What is Anxiety?

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According to the World Health Organization, 1 in 13 individuals worldwide suffers from anxiety. The organization reported that anxiety disorders are the most common mental disorders in the world with the most common anxiety disorder types being specific phobia and social phobia. Anxiety disorders affect 40 million adults in the United States ages 18 and older, or around 18% of the population any given year.

Panic disorder is more prevalent in woman than men and often has an onset during the late teen or early adulthood years.  Approximately 7.7 million individuals, age 18 and older, in the United States, suffer from post-traumatic stress disorder (PTSD).

Anxiety is an emotion, a reaction that most of us have felt at some point in our lives.

It is a normal perception to threat and prepares us to “freeze, flight or fight”.

This reaction is a basic and adaptive survival tool in the presence of actual threat, to facilitate our escape from the current threat and to avoid future ones through conditioned fear learning. When the reaction occurs in the absence of a realistic threat, however whether because the threat itself is unlikely or because harm from the perceived threat is unlikely – and it serves no useful purpose and instead and significantly disrupt one’s ability to function thus causing an anxiety disorder. Anxiety is a state that includes both an internal feeling of fear and if physiological expression of that fear.

This reaction is a basic and adaptive survival tool in the presence of actual threat, to facilitate our escape from the current threat and to avoid future ones through conditioned fear learning. When the reaction occurs in the absence of a realistic threat, however whether because the threat itself is unlikely or because harm from the perceived threat is unlikely – and it serves no useful purpose and instead and significantly disrupt one’s ability to function thus causing an anxiety disorder.

Recognizing anxiety disorder in older adults can be challenging because aging comes with a higher occurrence of medical problems. Some symptoms of anxiety in an adult may include headaches, back pain, or a rapid heartbeat which may seem normal problems for many. Because the symptoms may seem to be caused by physical aging, adults are reluctant to report these symptoms. This creates difficulty in separating a medical condition from symptoms of an anxiety disorder.

With adult patients, it is important to ask specific questions to determine if the symptoms are anxiety related, including the following:

    Is there anything going on in your life that is causing you concern?

    Can you say what triggers your feelings of anxiety?

    What were you doing when you noticed the chest pain?

    Do you find that you have a hard time getting over things

Screenshot at May 03 19 55 50 Afshin nasseri

An anxiety disorder goes beyond getting nervous about public speaking or a first date. People with these disorders experience:

    feelings of panic and fear

    obsessive thoughts

    painful, intrusive memories

    recurring nightmares

Physical symptoms such as “butterflies” in your stomach, heart pounding, startling easily, and muscle tension are quite common.

While normal stress might cause an individual to be fearful of a dangerous object, animal, or situation; a person with anxiety would experience fear and avoidance of an object or situation that poses little or no danger at all.

Many people experiencing the symptoms of anxiety can begin to wonder if there is something really wrong with them.  Unfortunately, the comments from people such as, ‘just pull yourself together’ are not helpful. 

1 out 5 individuals experience a significantly anxious mood at some point in their life. Anxiety can affect any one at any stage of their life. So, remember, you are not alone.  Understanding Anxiety and feeling afraid is very much a part of the experience of being human. For example, if a ferocious animal confronted us, it is likely that we would respond with fear.  This response is important because it initiates a whole series of physical and behavioral changes that ultimately serve to protect us.  In this example, when confronted by an animal, the feeling of fear would probably lead us to either run for our lives or become sufficiently ‘pumped’ to physically defend ourselves.  As you can see from this example, the experience of fear is part of a process of survival.   The experience of anxiety is remarkably like the experience of fear – but anxiety occurs in the absence of real danger.  That is, the individual may think that they are in danger, but the reality is that they are not.  To illustrate this, think of the anxiety one may feel when walking down a poorly lit neighborhood.  The individual may feel anxious because they perceive some potential danger.  This may not mean that there is any real danger in walking down this neighborhood, but what causes the experience of anxiety is that the person believes that they are in danger.  Therefore, the experience of anxiety and fear are basically the same except that in the case of anxiety, there may not be any actual danger, yet the person just thinks there is. 

Fight/Flight Response is important to fully understand the way our bodies react to threat or danger, whether real or imagined.  When a person is in danger or believes that they are in danger several changes occur.  This response has been named the fight/flight response.  As explained earlier, when confronted with danger we will typically flee from the situation or stand and fight. The main purpose of the fight/flight response is to protect the individual.  It is therefore important to remember that the experience of anxiety by itself is not harmful. When a person’s fight/flight response is activated, three systems are engaged.  These are the physical, cognitive, and behavioral systems. Physical system undergoes some major but temporary changes designed to enhance our ability to either run away or stand and be ready to fight.  Physically, as soon as danger is perceived, the brain sends a message to our autonomic nervous system. 

Our autonomic nervous system has two sections: the sympathetic branch and the parasympathetic branch. 

These control the physical changes that occur in the fight/flight response.  The sympathetic branch is the part that activates areas of the body for action.  When the sympathetic branch is activated, it includes all areas of the body, and therefore, the person experiences physical changes from head to toe. 

The sympathetic nervous system releases two hormones from the adrenal glands.  These chemicals are called adrenalin and noradrenalin and are basically messengers that serve to maintain the physical changes for enough time.

The physical changes that the sympathetic system produces are:

  Increase in heart rate and strength of every beat. A physical change that is quite noticeable to the person experiencing the fight/flight response, is an increase in heart rate and the strength of heartbeat.  An increase in heart rate enables blood to be pumped around the body faster, so that oxygen gets delivered more promptly to the various tissues of the body and waste products can be efficiently eliminated. 

   Redistribution of blood from areas that are not as vital to those that are needed most. There is also a change in blood flow – away from places where it is not needed like skin, fingers, and toes towards the places it is likely to be needed like large organs and muscles.  This is very clever because if we were injured in some way, we would be less likely to bleed to death, as the blood will be with the vital organs. 

  An increase in the rate and depth of breathing, and changes to heart rate, are especially important, as it provides the tissues with the extra amount of oxygen required to prepare for action.  The feelings produced by this increase in breathing can include shortness of breath, smothering feelings, tightness, and pain in the chest, and sighing and yawning.  One of the main side effects of this increase in breathing is that the blood supply to the head is decreased.  This is not dangerous but can produce undesirable symptoms, including: dizziness, light-headedness, blurred vision, confusion, feelings of unreality and hot flushes.

  Excessive sweating is another physical change in the fight/flight response. The body turns more slippery, making it difficult for a predator to grab, and cools the body, preventing it from overheating. 

  Widening of the pupils let in more light, which may result in the experience of blurred vision, or a sense that the light is too bright. Such changes enable the person to enhance the use of their vision to identify any hidden dangers.

Digestive system activity decreases, diverting more energy to systems more immediately related to fight or flight. Notably, are a decrease in salivation, resulting in a dry mouth and feelings of nausea or even constipation.  

  Finally, much of the muscle groups tense up in preparation for fight/flight and this results in subjective feelings of tension, sometimes resulting in aches and pains and trembling and shaking.  This process is a comprehensive, and the individual is left feeling quite exhausted.  

 The two main behaviors associated with fear and anxiety are to either fight or flee.  The overwhelming urges associated with this response are those of aggression and a desire to escape. As this is not always possible due to social constraints, people may express the urges through behaviors such as, pacing or snapping at people.

 Cognition, as the main objective of the fight/flight response is to alert of existence of danger, a major cognitive change is that the individual begins to shift their attention to the surroundings to search for potential threat.  Difficulty in concentrating is what people who are anxious experience.  This is a normal and important part of the fight/flight response as its purpose is to stop you from attending to your ongoing tasks and to allow you to scan your environment for possible danger.  A times an obvious threat cannot be found.  Unfortunately, we cannot accept not having an explanation for something and end up searching within ourselves for an explanation. 

Consequently, people start thinking that there is really something wrong with them – they must be losing their mind.

Systems Restore: Once the immediate danger has vanished, the body begins a process of restoration back to a more relaxed state.  This is once again controlled by the autonomic nervous system.  The parasympathetic branch begins the process of counteracting the sympathetic branch.  As a result, the heart rate begins to slow, breathing rate slows, the body’s temperature begins to lower, and the muscles begin to relax.  But the systems do not return to normal right away.  In primitive times, if a wild animal confronted us, it would be foolish to relax and be off guard as soon as the animal began to back off.  The chances of danger continuing in such a case causes the body to remain prepared for the need to once again face danger.  Therefore, some residual effects of the fight/flight response remain for some time and only gradually taper off.  This can leave the individual feeling tense for some time afterwards.  This helps to understand why it is that people can feel anxious for ongoing periods of time when no obvious stressor is present.

What Causes Anxiety? These factors can be effectively divided into biological and psychological causes.

Biological Factors, genetic factor has been linked to the development of anxiety disorders.  For example, in obsessive-compulsive disorder, about 20% of first-degree relatives have also suffered from the condition.  Overall, based on family studies, it has been suggested that individuals may inherit a vulnerability to developing an anxiety disorder.

Psychological Factors, this genetic vulnerability does not imply that those individuals will develop an anxiety disorder.  It greatly depends on the lifestyle of that person, the types of life stressors they have encountered and their early learning.  For example, if we were taught to fear certain neutral situations as a child it can become difficult to extinguish these learned patterns of behavior.  Certain patterns of thinking and behaving may contribute to the development of an anxiety disorder.

Anxiety is an especially important emotion that protects us from harm. In some the fight/flight response becomes activated in situations where no real danger is present.  Consider simply anticipating poor performance on an exam can be enough to activate the fight/flight response.  An anxiety disorder is usually diagnosed when a person cannot manage to function adequately in their daily life due to the frequency and severity of the symptoms of anxiety.  It is important to keep in mind however, that some anxiety is functional, enabling us to get to work on time, meet demands, and remain aware of our surroundings.

Anxiety disorders affect nearly 40 million adults every year, but these conditions are treatable.

Anxiety Disorders in Adults

Recognizing anxiety disorder in older adults can be challenging because aging comes with a higher occurrence of medical problems. Some symptoms of anxiety in an adult may include headaches, back pain, or a rapid heartbeat which may seem normal problems for many. Because the symptoms may seem to be caused by physical aging, adults are reluctant to report these symptoms. This creates difficulty in separating a medical condition from symptoms of an anxiety disorder.

With adult patients, it is important to ask specific questions to determine if the symptoms are anxiety related, including the following:

    Is there anything going on in your life that is causing you concern?

    Can you say what triggers your feelings of anxiety?

    What were you doing when you noticed the chest pain?

    Do you find that you have a hard time getting over things?

Anxiety Disorders Statistics

According to the World Health Organization, 1 in 13 individuals worldwide suffers from anxiety. The organization reported that anxiety disorders are the most common mental disorders in the world with the most common anxiety disorder types being specific phobia and social phobia. Anxiety disorders affect 40 million adults in the United States ages 18 and older, or around 18% of the population any given year.

Panic disorder is more prevalent in woman than men and often has an onset during the late teen or early adulthood years.  Approximately 7.7 million individuals, age 18 and older, in the United States, suffer from post-traumatic stress disorder (PTSD).

Available anxiety statistics tell us that only about a third of those suffering from an anxiety disorder seek treatment, even though the disorders are decidedly treatable.

Who is at Risk?

Both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Risk factors may vary from one type of anxiety disorder to another, though there are some general risk factors for anxiety disorders. They include:

    shyness or behavioral self-consciousness in childhood

    History of mental illness in biological relatives

    Trauma or exposure to stressful events

    Medical or physical conditions such as thyroid problem or arrhythmias

    Drug or alcohol use or abuse

Anxiety disorders affect nearly 40 million adults every year, but these conditions are treatable.

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