We ve all experienced minor anxiety at some point in our lives - It s the butterflies you feel in your stomach before a big date, the tense feeling you get when you know you re in danger. This stress response, or fight / flight response is what helps us deal with everyday problems and situations. In healthy individuals, this response is provoked by a genuine threat or challenge to help deal with a particular situation. Anxiety, however, is excessive or inappropriate arousal characterized by feelings of apprehension, uncertainty, and fear. Although these feelings are often not attributable to a real threat, they can paralyze the individual into withdrawal and fear.
Anxiety disorders are the most common psychiatric condition in the United States. About 25 million Americans will experience a form of anxiety disorders at some point during their life. Although treatment is usually very effective, only a quarter of those who experience this problem seek help. Anxiety disorders are classified into five different categories: Generalized Anxiety Disorder, Panic Disorder, Phobic Disorders, Obsessive-Compulsive Disorder, and Post-Traumatic Stress Disorder. Generalized Anxiety Disorder affects about 10 million Americans. It is characterized by a more-or-less constant state of tension and anxiety, which lasts more than six months.
It was extremely difficult to control worry. Sometimes, they think something terrible will happen even though there's no reason to think that it will. They may also worry about health, money, family or work. They may feel tense without knowing why. A diagnosis of GAD is confirmed when three or more of the following symptoms are present: feeling on edge or very restless; feeling tired; having difficulty concentrating; feeling irritable; having muscle tension; experiencing sleep disturbances. These symptoms should occur for more than six months and impair normal functioning.
Pani Disorder is characterized by periodic attacks of anxiety or terror, which usually last 15 to 30 minutes. The frequency of the attacks can vary from having daily attacks followed by weeks or months of remission from having frequent attacks (every week, for example) that occur for months. Panic attacks can occur spontaneously or in response to a particular situation. If the patient associates fear with harmless circumstances surrounding the original attack, similar circumstances later on may recall the anxiety and trigger additional panic attacks.
During a panic attack a person feels intense fear or discomfort with at least four or more of the following symptoms: rapid heart beat; sweating; shakiness; shortness of breath; a choking feeling; dizziness; nausea; fear of dying; fear of going insane; either hot flashes or chills; chest pains. A diagnosis is made when a person experiences at least two repeated, unexpected attacks followed by at least one month of fear that another will occur. Sometimes a patient will experience an attack with only one or two of the symptoms. These attacks are called limited-symptom attacks. They may either be residual symptoms from a full-blown attack, or precursors to a major attack. Phobias are overwhelming and irrational fears.
Although they are very common, phobias can vary in severity. In most cases the phobic situation can be avoided, but in some cases the anxiety caused can be incapacitating. One of the most common phobias is agoraphobia. This is especially seen in patients with panic disorders. Agoraphobia is characterized by a paralyzing terror of being in places or situations where the patient feels there is no escape.
This can usually cause patients to avoid public places, because they no longer feel safe. Social phobia is the fear of being publicly embarrassed and scrutinized. The symptoms can range from mild anxiety to a full-blown panic attack. Sometimes social phobia is evident by extreme shyness and discomfort in social settings.
Other symptoms include frequent blushing; trembling; and sweating. Simple phobias are irrational fears of specific objects or situations. The most common are fear of animals (usually spiders, snakes, and mice); flying; heights; confined spaces; and bridges. When facing the object or situation, the person may experience panicky feelings, sweating, rapid heartbeat, and avoidance behavior. Most phobic people are aware of how irrational their fears are and may endure intense anxiety instead of telling people. Simple phobias are among the most common medical disorders, but in many cases they are not severe enough to treat.
Obsessive-Compulsive disorder has been described as hiccups of the mind. Obsessions are persistent mental images, thoughts, or ideas, which may result in compulsive behaviors. Although individuals recognize that the obsessive thoughts and ritualized behavior patterns are senseless and excessive, they cannot stop them in spite of vigorous efforts. OCD is time-consuming and can disrupt normal functioning. The obsessive thoughts can range from worrying about locking the door to frightening fantasies of hurting a loved one.
Post-traumatic stress disorder is primarily a reaction to a traumatic event. However, it may also occur in people who witness an accident, are involved in a rescue, or who lose a loved one suddenly. Symptoms include emotional withdrawal, hopelessness, mood swings, sleep disorders, and inability to concentrate. Symptoms can occur weeks, months, or even years after the event. There are many different factors that seem to contribute to the development of anxiety disorders. Certain studies suggest that an imbalance of neurotransmitters like serotonin and dopamine may contribute to anxiety disorders.
Scientists are also beginning to identify the different areas of the brain associated with specific anxiety responses. Some people have panic attacks after exposure to certain foods or chemicals. Studies have indicated that many children and adults with anxiety disorders may have a hypersensitivity to high levels of carbon dioxide, which can be found in crowed spaces and airplanes. This would help explain why people are more prone to anxiety attacks in crowed spaces. Another factor is genetics. About 20%-25% of close relatives of people with panic disorder or OCD experiences these disorders.
Researchers have also identified a gene associated with people who have personality traits that include anxiety, anger, hostility, pessimism, and depression. The gene produces reduced about amounts of a protein that transports serotonin, which is needed to maintain positive emotions. Anxiety disorders affect more than 23 million Americans. Worry is very common among children, but only 5% have anxiety that can be classified as a disorder. One study suggests that children who are extremely shy and those likely to be the target of bullies are at a higher risk for developing anxiety disorders later in life. Women are twice as likely to get anxiety disorders than men are.
This may be because of hormonal factors, cultural pressures to meet everyone else s needs, and less self-restrictions on reporting anxiety to doctors. Most anxiety disorders respond well to treatment. The most effective approach is a combination of cognitive-behavior therapy and medication. Until recently, a group of drugs called benzodiazepines, were the primary medications for anxiety.
Examples of these drugs are Xanax and Valium. These drugs reinforce a chemical in the brain that inhibits nerve-cell excitability. However, these drugs cause daytime drowsiness and are extremely addictive. Increasingly, antidepressants are being used as the initial treatment. They are proving to be effective, to be less addictive, and to have fewer side effects than the standard anti-anxiety drugs. The drug BuSpar belongs to a new class of drugs known as azapirones.
This drug is used to treat GAD only. Unfortunately, it usually takes several weeks for the drug to be fully effective. The good side is unlike the benzodiazepines, BuSpar is not addictive. Cognitive therapy works on the principle that the thoughts that produce anxiety can be recognized and changed, thereby changing the response.
The essential goal is to recognize the anxiety-inducing situation and to learn to respond to it with new actions. Luckily, the prognosis for any of the anxiety disorders is excellent provided the correct treatment. Most patients experience less symptoms and less anxiety almost immediately and can lead normal healthy lives.