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Definition
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.
See also: Generalized Anxiety Disorder
Causes
Anxiety may result from many factors including:
- Appropriate response under stressful circumstances
- Drugs that affect the nervous system, such as:
- Caffeine
- Alcohol
- Cocaine
- Nicotine
- Amphetamines (eg, crystal meth)
- Some herbal medications
- Biological factors:
- Brain chemistry imbalances (eg, serotonin and norepinephrine)
- Personality traits
- Faulty perceptions and irrational beliefs (eg, phobias)
- Unresolved emotional conflicts
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.Risk factors for anxiety include:
Sex: femaleFamily member with anxiety disordersStressful life eventsIneffective coping strategiesHistory of physical or psychological trauma SymptomsAnxiety has psychological and physical symptoms. Psychological symptoms may include: Worry or dreadObsessive or intrusive thoughtsSense of imminent danger or catastropheFear or panicRestlessnessIrritabilityImpatienceAmbivalenceTrouble concentrating Physical symptoms may include: Rapid or irregular heartbeatSweating, especially the palmsDry mouthFlushing or blushingMuscle tensionShortness of breathLightheadedness or faintnessDifficulty sleepingShakingChoking sensationFrequent urinationNausea or vomitingDiarrheaConstipationFeeling of "butterflies" in the stomachSexual difficultiesTingling sensationsNail biting or other habitual behavior Symptoms of Anxiety 2008 Nucleus Medical Art, Inc. DiagnosisYour 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. TreatmentEffective treatment usually involves a combination of interventions, including:
Lifestyle ChangesGet sufficient rest and sleepAvoid tobaccoReduce or eliminate caffeinated beveragesDrink alcohol in moderationAvoid illicit drugsReduce exposure to stressful environmentsExercise regularly Relaxation TechniquesDeep breathingMeditationDeep muscle relaxationMassageEngaging in pleasurable activities Social SupportStrong support system of family and friendsCounseling to improve coping skillsSupport groups PsychotherapyPsychotherapy addresses thoughts, feelings, and behaviors that play a role in anxietyCognitive-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: BenzodiazepinesBuspironeTricyclic 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 concernmostly 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 Americahttp://www.adaa.org The Canadian Network for Mood and Anxiety Treatmentshttp://www.canmat.org CANADIAN RESOURCES: Canadian Psychological Associationhttp://www.cpa.ca/cpasite/home.asp Canadian Psychiatric Associationhttp://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/ .
Last reviewed February 2008 by Rosalyn Carson-DeWitt, MDPlease 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.
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