Anxiety Disorders



Anxiety disorders are a group of conditions that cause people to feel extreme fear or worry, sometimes accompanied by such symptoms as dizziness, chest pain, or difficulty sleeping or concentrating.

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Behavior

Mental disorders

Phobias

Psychology

Post-traumatic stress disorder

Separation anxiety disorder

What Are Anxiety Disorders?

Everyone worries now and then about things such as passing an upcoming math test or being chosen for a team. However, people who worry excessively may be experiencing an anxiety (ang-ZY-eh-tee) disorder. One type of anxiety disorder, known as generalized anxiety disorder, involves excessive or unrealistic worry about two or more life issues (such as school, work or money) for at least six months. According to the U.S. National Institute of Mental Health, anxiety disorders as a group are the most common mental disorder in the United States.

What Causes Anxiety Disorders?

It is not clear why anxiety disorders occur. The causes may well vary with the condition and involve a number of factors. Some anxiety disorders tend to run in families, for instance. Other factors may include traumatic experiences or psychological conflicts in a person's past. In recent years, attention has focused on biological factors, chiefly chemical imbalances in the brain.

Neurons * , or nerve cells, are at the center of all mental activity and, therefore, all mental disorders. The brain contains billions of neurons that communicate with each other.

Within each neuron are chemicals known as neurotransmitters * . When a message is sent from one neuron to another, the receiving neuron binds the released neurotransmitter by means of cell structures known as receptors * . Each receptor has a different effect. Receptors have been linked to a number of chemical and cellular effects that are turned on or off, depending on the message. Chemical abnormalities within the neuron can affect this on and off mechanism and contribute to mental disorders.

Researchers have found that people who have an imbalance of a neurotransmitter called serotonin often show persistent anxiety. Serotonin is a chemical that sparks the "fight or flight" response, the brain's normal response to a threat. Faced with pressure from a tough French test or danger from a rattlesnake, the amygdala, an almond-shaped part of the brain, may signal a state of arousal. This, in turn, will trigger the "fight or flight" response. Symptoms include a rapid heartbeat, a jump in blood pressure, sweating, nausea, trembling, and hyperventilation.

In a healthy person, this burst of energy is useful and helpful in responding to a real situation, such as a tough test or a hissing snake. In those with generalized anxiety disorder, however, these symptoms arrive without good cause. Many people continue to have symptoms of "fight or flight" even when there is no real threat. The result is a life so clouded by worry and anxiety at that people cannot function normally at school, at work, or at home.

* neurons are nerve cells. A typical neuron has a cell body, several short extensions called dendrites, and one long extension called an axon. The dendrites carry nerve impulses from other neurons toward the cell body. The axon carries nerve impulses away from the cell body to other neurons.

* neurotransmitters are brain chemicals that let brain cells communicate with each other and therefore allow the brain to function normally.

* receptors are cell structures that form a chemical bond with specific substances, such as neurotransmitters. This leads to a specific effect.

How Do People Know They Have an Anxiety Disorder?

Generalized anxiety disorder

Although it can develop in adult-hood, generalized anxiety disorder often strikes children and ado-lescents. When people have this disorder, unrealistic worries nag at them most days for at least six months. In addition, they have at least three of these symptoms: restlessness, irritability, a tendency to tire easily, difficulty concentrating, muscle tension, and disturbed sleep. In order to be diagnosed as a disorder, the worry must cause significant distress or get in the way of normal functioning.

Separation anxiety disorder

Separation anxiety disorder affects only children under age 18. Children worry excessively for at least four weeks about leaving their home, their parent, or their caregiver. They may fear that something will happen to them if they are separated from the parent or that the parent will never return if permitted to leave. Often these children refuse to go to school, claiming stomachaches or headaches. They may refuse to sleep alone or be alone in the house. They often have nightmares and physical symptoms, such as upset stomachs. Of course, many young children do not like to be away from their parents. For separation anxiety to be diagnosed as a disorder, it must be extreme.

Panic disorder

People with panic disorder have panic attacks. During a panic attack, the heart pounds, the hands shake, and people can grow weak and dizzy as pain grips their chest and a sense of unreality—is this really happening?—grips their mind. They may feel as if they are smothering, or going crazy, or about to die. People with severe panic attacks may go to hospital emergency rooms because they are certain that they are having a heart attack.

Panic attacks come on suddenly, without warning or apparent reason, and are over in minutes. Many people have an occasional bout of panic, but only a relatively small number go on to have panic disorder. People with panic disorder have repeated panic attacks and suffer crippling anxiety about when and where their next attack will occur. In extreme cases, they may be afraid to go out of their house for fear they will suffer a panic attack when they are in a place where escape is difficult, such as a crowded bus. This fear is called agoraphobia. Like other anxiety disorders, panic disorder usually starts when people are teenagers or young adults. It is more common in women than men.

How Are Anxiety Disorders Treated?

Treatment for anxiety disorders often involves behavioral therapies that teach people how to deal with worry in a more constructive manner. People with phobias or obsessive-compulsive disorder often are helped by therapy that, in a controlled way, exposes them to the thing they fear until they become accustomed to it and their fear lessens.

Cognitive therapy * can teach people to respond to difficult situations with thoughts that help prevent panic or worry. Relaxation techniques * can help people relieve muscle tension and breathe slowly and deeply so they do not hyperventilate (breathe too quickly and shallowly) and become dizzy. Biofeedback * can help them learn to monitor and control their own brain wave activity.

Other Anxiety Disorders

  • Separation anxiety disorder, in which children have an extreme fear of being separated from their parent or caregiver.
  • Panic disorder, which causes sudden bouts of overwhelming terror.
  • Phobias, which are irrational fears about specific things, such as snakes orflying in planes.
  • Post-traumatic stress disorder, in which people relive a crisis, such as wartime combat, in nightmares and waking flashbacks.
  • Obsessive-compulsive disorder, in which people are plagued by unwanted thoughts and may endlessly repeat a ritual, such as washing their hands.

* cognitive therapy is a form of counseling that helps people work to change distorted attitudes and ways of thinking.

* relaxation techniques are exercises such as meditation that help people reduce the physical symptoms of stress.

* biofeedback is a technique that helps people gain some voluntary control over normally involuntary body functions.

In addition to these therapies, various medications may help, particularly those that work by balancing out serotonin levels. Medications can be used alone or along with behavioral therapies. Although not a cure, the right drug often can relieve anxiety symptoms. If one drug does not work in a matter of weeks, there usually are others that can be tried.

Behavioral therapy for separation anxiety disorder may involve both individual and family therapy. Therapists try to teach the parents how to encourage healthier behaviors in the child, and they try to teach the child ways to reduce anxious feelings. Medications also may be helpful for children.

Living with an Anxiety Disorder

One of the hardest parts of living with an anxiety disorder is overcoming the stigma attached to any mental illness. People need to recognize that people with these disorders, like people with any other illness, cannot easily "just stop worrying." The symptoms are real and have a biological basis.

See also
Mental Disorders
Obsessive-Compulsive Disorder
Phobias
Post-Traumatic Stress Disorder

Resources

Books

Lee, Jordan, and Carolyn Simpson. Coping with Anxiety and Panic Attacks. New York: Rosen Publishing Group, 1997. A book that offers advice for young people on dealing with anxiety disorders.

Organizations

American Psychiatric Association, 1400 K Street Northwest, Washington, DC 20005. An organization of physicians that provides information about anxiety disorders on its website.
http://www.psych.org

Anxiety Disorders Association of America, 11900 Parklawn Drive, Suite 100, Rockville, MD 20852. A national nonprofit organization that promotes public awareness of anxiety disorders.
http://www.adaa.org

U.S. National Institute of Mental Health, 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. A government institute that provides information about anxiety disorders.
Telephone 888-8-ANXIETY
http://www.nimh.nih.gov

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