Anxiety
(Chronic Free-Floating Anxiety; Generalized Anxiety Disorder)
by
Amy Scholten, MPH
Definition |
Causes |
Risk Factors |
Symptoms |
Diagnosis |
Treatment |
Prevention
Definition
Anxiety is a normal state of dread, tension, and unease. It is considered a normal response to stress or uncertain situations. Prolonged or intense periods of anxiety may suggest an anxiety disorder. A disorder may also be indicated if anxiety:
- Occurs without an external threat ('free-floating' anxiety)
- Impairs daily functioning
The most common types of anxiety disorders are:
Anxiety is often complicated by the presence of
alcohol
or
drug abuse
and
depression.
Causes
Anxiety may result from many factors including:
- Appropriate response under stressful circumstances
-
Drugs that affect the nervous system, such as:
-
Biological factors:
- Brain chemistry imbalances (eg, serotonin and norepinephrine)
- Personality traits
- Faulty perceptions and irrational beliefs (eg, phobias)
- Unresolved emotional conflicts
Risk Factors
A risk factor increases your chance of getting a disease or condition.
Risk factors for anxiety include:
- Sex: female
- Family member with anxiety disorders
- Stressful life events
- Ineffective coping strategies
- History of physical or psychological trauma
Symptoms
Psychological symptoms may include:
- Worry or dread
- Obsessive or intrusive thoughts
- Sense of imminent danger or catastrophe
- Fear or panic
- Restlessness
- Irritability
- Impatience
- Ambivalence
- Trouble concentrating
Physical symptoms may include:
- Rapid or irregular heartbeat
- Sweating, especially the palms
- Dry mouth
- Flushing or blushing
- Muscle tension
- Shortness of breath
- Lightheadedness or faintness
- Difficulty sleeping
- Shaking
- Choking sensation
- Frequent urination
- Nausea or vomiting
- Diarrhea
- Constipation
- Feeling of "butterflies" in the stomach
- Sexual difficulties
- Tingling sensations
- Nail biting or other habitual behavior
Symptoms of Anxiety
© 2009 Nucleus Medical Media, Inc.
Diagnosis
Your doctor will ask about your symptoms and medical history. A psychiatric evaluation will be done. Your doctor may also perform a physical exam and diagnostic tests. Usually the results of these tests are normal. You may be referred to a psychotherapist for further evaluation.
Treatment
Effective treatment usually involves a combination of interventions, including:
Psychotherapy
This therapy addresses thoughts, feelings, and behaviors that play a role in anxiety. It helps you work through traumas and conflicts.
Cognitive-behavioral therapy
can help you identify negative thought patterns and behaviors. Over time, you can learn to retrain your thinking. This will help you choose better options in response to stress and anxiety.
Medication
For severe anxiety or anxiety disorder, medications may include:
- Benzodiazepines
- Buspirone
- Tricyclic antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
FDA Public Health Advisory for Antidepressants |
The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose.
Although the warning is for all antidepressants, of most concern are the SSRI class such as:
-
Prozac (
fluoxetine), Zoloft (
sertraline), Paxil (
paroxetine), Luvox (
fluvoxamine), Celexa (
citalopram), Lexapro (
escitalopram)
For more information, please visit:
http://www.fda.gov/cder/drug/antidepressants/ |
If you are diagnosed with an anxiety disorder, follow your doctor's
instructions.
Prevention
To help prevent anxiety, consider taking the following steps:
- Avoid situations, occupations, and people that cause you stress.
- If unavoidable, confront and overcome situations that provoke anxiety.
- Find a relaxation technique that works for you. Use it regularly.
- Develop and maintain a strong social support system.
- Express your emotions when they happen.
- Challenge irrational beliefs and counterproductive thoughts.
- Correct misperceptions. Ask others for their views.
-
Work with a
therapist.
- Avoid using nicotine or other drugs. Drink alcohol in moderation
RESOURCES:
Anxiety Disorders Association of America
http://www.adaa.org/
Mental Health America
http://www.nmha.org/
CANADIAN RESOURCES:
Canadian Psychiatric Association
http://www.cpa-apc.org/
Canadian Psychological Association
http://www.cpa.ca/
REFERENCES:
Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at:
http://www.fda.gov...
.
Published May 22, 2009. Accessed July 15, 2009.
Generalized anxiety disorder. National Institute of Mental Health website. Available at:
http://www.nimh.nih.gov/
. Accessed June 18, 2008.
Nietzel MT, Wakefield JC.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders
. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.
Tierney LM, McPhee SJ, Papadakis MA.
Current Medical Diagnosis and Treatment
. 45th ed. New York, NY: McGraw-Hill;2006.
12/4/2009
DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: Javnbakht M, Hejazi Kenari R, Ghasemi M. Effects of yoga on depression and anxiety of women. Complement Ther Clin Pract. 2009;15(2):102-104.
Last reviewed November 2009 by Theodor B. Rais, MD
Last Updated: 12/4/2009
