Anxiety disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 23, 2016
StartDiseasesAnxiety disorder

Anxiety disorder is a type of psychiatric disorder that is characterized by feelings of being overwhelmed or being unrealistically afraid of something. It can be brought on by both major life stressors and by more common, everyday incidents. Anxiety disorders are the most common form of mental illness experienced by both adults and children.

Contents

Definition & Facts

Anxiety is defined as experiencing feelings of worry, fear, apprehension, agitation, nervousness or panic that are out of proportion to the events or circumstances that prompt these feelings. Anxiety disorders are clinically defined as falling into one of six different types: generalized anxiety disorder, obsessive-compulsive anxiety disorder, panic disorder, phobias, posttraumatic stress disorder (P.T.S.D.), and social anxiety disorder. Each of these anxiety classifications is characterized by common feelings of severe emotional distress that have negative emotional, mental, and social impacts on a person's general quality of life.

Symptoms & Complaints

Some of the most common symptoms and complaints of anxiety disorders include but are not limited to:

  • Excessive worry
  • Extreme fear of certain things
  • Avoidance of social settings
  • Uncontrollable urges to repeat certain actions or behaviors in order to gain a sense of peace or inner calm
  • Difficulty sleeping or a marked change in sleep habits
  • Uncontrollable panic attacks
  • Experiencing episodes of extreme self-consciousness
  • Persistent self-doubt
  • Feeling the need to meet unrealistic standards of perfection
  • Frequent uncontrollable emotional outbursts that are unrelated to a given situation
  • Physical aches and pains that are not related to a physical illness or injury
  • Experiencing "flashbacks" or frequently re-living a traumatic event

Causes

While it isn't always clear what causes anxiety in some cases, currently accepted theories include:

  • Social factors
  • Cultural factors
  • Physical trauma
  • Extreme poverty
  • Experiencing a psychological shock
  • Brain injury
  • A possible chemical imbalance (the lack of, or excessive presence of, neurochemicals in the brain such as norepinephrine dopamine[, or serotonin) in the brain
  • Physical, emotional, sexual, or mental abuse
  • Being a survivor of a violent crime
  • Growing up in an excessively critical environment
  • An absence of adequate coping skills
  • Living in a dangerous or threatening environment
  • A traumatic childhood experience
  • Unrealistic social pressures
  • Unrealistic personal standards
  • Emotional over-sensitivity
  • Stress

Diagnosis & Tests

A physician will perform a detailed physical examination, including blood tests and urine tests, to rule out any underlying physical cause of anxiety. Sometimes a CT scan or an MRI may be performed to rule out any internal injuries or ailments. The physician will ask a series of questions in order to form a complete picture of what the patient may be experiencing.

The American Psychiatric Association maintains a listing of specific anxiety disorder criteria to help physicians accurately diagnose patients that suffer from anxiety episodes. This listing can be found in the Diagnostic and Statistical Manual of Mental Disorders. A general practitioner may refer the patient to a psychologist or psychiatrist that is more experienced in treating anxiety disorders for a more definitive diagnosis and treatment.

Treatment & Therapy

Psychotherapy and the use of medications to help alleviate the distressing symptoms of anxiety disorder are the preferred method of treatment. Most physicians will recommend a treatment plan utilizing both methods.

Psychotherapy is commonly called "talk therapy." It involves a therapist working with a patient to help discover any underlying psychological reasons that result in the patient experiencing anxiety episodes. Talking to a trained therapist can be beneficial in helping to ease some of the patient's anxiety symptoms.

Cognitive behavioral therapy is a type of psychotherapy. This method can teach a patient how to use certain therapy tools to reduce anxiety when it strikes, and help to reduce the overall frequency of anxiety episodes. These methods are one of the most effective ways for a patient to regain a sense of control over their reactions and their environment when anxiety strikes. Many patients report feeling empowered once they learn how to effectively apply the lessons learned in cognitive behavioral therapy.

For symptoms that don't respond well to psychotherapy efforts, medication may be required to obtain relief. Antidepressants and buspirone are usually the medications of choice when treating anxiety. They are generally very effective, but it may take several weeks before the patient see a noticeable decline in their anxiety symptoms.

Benzodiazepine is a type of sedative that is sometimes prescribed in order to bring acute episodes under control. They are not recommended for long term use, as they are habit forming and have a high risk of abuse.

Prevention & Prophylaxis

The earlier a patient seeks treatment, the sooner they can begin experiencing symptom relief. It is important for the individual to discuss any concerns with a physician or therapist, including any medication side effects, worsening of symptoms, or an increase in frequency of anxiety episodes.

Employing effective stress management techniques may help in the prevention and control of anxiety triggers. Keeping a record of reoccurring anxiety episodes, such as keeping a journal, may assist the patient and their therapist in assessing which events or scenarios that may worsen the patient's anxiety. Joining a support group may help the patient feel less isolated.

Avoiding using alcohol or other unhealthy substances as a means of coping with anxiety can also help. These substances only mask, and potentially compound, the problem, making it more difficult to recognize the need for medical therapy.

Taking steps to maintain good overall health, participating in some form of regular exercise, meditation or deep breathing exercises, changing activities to refocus the mind, or simply talking it out with someone are all steps that may be effective in lessening the level of anxiety a patient experiences.