Your response to the anxieties

While both fear and anxiety can provoke an arousal response, their other effects diverge. Very intense fear sometimes serves to "freeze" the body to protect it from harm, causing little or no change in heart rate and blocking the impulse to move. In anxiety, the physical changes caused by arousal lead to a second stage marked by thought patterns such as worry, dread, and mental replays of anxiety-arousing events.

As long as there's a good reason for fear or anxiety, and it doesn't interfere with the ability to work, play, and socialize, it is not considered a problem. But when anxiety takes on a life of its own and begins to disrupt everyday activities, the situation is no longer normal. A genuine emotional disorder is now at work... and it's time to see a doctor.

Effective treatments for anxiety disorders are available, and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment.

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

Scientists research mental health

Like heart disease and diabetes, the brain disorders are complex and probably result from a combination of genetic, behavioral, developmental, and other factors.

Other research focuses on the hippocampus, another brain structure that is responsible for processing threatening or traumatic stimuli. The hippocampus plays a key role in the brain by helping to encode information into memories. Studies have shown that the hippocampus appears to be smaller in people who have undergone severe stress because of child abuse or military combat. This reduced size could help explain why individuals with PTSD have flashbacks, deficits in explicit memory, and fragmented memory for details of the traumatic event.

In addition, with new findings about neurogenesis (birth of new brain cells) throughout life, perhaps a method will be found to stimulate growth of new neurons in the hippocampus in people with post-traumatic stress disorder.

Scientists are also conducting clinical trials to find the most effective ways of treating anxiety disorders. For example, one trial is examining how well medication and behavioral therapies work together and separately in the treatment of obsessive-compulsive disorder. Another trial is assessing the safety and efficacy of medication treatments for anxiety disorders in children and adolescents with co-occurring attention deficit hyperactivity disorder. For more information about clinical trials, for example the National Library of Medicine's clinical trials database.

Worries treatment: consult professional

The family is of great importance in the recovery of a person with an anxiety disorder. Ideally, the family should be supportive without helping to perpetuate the person's symptoms. If the family tends to trivialize the disorder or demand improvement without treatment, the affected person will suffer. You may wish to show this booklet to your family and enlist their help as educated allies in your fight against your anxiety disorder.

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

Treatment of fears

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

When you undergo treatment for an anxiety disorder, you and your doctor or therapist will be working together as a team. Together, you will attempt to find the approach that is best for you. If one treatment doesn't work, the odds are good that another one will. And new treatments are continually being developed through research. So don't give up hope.

Understanding fears

Unrestrained anxiety can lead to any of several emotional disorders, all characterized by an unpleasant and overwhelming mental tension with no apparent identifiable cause. While most people with anxiety disorders are completely aware that their thoughts and behavior are irrational and inappropriate, this insight gives them no help in controlling their symptoms.

Anxiety disorders are surprisingly frequent, and affect more Americans than does any other emotional disorder. They are more common than depression, manic depression, or abuse of alcohol and other substances. According to the American Psychiatric Association, while depressive disorders affect one person in 20, one in 12 suffers an anxiety disorder. Because consumers and doctors alike are less attuned to anxiety disorders than other emotional problems, these disorders often go unrecognized. This is unfortunate, because most cases of anxiety can be treated successfully. In fact, anxiety disorders are considered the most treatable of all emotional problems.

Causes of worries

Biochemical theory suggests that biologic imbalances, perhaps among the neurotransmitters in the brain, may be the primary cause of anxiety disorders. Indeed, in one study researchers were able to trigger a panic attack in some people simply by infusing certain chemicals. Many scientists involved in anxiety research now argue that correcting biochemical imbalances with medication should be the first goal of treatment. Other studies suggest that biochemical changes can also be achieved through the psychological and behavioral changes produced by psychotherapy.

Psychoanalytic theory holds that anxiety stems from unconscious conflict arising from discomfort or distress during childhood. Once the source of the anxiety is identified, it can be eliminated by resolving the underlying conflict. However, most studies find that people with anxiety disorders come from stable homes, with childhood backgrounds similar to those of people without anxiety disorders.

Stress, trauma, uncertainty. Most theorists agree that, other factors aside, stress, trauma, and uncertainties can play a role in the development of anxiety disorders. Studies show a relationship between anxiety and stress, which can be defined as a consequence of adapting to a change. Challenges such as the death of a loved one require a major adaptation that can contribute to the development of an anxiety disorder. Uncertainty during transitions, or about the future, can also produce anxiety. Some studies have found that a stressful event precedes the appearance of many anxiety disorders, though this result is not yet conclusive. The influence of these factors appears to vary with the disorder. In post-traumatic stress syndrome, such factors play a major role, whereas in obsessive- compulsive disorder, brain chemistry appears to be the primary culprit.

An imbalance in these neurotransmitters can cause a corresponding shift in our thoughts. But is the reverse also true? Can a determined change in our thinking alter the chemistry in the brain? Many experts are convinced this is true; and behavioral therapy aimed at changing our reactions does, in fact, cure many problems. Indeed, for some disorders, such as phobias, this type of therapy remains the most effective alternative.

Our everyday life and anxiety

Diet also can be a culprit. The most common dietary offenders are caffeine and caffeine-like substances found in coffee, tea, and many soft drinks. In sensitive individuals, the jitteriness precipitated by caffeine can reach panic levels. In rare cases, extreme vitamin deficiencies may also lead to anxiety.

The anxiety associated with taking or discontinuing medications and other substances can usually be easily relieved once the cause is recognized. It's therefore essential to provide your doctor with a complete run-down of your medicines--including over-the-counter products and of your eating and drinking habits.

Definitions and terms

Anxiety

• A state of uneasiness and apprehension, as about future uncertainties.


• Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.

Anxiety disorder

• A psychiatric disorder involving the presence of anxiety that is so intense or so frequently present that it causes difficulty or distress for the individual.

Anxiety disorders

• Any of various disorders in which anxiety is either the primary disturbance or is the result of confronting a feared situation or object; they include obsessive-compulsive disorder and posttraumatic stress disorder.

Fear

• Fear is an unpleasant feeling of perceived risk or danger, whether it be real or imagined.

Depression

• In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.

Mental health

• A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life.


• The psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment.

Stress

• A state of extreme difficulty, pressure, or strain.


• A physical and psychological response that results from being exposed to a demand or pressure.

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