Your response to the fear

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.

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.

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.

Professional may help you

If you, or someone you know, has symptoms of anxiety, a visit to the family physician is usually the best place to start. A physician can help determine whether the symptoms are due to an anxiety disorder, some other medical condition, or both. Frequently, the next step in getting treatment for an anxiety disorder is referral to a mental health professional.

It's important that you feel comfortable with the therapy that the mental health professional suggests. If this is not the case, seek help elsewhere. However, if you've been taking medication, it's important not to discontinue it abruptly, as stated before. Certain drugs have to be tapered off under the supervision of your physician.

Understanding anxiety disorders

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.

Each anxiety disorder has its own distinct features, but they are all bound together by the common theme of excessive, irrational fear and dread.

Common symptoms of depression

Although anxiety disorders take several distinct forms, certain general symptoms tend to appear in all of them. When discussing their condition, people with anxiety disorders often report the following: - cold/clammy hands - diarrhea - dizziness - dry mouth - fast pulse - fatigue - jitteriness - lump in the throat - muscle aches - numbness/tingling of hands, feet, or other body part - racing or pounding heart - rapid breathing - shakiness - sweating - tension - trembling - upset stomach

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.

Studies examine worries

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.

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.

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.

The anxiety associated with diets?

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.

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.

Strategies to make treatment more effective

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.

Stress management techniques and meditation may help you to calm yourself and enhance the effects of therapy, although there is as yet no scientific evidence to support the value of these "wellness" approaches to recovery from anxiety disorders. There is preliminary evidence that aerobic exercise may be of value, and it is known that caffeine, illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of an anxiety disorder. Check with your physician or pharmacist before taking any additional medicines.

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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