Worry never robs tomorrow of its sorrow, it only saps today of its joy.

Leo Buscaglia

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated.

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.

Anxiety, on the other hand, is more general and complex. It is felt in anticipation of danger, and is associated with the ability to predict, prepare for, and adapt to change. Often, it lasts a long time, and its cause remains ill-defined. For example, someone uneasy about public speaking may experience a tightness in the stomach for days before a scheduled talk.

Thousands of scientific studies over the past several years show that high blood pressure, ulcers, migraine headaches, strokes, alcoholism, depression, anger, fatigue, drug addiction and many other medical conditions are often due to the long-term effects of stress.

If you have been treated previously for an anxiety disorder, be prepared to tell the doctor what treatment you tried. If it was a medication, what was the dosage, was it gradually increased, and how long did you take it? If you had psychotherapy, what kind was it, and how often did you attend sessions? It often happens that people believe they have "failed" at treatment, or that the treatment has failed them, when in fact it was never given an adequate trial.

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.

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.

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

Symptoms of this disorder are often mild, and do not interfere with work or social situations. If symptoms are severe, however, they can disrupt daily activities. Because people with generalized anxiety disorder often have another physical or emotional disorder, such as depression, there has been much learned debate as to whether anxiety disorder exists on its own. But recent studies indicate that there really is such a disorder, and that it can be helped by diagnosis and treatment. The symptoms of generalized anxiety disorder usually begin in youth and may go untreated for decades. However, they tend to diminish with age. One study found that only 3 percent of cases of generalized anxiety disorder began in those 65 and over. The problem is more common among women than men and often runs in families.

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.

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.

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.

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.

Also, research indicates that other brain parts called the basal ganglia and striatum are involved in obsessive-compulsive disorder.

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.

It is not entirely clear why psychotropic medications work; yet, it appears that they reestablish balance within the chemistry of the brain. Behavior is determined through messages transmitted within the brain from one nerve cell to another through various chemicals. These chemicals are called neurotransmitters. Through the millions of nerve cells within the brain, chemicals trigger memories, sleep patterns, perceptions, feelings, moods and thoughts. The electric current that carries the messages are received by nerve ends, called synapses, which then release the neurotransmitter. These chemicals, in turn, propagate the message by stimulating the next nerves in line to send on the electrical message. Once used, the neurotransmitter chemical is returned and stored in the nerve end. This recycling process is called reuptake. When this signaling process goes askew, the effects are seen in a person's behavior and experienced in his emotions, perceptions, sensations, and ideas.

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.

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.

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.

Studies show that antidepressants have been effective in treating depression. A type of medicine called selective serotonin reuptake inhibitors (SSRIs) is most often prescribed by doctors. In "talk" therapy, the patient and therapist talk about the patient's experiences, relationships, events, and feelings. Two of the approaches found to be effective for treating depression are interpersonal therapy and cognitive- behavioral therapy.

Definition interpreting

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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