Anxiety and Anxiety Disorders

Anxiety is an unpleasant emotion triggered by anticipation of future events, memories of past events, or ruminations about the self. People with anxiety disorders are overwhelmed by worry and fear.

Clinical anxiety is often intense and unpredictable, stimulated by real or imagined dangers. According to studies conducted by the Centers for Disease Control (CDC), panic disorder, generalized anxiety disorder, post-traumatic stress disorder (PTSD), and phobias are the most common types of mental illness diagnosed in the general population. Anxiety disorders are often diagnosed in developed countries and are more prevalent in women than in men. Small children can be highly anxious by temperament. Elderly people may become anxious as their thinking processes become less clear. Although it stems from irrational fears, clinical anxiety is so painful to experience that many people disrupt their normal life to avoid feeling it. Some researchers believe that anxiety is synonymous with fear and that anxiety occurs when people feel threatened. Other psychologists view anxiety as a highly unpleasant emotion caused by unidentifiable dangers or dangers that pose no real threat. Unlike fear, which is caused by real dangers, anxiety is often difficult to identify and to alleviate.

Rather than attempting to formulate a strict definition of anxiety, many psychologists simply make a distinction between normal anxiety and neurotic anxiety or anxiety disorders. Normal anxiety occurs when people react appropriately to a stressful situation; for example, many people feel anxious on the first day at a new job. They may be uncertain whether coworkers will like them, unfamiliar with their duties, or unsure they made the correct decision in taking the job. Despite these feelings and accompanying physiological responses, most people carry on at a new job and eventually adapt. By contrast, the anxiety that is characteristic of anxiety disorders is disproportionately intense. Anxious feelings interfere with a person's ability to carry out many normal and even desirable activities. Some professional performers experience stage fright, the fear of speaking, singing, or acting in front of large groups of people. Although there is little real danger posed by these situations, each can provoke intense feelings of anxiety that derail a person's desires or obligations. Sigmund Freud (1856–1939) described neurotic anxiety as a danger signal. Freud believed that anxiety occurs when unconscious sexual or aggressive tendencies conflict with physical or moral limitations. Many psychologists still believe that anxiety can signal an unexpressed conflict.




Hamilton Depression Rating Scale (HDRS)





Hamilton Depression Rating Scale (HDRS)

Many psychologists agree that generalized anxiety disorder is partially inherited and is caused by chemical imbalances in the body. Treatment for anxiety varies depending on the severity of the symptoms and the particular patient. Often, drugs in the benzodiazepine family (Ativan or Xanax) are prescribed for anxiety. These drugs combat generalized anxiety by relaxing the central nervous system; they reduce tension and relax muscles. They can also cause drowsiness, making them an appropriate treatment for insomnia. In proper dosages, these medications can relieve anxiety without negatively affecting thought processes or causing sedation. Medication is typically most effective when combined with psychological therapies. Behavior therapy works to help an anxious person gain control over unwanted behaviors by learning to cope with difficult situations, often through controlled exposure to them. Cognitive therapy is designed to change the unproductive thought patterns that lead to anxious thoughts by teaching a client to examine her feelings and discriminate between rational and irrational thoughts.

Controlling or eliminating the physical symptoms of anxiety without medication is another method of treatment. Breathing techniques can slow the heart rate. Access to fresh air can ease sweating. Effective control of such symptoms can be useful in controlling the anxiety itself. The standard of care for treating most anxiety disorders is psychotherapy, often cognitive behavioral therapy, used in conjunction with medication. No single definitive cause for anxiety disorders existed as of 2015; genetics, hormonal shifts, and external stressors, including divorce, job loss, or birth of a child, can all be precipitants to both generalized anxiety and panic attacks.

See also Drug therapy ; Freud, Sigmund; Social psychology ; Stress .

Resources

BOOKS

Amen, Daniel G. Change Your Brain, Change Your Life: The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness. New York: Crown Publishing Group, 2000.

Clark, David A., and Aaron T. Beck. Cognitive Therapy of Anxiety Disorders: Science and Practice. New York: Guilford Press, 2010.

Lacan, Jacques, Jacques-Alain Miller, and A. Rae Price. Anxiety. Cambridge, UK: Polity Press, 2014.

Marker, Craig D., and Alison G. Aylward. Generalized Anxiety Disorder. Toronto, Canada: Hogrefe, 2012.

McKay, Dean, and Eric A. Storch. Handbook of Child and Adolescent Anxiety Disorders. New York: Springer, 2011.

Starcevic, Vladan. Anxiety Disorders in Adults: A Clinical Guide. Oxford, UK: Oxford University Press, 2010.

PERIODICALS

Friedman, Richard A. “Why Teenagers Act Crazy,” New York Times (June 28, 2014).

Stossel, Scott. “Surviving Anxiety,” The Atlantic (January/ February 2014).

WEBSITES

American Psychological Association. “Anxiety.” http://www.apa.org/topics/anxiety/ (accessed July 20, 2015).

Mayo Clinic. “Anxiety: Definition” http://www.mayoclinic.org/diseases-conditions/anxiety/basics/definition/con-20026282 (accessed July 20, 2015).

Psych Central. “Anxiety: An Introduction to Anxiety Disorders” http://psychcentral.com/disorders/anxiety/ (accessed July 20, 2015).

Psychology Today. “Anxiety” http://www.psychologytoday.com/basics/anxiety (accessed July 20, 2015).

ORGANIZATIONS

American Psychiatric Association, 1000 Wilson Blvd., Ste. 1825, Arlington, VA, 22209, (703) 907-7300, (888) 3577924), apa@psych.org, http://www.psychiatry.org .