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. As long as there's a good reason for fear or anxiety, and it doesn't interfere with the ability to work, play, and socialize, it is not considered a problem. But when anxiety takes on a life of its own and begins to disrupt everyday activities, the situation is no longer normal. A genuine emotional disorder is now at work... and it's time to see a doctor. 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.
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. 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.
Depressed people will seem sad, or "down," or may be unable to enjoy their normal activities. They may have no appetite and lose weight (although some people eat more and gain weight when depressed). They may sleep too much or too little, have difficulty going to sleep, sleep restlessly, or awaken very early in the morning. They may speak of feeling guilty, worthless, or hopeless; they may lack energy or be jumpy and agitated. They may think about killing themselves and may even make a suicide attempt. Some depressed people have delusions (false, fixed ideas) about poverty, sickness, or sinfulness that are related to their depression. Often feelings of depression are worse at a particular time of day, for instance, every morning or every evening. Not everyone who is depressed has all depression's symptoms, but everyone who is depressed has at least some of them, co-existing, on most days. Depression can range in intensity from mild to severe. Depression can co-occur with other medical disorders such as cancer, heart disease, stroke, Parkinson's disease, Alzheimer's disease, and diabetes. In such cases, the depression is often overlooked and is not treated. If the depression is recognized and treated, a person's quality of life can be greatly improved. The hallmark of this problem is chronic worry and tension with no apparent cause. People suffering from generalized anxiety disorders may worry excessively about health, money, family, or work, often anticipating disaster. Although they are usually aware that their anxiety is more intense than necessary, they can't seem to let it go. Constant worrying contributes to trouble sleeping and relaxing. People with anxiety disorders may startle easily and have trouble concentrating. Generalized anxiety disorder often leads to depression.
Experts have yet to agree on the root cause of anxiety disorders. In fact, most concede that several factors may be at work in each case. 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.
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. 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. In addition, with new findings about neurogenesis (birth of new brain cells) throughout life, perhaps a method will be found to stimulate growth of new neurons in the hippocampus in people with post-traumatic stress disorder. 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.
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.
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 explainingAnxiety
- 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.
|
