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Anxiety Disorder

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]:

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]
  • 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]
  • 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]
  • 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]
  • At least 3 of the following emotional, somatic, and cognitive symptoms are present most of the time: restlessness or nervousness, being easily fatigued, poor concentration, irritability, muscle tension, or sleep disturbance. [1] American Psychiatric Association[bestpractice.bmj.com]
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]
  • Side effects include dizziness, drowsiness, dry mouth, and weight gain, which can usually be alleviated by adjusting the dosage or switching to another tricyclic medication.[web.archive.org]
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]
  • Acute intermittent porphyria: a study of 50 cases. Q. J. Med. 28, 183–209. [ PubMed ] [ Google Scholar ] Gross U., Puy H., Meissauer U., Lamoril J., Deybach J. C., Doss M., et al.. (2002).[ncbi.nlm.nih.gov]
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]
  • They also are more likely to have a family history of depression. 3 Panic disorder . Panic disorders are twice as common in women as in men. 4 People with panic disorder have sudden attacks of terror when there is no actual danger.[womenshealth.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]
Cough
  • 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]
  • 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]
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.[doi.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]
Nausea
  • 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]
  • This anxiety interferes with day-to-day life and can manifest in physical symptoms such as headaches, nausea, trembling, and fidgeting.[ulifeline.org]
  • […] disorder, but general 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[web.archive.org]
  • Physical symptoms may include chest pain, dizziness, nausea, sweating, tingling or numbness, and a racing heartbeat.[uhs.umich.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]
  • 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]
  • Over the past several months, she has been having terrible stomachaches in the morning, and sometimes vomits before going to school.[anxietybc.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]
  • When confronted with these situations, the individual may experience blushing, diarrhea , elevated heart rate, nausea , sweating, or trembling. Social anxiety disorder often is accompanied by depression and an increased risk of alcohol abuse .[britannica.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]
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]
  • They may cause dizziness, drowsiness, dry mouth, constipation, or weight gain. Monoamine oxidase inhibitors (MAOIs).[womenshealth.gov]
Bulimia
  • 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]
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]
  • 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]
  • 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]
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]
  • 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]
  • 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]
  • 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]
  • Physical symptoms may include chest pain, dizziness, nausea, sweating, tingling or numbness, and a racing heartbeat.[uhs.umich.edu]
Heart Disease
  • BACKGROUND: The Center for Epidemiological Studies Depression Scale (CES-D) is an instrument that is commonly used to screen for depression in patients with chronic disease, but the characteristics of the CES-D in adults with congenital heart disease[ncbi.nlm.nih.gov]
  • In addition, studies have shown that anxiety disorders run in families, which means that they can at least partly be inherited from one or both parents, like the risk for heart disease or cancer.[web.archive.org]
  • Anxiety disorders are real, serious medical conditions - just as real and serious as physical disorders such as heart disease or diabetes. Anxiety disorders are the most common and pervasive mental disorders in the United States.[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]
  • 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]
Hypertension
  • Maternal treatment with a serotonin reuptake inhibitor is also associated with hypertensive disease of pregnancy and cesarean delivery.[ncbi.nlm.nih.gov]
  • 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]
  • 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]
  • Mercado-Asis and Karel Pacak, Pheochromocytoma: Unmasking the Chameleon, Endocrine Hypertension, 10.1007/978-1-60761-548-4_7, (123-148), (2012).[doi.org]
  • As noted above, older adults also tend to emphasize somatic rather than psychological symptoms of anxiety. 11 Differential diagnosis Older adults undergo changes in health, ranging from normal aging to chronic medical conditions including hypertension[web.archive.org]
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. There are different forms of anxiety disorders with each of them varying in seriousness but they have identical presentations.[symptoma.com]
  • 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]
  • 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]
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.[doi.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.[doi.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]
Flushing
  • “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]
  • […] problems Attention problems Problem-solving difficulties Worry Restlessness Fidgeting Task avoidance Rapid speech Irritability Withdrawal Perfectionism Lack of participation Failing to complete tasks Seeking easy tasks Stomach discomfort Rapid heart rate Flushing[nasponline.org]
  • 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]
  • 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]
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]
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]
  • 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]
  • There are several different types of anxiety disorders. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder.[web.archive.org]
  • [NICE’s guideline on social anxiety disorder, recommendations 1.2.5 to 1.2.9 and 1.4.5 to 1.4.8] Suspected anxiety disorder An anxiety disorder may be suspected in people with a past history of an anxiety disorder, possible somatic symptoms of an anxiety[pathways.nice.org.uk]
  • On the other hand, social anxiety disorder has been termed "the neglected anxiety disorder" because its diagnosis is often missed.[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]
  • 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]
  • A child who sees a scary movie and then has trouble falling asleep or has a similar temporary fear can be reassured and comforted. But that is not enough to help a child with an anxiety disorder get past his or her fear and anxiety.[web.archive.org]
  • Being outside of the home alone This anxiety is often increased by a fear of embarrassment, as the person fears suffering a panic attack and showing distress in public.[med.upenn.edu]
  • Panic disorder symptoms include: Sudden and repeated attacks of intense fear Feelings of being out of control during a panic attack Intense worries about when the next attack will happen Fear or avoidance of places where panic attacks have occurred in[web.archive.org]
Panic Attacks
  • If a person begins to avoid these situations due to fear of a panic attack, they may also have agoraphobia (see below). Some people suffer panic attacks on a daily or weekly basis.[med.upenn.edu]
  • Patients with a postpanic anxiety disorder (PPAD) have panic attacks less frequently than patients with a panic disorder.[ncbi.nlm.nih.gov]
  • Group cognitive behavioural treatment focusing on preventing panic attacks and generalised anxiety did not appear to have an impact on core separation anxiety symptoms.[ncbi.nlm.nih.gov]
  • You’ve had one or more panic attacks iStock/ljubaphoto Fisher emphasizes that one panic attack does not necessarily indicate symptoms of anxiety disorder, as panic attacks are a normal, evolutionary response to extreme fear.[rd.com]
  • The Problem with "Panic Attacks" Also, contrary to current psychiatric/psychological nomenclature, people with social anxiety do not have "panic attacks".[socialanxietyinstitute.org]
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]
  • Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales.[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]
  • However, it was withdrawn from the market in Switzerland and Germany due to cases of liver failure and ‘unproven’ efficacy.[doi.org]
  • 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]
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]
  • Some research suggests that family history can play a part in increasing the chances that a person will develop chronic anxiety.[timberlineknolls.com]
  • 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]
Irritability
  • 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]
  • 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]
  • Thus, a modified single factor model allowing the error terms of items associated with relaxing difficulties and irritability to covary was an appropriate solution.[ncbi.nlm.nih.gov]
  • 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]
  • Signs and Symptoms of Anxiety Feeling nervous, irritable or on edge Having a sense of impending danger, panic or doom Having an increased heart rate Breathing rapidly (hyperventilation), sweating, and/or trembling Feeling weak or tired Difficulty concentrating[adaa.org]
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]
  • In addition to anxiety, young people with Generalized Anxiety Disorder may have physical symptoms such as headaches, tiredness and muscle tension.[web.archive.org]
  • 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]
  • A person with GAD may become exhausted by worry and experience headaches, tension or nausea.[myburke.org]
  • These kids often have headaches and stomachaches especially on school days, and the school nurse might know them well.[worrywisekids.org]
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]
  • […] 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]
  • Shakiness, dizziness, and sweating are all common symptoms for those who suffer from anxiety. You don’t want give yourself feelings of panic, when all you need is a snack. Meditation can help the brains ability to change.[foxnews.com]
  • Other common complaints are autonomic in nature, such as sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort. [2] World Health Organization. International classification of diseases, tenth revision.[bestpractice.bmj.com]
  • In addition to anxiety, people often also have physical symptoms, including shortness of breath, dizziness, sweating, rapid heartbeat, and/or tremor.[merckmanuals.com]
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]
  • Jerome Sarris, Alexander Panossian, Isaac Schweitzer, Con Stough and Andrew Scholey, Herbal medicine for depression, anxiety and insomnia: A review of psychopharmacology and clinical evidence, European Neuropsychopharmacology, 21, 12, (841), (2011).[doi.org]
  • Symptoms include increased arousal such as insomnia, irritability, difficulty concentrating, hypervigilance, or exaggerated startle response.[sparknotes.com]
  • Feelings of apprehension or dread Feeling tense and jumpy Restlessness or irritability Anticipating the worst Physical symptoms may include: Racing heartbeat or shortness of breath Upset stomach Sweating, tremors and twitches Headaches, fatigue and insomnia[myburke.org]
Hyperactivity
  • 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]
  • Anxiety disorders also often co-occur with other disorders such as depression, eating disorders, and attention-deficit/hyperactivity disorder (ADHD).[web.archive.org]
  • Anxiety disorders are characterised by long term worry, tension, nervousness, fidgeting and symptoms of autonomic system hyperactivity. Meditation is an age-old self regulatory strategy which is gaining more interest in mental health and psychiatry.[ncbi.nlm.nih.gov]
  • […] orgasm. 13-15 Negative emotions, including anxiety or fear of failing to meet a partner's expectations, represent one of the most common causes of premature ejaculation (PE). 16-20 This has been explained by investigators as being caused by a sympathetic hyperactivity[web.archive.org]
  • […] investigate the biological validity of a simple measure of mood instability and evaluate its genetic relationship with several psychiatric disorders, including major depressive disorder (MDD), bipolar disorder (BD), schizophrenia, attention deficit hyperactivity[ncbi.nlm.nih.gov]
Sexual Dysfunction
  • Anxiety disorders in patients with sexual dysfunction The complex relationship between anxiety disorders and desire disorders is rarely clarified in the medical literature.[web.archive.org]
  • Sexual dysfunction is particularly common among people affected by panic disorder (who may fear that a panic attack will occur during sexual arousal) and posttraumatic stress disorder.[en.wikipedia.org]
  • Examples may include: paroxetine (Paxil, Paxil CR) sertraline (Zoloft) fluvoxamine (Luvox, Luvox CR) fluoxetine (Prozac, Sarafem) Possible side effects may include: headaches insomnia nausea sexual dysfunction A doctor may prescribe serotonin and norepinephrine[medicalnewstoday.com]
  • Some people also experience sexual dysfunction with SSRIs. Adjusting the dosage or switching to another SSRI may help with these side effects.[web.archive.org]
  • Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002 63 :357–366. [ PubMed ] [ Google Scholar ] Stein MB, Cantrell CR, and Sokol MC. et al.[ncbi.nlm.nih.gov]
Premature Ejaculation
  • ejaculation (PE). 16-20 This has been explained by investigators as being caused by a sympathetic hyperactivity that reduces ejaculation control. 20-22 Others have pointed to the role of attention, suggesting that men who are anxious during sexual intercourse[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]
Dyspareunia
  • […] 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]
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]

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%.

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.

References

Article

  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.

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Last updated: 2019-07-11 21:45