Why worries fill us?

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.

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 depression

Unrestrained anxiety can lead to any of several emotional disorders, all characterized by an unpleasant and overwhelming mental tension with no apparent identifiable cause. While most people with anxiety disorders are completely aware that their thoughts and behavior are irrational and inappropriate, this insight gives them no help in controlling their symptoms.

Faced by a threat, your body responds with a complex cascade of chemicals. The hypothalamus, alerted by the brain, pumps out a specialized hormone that ultimately prompts the two adrenal glands (perched atop the kidneys) to release the energizing hormone known as adrenaline. The result--faster pulse, higher blood pressure, sharpened awareness--is the "fight or flight" response to fear and anxiety.

Root cause of anxiety disorders

Biochemical theory suggests that biologic imbalances, perhaps among the neurotransmitters in the brain, may be the primary cause of anxiety disorders. Indeed, in one study researchers were able to trigger a panic attack in some people simply by infusing certain chemicals. Many scientists involved in anxiety research now argue that correcting biochemical imbalances with medication should be the first goal of treatment. Other studies suggest that biochemical changes can also be achieved through the psychological and behavioral changes produced by psychotherapy.

Learning theory views anxiety as a learned behavior that can be unlearned. This theory posits that a person's anxiety can be reduced by persistently confronting the feared situation or object. And some people do, in fact, change their thinking and experience significant relief without any medication.

Psychoanalytic theory holds that anxiety stems from unconscious conflict arising from discomfort or distress during childhood. Once the source of the anxiety is identified, it can be eliminated by resolving the underlying conflict. However, most studies find that people with anxiety disorders come from stable homes, with childhood backgrounds similar to those of people without anxiety disorders.

Stress, trauma, uncertainty. Most theorists agree that, other factors aside, stress, trauma, and uncertainties can play a role in the development of anxiety disorders. Studies show a relationship between anxiety and stress, which can be defined as a consequence of adapting to a change. Challenges such as the death of a loved one require a major adaptation that can contribute to the development of an anxiety disorder. Uncertainty during transitions, or about the future, can also produce anxiety. Some studies have found that a stressful event precedes the appearance of many anxiety disorders, though this result is not yet conclusive. The influence of these factors appears to vary with the disorder. In post-traumatic stress syndrome, such factors play a major role, whereas in obsessive- compulsive disorder, brain chemistry appears to be the primary culprit.

Our eating maybe root of anxiety

Although it's uncommon, certain medical problems can mimic the symptoms of anxiety, or even produce it. The palpitations and shortness of breath caused by an irregular heartbeat can easily be mistaken for anxiety. A clot in the lung (pulmonary embolism) often causes unexplained feelings of anxiety. Neurological problems such as epilepsy and brain disorders can be responsible for symptoms of anxiety. So can anemia, diabetes, thyroid disease, and adrenal problems. In general, these symptoms will disappear when the underlying disease is brought under control, although the anxiety sometimes requires separate treatment.

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.

Scientists research depression

Many organizations today supports research into the causes, diagnosis, prevention, and treatment of anxiety disorders and other mental illnesses. Studies examine the genetic and environmental risks for major anxiety disorders, their course--both alone and when they occur along with other diseases such as depression--and their treatment. The ultimate goal is to be able to cure, and perhaps even to prevent, anxiety disorders.

Other research focuses on the hippocampus, another brain structure that is responsible for processing threatening or traumatic stimuli. The hippocampus plays a key role in the brain by helping to encode information into memories. Studies have shown that the hippocampus appears to be smaller in people who have undergone severe stress because of child abuse or military combat. This reduced size could help explain why individuals with PTSD have flashbacks, deficits in explicit memory, and fragmented memory for details of the traumatic event.

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.

Treatment of anxiety disorders

Before treatment can begin, the doctor must conduct a careful diagnostic evaluation to determine whether your symptoms are due to an anxiety disorder, which anxiety disorder(s) you may have, and what coexisting conditions may be present. Anxiety disorders are not all treated the same, and it is important to determine the specific problem before embarking on a course of treatment. Sometimes alcoholism or some other coexisting condition will have such an impact that it is necessary to treat it at the same time or before treating the anxiety disorder.

In many instances, medications are essential. If you suffer from mania, a major depression, or a paranoid disorder, medications may actually be able to restore you to your normal self. For other conditions, such as schizophrenia, medications control and modify symptoms to the degree that a person can stay in his community. Medications also ease the more distressing symptoms, allowing a person to engage in a therapeutic relationship and re-engage in the activities of her daily life. Sometimes a drug is a useful additional measure during particularly stressful times, perhaps in the initial stage of treatment or at a time of crisis. Those patients with thought disorders or hallucinatory experiences can be maintained only with appropriate antipsychotic medications.

Medicine for anxiety disorders

Psychopharmacology, the treatment of psychiatric disorders and emotional distress with medication, has developed over the last fifty years, as our understanding of the workings of the brain has increased in sophistication. When medication is prescribed for mental and emotional illness, the most frequent goal is to restore the chemical balance within the brain, thereby restoring equilibrium to the entire system. Certain drugs function to address certain symptoms, such as when sedatives are prescribed for insomnia. Medications can work to slow disease processes, such as when anti-oxidants are used to treat Alzheimer's. Still other drugs control cravings and curb other problematic behaviors, such as taken to control alcoholism.

Medication is most helpful when there is clear disorder or, sometimes, a specific target symptom for a particular drug. Usually, a pattern of symptoms point to a specific chemical imbalance. Whenever an imbalance appears evident through a person's disordered behavior and emotional state, medication centers on modifying the strength of the signal or readjusting the balance among them.

Learn anxiety with professional

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.

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.

You may be concerned about paying for treatment for an anxiety disorder. If you belong to a Health Maintenance Organization or have some other kind of health insurance, the costs of your treatment may be fully or partially covered. There are also public mental health centers that charge people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

Terms and definitions on this page

Anxiety

• 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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