Your response to the anxieties Fear and anxiety are a normal--even essential--part of life. They prepare us for danger, creating physiological changes that enable us to effectively respond to a threat. Fear is very straightforward. It arises in response to immediate danger, so it is usually unexpected, very intense, and limited to the situation at hand. Your response to the fear, such as jumping out of the path of an oncoming car, quickly resolves the situation. Both fear and anxiety send signals through the body that prepare all systems for possible danger. Hormones, such as adrenaline and catecholamine, are released in what is known as the "fight or flight" response. The sudden increase in hormone levels speeds up the heart and increases the amount of blood being pumped. At the same time, the muscles tighten, increasing the individual's ability to fight or flee from danger. The intensity of these physiological responses varies according to the seriousness of the event or thought that sparked the emotion, the strength of the individual's fear or anxiety, and his or her previous experience and genetic makeup. While both fear and anxiety can provoke an arousal response, their other effects diverge. Very intense fear sometimes serves to "freeze" the body to protect it from harm, causing little or no change in heart rate and blocking the impulse to move. In anxiety, the physical changes caused by arousal lead to a second stage marked by thought patterns such as worry, dread, and mental replays of anxiety-arousing events. Effective treatments for anxiety disorders are available, and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment.
Understanding worries Anxiety disorders are surprisingly frequent, and affect more Americans than does any other emotional disorder. They are more common than depression, manic depression, or abuse of alcohol and other substances. According to the American Psychiatric Association, while depressive disorders affect one person in 20, one in 12 suffers an anxiety disorder. Because consumers and doctors alike are less attuned to anxiety disorders than other emotional problems, these disorders often go unrecognized. This is unfortunate, because most cases of anxiety can be treated successfully. In fact, anxiety disorders are considered the most treatable of all emotional problems. Major depression, the kind of depression that will most likely benefit from treatment with medications, is more than just "the blues." It is a condition that lasts 2 weeks or more, and interferes with a person's ability to carry on daily tasks and enjoy activities that previously brought pleasure. Depression is associated with abnormal functioning of the brain. An interaction between genetic tendency and life history appears to determine a person's chance of becoming depressed. Episodes of depression may be triggered by stress, difficult life events, side effects of medications, or medication/substance withdrawal, or even viral infections that can affect the brain.
Depression's research Using brain imaging technologies and neurochemical techniques, scientists are finding that a network of interacting structures is responsible for these emotions. Much research centers on the amygdala, an almond-shaped structure deep within the brain. The amygdala is believed to serve as a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret them. It can signal that a threat is present, and trigger a fear response or anxiety. It appears that emotional memories stored in the central part of the amygdala may play a role in disorders involving very distinct fears, like phobias, while different parts may be involved in other forms of anxiety. Also, research indicates that other brain parts called the basal ganglia and striatum are involved in obsessive-compulsive disorder. By learning more about brain circuitry involved in fear and anxiety, scientists may be able to devise new and more specific treatments for anxiety disorders. For example, it someday may be possible to increase the influence of the thinking parts of the brain on the amygdala, thus placing the fear and anxiety response under conscious control. Scientists are also conducting clinical trials to find the most effective ways of treating anxiety disorders. For example, one trial is examining how well medication and behavioral therapies work together and separately in the treatment of obsessive-compulsive disorder. Another trial is assessing the safety and efficacy of medication treatments for anxiety disorders in children and adolescents with co-occurring attention deficit hyperactivity disorder. For more information about clinical trials, for example the National Library of Medicine's clinical trials database.
Drugs for psychiatric disorders Psychiatrists or other physicians can prescribe medications for anxiety disorders. These doctors often work closely with psychologists, social workers, or counselors who provide psychotherapy. Although medications won't cure an anxiety disorder, they can keep the symptoms under control and enable you to lead a normal, fulfilling life. Although there are numerous chemicals that perform vital functions within the brain, three basic chemicals, or neurotransmitters, seem most critical in regulating this process and maintaining balance: serotonin, which is related to anxiety, depression, and aggression; dopamine, which affects reality perception and pleasurable experiences; and norepinephrine, which affects attention, concentration, and mood.
Anxiety and illness Prescription drugs and those purchased over the counter also can cause anxiety symptoms. Cold medicines, diet pills, antispasmodic medications, stimulants, digitalis, thyroid supplements, and, paradoxically, antidepressants given to reduce panic all may cause anxiety. Discontinuing a variety of drugs, including tranquilizers, sleeping pills, and certain blood-pressure medicines can lead to withdrawal symptoms that often include anxiety. The anxiety associated with taking or discontinuing medications and other substances can usually be easily relieved once the cause is recognized. It's therefore essential to provide your doctor with a complete run-down of your medicines--including over-the-counter products and of your eating and drinking habits.
Stress management meditation Many people with anxiety disorders benefit from joining a self-help group and sharing their problems and achievements with others. Talking with trusted friends or a trusted member of the clergy can also be very helpful, although not a substitute for mental health care. Participating in an Internet chat room may also be of value in sharing concerns and decreasing a sense of isolation, but any advice received should be viewed with caution. Most people with depression can get help from treatment. For most people, spotting depression early and getting it treated might cut down on how long and how serious the depression is. The most common treatments are antidepressant medicines, "talk" therapy, or a combination of both. You and your doctor can work together to decide on the right depression treatment for you.
Professional help you Among the professionals who can help are psychiatrists, psychologists, social workers, and counselors. However, it's best to look for a professional who has specialized training in cognitive-behavioral therapy and/or behavioral therapy, as appropriate, and who is open to the use of medications, should they be needed. Psychologists, social workers, and counselors sometimes work closely with a psychiatrist or other physician, who will prescribe medications when they are required. For some people, group therapy is a helpful part of treatment. Remember, though, that when you find a health care professional that you're satisfied with, the two of you are working together as a team. Together you will be able to develop a plan to treat your anxiety disorder that may involve medications, cognitive-behavioral or other talk therapy, or both, as appropriate.
Treatment of mental disorders Effective treatments for each of the anxiety disorders have been developed through research. In general, two types of treatment are available for an anxiety disorder--medication and specific types of psychotherapy (sometimes called "talk therapy"). Both approaches can be effective for most disorders. The choice of one or the other, or both, depends on the patient's and the doctor's preference, and also on the particular anxiety disorder. For example, only psychotherapy has been found effective for specific phobias. When choosing a therapist, you should find out whether medications will be available if needed. When you undergo treatment for an anxiety disorder, you and your doctor or therapist will be working together as a team. Together, you will attempt to find the approach that is best for you. If one treatment doesn't work, the odds are good that another one will. And new treatments are continually being developed through research. So don't give up hope.
Definitions used on this pageAnxiety
- A state of uneasiness and apprehension, as about future uncertainties.
- Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.
Anxiety disorder
- A psychiatric disorder involving the presence of anxiety that is so intense or so frequently present that it causes difficulty or distress for the individual.
Anxiety disorders
- Any of various disorders in which anxiety is either the primary disturbance or is the result of confronting a feared situation or object; they include obsessive-compulsive disorder and posttraumatic stress disorder.
Fear
- Fear is an unpleasant feeling of perceived risk or danger, whether it be real or imagined.
Depression
- In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.
Mental health
- A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life.
- The psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment.
Stress
- A state of extreme difficulty, pressure, or strain.
- A physical and psychological response that results from being exposed to a demand or pressure.
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