Anxiety disorders are a group of mental disorders characterized by excessive bouts of anxiety and fear.
Presentation
The disorder is characterised by excessive bouts of anxiety and worry. The clinical presentation of anxiety disorders includes all or some of the following symptoms on a general scale [8]:
- Restlessness or feeling keyed-up or on edge
- Being fatigued quickly
- Difficulty in concentration and the mind going blank
- Muscle tension
- Irritability
- Sleep disturbance
- Suicidal ideation is not a diagnostic feature but it is associated with anxiety disorder.
Entire Body System
- Fatigue
This disorder is characterized by at least 6 months of pervasive and excessive anxiety; recurring worry about common events; and physical symptoms, such as muscle tension, insomnia, and fatigue (3). [doi.org]
Symptoms include excessive anxiety or worry, restlessness, fatigue, difficulty concentrating, and irritability. Other symptoms may be physical and include nausea, diarrhea, vomiting, headaches, sweating, and increased heart rate and blood pressure. [web.archive.org]
However, GAD was also highly associated with impaired psychological well-being, stress and fatigue (p CONCLUSIONS: In AMI patients, GAD was independently associated with less prehospital delay, but led to an impaired psychological state. [ncbi.nlm.nih.gov]
- Weight Gain
The NNTHs for discontinuation due to adverse events, somnolence, sedation, ≥ 7% weight gain, and akathisia relative to placebo were estimated with 95% confidence intervals to reflect the magnitude of variance. [ncbi.nlm.nih.gov]
Over the long term, it can even increase your risk of inflammation, weight gain, and chronic conditions like heart disease, says Chantal Gagnon, Ph.D., a licensed psychotherapist and Florida-based mental health counselor. [womenshealthmag.com]
Occasionally, upset stomach, diarrhea, insomnia, or weight gain may occur. Some children have behavioral adverse effects (eg, agitation, disinhibition); these effects are usually mild to moderate. [merckmanuals.com]
These drugs might cause side effects, including dizziness, drowsiness, dry mouth, and weight gain. Imipramine and clomipramine are two examples of tricyclics. [medicalnewstoday.com]
- Acute Intermittent Porphyria
Overall, the diagnosis of acute intermittent porphyria should be considered in any psychiatric syndrome with unexplained pain, especially if the pain is cyclical in nature [ 17 ]. [ncbi.nlm.nih.gov]
- Weight Loss
While most adverse events were mild to moderate, including nausea, anorexia, weight loss, pharyngitis, and mydriasis, three participants in the venlafaxine group developed new suicidal ideation, compared with none in the placebo group. [doi.org]
(My friend Anne says that the most effective weight-loss program she ever tried was the Stressful-Divorce Diet.) [theatlantic.com]
- Family History of Depression
During a routine visit, a 59-year-old woman, who describes herself as a lifetime “worrier” and has a family history of depression, reports having restless sleep, muscle tension, and fatigue. [doi.org]
Women with GAD have a higher risk of depression and other anxiety disorders than men with GAD. They also are more likely to have a family history of depression. 3 Panic disorder. [womenshealth.gov]
Respiratoric
- Cough
There may be symptoms like chest pain, difficulty breathing especially after exercise, fatigue, cough, palpitations etc. this needs to be ruled out. [news-medical.net]
Also avoid over-the-counter diet pills and cough and cold medicines that contain a decongestant. Confront the things that have made you anxious in the past. Begin by just picturing yourself confronting these things. [familydoctor.org]
No caffeine, minimize use of asthma medications if possible (bronchodilators, theophylline), avoid use of nasal decongestants, some cough medications, and diet pills. Good sleep habits. [web.archive.org]
- Dyspnea
Definition (NCI_CTCAE) A disorder characterized by apprehension of danger and dread accompanied by restlessness, tension, tachycardia, and dyspnea unattached to a clearly identifiable stimulus. [fpnotebook.com]
Paz-Díaz HMontes de Oca MLopez JMCelli BR Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD. Am J Phys Med Rehabil 2007;86 (1) 30- 36 PubMed Google Scholar Crossref 57. [archinte.ama-assn.org]
- Yawning
By Richard Klasco, M.D Photo Credit Ask Well Photo Credit Why Do We Yawn? Reading about yawning makes people yawn. You are probably yawning right now. By Roni Caryn Rabin Latest Search Latest Articles Search Articles 13898 results for sorted by [nytimes.com]
Gastrointestinal
- Nausea
This anxiety interferes with day-to-day life and can manifest in physical symptoms such as headaches, nausea, trembling, and fidgeting. [ulifeline.org]
However, when childhood anxiety begins to interfere with the child's abilty to function normally and to make judgments, to affect their learning, and to cause physical symptoms such as sweating, nausea, vomiting, heart palpitations, and other signs of [web.archive.org]
For example, a sudden episode of trembling or nausea accompanied by a fear of dying would be considered an LSA. Not everyone who experiences an LSA has a mental illness. [med.upenn.edu]
- Vomiting
However, when childhood anxiety begins to interfere with the child's abilty to function normally and to make judgments, to affect their learning, and to cause physical symptoms such as sweating, nausea, vomiting, heart palpitations, and other signs of [web.archive.org]
A person with a fear of vomiting (either fearing that they will vomit, or that that they'll see someone else vomit) would be considered to have Emetophobia. [anxietycoach.com]
In addition, flu-like symptoms, nausea/vomiting, and muscle pain/stiffness were judged likely to represent valid symptom categories. [ncbi.nlm.nih.gov]
’s been a while since I last vomited. [theatlantic.com]
- Diarrhea
Other symptoms may be physical and include nausea, diarrhea, vomiting, headaches, sweating, and increased heart rate and blood pressure. If your child experiences any of these symptoms over a period of time, you should check with your doctor. [web.archive.org]
They can also have side effects, such as dry mouth, nausea, and diarrhea. These symptoms bother some people so much that they stop taking these medications. [healthline.com]
Restlessness or irritability Anticipating the worst and being watchful for signs of danger Physical symptoms: Pounding or racing heart and shortness of breath Sweating, tremors and twitches Headaches, fatigue and insomnia Upset stomach, frequent urination or diarrhea [nami.org]
- Constipation
Depending on the medication your doctor prescribes, you may experience any of the following side effects: Insomnia Lowered libido Stomach aches Increase heart rate Constipation Blurry vision Anti-Anxiety Drug Addiction, Dependence and Withdrawal Unfortunately [psychguides.com]
- Bulimia Nervosa
Patients with psychiatric disorders which were considered to be the primary diagnosis i.e. schizophrenia, major depressive disorder, bipolar disorder, mental retardation, anorexia / bulimia nervosa, Tourette syndrome, patients with trichotillomania or [doi.org]
Cardiovascular
- Palpitations
Other symptoms of a panic attack include sweating, chest pain, palpitations (unusually strong or irregular heartbeats), and a feeling of choking, which may make the person feel like he or she is having a heart attack or "going crazy." [web.archive.org]
Pediatric generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about a variety of events and is accompanied by physical symptoms such as headaches, tension, restlessness, gastrointestinal distress, and heart palpitations [ncbi.nlm.nih.gov]
Other symptoms of a panic attack include sweating, chest pain, palpitations (unpleasant sensations of irregular heartbeats) and a feeling of choking, which might make the person feel like he or she is having a heart attack or "going crazy." [my.clevelandclinic.org]
Recurrent panic attacks--sudden waves of intense anxiety, apprehension, fearfulness, or terror, with physical symptoms such as shortness of breath, palpitations, sweating, and chest pains. Specific phobias. [health.harvard.edu]
- Chest Pain
Other symptoms of a panic attack include sweating, chest pain, palpitations (unusually strong or irregular heartbeats), and a feeling of choking, which may make the person feel like he or she is having a heart attack or "going crazy." [web.archive.org]
Recurrent panic attacks--sudden waves of intense anxiety, apprehension, fearfulness, or terror, with physical symptoms such as shortness of breath, palpitations, sweating, and chest pains. Specific phobias. [health.harvard.edu]
During a panic attack, a person has symptoms such as heart palpitations, sweating, trembling, dizziness, chest pain, and fear of losing control, going crazy, or dying. Panic disorder can occur with or without agoraphobia. [sparknotes.com]
But when you're having a full blown panic attack or anxiety attack, the symptoms — chest pain, flushing skin, racing heart, and difficulty breathing — can make you feel as though you're going to faint, lose your mind, or die. [everydayhealth.com]
- Hypertension
Maternal treatment with a serotonin reuptake inhibitor is also associated with hypertensive disease of pregnancy and cesarean delivery. [ncbi.nlm.nih.gov]
Spells (defined as profuse sweating, tachycardia, and headache) and hypertension at diagnosis were present in 51.4% and 66.6%, respectively. Bilateral disease was found in 12.5%, malignant pheochromocytoma in 29.6%, and hereditary forms in 23.0%. [doi.org]
Anxiety disorders may also contribute to morbidity and mortality via direct stimulation such as hypertension or cardiac arrhythmia or neuroimmune and neuroendocrine mechanisms. [symptoma.com]
- Tachycardia
Spells (defined as profuse sweating, tachycardia, and headache) and hypertension at diagnosis were present in 51.4% and 66.6%, respectively. Bilateral disease was found in 12.5%, malignant pheochromocytoma in 29.6%, and hereditary forms in 23.0%. [doi.org]
Definition (NCI_CTCAE) A disorder characterized by apprehension of danger and dread accompanied by restlessness, tension, tachycardia, and dyspnea unattached to a clearly identifiable stimulus. [fpnotebook.com]
A combination of these disorders can bring about physical symptoms like tachycardia and shakiness. There are different forms of anxiety disorders with each of them varying in seriousness but they have identical presentations. [symptoma.com]
The cardinal symptoms of serotonin syndrome are tachycardia, hemodynamic instability, confusion, and fever. [clinicaladvisor.com]
They are prone to flare up at times of high stress and are frequently accompanied by physiological symptoms such as headache, sweating, muscle spasms, tachycardia, palpitations, and hypertension, which in some cases lead to fatigue. [en.wikipedia.org]
Skin
- Flushing
They may have an increased heart rate, palpitations, profuse perspiration, chest-pain, a choking feeling, lightheadedness, nausea or a churning stomach, shivering chills, hot flushes, numbness in the hands and feet, or a general feeling of impending doom [bumrungrad.com]
But when you're having a full blown panic attack or anxiety attack, the symptoms — chest pain, flushing skin, racing heart, and difficulty breathing — can make you feel as though you're going to faint, lose your mind, or die. [everydayhealth.com]
“If you find that every time you have to be around other people your heart rate is accelerating and you feel kind of flushed and nauseous or something like that, then that’s a different thing,” says Fisher. [rd.com]
Physical symptoms of anxiety include: Muscle tension or trembling Pounding heart Dizziness or light-headedness Sweating, feeling hot or flushed Tightness in chest or throat, breathing difficulties Trouble falling asleep, waking in the night or too early [caps.ucsc.edu]
They may blotch, flush, sweat, hyperventilate, tremble, and startle easily. Anxiety during adolescence typically centers on changes in the way the adolescent's body looks and feels, social acceptance, and conflicts about independence. [aacap.org]
- Increased Sweating
Appearance looks strained, with increased sweating from the hands, feet, and axillae, and they may be tearful, which can suggest depression. [en.wikipedia.org]
Musculoskeletal
- Back Pain
[…] like headaches, stomachaches, and back pain. [rd.com]
The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. [ncbi.nlm.nih.gov]
(eg, knee osteoarthritis, back pain), and 4 from patients categorized as having “other medical illnesses” (ie, obesity, lupus, and epilepsy). [archinte.ama-assn.org]
- Low Back Pain
The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. [ncbi.nlm.nih.gov]
Wand BMBird CMcAuley JHDore CJMacDowell MDe Souza LH Early intervention for the management of acute low back pain: a single-blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. [archinte.ama-assn.org]
- Muscle Twitch
The physiological manifestations that accompany social anxiety may include intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling, swallowing with difficulty, and muscle twitches. [anxietynetwork.com]
Emotional Symptoms The feelings that accompany social anxiety include anxiety, high levels of fear, nervousness, automatic negative emotional cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling, and muscle twitches. [socialphobia.org]
Psychiatrical
- Anxiety Disorder
Anxiety Disorders There are several types of anxiety disorders including panic disorder, social anxiety disorder, specific phobias, and generalized anxiety disorder. Anxiety is a normal human emotion that everyone experiences at times. [web.archive.org]
disorders Anxiety disorders are generalised anxiety disorder, social anxiety disorder, post-traumatic stress disorder, panic disorder, obsessive–compulsive disorder and body dysmorphic disorder. [pathways.nice.org.uk]
[…] women with a specific phobia but not in women with a social anxiety disorder. [ncbi.nlm.nih.gov]
- Fear
We identified nine patterns of anxious arousal across groups that we further clustered into three groups: fear habituation, fear plateau, and fear increase. [ncbi.nlm.nih.gov]
Phobias A phobia is the excessive or unreasonable fear of something that actually presents little or no danger. Phobias can take many forms; common forms are fear of heights and fear of animals. [ulifeline.org]
Specific phobias : A specific phobia is an intense fear of a specific object or situation, such as snakes, heights, or flying. The level of fear is usually inappropriate to the situation and may cause the person to avoid common, everyday situations. [web.archive.org]
This disorder, agoraphobia, seems to stem from feelings about being away from parents and fears of being away from home rather than fear of the world. [aacap.org]
- Chronic Anxiety
From Wikidata Jump to navigation Jump to search cognitive disorder with an excessive, irrational dread of everyday situations anxiety state anxiety neurosis chronic anxiety anxiety edit English anxiety disorder cognitive disorder with an excessive, irrational [wikidata.org]
Recent biological investigations have led to the formulation of hypotheses in relation to anticipatory and chronic anxiety in terms of changes in synaptic connections, enhancement of transmitter release as well as alterations in molecular configuration [ncbi.nlm.nih.gov]
This guideline covers the care and treatment of people aged 18 and over with generalised anxiety disorder (chronic anxiety) or panic disorder (with or without agoraphobia or panic attacks). [nice.org.uk]
The Anxiety Trick The fears, phobias, and worry that you experience with chronic anxiety disorders often seem "irrational", and difficult to overcome. That's because there is a "Trick" to chronic anxiety problems. [anxietycoach.com]
- Withdrawn
However, it was withdrawn from the market in Switzerland and Germany due to cases of liver failure and 'unproven' efficacy. [ncbi.nlm.nih.gov]
In extreme cases, called social phobia, the adolescent becomes very withdrawn, and though he wants to take part in social activities, he's unable to overcome intense self-doubt and worry. [aacap.org]
But she also began exhibiting inappropriate behaviors, which ended when the medication was withdrawn. [nytimes.com]
At home, they behave like typical children, but in social situations, especially at school, they are silent and withdrawn. They might talk to grandparents but not to other relatives; they might whisper to one other child, or talk to no one. [web.archive.org]
- Obsessive Thoughts
Symptoms Obsessive-compulsive disorder covers both obsessive thoughts and compulsive behavior. Obsessive thoughts are constant and repetitive thoughts that are very hard to shake off. [ncbi.nlm.nih.gov]
Obsessive Compulsive Disorder (OCD) A person with Obsessive Compulsive Disorder experiences intrusive, unwelcome thoughts (called obsessions) which are so persistent and upsetting that he fears the thoughts might not stop. [anxietycoach.com]
Some OCD sufferers may only have obsessive thoughts without the related rituals. [uhs.umich.edu]
Anxiety-related symptoms such as worry, panic attacks, and obsessive thoughts or behaviors were also seen in significant numbers of these patients, as were secondary anxiety symptoms (worry and embarrassment). [web.archive.org]
Urogenital
- Sexual Dysfunction
Sexual dysfunctions (SDs) are defined in DSM as disturbances of the 3 phases of the sexual response cycle: desire, arousal, and orgasm, in addition to sexual pain disorder. Anxiety plays an important role in the pathogenesis and maintenance of SDs. [web.archive.org]
BASHH Special Interest Group for Sexual Dysfunction. Recommendations for the management of vaginismus: BASHH special interest group for sexual dysfunction. Int J STD AIDS. 2006;17:14–8. [PubMed] [Google Scholar] 4. Graziottin A. [ncbi.nlm.nih.gov]
The spasms close the vagina and can prevent sexual activity and medical exams. Alternative Names Sexual dysfunction - vaginismus Causes Vaginismus is a sexual problem. [m.ufhealth.org]
Sexual dysfunction can take a toll on relationships. Being proactive and getting treatment can be crucial in saving a marriage or relationship. It’s important to remember that there’s nothing to be ashamed of. [healthline.com]
- Dyspareunia
Dyspareunia Dyspareunia is the medical term for painful sexual intercourse. It’s often confused with vaginismus, but dyspareunia could be due to cysts, pelvic inflammatory disease, or vaginal atrophy. There’s not always a reason for vaginismus. [healthline.com]
They are closely interrelated and commonly overlooked in clinical practice.1 Pain may be experienced at vaginal entry, (superficial dyspareunia) or deep in the pelvis (deep dyspareunia). [ncbi.nlm.nih.gov]
[…] anxiety and retarded ejaculation is unclear, although some investigators suggest that sexual performance anxiety can contribute to retarded ejaculation. 18,27 Anxiety disorders and pain disorders High levels of anxiety have been found in women with dyspareunia [web.archive.org]
A medical history and complete physical exam are needed to look for other causes of pain with sexual intercourse (dyspareunia). Treatment A health care team made up of a gynecologist, physical therapist, and sexual counselor can help with treatment. [m.ufhealth.org]
- Premature Ejaculation
[…] between anxiety and retarded ejaculation is unclear, although some investigators suggest that sexual performance anxiety can contribute to retarded ejaculation. 18,27 Anxiety disorders and pain disorders High levels of anxiety have been found in women [web.archive.org]
The most common manifestations in individuals with anxiety disorder are avoidance of intercourse, premature ejaculation or erectile dysfunction among men and pain during intercourse among women. [en.wikipedia.org]
- Urinary Incontinence
During the psychiatric interview, only one organic sign was reported: a recent urinary incontinence. Neurological examination revealed an areflective paraparesia and a right plantar extension reflex. [ncbi.nlm.nih.gov]
- Female Sexual Dysfunction
sexual dysfunctions (76) Sex therapy and Kegels Vaginismus resolved or largely resolved 10% in vaginismus group 80% success 51% success 3-month FU: success rate <76 (67%) [62] Van Lankveld et al. (2006) Randomized controlled treatment outcome study Pelvic [medscape.com]
Neurologic
- Irritability
At least 3 key symptoms out of a possible 6 are required to make a diagnosis: restlessness or nervousness, easy fatigability, poor concentration, irritability, muscle tension, or sleep disturbance. [bestpractice.bmj.com]
His friends have noticed that Mitchell is irritable and angry most of the time, but when they try to distract him or ask him to hang out he blows them off. Mitchell knows he cannot stop now. [anxietybc.com]
Studies evaluating the impact of a GFD on patients with irritable bowel syndrome (IBS) were also included. Results Prevalence rates of NCGS (0.5–13%) differed widely. [doi.org]
Symptoms include excessive anxiety or worry, restlessness, fatigue, difficulty concentrating, and irritability. Other symptoms may be physical and include nausea, diarrhea, vomiting, headaches, sweating, and increased heart rate and blood pressure. [web.archive.org]
Symptoms include increased arousal such as insomnia, irritability, difficulty concentrating, hypervigilance, or exaggerated startle response. [sparknotes.com]
- Headache
With pharmacotherapy, systematic tracking of treatment-emergent adverse events such as headaches, stomach aches, behavioral activation, worsening symptoms, and emerging suicidal thoughts is important. [ncbi.nlm.nih.gov]
N Engl J Med 327:1109–1114 PubMed Google Scholar Sjaastad O, Bakketeig LS (2004) Caffeine-withdrawal headache: the Vaga study of headache epidemiology. [doi.org]
In addition to anxiety, young people with Generalized Anxiety Disorder may have physical symptoms such as headaches, tiredness and muscle tension. [web.archive.org]
I have been practising in Adult Psychiatry, General Psychiatry, Consultation Liason Psychiatry, Women and Childhood Psychiatric Disorders, Substance Use Disorders, psychiatric problems of elderly age group, primary headaches and other related disorders [bodymindheal.wordpress.com]
- Dizziness
Dizziness embracing vertigo, unsteadiness and imbalance are common in the elderly, so is generalized anxiety disorder, which is a common psychiatric problem in later life. [ncbi.nlm.nih.gov]
Dizziness and Panic Disorder: a Review of the Association Between Vestibular Dysfunction and Anxiety Simon,Naomi et al. Annals of Clinical Psychiatry (1998),10(2):75 http://dx.doi.org/10.3109/10401239809147746 [doi.org]
[…] symptoms include: Feelings of panic, fear, and uneasiness Problems sleeping Cold or sweaty hands and/or feet Shortness of breath Heart palpitations An inability to be still and calm Dry mouth Numbness or tingling in the hands or feet Nausea Muscle tension Dizziness [web.archive.org]
Some of the most common anxiety symptoms include irrational feelings of fear, dread, or danger tension worry physical symptoms such as agitation, trembling, nausea, hot or cold flashes, dizziness, shortness of breath, or frequent urination. [health.harvard.edu]
- Insomnia
This disorder is characterized by at least 6 months of pervasive and excessive anxiety; recurring worry about common events; and physical symptoms, such as muscle tension, insomnia, and fatigue (3). [doi.org]
Symptoms include increased arousal such as insomnia, irritability, difficulty concentrating, hypervigilance, or exaggerated startle response. [sparknotes.com]
Sleep studies and rebound insomnia: methodological problems, laboratory findings, and clinical implications. [ncbi.nlm.nih.gov]
- Hyperactivity
Anxiety disorders also often co-occur with other disorders such as depression, eating disorders, and attention-deficit/hyperactivity disorder (ADHD). [web.archive.org]
Abstract The present study was aimed at verifying whether the presence of generalized anxiety disorder (GAD) affects executive functions in children with attention-deficit hyperactivity disorder (ADHD). [ncbi.nlm.nih.gov]
Workup
When the chances of anxiety disorder being caused by a medical disorder is low or not presented clearly, initial laboratory studies to be carried out include:
- Complete blood cell count
- Urine drug screen
- Chemistry profile
- Urinalysis
- Thyroid function tests
To further exclude medical disorders, the following studies may be carried out:
- Electroencephalography, lumbar puncture, and head/brain imaging
- Tests for infection
- Thyroid function
- Arterial blood gas analysis
- Electrolyte analysis
- Chest radiography
- Electrocardiography
Treatment
Treatment of anxiety disorders is made up of a combination of pharmacotherapy and psychotherapy. The drugs of choice are antidepressant agents [9]. The preferred type these days are the newer agents as they have a much safer adverse effect profile as well as a higher ease of use than selective serotonin reuptake inhibitors (SSRIs) and other older tricyclic antidepressants (TCAs).
The outcome of treatment is determined by several factors which include the following:
- Severity of diagnosis
- Level of functioning prior to onset of symptoms
- Degree of motivation for treatment
- Level of support (eg, family, friends, work, school)
- Ability to comply with medication and/or psychotherapeutic regimen
Prognosis
This disorder has a high rate of comorbidity with the abuse of drugs and alcohol as well as major depression. Therefore the increased morbidity and mortality that is common with anxiety disorders is related to this high rate of comorbidity [6]. Anxiety disorders may also contribute to morbidity and mortality via direct stimulation such as hypertension or cardiac arrhythmia or neuroimmune and neuroendocrine mechanisms.
Considerable evidences show that some variants of anxiety disorder leads to significant functional impairment as well as a decreased quality of life.
Severe cases of anxiety disorders may be further complicated by suicide, with or without secondary mood disorders such as depression [7].
Etiology
A known or unrecognised medical condition is often the first consideration when looking at the causes of anxiety disorders [3]. Most of the time however, anxiety disorder arises as a result of over-the-counter medication or substance abuse. Unfortunately, this is missed most of the time in diagnosis.
Genetic factors also significantly impact risk for anxiety disorders as is the case with environmental factors like early childhood trauma. The arguments on how genes and environment contributes to risk of anxiety disorder has led to the understanding that while some individuals are resilient to stress others are vulnerable to it and this leads to a form of anxiety disorder.
Epidemiology
Over 273 million or 4.5% of the world population had an anxiety disorder according to 2010 statistics. The condition is also seen most in females (5.2%) as against (2.8%) in males [4].
In Europe, Africa and Asia, the lifetime rates of anxiety disorders are between 9 and 16%. The yearly rates are also between 4 and 7%. In the U.S between 11 and 18% of adults develop the condition in a year and the lifetime prevalence is 29%.
Pathophysiology
The major mediators of the symptoms synonymous with anxiety disorders in the central nervous system (CNS) include gamma-aminobutyric acid (GABA), dopamine, serotonin and norepinephrine. Other peptides and neurotransmitters like the corticotropin-releasing factor may also be involved [5]. The autonomic nervous system, with emphasis on the sympathetic nervous system, mediates a good number of the symptoms.
It has been demonstrated with the aid of positron emission tomography (PET) that there is often increased flow in the right parahippocampal area as well as a reduction in serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of people with anxiety disorders (especially panic disorders).
Prevention
There are no guidelines for the prevention of anxiety disorder.
Summary
Anxiety disorders refer to a group of mental disorders that trigger fear and anxiety. The anxiety brings about worries about future events and fear brings about reactions (often inexplicable and exaggerated to onlookers) to current events [1]. A combination of these disorders can bring about physical symptoms like tachycardia and shakiness.
There are different forms of anxiety disorders with each of them varying in seriousness but they have identical presentations. The different types of anxiety disorders include panic disorder (most severe of the group), phobic disorder and generalised anxiety disorder.
Anxiety disorders are often genetic but they may also arise due to use of certain drugs like alcohol and caffeine. It may also be seen following withdrawal from certain drugs. In some cases, anxiety disorders occur in tandem with bipolar disorders, eating disorders and major depressive disorders [2].
With anxiety disorders, the emotions presented may range from simple nervousness to full blown bouts of terror. There are other psychiatric problems that show the same symptoms as anxiety disorders. Hyperthyroidism is the prime example.
Patient Information
There is nothing wrong with the occasional feeling of anxiety especially when your life is generally stressful. However, you are dealing with an anxiety disorder when it becomes severe and impedes your day to day activities.
Anxiety disorders can be developed as a child or as an adult and there are various forms of anxiety disorder that are slightly different. They often bring about similar symptoms and it takes the help of a professional to determine what variant you are dealing with.
Depending on the cause of the anxiety disorder, it may become a long-term challenge. In some cases it is accompanied by mood disorders. The condition often improves with medication and psychological counselling known as psychotherapy. Making lifestyle changes and using relaxation techniques can also bring about improvement in the condition.
References
- Keeton CP, Kolos AC, Walkup JT. Pediatric generalized anxiety disorder: epidemiology, diagnosis, and management. Paediatr Drugs. 2009;11(3):171-83.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: APA Press; 2013.
- Martinez RC, Ribeiro de Oliveira A, Brandão ML. Serotonergic mechanisms in the basolateral amygdala differentially regulate the conditioned and unconditioned fear organized in the periaqueductal gray. Eur Neuropsychopharmacol. Nov 2007;17(11):717-24.
- Freitas-Ferrari MC, Hallak JE, Trzesniak C, Filho AS, Machado-de-Sousa JP, Chagas MH. Neuroimaging in social anxiety disorder: a systematic review of the literature. Prog Neuropsychopharmacol Biol Psychiatry. May 30 2010;34(4):565-80.
- Katerndahl DA, Talamantes M. A comparison of persons with early-versus late-onset panic attacks. J Clin Psychiatry. Jun 2000;61(6):422-7.
- Wittchen HU, Zhao S, Kessler RC, Eaton WW. DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51:355.
- Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62:593.
- Kessler RC, Gruber M, Hettema JM, et al. Co-morbid major depression and generalized anxiety disorders in the National Comorbidity Survey follow-up. Psychol Med 2008; 38:365.
- Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21:655.
- Wittchen HU, Jacobi F. Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005; 15:357.