Anxiety

General Anxiety Disorder

Overview

Anxiety is a feeling of nervousness, apprehension, fear, or worry. Some fears and worries are justified, such as worry about a loved one or in anticipation of taking a quiz, test, or other examination. Problem anxiety interferes with the sufferer's ability to sleep or otherwise function. It is noteworthy that teenagers are particularly susceptible to having irritability as a symptom of a number of emotional problems, including anxiety. Anxiety may occur without a cause, or it may occur based on a real situation but may be out of proportion to what would normally be expected. Severe anxiety can have a serious impact on daily life.

Symptoms

Anxiety can be accompanied by a variety of physical symptoms. Most commonly, these symptoms are related to the heart, lungs, nervous, and gastrointestinal systems. You may have upset stomach, diarrhea, trouble breathing, feel as if you may faint or are having a heart attack.

Panic disorder: recurrent episodes of panic attacks, worry about having an attack, about what it means, or changing the way one behaves because of the panic attacks for at least a month. Panic attacks are separate and intense periods of fear or feelings of doom developing over a very short time frame - 10 minutes - and they're associated with at least four of the following:

Palpitations
Sweating
Trembling
Shortness of breath
Sense of choking
Chest pain
Nausea or other stomach upset
Dizziness
A feeling of being detached from the world (derealization)
Being unable to think, feeling as if the mind has gone blank
Fear of dying
Numbness or tingling
Chills or hot flashes

Generalized anxiety disorder: excessive, unrealistic, and difficult to control worry over a period of at least six months. It's associated with three of the following:

Restlessness
Easily tired
Trouble concentrating
Irritability
Muscle tension
Sleep problems

Phobic disorders: intense, persistent, and recurring fear of certain objects (such as snakes, spiders, or blood) or situations (such as heights, speaking in front of a group, or public places). These exposures may trigger a panic attack.

Stress disorders: anxiety (also known as post-traumatic stress disorder) caused by the exposure to either death or near-death circumstances such as fires, floods, earthquakes, shootings, automobile accidents, or wars, for example. Other traumatic events may not have had the threat of death or near-death but resulted in the severe injury or threat thereof. Examples of such trauma include victimization through physical or sexual abuse, witnessing the abuse of another or over-exposure to inappropriate material (for example, exposure of children to pornographic images or acts). The traumatic event is re-experienced in thoughts and dreams. Common behaviors include the following:

Re-experiencing the trauma, either when awake (flashbacks) or when asleep (nightmares)
Avoiding activities, places, or people associated with the triggering event
Difficulty concentrating
Difficulty sleeping
Being hyper vigilant (you closely watch your surroundings)
Feeling a general sense of depression, irritability, doom and gloom with diminished emotions such as loving feelings or aspirations for the future

Symptoms such as chest pain, shortness of breath, palpitations, dizziness, fainting, and weakness generally should not be attributed to anxiety and require evaluation by a doctor.

Causes

Problem anxiety may be caused by a mental condition, a physical condition, the effects of drugs, or from a combination of these. The doctor's initial task is to see if your anxiety is caused by a medical condition. Conditions as varied as anemia, asthma attack, infection, drug intoxication or withdrawal, or a number of heart conditions are just a few examples of medical problems that can be associated with anxiety.

These common external factors can cause anxiety:

Stress at work
Stress from school
Stress in a personal relationship such as marriage or friendships
Financial stress
Stress from an emotional trauma such as the death of a loved one, a natural disaster, victimization by crime, physical abuse or sexual abuse (for example, acute stress disorder or post traumatic stress disorder)
Stress from a serious medical illness
Side effects of medication
Intoxication (being "high" on) with an illicit drug, such as cocaine or amphetamines
Withdrawal from an illicit drug, such as opiates (for example, heroin) or from prescription drugs like Vicodin, benzodiazepines, or barbituates
Symptoms of a medical illness
Lack of oxygen: In circumstances as diverse as high altitude sickness, emphysema, or pulmonary embolism (a blood clot with the vessels of the lung)

The doctor has often the difficult task of determining which symptoms come from which causes. For example, in a study of people with chest pain that could be heart disease but turned out not to be heart related, 43% were found to have a panic disorder - a common form of anxiety.