Anxiety is a normal state of apprehension, tension, and uneasiness in response to a real or perceived threat. Although anxiety is considered a normal response to temporary periods of stress or uncertain situations, prolonged, intense, or inappropriate periods of anxiety may indicate an anxiety disorder.
Other indicators of an anxiety disorder are anxiety that occurs without an external threat (“free-floating” anxiety) and anxiety that impairs daily functioning.
The most common types of anxiety disorders are: phobias, post-traumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder, social anxiety disorder, and generalized anxiety disorder. Anxiety and anxiety disorders are often complicated by the presence of alcohol/drug abuse and depression.
Your doctor will ask about your symptoms and medical history. You will be given a psychiatric evaluation. Your doctor may also perform a physical exam and diagnostic tests. Usually the results of these tests are normal. You may be referred to a psychotherapist for further evaluation.
Treatment
Effective treatment usually involves a combination of interventions, including:
Psychotherapy addresses thoughts, feelings, and behaviors that play a role in anxiety
Cognitive-behavioral therapy can help you identify negative thought patterns and behaviors. Over time, you can learn to retrain your thinking and choose more functional behaviors in response to stress and anxiety.
Psychotherapy helps you work through unresolved psychological trauma and conflict
Medication
For severe anxiety or anxiety disorder, medications may include:
Benzodiazepines
Buspirone
Tricyclic antidepressants
Selective serotonin reuptake inhibitors (SSRIs)
Please Note:
On March 22, 2004, the Food and Drug Administration (FDA) issued a Public Health Advisory that cautions physicians, patients, families, and caregivers of patients with depression to closely monitor both adults and children receiving certain antidepressant medications. The FDA is concerned about the possibility of worsening depression and/or the emergence of suicidal thoughts, especially among children and adolescents at the beginning of treatment, or when there is an increase or decrease in the dose. The medications of concern—mostly SSRIs (Selective Serotonin Re-uptake Inhibitors)—are:
Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram), Lexapro (escitalopram), Wellbutrin (bupropion), Effexor (venlafaxine), Serzone (nefazodone), and Remeron (mirtazapine).
Of these, only Prozac (fluoxetine) is approved for use in children and adolescents for the treatment of major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for use in children and adolescents for the treatment of obsessive compulsive disorder. For more information, please visit
http://www.fda.gov/cder/drug/antidepressants
.
Prevention
To help prevent anxiety, consider taking the following steps:
Avoid situations, occupations, and people that cause you stress.
If unavoidable, confront and overcome situations that provoke anxiety.
Find a relaxation technique that works for you and use it regularly.
Develop and maintain a strong social support system.
Express your emotions when they happen.
Challenge irrational beliefs and counterproductive thoughts.
Correct misperceptions; ask others for their views.
Work with a psychotherapist or marriage and family counselor.
Avoid using nicotine or other drugs, and drink alcohol in moderation.
RESOURCES:
Anxiety Disorders Association of America http://www.adaa.org
The Canadian Network for Mood and Anxiety Treatments http://www.canmat.org
CANADIAN RESOURCES:
Canadian Psychological Association http://www.cpa.ca/cpasite/home.asp
Canadian Psychiatric Association http://www.cpa-apc.org
References:
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders
. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.
Current Medical Diagnosis and Treatment
. 45th ed. McGraw-Hill; 2006.
National Institute of Mental Health website. Available at:
http://www.nimh.nih.gov/
.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
