More than 20 million Americans suffer from anxiety
disorders.They are tormented by panic attacks, obsessive thoughts,
flashbacks, nightmares, or countless frightening physical symptoms.
Anxiety disorders are the most common of all the mental disorders. At the The National Institute of Mental Health (NIMH),
the Federal agency that conducts and supports research related to
mental disorders, mental health, and the brain, scientists are learning
more and more about the nature of anxiety disorders, their causes, and
how to alleviate them. NIMH also conducts educational outreach
activities about anxiety disorders and other mental illnesses.
Anxiety is a feeling of apprehension, uncertainty, and fear in
anticipation of or in response to some real or perceived danger. Mild
forms of anxiety caused by emotional conflict or life stress are fairly
common and are not usually a clinical problem. Exaggerated fear may
lead to an anxiety attack.
Anxiety disorders are often related to the biological makeup and
life experiences of the individual, and they frequently run in
families. There are several types of anxiety disorders, each with its
own distinct features.
- Generalized Anxiety Disorder - Constant, exaggerated
worrisome thoughts and tension about everyday routine life events and
activities, lasting at least six months. Almost always anticipating the
worst even though there is little reason to expect it; accompanied by
physical symptoms, such as fatigue, trembling, muscle tension,
headache, or nausea. - Panic Disorder - People with panic disorder have
feelings of terror that strike suddenly and repeatedly with no warning.
They can't predict when an attack will occur, and many develop intense
anxiety between episodes, worrying when and where the next one will
strike. In between times there is a persistent, lingering worry that
another attack could come any minute.
When a panic attack strikes, most likely your heart pounds and you
may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel
numb, and you might feel flushed or chilled. You may have chest pain or
smothering sensations, a sense of unreality, or fear of impending doom
or loss of control. You may genuinely believe you're having a heart
attack or stroke, losing your mind, or on the verge of death. Attacks
can occur any time, even during nondream sleep. While most attacks
average a couple of minutes, occasionally they can go on for up to 10
minutes. In rare cases, they may last an hour or more.
- Post-Traumatic Stress Disorder - Persistent symptoms
that occur after experiencing a traumatic event such as rape or other
criminal assault, war, child abuse, natural disasters, or crashes.
Nightmares, flashbacks, numbing of emotions, depression, and feeling
angry, irritable or distracted and being easily startled are common. - Phobias - Phobias occur in several forms. A specific
phobia is a fear of a particular object or situation. Social phobia is
a fear of being painfully embarrassed in a social setting. And
agoraphobia, which often accompanies panic disorder, is a fear of being
in any situation that might provoke a panic attack, or from which
escape might be difficult if one occurred.
In many cases, anxiety associated with recent stress is time
limited. If it persists, brief, supportive counseling and/or short-term
use of medication may be helpful. Chronic, generalized anxiety can
usually be treated through psychotherapy and relaxation techniques.
Medication, for example, minor tranquilizers, may help control the
symptoms of anxiety. If medication is used, it should be used along
with and not as a substitute for any appropriate therapy or relaxation
techniques. If troublesome anxiety attacks, phobias, or obsessions are
present, psychiatric intervention combining medication and behavioral
techniques is usually necessary. The newer serotonin-specific reuptake
inhibitors can also be effective. A thorough evaluation should be done
to rule out other emotional problems, such as depression, as well as
medical disorders, such as thyroid dysfunction, that can cause anxiety.
Two clinically-proven effective forms of psychotherapy used to treat
anxiety disorders are behavioral therapy and cognitive-behavioral
therapy. Behavioral therapy focuses on changing specific actions and
uses several techniques to stop unwanted behaviors. In addition to the
behavioral therapy techniques, cognitive-behavioral therapy teaches
patients to understand and change their thinking patterns so they can
react differently to the situations that cause them anxiety.
It is common for an anxiety disorder to accompany depression, eating
disorders, substance abuse, or another anxiety disorder. Anxiety
disorders can also co-exist with physical disorders. In such instances,
the accompanying disorders will also need to be treated. Before
beginning any treatment, however, it is important to have a thorough
medical examination to rule out other possible causes of symptoms.
For More Information:
Publications and other information about Anxiety Disorders are available from the NIMH Anxiety Disorders website at http://www.nimh.nih.gov/ or by calling toll-free 1-88-88-ANXIETY (1-888-826-9438).
