Anxiety Disorders

Overview

An anxiety disorder is an excessive or inappropriate response to stress that leaves you with feelings of apprehension, uncertainty and fear. It can paralyze you into inaction or withdrawal. An anxiety disorder isn’t just a case of “nerves.” According to the National Institute of Mental Health, an estimated 40 million Americans, or 18 percent of the population, experience this illness.

Anxiety is expressed physically through a series of responses such as:

  • a rise in blood pressure
  • a fast heart rate
  • rapid breathing
  • an increase in muscle tension
  • a decrease in intestinal blood flow, sometimes resulting in nausea or diarrhea

Without treatment, an anxiety disorder can significantly disrupt your life because symptoms usually become progressively worse. Tormented by panic attacks, irrational thoughts and fears, compulsive behaviors or rituals, flashbacks, nightmares or countless frightening physical symptoms, people with anxiety disorders rely heavily on emergency departments and other medical services to address their symptoms.

Their work, family and social lives are disrupted, and some even become housebound. Many individuals who suffer from this disorder have other mental disorders such as depression or substance abuse.

Fortunately, treatment for anxiety disorders is, in general, very effective. Early diagnosis may aid early recovery, prevent the disorder from becoming worse and possibly prevent the disorder from developing into depression. Yet, because of a widespread lack of understanding and the stigma associated with anxiety disorders, only about one-third of those who experience them are diagnosed and receive treatment.

In recent years, a number of different anxiety disorders have been categorized:

  • Generalized anxiety disorder (GAD) affects about 6.8 million Americans and affects twice as many women as men. GAD is characterized by at least six months of a more-or-less constant state of tension or worry not related to any event. If you suffer from GAD, you may always expect a catastrophe to happen. Though you may know your feelings are unrealistic, you cannot control them. The worries that accompany GAD are nonspecific and are not as obsessive as the thoughts and worries experienced with obsessive-compulsive disorder. However, more than half the people who suffer from GAD also have another anxiety disorder or depression.
  • Panic attacks develop abruptly and generally reach a peak within 10 minutes. They develop without warning and are not necessarily related to any specific event. The word anxiety is derived from the Latin angere, which means to choke or strangle, and many women who suffer from panic attacks report the physical sensation of their throat tightening, cutting off their breath. This physical sensation can lead to additional anxious feelings.
  • Panic disorder, defined as repeated panic attacks or worry about such attacks, affects about six million Americans. It typically strikes in late adolescence or early adulthood. Women are twice as likely as men to develop panic disorder. People with panic disorder may also suffer from depression, abuse alcohol or abuse drugs such as marijuana. About one-third of people with panic disorder develop agoraphobia, the fear of having a panic attack in public. It may lead a person to avoid public spaces for fear that escape might be difficult or help unavailable if they have a panic attack. Often they won’t leave their homes.
  • Phobias are irrational and involuntary and include overwhelming fears that lead a person to avoid common objects, events or situations, or become excessively anxious as they approach them. While they vary in severity, in some cases the anxiety associated with the feared object or situation can be incapacitating. Most people who suffer from phobias are aware of the irrationality of their fear, and many avoid certain objects or situations or endure intense anxiety. Specific phobias are among the most common mental health disorders.Specific phobias include fear of animals, heights (acrophobia), air travel (pterygophobia), water, confined spaces (claustrophobia), bridges or other things. About 19.2 million Americans suffer from specific phobias, and they are twice as common in women as men.
  • Social phobia, or social anxiety disorder, is caused by a fear of being embarrassed in a social situation or publicly scrutinized and humiliated. Social phobia is often accompanied by depression and may lead to alcohol or other drug abuse. About 15 million people have social phobia, which is equally common among women and men. The disorder typically beings in childhood or early adolescence and rarely develops after age 25.
  • Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent and intrusive thoughts, images or impulses that cause anxiety. These mental images or ideas are called obsessions. The person tries to control these obsessions or keep her fears from being realized by performing repetitive behaviors called compulsions.The compulsions are often rigid and must be performed in a certain time-consuming order. Although adults with OCD often know these rituals are excessive, they cannot stop doing them in spite of strenuous efforts to ignore or suppress the thoughts or actions. Repeated hand washing, reordering of belongings, rechecking objects in one’s house, or silently repeating words, numbers or prayers are examples of compulsions. More than half of OCD sufferers have obsessive thoughts without ritualistic behavior. About 2.2 million Americans have OCD. One-third of adults affected with OCD had their first symptoms in childhood. OCD affects men and women with equal frequency.OCD should not be confused with obsessive-compulsive personality disorder, which defines certain character traits such as being a perfectionist, excessively conscientious, morally rigid and preoccupied with rules and order. These traits do not necessarily occur in people with OCD.
  • Post-traumatic stress disorder (PTSD) develops after exposure to an extremely stressful event that involved serious physical harm or the threat of harm to one’s physical integrity. About 7.7 million people suffer from PTSD. Trauma such as a rape, childhood sexual abuse, military combat or war-related incidents and natural disasters during which you experienced intense fear, helplessness and horror are common causes of PTSD.

Although anxiety is a normal human response to stress, health care professionals and researchers don’t know why some people have severe anxiety or panic in response to everyday situations. They do have several theories, however. Among the possible causes of anxiety disorders:

  • A biological tendency toward anxiety, including greater sensitivity to the effects of hormones released during anxiety, such as adrenaline; or an imbalance of certain substances called neurotransmitters (chemical messengers in the brain)
  • Differences in activity in certain areas of the brain in people with GAD
  • Genetic or familial factors. About 30 percent of close relatives with generalized anxiety disorder suffer from the disorder themselves; 18 to 41 percent of people with relatives with panic disorder also suffer from panic attacks; and first-degree relatives of people with phobias are three times more likely to suffer from phobias themselves.
  • Changes in certain areas of the brain in people with anxiety disorders
  • Family background, such as an early childhood conflict or trauma, or “learned” fears or phobias
  • Stressful events and an exaggerated negative interpretation of them
  • Other illnesses or medications can cause symptoms of an anxiety disorder

While anxiety disorders can strike anyone of any age, gender or socioeconomic background, they most often begin in young adulthood. They often start mildly and progress, although GAD appears to be the most common form of anxiety in older ages. In addition, except for OCD, anxiety disorders strike women at twice the rate of men.

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