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What Is Anxiety? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Anxiety is a feeling of nervousness, unease, or worry that typically occurs in the absence of an imminent threat. It differs from fear, which is the body’s natural response to immediate danger.

Anxiety is part of the body’s natural reaction to stress, so it can be helpful at times, making you more alert and ready for action.

Anxiety disorders and normal feelings of anxiousness are two different things. Many of us get anxious when faced with particular situations we find stressful, but if those feelings don’t subside, the anxiety could be more chronic. When feelings of fear or nervousness become excessive, difficult to control, or interfere with daily life, an anxiety disorder may be present. Anxiety disorders are among the most common mental disorders in the United States.

It’s common to think about anxiety in a way that may hinder our ability to overcome it. “The biggest misconception about anxiety is that it’s to be feared and avoided at all costs,” says Noah Clyman, a licensed clinical social worker and the director of NYC Cognitive Therapy, a private psychotherapy practice in New York City.

“I teach my clients that negative emotions, such as sadness, anger, and fear, are important to our survival, and emotional discomfort is a very normal, universal human experience,” he says.

Signs and Symptoms of Anxiety Disorders

Your heart beats fast, and your breathing speeds up. Your chest may feel tight, and you might start to sweat. If you’ve ever felt it, you know that anxiety is just as much a physical state as a mental state. That’s because there’s a very strong biological chain reaction that occurs when we encounter a stressful event or begin to worry about potential stressors or dangers in the future. Other physical symptoms include headaches and insomnia. Psychological symptoms may include feeling restless or tense, having a feeling of dread, or experiencing ruminative or obsessive thoughts.

Some of the most common symptoms of anxiety disorders include:

  • Feelings of apprehension
  • Anticipating the worst
  • Irritability
  • Tremors or twitches
  • Frequent urination or diarrhea
  • Nausea or upset stomach

When Should I Seek Treatment?

When the symptoms of anxiety and the associated behaviors are having a detrimental impact on your life and day-to-day functioning, it’s important to get help.

Suma Chand, PhD, the director of the cognitive behavioral therapy program in the department of psychiatry and behavioral neuroscience at St. Louis University School of Medicine in Missouri, says a person who has panic disorder is “very avoidant of many situations that could trigger [their] panic symptoms” and the panic disorder is impacting their ability to go to work regularly, go shopping, attend church, and the like. The ability to function while in these situations is negatively impacted as well. If you’re avoiding situations that trigger your anxiety or you experience tremendous discomfort and can’t function effectively when you’re in those situations, it’s necessary to seek treatment.

Causes and Risk Factors of Anxiety Disorders

Researchers think that various factors may contribute to anxiety. The more risk factors an individual has, the greater the likelihood that they’ll develop an anxiety disorder, notes Dr. Chand.

  • Family history Having a family member with anxiety increases the likelihood of developing an anxiety disorder. Although this may suggest genetic transmission, Chand explains that “there is also the possibility of learning anxious responses from family members with anxiety.”
  • Temperaments of behavioral inhibition, negative affectivity, and anxiety sensitivity

Starting from infancy, according to Chand, people with a temperament of behavioral inhibition have heightened reactions to new and different situations and stimuli. This causes them to them to start withdrawing from new or unfamiliar social situations as they grow older.

Negative affectivity is the tendency to experience negative emotions, while anxiety sensitivity means you’re disposed to believe that symptoms of anxiety are harmful.

  • Traumatic events Children who have endured abuse (physical, emotional, or sexual) or other traumatic experiences tend to develop anxiety disorders. Adults exposed to traumatic experiences can also develop anxiety.
  • Stress can be associated with the development of anxiety, whether it’s a major stressor such as a serious illness or the ongoing stress caused by work issues, financial and family conflicts, and chronic health problems. According to the National Institute of Mental Health, thyroid problems or heart arrhythmias can produce or aggravate anxiety symptoms.
  • Drug or alcohol use, misuse, or withdrawal can cause anxiety.
  • Brain structure Changes in the areas that regulate stress and anxiety may contribute to the disorder.

“There is a genetic component to anxiety disorders, no doubt,” says Chand. “This tends to make the individual vulnerable to developing an anxiety disorder, rather than cause them to directly inherit one,” she says. Environmental factors, she adds, interact with genetic predispositions to trigger the onset of anxiety disorders. A study published in August 2017 in the journal Emotion may offer clues as to how both genes and environment combine to make anxiety take root.

When researchers from Pennsylvania State University in State College and Rutgers University in Newark, New Jersey, showed babies pictures of angry, happy, and neutral faces, they found that the infants of anxious mothers took longer to look away from the angry faces, which meant that the infants had a tendency to focus more on potential threat.

An author of the study, Koraly Perez-Edgar, PhD, a professor of psychology at the Pennsylvania State University in University Park, says that this focus on threat may be one way that anxiety begins to take hold.

“Individuals who attend to aspects of the environment that they consider threatening can potentially create a cycle that strengthens biases toward threat, as well as toward the view that the environment is threatening, which can then lead to social withdrawal and anxiety,” she says.

“People can learn to be anxious in various situations,” says Jonathan Abramowitz, PhD, a professor of clinical psychology at the University of North Carolina in Chapel Hill and the editor in chief of the Journal of Obsessive-Compulsive and Related Disorders.

“This can occur through experiences in which anxiety or fear becomes associated with a specific stimulus or a stressful or traumatic event, by learning about something fearful, and through vicarious conditioning,” he says.

Vicarious conditioning, says Dr. Abramowitz, occurs when you watch someone else experience a stressful and traumatic event — like food poisoning or being bitten by a dog — and come to see certain situations as dangerous.

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