Anxiety

What Is Anxiety?

Anxiety, or extreme apprehension and worry, is a normal reaction to stressful situations. In some cases, however, worry becomes excessive or chronic and can cause sufferers to dread everyday situations.

The condition of steady, pervasive anxiety is called Generalized Anxiety Disorder. Other anxiety-related disorders include panic attacks—severe episodes of anxiety that occur in response to specific triggers—and obsessive-compulsive disorder, which is marked by persistent intrusive thoughts or compulsions to carry out specific behaviors (such as hand-washing). Anxiety so frequently co-occurs with depression that the two are thought to be twin faces of one disorder. Like depression, it strikes twice as many adult females as males.

Generally, anxiety arises first, often during childhood. Evidence suggests that both biology and environment can contribute to the disorder. Some people may have a genetic predisposition to anxiety; however, even so, development of the condition is not inevitable. Early traumatic experiences can also reset the body’s normal fear-processing system so that it is hyper-reactive.

Anxiety is typified by exaggerated worries and expectations of negative outcomes in unknown situations, and such concerns are often accompanied by physical symptoms. These include muscle tension, headaches, stomach cramps, and frequent urination. Behavioral therapies, with or without medication to control symptoms, have proved highly effective against anxiety, especially in children.

Symptoms of Anxiety

Typically, those who suffer from prolonged anxiety experience a range of symptoms, including:

  • excessive worry about health, money, family, work, or school performance—even when there are no signs of trouble
  •  irrational expectations of the worst outcome in many situations
  •  inability to relax
  •  irritability
  •  insomnia
  •  tiredness
  •  headaches
  •  muscle tension
  •  difficulty swallowing
  •  trembling or twitching
  •  frequent urination

Causes of Anxiety

In people with anxiety disorders, the brain circuitry that controls the threat response goes awry. At the heart of the circuit is the amygdala, a structure that flags incoming signals as worrisome and communicates with other parts of the brain to put the body on alert for danger. Early life events, especially traumatic ones, can program the circuitry so that it is oversensitive and sends out alarms too frequently and with only minor provocations. Survival mandates a system for perceiving threats and taking quick, automatic action, but those with anxiety see threats where there are none, perhaps because emotional memories color their perceptions.

Treatment of Anxiety

Research demonstrates that the most effective treatments for anxiety are behavioral. Such treatments often involve gradually exposing sufferers to the situations they fear. Anxiety therapy may also focus on changing distorted thought patterns that underlie the condition. Drugs may help patients control their anxiety, but they are typically effective only during treatment and do. not usually cure the condition. Increasingly, researchers are finding that mindfulness meditation can be a successful technique that helps lessen anxiety.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that may develop after exposure to a terrifying event or ordeal in which severe physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or unnatural disasters, accidents, or military combat. Many people with PTSD tend to re-experience the ordeal that set the condition in motion, especially when they are exposed to events or objects reminiscent of the causal trauma. People who have suffered childhood abuse or other previous traumatic experiences carry a vulnerability that renders them more likely to develop the disorder. And people who experience emotional distancing may be more prone to PTSD.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is a potentially disabling anxiety disorder. People afflicted with OCD become trapped in a pattern of repetitive, senseless thoughts and behaviors that are very difficult to overcome. Left untreated, a severe case of OCD can destroy a person's capacity to function at work or school—or to lead a comfortable existence at home. Although OCD symptoms typically begin during the teen years or early adulthood, research shows that some children may even develop the illness during preschool.

Panic Disorder

A person with panic disorder experiences sudden and repeated episodes of intense fear accompanied by physical symptoms such as chest pain, heart palpitations, breathlessness, vertigo, or abdominal distress. Those who suffer from panic disorder often develop phobias about places where previous episodes have occurred—such as shopping malls. They also develop fears about experiences that have set off previous attacks, such as taking a flight.

Approximately 2.4 million Americans—or 1.7 percent of the population between the ages of 18 and 54—suffer from panic disorder each year. Women are twice as likely as men to develop the disorder.

Panic disorder is treated with medications and cognitive-behavioral therapy, a type of psychotherapy that teaches patients to view their attacks in a different way and demonstrates how to reduce anxiety.

How to Cope

Anxiety disorders can often be addressed successfully with a combination of therapy and medication. For therapy, patients may undergo psychotherapy or cognitive behavioral therapy, in which they learn to change how they respond to situations that induce anxiety. For medications, clinicians may, for limited periods of time, prescribe antidepressants such as selective serotonin reuptake inhibitors or tricyclics, tranquilizers such as benzodiazepines; they may also prescribe beta blockers for specific events. Different strategies can also help people who experience feelings of anxiety but the severity of which falls below the clinical threshold for diagnosis. Habits such as exercising, sleeping well, and limiting the amount of caffeine and alcohol consumed can prove helpful. Strategies such as taking deep breaths, acknowledging limits to fully controlling situations, push back against anxious or irrational thoughts, and observing the circumstances that tend to produce anxiety are proven to reduce anxiety by helping people feel better prepared in the future.

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