  • Have your feelings of anxiety been occasional or continuous?
  • When did you first begin noticing your feelings of anxiety?
  • Does anything in particular seem to trigger your anxiety or make it worse?
  • What, if anything, seems to improve your feelings of anxiety?
  • What traumatic experiences have you had recently or in the past?
  • What, if any, physical or mental health conditions do you have?
  • Do you take any prescription drugs?
  • Do you regularly drink alcohol or use recreational drugs?
  • Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time.

 

Living with Anxiety

 

How can I take care of myself if I have an anxiety disorder?

Aside from seeking professional medical help and treatment, certain strategies can help you manage an anxiety disorder and make treatment more effective. They include:

  • Stress management: Chronic or intense stress worsens anxiety disorders. Explore stress management techniques, like meditation, breathing exercises, mindfulness and regular exercise. 
  • Support groups: Participating in a support group for people with anxiety — in-person or online — can provide opportunities to relate to others, share experiences and learn different coping strategies.
  • Education: Learning more about your condition and educating loved ones can help you and them better understand the condition and offer support.
  • Limiting or avoiding caffeine: Caffeine can make the physical symptoms of anxiety worse. Talk to your healthcare provider if you’re concerned about your level of caffeine consumption.

Related Support Group Web Sites

Helpful Apps

Calm (Apple) | (Android)

Worry Time (Apple)

 Breathe (Apple Watch)

Triangle of Life (iPhone) | (iPad)

 

When should I see my healthcare provider?

 

Your healthcare provider is your partner in your care. If you feel like treatment for an anxiety disorder isn’t working or have questions about your medication, contact your provider. Together, you can figure out how to best move forward.

 

Foods and Drinks Linked to Anxiety

What to Avoid and What to Eat

 

Discover which foods and drinks can contribute to anxiety and which ones can help reduce symptoms. Read this guide on how you can help improve your anxious feelings through your diet.

When you’re feeling sad or anxious, it’s normal to crave comfort foods. But have you ever felt even more anxiety-ridden or blue after indulging in sugary confections or a fried meal? Experts and studies alike suggest this cyclical effect isn’t a coincidence.

Nearly 60% of calories in the average American’s diet come from ultra processed foods, which are foods that have gone through extensive processing to the point that they can no longer be classified as whole foods. Research has shown that consuming ultra processed foods is associated with anxiety and depression symptoms.

So, what is the connection between what we eat and anxiety? The answer is our gut.

The foods you eat directly affect your gut microbiome, which is your gut’s ecosystem of microorganisms, including bacteria, viruses and fungi. Your gut contains a delicate balance of healthy and potentially harmful bacteria. Ultra processed foods often encourage the growth of bad bacteria, disrupting this balance and driving intestinal inflammation. That inflammation directly affects your brain, as the gut and brain are connected via the vagus nerve, which sends neurochemicals between the brain and the gut.

In fact, you can think of your gut as your “second brain.” It supplies 90% of your body’s serotonin receptors, the “feel good” neurotransmitter that helps regulate your mood, emotions, digestion and sleep.

Foods That Promote Anxiety

Here are some examples of foods that have been associated with feelings of anxiety.

1. Processed meats and cheeses

Salami, prosciutto, brie and aged cheddar may taste delicious, but these cured meats and aged cheeses you often find on a charcuterie board may have an anxiety-inducing effect.

Research shows that these foods can aggravate histamine production in your body. Histamines are chemicals your immune system releases when they target an invader in your body, causing allergy symptoms in response.

While the connection between histamine and anxiety isn’t fully understood, research suggests that those with anxiety disorders may have more trouble breaking down histamine, a condition known as histamine intolerance. When histamine builds up in the body, it can lead to symptoms that mimic anxiety, including increased heart rate and gastrointestinal distress, which can amplify anxiety.

The histamine content in cheese and meats increases during the aging process. That’s because its proteins break down, freeing an amino acid called histidine, which can be converted into histamine.

2. Fried foods

French fries, fried chicken, onion rings, donuts and beer-battered fish are some examples of the plethora of fried foods that are often cooked with vegetable oils, a process that increases inflammation and contributes to feelings of anxiety.

Many experts are concerned that omega-6 fatty acids found in seed oils – such as safflower, sunflower and grapeseed oils – used in cooking could contribute to inflammation. The body converts linoleic acid, the most common type of omega-6, into arachidonic acid, which plays a complex role in inflammation and has been associated with both inflammatory and noninflammatory reactions in the body.

That inflammation may contribute to generalized anxiety disorder, post-traumatic stress disorder, panic disorder and certain phobias, according to research published in the journal Neuropsychopharmacology.

3. Sugary foods and beverages

Sugar has been shown to feed bad bacteria (flora) in your gut and promote inflammation.

Additionally, consuming high amounts of sugar can cause blood sugar spikes and crashes, which can affect your mood and contribute to anxiety. When blood glucose rapidly fluctuates (specifically when it drops), it can mirror anxiety symptoms or make existing anxiety even more intense.

We find added and refined sugars in so many foods these days, Often you don’t realize they’re in savory foods, like salad dressings, store-bought tomato sauces and … ketchup. Watching for those and being careful about what you’re consuming becomes so important.

4. Highly caffeinated drinks

Beverages that contain caffeine, such as coffee and energy drinks, can increase anxiety.

This is because caffeine activates adenosine receptors, which are involved in mediating the body's fight-or-flight response, in the peripheral and central nervous systems.

Experts say that excessive intake of caffeine can boost the risk of panic attacks, especially in people who have diagnosed psychiatric conditions. Research found in the journal General Hospital Psychiatry revealed that consuming the amount of caffeine found in five cups of coffee can induce a panic attack in people with panic disorder and increase anxiety in those who don’t have the disorder.

5. Alcohol

There’s substantial evidence behind alcohol’s potential contributions to anxiety and depression. Recent research suggests that regular, high consumption of alcoholic beverages may contribute to long-term anxiety, but more studies are needed to understand this relationship.

Foods and Drinks That Reduce Anxiety

On the other hand, there are many foods that can help support a healthy gut, which can contribute to a steady mood. However, it’s important to note that if you’ve been dealing with crippling anxiety, these foods likely won’t make much of an impact. Talk to your health care provider and licensed therapist for support.

Generally speaking, these foods can help reduce anxiety for some people:

1. Fatty fish

Fatty fish are loaded with omega-3 fatty acids, which can combat inflammation in your body and promote serotonin production, which can help keep anxious thoughts at bay.

Research indicates that those who regularly enjoy seafood have a reduced risk of developing depression, which can go hand-in-hand with anxiety.

Choose these fish:

  • Mackerel
  • Salmon 
  • Anchovies
  • Sardines
  • Herring

2. Dark chocolate

Dark chocolate is loaded with antioxidants, so it’s no surprise it’s been linked with benefits for your gut and mood. Studies suggest that a high intake of inflammation-fighting antioxidants, whether through food or supplements, is associated with improved anxiety and depression symptoms.

Recent research found that consuming dark chocolate with 85% cocoa can have a prebiotic-like effect on your gut. Prebiotics enable gut-healthy probiotics to flourish, which can help support a positive mental state.

3. Fermented foods

Studies have long shown that regularly consuming fermented foods can help alleviate anxiety thanks to their high levels of probiotics, which can support a healthy microbiome and a stable mood.

Fermented foods include:

  • Yogurt and kefir 
  • Miso
  • Tempeh 
  • Kimchi
  • Sauerkraut
  • Pickled vegetables

4. High-fiber foods

Fiber from whole foods – such as fruits, vegetables, whole grains and beans – help manage blood sugar levels, which can help stave off anxiety.

High-fiber foods break down much more slowly in your body and they prevent that insulin spike and that sugar crash that people might feel when they eat a sugary doughnut, If you can even out your blood sugar, it can be more calming for your system.

 

5. Herbal teas

If you’ve ever sipped on a cup of chamomile tea before bed, you know firsthand how powerful a soothing herbal tea can be for relaxation. Sipping on lavender tea, for example, has been shown to reduce feelings of anxiety and depression.

Apart from chamomile and lavender, other herbal teas that may contribute to calmness and support digestive health include:

  • Peppermint tea
  • Ginger tea
  • Ashwagandha tea 

 

One Final Note..

 

Certain foods and beverages, especially ultra processed options, may amplify feelings of anxiety and depression.

To support your mental health and wellness, limit your consumption of those foods and, instead, reach for healthier options that can support a healthy gut and, in part, produce a calming effect on your mind.

However, if you think there’s a bigger issue going on, it’s always a good idea to reach out to your doctor or a mental health professional.

You don’t need to live with constant worry and fear. If you notice symptoms of an anxiety disorder, talk to a healthcare provider. It’s best to get diagnosed and treated as soon as possible. Doing so can limit the problems that anxiety disorders can cause. Often, a combination of medications and counseling for anxiety can help you feel your best.

 

 

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Most recent revision July 02, 2025 06:18:44 AM

 

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