Anxiety

Anxiety Disorders affect over 40 million American adults, about 1 out of 7 people, in a given year.

Anxiety is a mental and physiological response to a stressor. It is characterized by fear, worry, irritability and related to situations perceived as uncontrollable or unavoidable.

Anxiety is considered a normal reaction to a problem and can be helpful in dangerious situations. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder. The intensity and frequency of anxiety determines if it is a normal response or an abnormal reaction.

If your level of anxiety interferes with every day activities and impairs your ability to carry a normal life, you could have generalized anxiety disorder.

General anxiety disorder

Symptoms of general anxiety disorder can be categorized into two primary classes:

• Emotional

People with generalized anxiety disorder frequently experience constant worrying or obsession about small or large concerns. These can include frequent nightmares, obsessions about danger, irritability, and restlessness.

• Physiological

Some of the physiological symptoms include: heart palpitations, fatigue, high blood pressure, sweating, pupillary dilation and sweating.

Causes

As with many other mental conditions, anxiety is usually caused by a combination of genetics and environmental stressors. It usually involves the release of three key brain chemicals: serotonin, norepinephrine and dopamine.

Complications

Generalized anxiety disorder is a serious condition that if left untreated, can lead to, or worsen, other conditions such as irritable bowel syndrome, stomach ulcers, skin problems (acne), and insomnia.

Panic disorder



Panic disorder is a condition characterized by recurrent episodes of panic attacks

A panic attack is an sudden episode of extreme fear and apprehension . It is usually brief in duration, typically not lasting more than 30 minutes.

Panic attacks can be extremely frightening and often appear for no apparent reason. When panic attacks occur, they trigger severe emotional and physical reactions. During a typical episode, you might think you're losing your mind or dying.

You might have experienced one or two panic attacks in your life. But if the panic attacks are more frequent and you are in constant fear of another one, you may have panic disorder.

Symptoms of panic disorder

• Heart palpitations, pounding heart, or rapid heart rate

• Excessive sweating or having chills

• Trembling or shaking

• smothering or feelings of choking

• Shortness of breath

• Chest pains

• Cramps or constipation

• Feeling dazed, faint, or lightheaded

• Depersonalization (being detached from oneself)

• fear of that you are losing your mind

• fear of death

• paresthesias (Tingling or numbness in the hands and fingers)

Causes

Environmental factors such as an overly cautious view of the world expressed by parents and cumulative stress over time have been found to be correlated with panic attacks.

Panic disorder is also known to run in families, so heredity also plays a strong factor in who might get it.

Did you know?

• New research supports the notion that people who suffer from panic attacks often have difficulty with assertiveness and over-sensitivity.
• Their communication style, though well mannered and polite, is also characteristically un-assertive. This rather careful approach of communicating seems to contribute to preoccupation about what others might think and, subsequently, panic attacks. Source: Bourne, E. (2005).

Some medications are also known to cause panic attacks in some individuals. Alcohol withdrawal and benzodiazepine withdrawal are the most well known to cause these effects as a rebound withdrawal symptom of their tranquillizing properties.

• An existing predisposition to psychiatric illnesses such as anxiety or depression.

• Lifetime experiences that includes the amount and severity of trauma since early childhood.

• The distinctive traits of a person’s personality – often called the temperament.

• The way the brain controls the release of stress hormone, such as adrenaline, during the “flight-or-fight” response.

Treatment

Panic disorder is usually treated with a combination of cognitive-behavioral therapy (CBT) and medication management. Psychoanalytic therapy is also used for the treatment of panic disorder. Research has shown that both types of therapy yield the most promising results than other forms of therapy.

• Cognitive behavioral therapy: This type of therapy works by using a blend of both cognitive and behavioral therapy. CBT examines the correlation between thought patterns and maladaptive or self-destructive behaviors. The therapy then includes modifying the thinking habits and the behavior.

  With CBT, your therapist might teach you good breathing and relaxation techniques. In addition, he/she might help you re-create the symptoms of panic disorder in a safe environment. This is an important step because with the help of a professional, you will gradually master the skills that will help you overcome this condition. This technique can also help you successfully confront situations that you might normally avoid, such as going to the mall or to a social event.

• Psychoanalytic therapy: Psychodynamic theory believes that the past - poor childhood memories or other unresolved conflicts - is the cause for conditions that last into adulthood, for instance, poor self-image, depression, or a sense of feeling unfinished. This type of treatment is typically more long-term than some of the other types of therapy.

  With psychoanalytic therapy, your therapist might not try to re-create a panic attack. Instead, he/she will try to analyze your past and identify the internal emotional struggle that could be the cause of the symptoms. This approach can take time so please be patient.

Medications

Currently, the U.S. Food and Drug Administration (FDA) has approved several medications for anxiety and panic disorder. These include:

• Benzodiazepines. These medications, like Alprazolam (Xanax) and Diazepam (Valium), can help relax and sleep better. Individuals who take these medications sometimes experience memory problems or dependency.

• Antidepressants. These can include Fluoxetine (Prozac), Sertraline (Zoloft) and Citalopram (Celexa) . Antidepressants can be useful in reducing the sympsoms of co-occurring conditions, such as anxiety or depression.

Online citations

Panic Disorder. Comprehensive overview covers symptoms, causes, treatment and coping with panic disorder. The Mayo-Clinic.

Panic Attack Symptoms. Provides information on panic disorder & treatment. WebMD.

Citations

American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association.

Barker, P. (2009). Psychiatric and Mental Health Nursing: The Craft of Caring. Oxford University Press, USA. 166–167.

Bourne, E. (2005). The Anxiety and Phobia Workbook, 4th Edition: New Harbinger Press.

Coryell W, Noyes R, Clancy J (June 1982). "Excess mortality in panic disorder. A comparison with primary unipolar depression". Arch. Gen. Psychiatry 39 (6): 701–3.

Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R)

Ohman, A. (2000). Fear and anxiety: Evolutionary, cognitive, and clinical perspectives. In M. Lewis & J. M. Haviland-Jones (Eds.). Handbook of emotions. (573-593). New York: The Guilford Press.

Article created: May 24, 2011

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