Anxiety.
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Anxiety.
I
INTRODUCTION
Anxiety, emotional state in which people feel uneasy, apprehensive, or fearful. People usually experience anxiety about events they cannot control or predict, or about
events that seem threatening or dangerous. For example, students taking an important test may feel anxious because they cannot predict the test questions or feel
certain of a good grade. People often use the words fear and anxiety to describe the same thing. Fear also describes a reaction to immediate danger characterized by a
strong desire to escape the situation.
The physical symptoms of anxiety reflect a chronic "readiness" to deal with some future threat. These symptoms may include fidgeting, muscle tension, sleeping
problems, and headaches. Higher levels of anxiety may produce such symptoms as rapid heartbeat, sweating, increased blood pressure, nausea, and dizziness.
All people experience anxiety to some degree. Most people feel anxious when faced with a new situation, such as a first date, or when trying to do something well, such
as give a public speech. A mild to moderate amount of anxiety in these situations is normal and even beneficial. Anxiety can motivate people to prepare for an upcoming
event and can help keep them focused on the task at hand.
However, too little anxiety or too much anxiety can cause problems. Individuals who feel no anxiety when faced with an important situation may lack alertness and
focus. On the other hand, individuals who experience an abnormally high amount of anxiety often feel overwhelmed, immobilized, and unable to accomplish the task at
hand. People with too much anxiety often suffer from one of the anxiety disorders, a group of mental illnesses. In fact, more people experience anxiety disorders than
any other type of mental illness. A survey of people aged 15 to 54 in the United States found that about 17 percent of this population suffers from an anxiety disorder
during any given year.
II
ANXIETY DISORDERS
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, a handbook for mental health professionals, describes a variety of anxiety disorders.
These include generalized anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.
A
Generalized Anxiety Disorder
People with generalized anxiety disorder feel anxious most of the time. They worry excessively about routine events or circumstances in their lives. Their worries often
relate to finances, family, personal health, and relationships with others. Although they recognize their anxiety as irrational or out of proportion to actual events, they
feel unable to control their worrying. For example, they may worry uncontrollably and intensely about money despite evidence that their financial situation is stable.
Children with this disorder typically worry about their performance at school or about catastrophic events, such as tornadoes, earthquakes, and nuclear war.
People with generalized anxiety disorder often find that their worries interfere with their ability to function at work or concentrate on tasks. Physical symptoms, such as
disturbed sleep, irritability, muscle aches, and tension, may accompany the anxiety. To receive a diagnosis of this disorder, individuals must have experienced its
symptoms for at least six months.
Generalized anxiety disorder affects about 3 percent of people in the general population in any given year. From 55 to 66 percent of people with this disorder are
female.
B
Phobias
A phobia is an excessive, enduring fear of clearly defined objects or situations that interferes with a person's normal functioning. Although they know their fear is
irrational, people with phobias always try to avoid the source of their fear. Common phobias include fear of heights (acrophobia), fear of enclosed places
(claustrophobia), fear of insects, snakes, or other animals, and fear of air travel. Social phobias involve a fear of performing, of critical evaluation, or of being
embarrassed in front of other people. See Phobia.
C
Panic Disorder
Panic is an intense, overpowering surge of fear. People with panic disorder experience panic attacks--periods of quickly escalating, intense fear and discomfort
accompanied by such physical symptoms as rapid heartbeat, trembling, shortness of breath, dizziness, and nausea. Because people with this disorder cannot predict
when these attacks will strike, they develop anxiety about having additional panic attacks and may limit their activities outside the home. See Panic Disorder.
D
Obsessive-Compulsive Disorder
In obsessive-compulsive disorder, people persistently experience certain intrusive thoughts or images (obsessions) or feel compelled to perform certain behaviors
(compulsions). Obsessions may include unwanted thoughts about inadvertently poisoning others or injuring a pedestrian while driving. Common compulsions include
repetitive hand washing or such mental acts as repeated counting. People with this disorder often perform compulsions to reduce the anxiety produced by their
obsessions. The obsessions and compulsions significantly interfere with their ability to function and may consume a great deal of time. See Obsessive-Compulsive
Disorder.
E
Post-Traumatic Stress Disorder
Post-traumatic stress disorder sometimes occurs after people experience traumatic or catastrophic events, such as physical or sexual assaults, natural disasters,
accidents, and wars. People with this disorder relive the traumatic event through recurrent dreams or intrusive memories called flashbacks. They avoid things or places
associated with the trauma and may feel emotionally detached or estranged from others. Other symptoms may include difficulty sleeping, irritability, and trouble
concentrating. See Post-Traumatic Stress Disorder.
III
CAUSES
Most anxiety disorders do not have an obvious cause. They result from a combination of biological, psychological, and social factors.
A
Genetics and Neurobiology
Studies suggest that anxiety disorders run in families. That is, children and close relatives of people with disorders are more likely than most to develop anxiety
disorders. Some people may inherit genes that make them particularly vulnerable to anxiety. These genes do not necessarily cause people to be anxious, but the genes
may increase the risk of anxiety disorders when certain psychological and social factors are also present.
Anxiety also appears to be related to certain brain functions. Chemicals in the brain called neurotransmitters enable neurons, or brain cells, to communicate with each
other. One neurotransmitter, gamma-amino butyric acid (GABA), appears to play a role in regulating one's level of anxiety. Lower levels of GABA are associated with
higher levels of anxiety. Some studies suggest that the neurotransmitters norepinephrine and serotonin play a role in panic disorder.
B
Psychological Factors
Psychologists have proposed a variety of models to explain anxiety. Austrian psychoanalyst Sigmund Freud suggested that anxiety results from internal, unconscious
conflicts. He believed that a person's mind represses wishes and fantasies about which the person feels uncomfortable. This repression, Freud believed, results in
anxiety disorders, which he called neuroses.
More recently, behavioral researchers have challenged Freud's model of anxiety. They believe one's anxiety level relates to how much a person believes events can be
predicted or controlled. Children who have little control over events, perhaps because of overprotective parents, may have little confidence in their ability to handle
problems as adults. This lack of confidence can lead to increased anxiety.
Behavioral theorists also believe that children may learn anxiety from a role model, such as a parent. By observing their parent's anxious response to difficult situations,
the child may learn a similar anxious response. A child may also learn anxiety as a conditioned response. For example, an infant often startled by a loud noise while
playing with a toy may become anxious just at the sight of the toy. Some experts suggest that people with a high level of anxiety misinterpret normal events as
threatening. For instance, they may believe their rapid heartbeat indicates they are experiencing a panic attack when in reality it may be the result of exercise.
C
Social Factors
While some people may be biologically and psychologically predisposed to feel anxious, most anxiety is triggered by social factors. Many people feel anxious in response
to stress, such as a divorce, starting a new job, or moving. Also, how a person expresses anxiety appears to be shaped by social factors. For example, many cultures
accept the expression of anxiety and emotion in women, but expect more reserved emotional displays from men.
IV
TREATMENT
Mental health professionals use a variety of methods to help people overcome anxiety disorders. These include psychoactive drugs and psychotherapy, particularly
behavior therapy. Other techniques, such as exercise, hypnosis, meditation, and biofeedback, may also prove helpful.
A
Medications
Psychiatrists often prescribe benzodiazepines, a group of tranquilizing drugs, to reduce anxiety in people with high levels of anxiety. Benzodiazepines help to reduce
anxiety by stimulating the GABA neurotransmitter system. Common benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium). Two
classes of antidepressant drugs--tricyclics and selective serotonin reuptake inhibitors (SSRIs)--also have proven effective in treating certain anxiety disorders.
Benzodiazepines can work quickly with few unpleasant side effects, but they can also be addictive. In addition, benzodiazepines can slow down or impair motor behavior
or thinking and must be used with caution, particularly in elderly persons. SSRIs take longer to work than the benzodiazepines but are not addictive. Some people
experience anxiety symptoms again when they stop taking the medications.
B
Psychotherapy
Therapists who attribute the cause of anxiety to unconscious, internal conflicts may use psychoanalysis to help people understand and resolve their conflicts. Other
types of psychotherapy, such as cognitive-behavioral therapy, have proven effective in treating anxiety disorders. In cognitive-behavioral therapy, the therapist often
educates the person about the nature of his or her particular anxiety disorder. Then, the therapist may help the person challenge irrational thoughts that lead to
anxiety. For example, to treat a person with a snake phobia, a therapist might gradually expose the person to snakes, beginning with pictures of snakes and
progressing to rubber snakes and real snakes. The patient can use relaxation techniques acquired in therapy to overcome the fear of snakes.
Research has shown psychotherapy to be as effective or more effective than medications in treating many anxiety disorders. Psychotherapy may also provide more
lasting benefits than medications when patients discontinue treatment.
Contributed By:
Lynn F. Bufka
David H. Barlow
Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.
Anxiety.
I
INTRODUCTION
Anxiety, emotional state in which people feel uneasy, apprehensive, or fearful. People usually experience anxiety about events they cannot control or predict, or about
events that seem threatening or dangerous. For example, students taking an important test may feel anxious because they cannot predict the test questions or feel
certain of a good grade. People often use the words fear and anxiety to describe the same thing. Fear also describes a reaction to immediate danger characterized by a
strong desire to escape the situation.
The physical symptoms of anxiety reflect a chronic "readiness" to deal with some future threat. These symptoms may include fidgeting, muscle tension, sleeping
problems, and headaches. Higher levels of anxiety may produce such symptoms as rapid heartbeat, sweating, increased blood pressure, nausea, and dizziness.
All people experience anxiety to some degree. Most people feel anxious when faced with a new situation, such as a first date, or when trying to do something well, such
as give a public speech. A mild to moderate amount of anxiety in these situations is normal and even beneficial. Anxiety can motivate people to prepare for an upcoming
event and can help keep them focused on the task at hand.
However, too little anxiety or too much anxiety can cause problems. Individuals who feel no anxiety when faced with an important situation may lack alertness and
focus. On the other hand, individuals who experience an abnormally high amount of anxiety often feel overwhelmed, immobilized, and unable to accomplish the task at
hand. People with too much anxiety often suffer from one of the anxiety disorders, a group of mental illnesses. In fact, more people experience anxiety disorders than
any other type of mental illness. A survey of people aged 15 to 54 in the United States found that about 17 percent of this population suffers from an anxiety disorder
during any given year.
II
ANXIETY DISORDERS
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, a handbook for mental health professionals, describes a variety of anxiety disorders.
These include generalized anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.
A
Generalized Anxiety Disorder
People with generalized anxiety disorder feel anxious most of the time. They worry excessively about routine events or circumstances in their lives. Their worries often
relate to finances, family, personal health, and relationships with others. Although they recognize their anxiety as irrational or out of proportion to actual events, they
feel unable to control their worrying. For example, they may worry uncontrollably and intensely about money despite evidence that their financial situation is stable.
Children with this disorder typically worry about their performance at school or about catastrophic events, such as tornadoes, earthquakes, and nuclear war.
People with generalized anxiety disorder often find that their worries interfere with their ability to function at work or concentrate on tasks. Physical symptoms, such as
disturbed sleep, irritability, muscle aches, and tension, may accompany the anxiety. To receive a diagnosis of this disorder, individuals must have experienced its
symptoms for at least six months.
Generalized anxiety disorder affects about 3 percent of people in the general population in any given year. From 55 to 66 percent of people with this disorder are
female.
B
Phobias
A phobia is an excessive, enduring fear of clearly defined objects or situations that interferes with a person's normal functioning. Although they know their fear is
irrational, people with phobias always try to avoid the source of their fear. Common phobias include fear of heights (acrophobia), fear of enclosed places
(claustrophobia), fear of insects, snakes, or other animals, and fear of air travel. Social phobias involve a fear of performing, of critical evaluation, or of being
embarrassed in front of other people. See Phobia.
C
Panic Disorder
Panic is an intense, overpowering surge of fear. People with panic disorder experience panic attacks--periods of quickly escalating, intense fear and discomfort
accompanied by such physical symptoms as rapid heartbeat, trembling, shortness of breath, dizziness, and nausea. Because people with this disorder cannot predict
when these attacks will strike, they develop anxiety about having additional panic attacks and may limit their activities outside the home. See Panic Disorder.
D
Obsessive-Compulsive Disorder
In obsessive-compulsive disorder, people persistently experience certain intrusive thoughts or images (obsessions) or feel compelled to perform certain behaviors
(compulsions). Obsessions may include unwanted thoughts about inadvertently poisoning others or injuring a pedestrian while driving. Common compulsions include
repetitive hand washing or such mental acts as repeated counting. People with this disorder often perform compulsions to reduce the anxiety produced by their
obsessions. The obsessions and compulsions significantly interfere with their ability to function and may consume a great deal of time. See Obsessive-Compulsive
Disorder.
E
Post-Traumatic Stress Disorder
Post-traumatic stress disorder sometimes occurs after people experience traumatic or catastrophic events, such as physical or sexual assaults, natural disasters,
accidents, and wars. People with this disorder relive the traumatic event through recurrent dreams or intrusive memories called flashbacks. They avoid things or places
associated with the trauma and may feel emotionally detached or estranged from others. Other symptoms may include difficulty sleeping, irritability, and trouble
concentrating. See Post-Traumatic Stress Disorder.
III
CAUSES
Most anxiety disorders do not have an obvious cause. They result from a combination of biological, psychological, and social factors.
A
Genetics and Neurobiology
Studies suggest that anxiety disorders run in families. That is, children and close relatives of people with disorders are more likely than most to develop anxiety
disorders. Some people may inherit genes that make them particularly vulnerable to anxiety. These genes do not necessarily cause people to be anxious, but the genes
may increase the risk of anxiety disorders when certain psychological and social factors are also present.
Anxiety also appears to be related to certain brain functions. Chemicals in the brain called neurotransmitters enable neurons, or brain cells, to communicate with each
other. One neurotransmitter, gamma-amino butyric acid (GABA), appears to play a role in regulating one's level of anxiety. Lower levels of GABA are associated with
higher levels of anxiety. Some studies suggest that the neurotransmitters norepinephrine and serotonin play a role in panic disorder.
B
Psychological Factors
Psychologists have proposed a variety of models to explain anxiety. Austrian psychoanalyst Sigmund Freud suggested that anxiety results from internal, unconscious
conflicts. He believed that a person's mind represses wishes and fantasies about which the person feels uncomfortable. This repression, Freud believed, results in
anxiety disorders, which he called neuroses.
More recently, behavioral researchers have challenged Freud's model of anxiety. They believe one's anxiety level relates to how much a person believes events can be
predicted or controlled. Children who have little control over events, perhaps because of overprotective parents, may have little confidence in their ability to handle
problems as adults. This lack of confidence can lead to increased anxiety.
Behavioral theorists also believe that children may learn anxiety from a role model, such as a parent. By observing their parent's anxious response to difficult situations,
the child may learn a similar anxious response. A child may also learn anxiety as a conditioned response. For example, an infant often startled by a loud noise while
playing with a toy may become anxious just at the sight of the toy. Some experts suggest that people with a high level of anxiety misinterpret normal events as
threatening. For instance, they may believe their rapid heartbeat indicates they are experiencing a panic attack when in reality it may be the result of exercise.
C
Social Factors
While some people may be biologically and psychologically predisposed to feel anxious, most anxiety is triggered by social factors. Many people feel anxious in response
to stress, such as a divorce, starting a new job, or moving. Also, how a person expresses anxiety appears to be shaped by social factors. For example, many cultures
accept the expression of anxiety and emotion in women, but expect more reserved emotional displays from men.
IV
TREATMENT
Mental health professionals use a variety of methods to help people overcome anxiety disorders. These include psychoactive drugs and psychotherapy, particularly
behavior therapy. Other techniques, such as exercise, hypnosis, meditation, and biofeedback, may also prove helpful.
A
Medications
Psychiatrists often prescribe benzodiazepines, a group of tranquilizing drugs, to reduce anxiety in people with high levels of anxiety. Benzodiazepines help to reduce
anxiety by stimulating the GABA neurotransmitter system. Common benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium). Two
classes of antidepressant drugs--tricyclics and selective serotonin reuptake inhibitors (SSRIs)--also have proven effective in treating certain anxiety disorders.
Benzodiazepines can work quickly with few unpleasant side effects, but they can also be addictive. In addition, benzodiazepines can slow down or impair motor behavior
or thinking and must be used with caution, particularly in elderly persons. SSRIs take longer to work than the benzodiazepines but are not addictive. Some people
experience anxiety symptoms again when they stop taking the medications.
B
Psychotherapy
Therapists who attribute the cause of anxiety to unconscious, internal conflicts may use psychoanalysis to help people understand and resolve their conflicts. Other
types of psychotherapy, such as cognitive-behavioral therapy, have proven effective in treating anxiety disorders. In cognitive-behavioral therapy, the therapist often
educates the person about the nature of his or her particular anxiety disorder. Then, the therapist may help the person challenge irrational thoughts that lead to
anxiety. For example, to treat a person with a snake phobia, a therapist might gradually expose the person to snakes, beginning with pictures of snakes and
progressing to rubber snakes and real snakes. The patient can use relaxation techniques acquired in therapy to overcome the fear of snakes.
Research has shown psychotherapy to be as effective or more effective than medications in treating many anxiety disorders. Psychotherapy may also provide more
lasting benefits than medications when patients discontinue treatment.
Contributed By:
Lynn F. Bufka
David H. Barlow
Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.
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