Question

    Anxiety Disorder

    English: The Scream[1]

    Anxiety disorders are a group of mental disorders characterized by excessive bouts of anxiety and fear.

    The disease is caused by this process: mental.

    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]:

    Jaw & Teeth
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  • Entire body system
    Agitation
    • . † Behavioral adverse effects (eg, disinhibition, agitation) are common but are usually mild to moderate.[merckmanuals.com]
    • But if you chronically find yourself lying awake, worried or agitated—about specific problems (like money), or nothing in particular—it might be a sign of an anxiety disorder.[health.com]
    • In rare cases, they can cause agitation.[umm.edu]
    • Common side effects of these medications include headache, GI complaints, tremor, agitation, drowsiness and insomnia.[baltimorepsych.com]
    • "I get easily agitated."[mentalhealth.com]
    Chronic Fatigue Syndrome
    • Anorexia is a serious psychological disorder and is Bulimia People with bulimia nervosa, an eating disorder that involves episodes of bingeing and purging, experience symptoms and signs such as deteriorating teeth, Chronic Fatigue Syndrome (CFS or SEID[medicinenet.com]
    • They include migraines, obstructive sleep apnea, mitral valve prolapse, irritable bowel syndrome, chronic fatigue syndrome, and premenstrual syndrome.[umm.edu]
    Family History of Depression
    • They also are more likely to have a family history of depression. 3 Panic disorder .[womenshealth.gov]
    Fatigue
    • ) Chronic fatigue syndrome (CFS) or systemic exertion intolerance disease (SEID) is a debilitating and complex disorder characterized by profound fatigue Colic in Babies Colic is crying or fussing that begins suddenly, lasting for a total of three hours[medicinenet.com]
    • The Womenshealth.gov website says physical symptoms of generalized anxiety disorder include: Significant and unexplained fatigue.[mentalhelp.net]
    • Physical symptoms often include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, hot flashes and feeling out of breath[washingtonpost.com]
    • The clinical presentation of anxiety disorders includes all or some of the following symptoms on a general scale: Restlessness or feeling keyed-up or on edge Being fatigued quickly Difficulty in concentration and the mind going blank Muscle tension Irritability[symptoma.com]
    • […] happens to others, fears will happen to them; everything is contagious by association: divorce, illness, car accidents, food poisoning Reviewing events to make sure that didn't hurt anyone's feelings or do anything wrong Sleep difficulties, irritability, fatigue[worrywisekids.org]
    Weight Gain
    • 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]
    • Common side effects can include sleepiness, weight gain, nausea , and sexual problems.[webmd.com]
    • Occasionally, upset stomach, diarrhea, insomnia, or weight gain may occur.[merckmanuals.com]
    • These include weight gain and increased high blood sugar levels, which can increase the risk for diabetes.[umm.edu]
    • They may cause dizziness, drowsiness, dry mouth, constipation, or weight gain.[womenshealth.gov]
    Weight Loss
    • (My friend Anne says that the most effective weight-loss program she ever tried was the Stressful-Divorce Diet.)[theatlantic.com]
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  • Face, Head & Neck
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  • neurologic
    Dizziness
    • Shakiness, dizziness, and sweating are all common symptoms for those who suffer from anxiety.[foxnews.com]
    • 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.[sparknotes.com]
    • Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, feelings of unreality, and fear of dying.[mentalhealthamerica.net]
    • Often mistaken for a heart attack, a panic attack causes powerful, physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.[nami.org]
    • Symptoms All anxiety disorders share some general symptoms: Panic, fear, and uneasiness Sleep problems Not being able to stay calm and still Cold, sweaty, numb or tingling hands or feet Shortness of breath Heart palpitations Dry mouth Nausea Tense muscles Dizziness[webmd.com]
    Headache
    • These kids often have headaches and stomachaches especially on school days, and the school nurse might know them well.[worrywisekids.org]
    • A person with GAD may become exhausted by worry and experience headaches, tension or nausea.[nami.org]
    • It is often accompanied by physical symptoms such as headaches, muscular tension, restlessness, heart palpitations, and stomach upset.[childrenshospital.org]
    Hyperactivity
    • Suggested Reading on Anxiety by Our Doctors Related Diseases & Conditions 116 articles Childhood ADD or ADHD (Attention Deficit Hyperactivity Disorder in Children) Attention deficit hyperactivity disorder (ADHD) causes the following symptoms in children[medicinenet.com]
    • You must have medical documentation of one of the following: Constant generalized anxiety, with three of the following four symptoms: motor tension, vigilance and scanning, autonomic hyperactivity, or apprehensive expectation.[disability-benefits-help.org]
    • Children who have an anxiety disorder are likely to have other disorders such as depression, eating disorders, attention deficit disorders both hyperactive and inattentive.[en.wikipedia.org]
    • . * Hyperactivity: "I move excessively (e.g., can't sit still; restless; always on the go)."[mentalhealth.com]
    • Diagnosing children with an anxiety disorder can be very difficult, since anxiety often results in disruptive behaviors that overlap with attention-deficit hyperactivity disorder or oppositional disorder.[umm.edu]
    Insomnia
    • It is highly recommended that you read full list of here rules/guidelines here Rotating List /r/socialanxiety /r/mentalhealth /r/misophonia /r/HealthAnxiety /r/depression /r/ptsd /r/dbtselfhelp /r/BackOnYourFeet /r/psychology /r/insomnia Full List Located[reddit.com]
    • Symptoms include increased arousal such as insomnia, irritability, difficulty concentrating, hypervigilance, or exaggerated startle response.[sparknotes.com]
    • ., a clinical psychologist in San Francisco who specializes in anxiety, stress, and insomnia.[womenshealthmag.com]
    • Feeling tense and jumpy Restlessness or irritability Anticipating the worst and being watchful for signs of danger Physical symptoms: Pounding or racing heart and shortness of breath Upset stomach Sweating, tremors and twitches Headaches, fatigue and insomnia[nami.org]
    • Stomach problems, dizziness, headaches, insomnia, sweatiness, muscle tension...[buzzfeed.com]
    Irritability
    • Common responses to the sounds are disgust, anger, stress, or annoyance/irritation.[anxietyclinic.vcu.edu]
    • Symptoms include irritability, anxious expectations, pangs of conscience, anxiety attacks, or phobias.[fpnotebook.com]
    • Physical symptoms often include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, hot flashes and feeling out of breath[washingtonpost.com]
    Paresthesia
    • […] or hot flushes Derealization (feelings of unreality) or depersonalization (being detached from oneself) Fear of losing control Feeling dizzy, unsteady, lightheaded, or faint Feeling of choking Nausea or abdominal distress Palpitations or tachycardia Paresthesias[clevelandclinicmeded.com]
    Tremor
    • […] symptoms: Feelings of apprehension or dread Feeling tense and jumpy Restlessness or irritability Anticipating the worst and being watchful for signs of danger Physical symptoms: Pounding or racing heart and shortness of breath Upset stomach Sweating, tremors[nami.org]
    • A person experiencing Parkinson's Disease Parkinson's disease is a slowly progressive neurological disease characterized by a fixed inexpressive face, a tremor at rest, slowing of voluntary movements, Rosacea Rosacea is a skin disease that causes redness[medicinenet.com]
    • Common side effects of these medications include headache, GI complaints, tremor, agitation, drowsiness and insomnia.[baltimorepsych.com]
    • Symptoms include sweating, shortness of breath, pounding heart, dry mouth, and tremor.[umm.edu]
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  • Immune System
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  • Skin
    Flushing
    • Arm Yourself With Information When you're having a panic attack or anxiety attack, the symptoms — chest pain, flushing skin, a racing heart, and difficulty breathing — can make you feel like you're going to faint, lose your mind, or die.[everydayhealth.com]
    • For doctors to diagnose a panic attack, they look for at least four of the following signs: sweating, trembling, shortness of breath, a choking sensation, chest pain, nausea, dizziness, fear of losing your mind, fear of dying, flushing, feeling that danger[huffingtonpost.com]
    • These feelings may be accompanied by symptoms such as breathlessness, a choking sensation, palpitations, restlessness, muscular tension, tightness in the chest, giddiness, trembling, and flushing, which are produced by the action of the autonomic nervous[medical-dictionary.thefreedictionary.com]
    • Box 1: DSM IV-TR Criteria for a Panic Attack A panic attack is a period of intense fear or discomfort, developing abruptly and peaking within 10 minutes, and requiring at least four of the following: Chest pain or discomfort Chills or hot flushes Derealization[clevelandclinicmeded.com]
    • But then I flushed and … something happened.[theatlantic.com]
    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]
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  • respiratoric
    Cough
    • Also avoid over-the-counter diet pills, and cough and cold medicines that contain a decongestant.[familydoctor.org]
    • Some symptoms can include palpitations, chest pain, difficulty breathing after exertion, fatigue, cough, and shortness of breath while lying down.[umm.edu]
    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]
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  • gastrointestinal
    Bulimia
    • Anorexia is a serious psychological disorder and is Bulimia People with bulimia nervosa, an eating disorder that involves episodes of bingeing and purging, experience symptoms and signs such as deteriorating teeth, Chronic Fatigue Syndrome (CFS or SEID[medicinenet.com]
    Diarrhea
    • They can also have side effects, such as dry mouth, nausea, and diarrhea.[healthline.com]
    • […] irritability Anticipating the worst and being watchful for signs of danger Physical symptoms: Pounding or racing heart and shortness of breath Upset stomach Sweating, tremors and twitches Headaches, fatigue and insomnia Upset stomach, frequent urination or diarrhea[nami.org]
    • Irritable bowel syndrome (IBS), a condition characterized by stomachaches, cramping, bloating, gas, constipation, and/or diarrhea, "is basically an anxiety in the digestive tract," Winston says.[health.com]
    • Occasionally, upset stomach, diarrhea, insomnia, or weight gain may occur.[merckmanuals.com]
    • […] either pounding too hard or fluttering (palpitations) Abdominal pain and/or stomach upset Avoiding eye contact Blushing Children with social phobia may weep, have tantrums, cling to parents, or shut themselves out Clammy hands Cold hands Confusion Crying Diarrhea[medicalnewstoday.com]
    Loss of Appetite
    Nausea
    • Social anxiety can cause physical symptoms such as trembling, nausea, and sweating in social settings.[ulifeline.org]
    • Physical symptoms often include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, hot flashes and feeling out of breath[washingtonpost.com]
    • Common side effects can include sleepiness, weight gain, nausea , and sexual problems.[webmd.com]
    • Children often report stomachaches, headaches, or nausea when separation occurs or is anticipated (such as before school or at the end of a vacation).[anxietyclinic.vcu.edu]
    • Side effects may include: Headaches Insomnia Nausea Sexual dysfunction.[medicalnewstoday.com]
    Vomiting
    • I didn’t vomit in the 1980s.[theatlantic.com]
    • 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]
    • Joan Baez and Matt Lauer have come out as emetophobes: they share Stossel’s dread of vomiting.[newyorker.com]
    • […] phobias about animals and insects, things in the natural environment like storms or heights, situations related to blood, injections, or other medical procedures, situations such as tunnels, air travel, bridges, elevators, or other situations such as vomiting[anxietyclinic.vcu.edu]
    • Along with the worry and dread, people with generalized anxiety have physical symptoms, such as chest pain, headache, tiredness, tight muscles, stomachaches, or vomiting.[kidshealth.org]
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  • musculoskeletal
    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]
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  • cardiovascular
    Chest Pain
    • Arm Yourself With Information When you're having a panic attack or anxiety attack, the symptoms — chest pain, flushing skin, a racing heart, and difficulty breathing — can make you feel like you're going to faint, lose your mind, or die.[everydayhealth.com]
    • 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.[sparknotes.com]
    • Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, feelings of unreality, and fear of dying.[mentalhealthamerica.net]
    • Often mistaken for a heart attack, a panic attack causes powerful, physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.[nami.org]
    Heart Disease
    • Anxiety disorders are real, serious medical conditions - just as real and serious as physical disorders such as heart disease or diabetes.[adaa.org]
    • 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]
    • Diagnosis The physical symptoms of an anxiety disorder can be easily confused with other medical conditions like heart disease or hyperthyroidism.[nami.org]
    • Anxiety has been linked to: gastroesophageal reflux disease ( GERD ) thyroid disorders heart disease menopause If your primary care provider suspects that a medical condition or substance abuse problem is causing anxiety, they may perform more tests.[healthline.com]
    • Anxiety disorders can be caused by a combination of biological and/or environmental factors like many other disorders such as heart disease or diabetes.[anxietyclinic.vcu.edu]
    Palpitations
    • The sensation of having a 'thumping heart' (palpitations).[patient.info]
    • During a panic attack , you may also sweat, have chest pain , and feel palpitations (unusually strong or irregular heartbeats).[webmd.com]
    • Heart palpitations, vertigo, stomach aches, and insomnia have all been friends of mine that never arrive saying, "Hey![huffingtonpost.com]
    • It is often accompanied by physical symptoms such as headaches, muscular tension, restlessness, heart palpitations, and stomach upset.[childrenshospital.org]
    • People suffering from chronic, generalized anxiety often report the following symptoms: Muscle tension Physical weakness Poor memory Sweaty hands Fear or confusion Inability to relax Constant worry Shortness of breath Palpitations Upset stomach Poor concentration[psychcentral.com]
    Tachycardia
    • 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.[symptoma.com]
    • , 14q, 22q, 4q31-q34, and probably 9q31 may be associated with the heritability of panic disorder phenotype. [20] The cognitive theory regarding panic is that patients with panic disorder have a heightened sensitivity to internal autonomic cues (eg, tachycardia[emedicine.medscape.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]
    • […] discomfort Chills or hot flushes Derealization (feelings of unreality) or depersonalization (being detached from oneself) Fear of losing control Feeling dizzy, unsteady, lightheaded, or faint Feeling of choking Nausea or abdominal distress Palpitations or tachycardia[clevelandclinicmeded.com]
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  • urogenital
    Premature Ejaculation
    • 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]
    Sexual Dysfunction
    • Sexual dysfunction often accompanies anxiety disorders, although it is difficult to determine whether anxiety causes the sexual dysfunction or whether they arise from a common cause.[en.wikipedia.org]
    • Side effects may include: Headaches Insomnia Nausea Sexual dysfunction.[medicalnewstoday.com]
    • Sexual dysfunction, including lowered sex drive, is a common side effect of many antidepressants as is weight gain.[umm.edu]
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  • psychiatrical
    Anxiety Disorder
    • Anxiety disorders can be developed as a child or as an adult and there are various forms of anxiety disorder that are slightly different.[symptoma.com]
    • There are a number of anxiety disorders: including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism.[en.wikipedia.org]
    • Anxiety disorders may run in families.[everydayhealth.com]
    • , Anxiety disorder, unspecified , [X]Anxiety disord unspecified , [X]Anxiety disorder, unspecified , Anxiety disorders , ANXIETY DIS , anxiety disorder (diagnosis) , anxiety disorder , Anxiety Disorders , Anxiety NOS , Anxiety Disorders [Disease/Finding[fpnotebook.com]
    Chronic Anxiety
    Claustrophobia
    • Claustrophobia: Participants will be questioned about potential discomfort in being in an enclosed space, such as an MRI scanner.[clinicaltrials.gov]
    • A person who fears airplanes, elevators, tunnels, and bridges is usually considered to have Panic Disorder or claustrophobia.[anxietycoach.com]
    • For example: Fear of confined spaces or of being trapped (claustrophobia).[patient.info]
    • The most common specific phobias are fear of animals (usually spiders, snakes, or mice), flying ( pterygophobia ), heights ( acrophobia ), water, injections, public transportation, confined spaces ( claustrophobia ), dentists ( odontiatophobia ), storms[umm.edu]
    • To name a few: enclosed spaces (claustrophobia); heights (acrophobia); fainting (asthenophobia); being trapped far from home (a species of agoraphobia); germs (bacillophobia); cheese (turophobia); flying (aerophobia); vomiting (emetophobia); and, naturally[theatlantic.com]
    Panic Attacks
    • His second panic attack "was really a full-blown panic attack, where I thought I was going to die," Sideman said.[huffingtonpost.com]
    • Panic Disorder People who have panic disorder experience panic attacks and worry or concern about possible future panic attacks.[anxietyclinic.vcu.edu]
    • The second stage is the symptoms of the panic attack itself.[anxieties.com]
    • Often, an individual will experience panic attacks or extreme anxiety in specific situations.[en.wikipedia.org]
    • If the anxiety is untreated, it can become overwhelming, leading to panic attacks or withdrawal from society.[additudemag.com]
    Withdrawn
    • When someone frequently avoids situations that make him or her anxious, it can actually make the anxiety worse over time and can cause the person to feel isolated and withdrawn.[teenmentalhealth.org]
    • The individual's personality - children who are withdrawn, restrained, shy or timid when confronted with a new situation are thought to be more prone to developing social anxiety disorder.[medicalnewstoday.com]
    • Unlike pharmacotherapy, whose beneficial effects do not last in the great majority of patients after medication is withdrawn, behavioral therapy has shown continued efficacy in follow-up studies ranging from 1 to 6 years, although booster sessions may[baltimorepsych.com]
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  • Ears
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  • 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

    Laboratory

    Serum
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  • 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].

    Complications

    Agoraphobia
    • Panic disorder can occur with or without agoraphobia.[sparknotes.com]
    • Agoraphobia Agoraphobia may be the result of repeat, unexpected panic attacks, which, in turn, may be linked to cognitive distortions, conditioned responses, and/or abnormalities in noradrenergic, serotonergic, or GABA-related neurotransmission.[emedicine.medscape.com]
    • Agoraphobia This too is common.[patient.info]
    • Agoraphobia Agoraphobia means "fear of the marketplace," and people who experience agoraphobia have anxiety about being in places or situations from which it might be difficult or embarrassing to escape.[anxietyclinic.vcu.edu]
    • "I found a therapist who understood what panic disorder was, understood agoraphobia, and knew cognitive behavioral therapy, which I had not known about."[huffingtonpost.com]
    Amphetamine
    • Anxiety symptoms can result from intoxication on alcohol, amphetamines (and related substances), caffeine, cannabis (marijuana), cocaine, hallucinogens, inhalants, phencyclidine (PCP) and related substances, and other or unknown substances.[minddisorders.com]
    • Injury (eg, accidents, surgery) Illness Interpersonal conflict or loss Use of cannabis (can be associated with panic attacks, perhaps because of breath-holding) [ 21 ] Use of stimulants, such as caffeine, decongestants, cocaine, and sympathomimetics (eg, amphetamine[emedicine.medscape.com]
    • When Evidence Says No, But Doctors Say Yes Cochrane Reviews (the best evidence-based, standardized reviews available) Research Topics Separation Anxiety Disorder - Latest Research (2016-2017) Amphetamine Amphetamine (extended release) Aripiprazole Atomoxetine[mentalhealth.com]
    • These include alcohol, tobacco, cannabis, sedatives (including prescription benzodiazepines), opioids (including prescription pain killers and illicit drugs like heroin), stimulants (such as caffeine, cocaine and amphetamines), hallucinogens, and inhalants[en.wikipedia.org]
    • Overuse of caffeine or abuse of amphetamines can cause symptoms resembling a panic attack.[umm.edu]
    Anxiety
    • Social physique anxiety (SPA) is a subtype of social anxiety.[en.wikipedia.org]
    • Anxiety disorders are a group of mental disorders characterized by excessive bouts of anxiety and fear.[symptoma.com]
    • Signs and symptoms of anxiety attacks and anxiety disorders Anxiety Disorders – Guide to the different types of anxiety disorders, their symptoms, and how to get help.[helpguide.org]
    • , Anxiety disorder, unspecified , [X]Anxiety disord unspecified , [X]Anxiety disorder, unspecified , Anxiety disorders , ANXIETY DIS , anxiety disorder (diagnosis) , anxiety disorder , Anxiety Disorders , Anxiety NOS , Anxiety Disorders [Disease/Finding[fpnotebook.com]
    Bipolar Disorder
    • In some cases, anxiety disorders occur in tandem with bipolar disorders, eating disorders and major depressive disorders.[symptoma.com]
    • Severe depression, bipolar disorder, prodromal schizophrenia, delusional disorder, and adjustment disorder can all mimic the signs and symptoms of anxiety.[clevelandclinicmeded.com]
    • Northern County Psychiatric Associates Attention Deficit Disorder Adult AD/HD Children & Adolescents Family Issues Medication Organization Skills School Depression Children & Adolescents Adults Medication Postpartum Seasonal Depression Bipolar Disorder[baltimorepsych.com]
    Constipation
    • Irritable bowel syndrome (IBS), a condition characterized by stomachaches, cramping, bloating, gas, constipation, and/or diarrhea, "is basically an anxiety in the digestive tract," Winston says.[health.com]
    • 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]
    • They may cause dizziness, drowsiness, dry mouth, constipation, or weight gain.[womenshealth.gov]
    Depression
    • depression, PTSD doxepin (Sinequan or Adapin) panic, depression clomipramine (Anafranil) panic, OCD, depression OTHER ANTIDEPRESSANTS trazodone (Desyrel) depression, generalized anxiety MONOAMINE OXIDASE INHIBITORS (MAOIs) phenelzine (Nardil) panic, OCD[anxieties.com]
    • In some cases, anxiety disorders occur in tandem with bipolar disorders, eating disorders and major depressive disorders.[symptoma.com]
    • Depression and Anxiety Depression and anxiety disorders are different, but it's common for someone with an anxiety disorder to suffer from depression, too.[everydayhealth.com]
    • Additionally, patients with both anxiety and depression were found to have lower morbidity than those with depression alone.[en.wikipedia.org]
    • Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions.[adaa.org]
    Erectile Dysfunction
    • Bloating Erectile Dysfunction (ED, Impotence) Erectile dysfunction (ED, impotence) is the failure to achieve or maintain an erection.[medicinenet.com]
    • 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]
    Hypertension
    • 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]
    • 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]
    Hyperventilation
    • In experimental settings, symptoms can be elicited in people with panic disorder by hyperventilation, inhalation of carbon dioxide, caffeine consumption, or intravenous infusions of hypertonic sodium lactate or hypertonic saline, [24] cholecystokinin,[emedicine.medscape.com]
    • Symptoms include rapid heartbeat, dizziness, and hyperventilation, and may be mistaken for a more serious ailment, like a heart attack.[additudemag.com]
    • Some of the symptoms you may notice are: Increased heart rate Unexplained sweating Shaking Inability to breathe deeply Hyperventilating Feeling cold for no reason Having hot flashes for no reason Stomach cramps Feelings of dizziness Short-Term and Long-Term[psychguides.com]
    • Symptoms of an Anxiety Attack Surge of overwhelming panic Feeling of losing control or going crazy Heart palpitations or chest pain Feeling like you’re going to pass out Trouble breathing or choking sensation Hyperventilation Hot flashes or chills Trembling[helpguide.org]
    • For example, hyperventilation is one of the primary physical manifestations of panic disorders.[umm.edu]
    Irritable Bowel Syndrome
    • Irritable bowel syndrome (IBS) .[womenshealth.gov]
    • Irritable bowel syndrome (IBS), a condition characterized by stomachaches, cramping, bloating, gas, constipation, and/or diarrhea, "is basically an anxiety in the digestive tract," Winston says.[health.com]
    • Anxiety frequently accompanies gastrointestinal conditions, particularly irritable bowel syndrome.[umm.edu]
    Mania
    • Yet the case for medication, I can also tell you, is complicated by drawbacks and side effects that range from sedation to weight gain to mania to headaches to digestive and urinary troubles to neuromuscular problems to dependency and addiction to, some[theatlantic.com]
    Obsessive-Compulsive Disorder
    • Manuscripts that focus on disorders formerly categorized as anxiety disorders (obsessive-compulsive disorder...[journals.elsevier.com]
    • Obsessive-Compulsive Disorder and Related Disorders Social Anxiety Disorder Adult Separation Anxiety Disorder Trauma and PTSD Program Hispanic Treatment Program[columbiapsychiatry.org]
    • Anxiety disorders include a set of related mental conditions that include: generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, social phobia, and simple phobias.[psychcentral.com]
    • Obsessive compulsive disorder: diagnosis and management.[umm.edu]
    • Obsessive-compulsive Disorder: A person with obsessive-compulsive disorder experiences obsessions, compulsions, or both.[sparknotes.com]
    Pheochromocytoma
    • There Pheochromocytoma Pheochromocytoma is a tumor of the adrenal gland.[medicinenet.com]
    • Occasionally, an anxiety disorder may be a side-effect of an underlying endocrine disease that causes nervous system hyperactivity, such as pheochromocytoma or hyperthyroidism.[en.wikipedia.org]
    Phobia
    • Specific phobia Genetic factors seem to play a role in specific phobia as well (eg, in blood-injury phobia), and the risk for such phobias also seems to be moderately heritable. [28] In addition, specific phobia can be acquired by conditioning, modeling[emedicine.medscape.com]
    • Specific Phobia A Specific Phobia is a pattern of excessive fear of some ordinary object, situation, or activity.[anxietycoach.com]
    • » Panic Disorder Treatment Social Anxiety Disorder Symptoms (also known as social anxiety disorder) » Social Anxiety Treatment Specific phobias (also known as simple phobias) » Specific/Simple Phobia Treatment Our complete Anxiety Library… More Information[psychcentral.com]
    • Millions of people all over the world suffer from this devastating and traumatic problem every day, either from a specific social phobia or from a more generalized social phobia.[anxietynetwork.com]
    • Over time, they may develop a phobia of social situations.[en.wikipedia.org]
    Posttraumatic Stress Disorder
    • Anxiety disorders include a set of related mental conditions that include: generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, social phobia, and simple phobias.[psychcentral.com]
    • Manuscripts that focus on disorders formerly categorized as anxiety disorders (obsessive-compulsive disorder, posttraumatic stress disorder) and the new category of illness anxiety disorder are also within the scope of the journal.[journals.elsevier.com]
    • The clinic now includes programs in obsessive-compulsive disorder (OCD), posttraumatic stress disorder and related traumatic conditions (PTSD and Trauma program), social anxiety disorder, adult separation anxiety disorder, the Hispanic Treatment Program[columbiapsychiatry.org]
    • Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are closely related to anxiety disorders, which some may experience at the same time as depression.[adaa.org]
    Sleep Deprivation
    • Often GAD sufferers will worry so much that they lose sleep and find themselves constantly tired and sleep deprived. - Headaches.[youtube.com]
    Supraventricular Tachycardia
    • People with a heart-rhythm disturbance called paroxysmal supraventricular tachycardia have many of the same symptoms as those with panic attacks.[umm.edu]
    Tension Headache
    • Accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.[mentalhealthamerica.net]
    • Symptoms of Anxiety Someone suffering from GAD will generally experience several of these symptoms: – Excessive worry – Unrealistically negative view of problems – Restlessness, or feeling “on edge” – Irritability – Muscle tensionHeadaches – Sweating[additudemag.com]
    • Symptoms of GAD can include: Excessive, ongoing worry and tension An unrealistic view of problems Restlessness or a feeling of being "edgy" Irritability Muscle tension Headaches Sweating Difficulty concentrating Nausea The need to go to the bathroom frequently[webmd.com]
    Trichotillomania
    • Related Problems Trichotillomania Children and adults who have trichotillomania repeatedly pull out hairs from one or several parts of the body.[anxietyclinic.vcu.edu]
    • The students I have known who suffer from trichotillomania also had OCD.[webspace.ship.edu]
  • more...
  • 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%.

    Sex distribution
    Age distribution

    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.

    Self-assessment

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    References

    1. Keeton CP, Kolos AC, Walkup JT. Pediatric generalized anxiety disorder: epidemiology, diagnosis, and management. Paediatr Drugs. 2009;11(3):171-83. 
    2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: APA Press; 2013.
    3. 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.
    4. 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. 
    5. Katerndahl DA, Talamantes M. A comparison of persons with early-versus late-onset panic attacks. J Clin Psychiatry. Jun 2000;61(6):422-7. 
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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.



    Media References

    1. English: The Scream, Public Domain

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