Understanding Anxiety and Anxiety Disorders Introduction
What is Anxiety?
What is anxiety? Ask anyone to define anxiety and you will quickly realize there is no shortage of examples that people can provide. Although anxiety is a very common human experience, the descriptions that people provide are quite varied.
Anxiety is a human emotion. Everyone experience it. Yet, each person experiences this emotion in unique ways. The following case examples illustrate these various experiences of anxiety:
Sally is a 24-year-old sales associate in a highly prestigious pharmaceutical firm. She constantly works under a great deal of pressure. She says it's "no big deal." She even believes she thrives off this stress. However, she recently walked into her local grocery store and began to sweat. Her heart began to race. She felt like she was losing control. This happened on several occasions. She became so distressed she decided to order her groceries online to avoid another repeat episode.
Bill is a 47-y...More
Fast Facts: Learn! Fast!
What is Anxiety?
- Anxiety is a human emotion that everyone experiences.
- Anxiety is a complex, individual experience that is produced by multiple causes and is expressed by a diverse set of symptoms, including physical, emotional, behavioral, and cognitive ones.
- People differ in how often, and how intensely, they experience anxiety.
- A normal degree of anxiety is part of the everyday human experience, but sometimes people may experience anxiety to such a heightened degree that it causes them great distress.
- Abnormal anxiety is a chronic condition that impairs a person's functioning and interferes with his/her well-being.
What are the symptoms of anxiety?
- Anxiety can produce physical, behavioral, emotional, cognitive and psychological symptoms. Common physical symptoms include a feeling of restlessness, feeling "keyed up," or "on-edge;", shortness of breath, or a feeling of choking, sweaty palms, a racing heart, muscle tension, nausea, feeling faint or shaky and sleep disturbances.
- Behavioral symptoms of anxiety refer to what people do (or don't do) when they are anxious. Typical behavioral responses to anxiety may include avoidance, such as avoiding social situations or taking the stairs instead of an elevator, escaping behaviors, such as excessive drinking or drug use; or limiting the amount and scope of daily behaviors and activities to feel safe.
- Emotional symptoms of anxiety include distress, apprehension, dread, nervousness, feeling overwhelmed, panic, worry, jumpiness or edginess.
- The thoughts people experience when anxious are commonly referred to as worry. Although the content of the thoughts may vary depending on the person and situation, common themes include "What if _ happens?" or "I can't possibly tolerate not knowing_" or "I am going crazy" or "What's happening to me?"
- Psychological symptoms of anxiety may include problems with concentration, or difficulty with staying on task; memory difficulties; and, depressive symptoms such as hopelessness, a lack of energy, and a poor appetite.
What causes anxiety?
- The biopsychosocial model suggests that the causes of anxiety can be roughly categorized into three main groups: 1. biological causes, 2. psychological causes, and 3. environmental or social causes.
- The biological category refers to the body's physiological, adaptive responses to fear. It also refers to genetic traits, and the brain functioning that we inherit.
- The biological model involves 6 systems in the body including the nervous system (including the brain), the cardiovascular, respiratory, digestive, excretory, and endocrine system.
- Biological causes also include the "fight or flight" response where when we are in the presence of an immediate danger, our bodies will automatically begin to prepare us to either attack the threat (fight) or to escape from the danger (flight). A person's heart begins to beat very fast and this increased blood flow ensures extra oxygen is delivered to the muscles to prepare for that fighting or flight.
- The psychological factors refer to our thoughts, beliefs, and perceptions about our experiences, our environment, and ourselves.
- Research has identified four important variables that predict a psychological vulnerability to anxiety. These are perceived control (our ability to control a potentially stressful event), cognitive appraisals (the way we evaluate and assess a particular environmental event or situation), cognitive beliefs (our core beliefs about ourselves, and the world around us), and cognitive distortions (errors we make in our thinking).
- Environment refers to our life experiences, particularly social interactions with other people, especially caregivers, family members, etc.
How common are Anxiety Disorders?
- According to the National Institute of Mental Health (NIMH, 2008), approximately 40 million American adults (about 18%) have an anxiety disorder in a given year.
- On average, the first episode occurs before a person is 21.5 years old.
- Both adults and children can be diagnosed with Anxiety Disorders, although some disorders are more common in one group than the other.
- Many of these disorders develop during childhood, and persist into adulthood when left untreated.
- While both adults and children may experience anxiety, children may display different symptoms and may also describe their symptoms differently.
- In order to be diagnosed with an anxiety disorder, the criteria require that symptoms must cause a person significant distress or problems in their functioning.
What is a panic attack?
- Panic attacks are a specific, common symptom of many anxiety disorders.
- Panic attacks are sudden, extreme feelings of fear and/or discomfort lasting for a distinct period of time. This sudden surge peaks in intensity within a few minutes, at which point it begins subside.
- There is often a sense of doom and gloom and a powerful desire to escape.
- Common symptoms include palpitations and/or pounding heart; sweating; trembling or shaking; chest pain or discomfort; feeling dizzy; numbness or tingling sensations; hot flashes or chills; fear of losing control or "going crazy" or a fear of dying.
- Panic attacks are a false alarm that triggers the "fight or flight" response system.
- There are 2 types of panic attacks - uncued and cued.
- Unexpected, or uncued, panic attacks seem to come from "out of the blue." They do not have an identifiable source that sets them off. It is believed these occur in response to some kind of life stress. They are found in Panic Disorder.
- Expected, or cued, panic attacks are attacks with an obvious trigger. They occur when a person is exposed to certain situations or objects where panic attacks have happened before. The onset is sudden and occurs immediately upon exposure to the situation or object.
- Cued panic attacks are found in Social Anxiety Disorder, specific Phobias, and agoraphobia.
- Panic disorder is characterized by uncued (unexpected) panic attacks.
- In order to be diagnosed with Panic Disorder, a person must experience repeated, unexpected (uncued) panic attacks and be followed by constant concerns about having more attacks; worrying about the consequences of the attacks; or significantly changing behavior to avoid the attacks. These worries and concerns about experiencing another attack must continue for a month or longer for a diagnosis of Panic Disorder.
What types of Anxiety Disorders are there?
- Separation Anxiety Disorder is characterized by a developmentally inappropriate and excessive fear of becoming separated from a primary attachment figure. For more information about Symptoms and Treatments
- Selective Mutism occurs when a child or adult persistently refuses to speak in specific situations where speaking is expected. For more information about Symptoms and Treatments
- Agoraphobia is characterized by an intense fear or anxiety that occurs when someone is faced with a situation that is difficult or embarrassing to leave, or where help would be unavailable if they were to experience panic-like symptoms, such as becoming dizzy or disoriented. For more information about Symptoms and Treatments
- Specific phobia is the intense fear, anxiety, and avoidance of a specific object or situation, such as flying, heights, getting a shot, or being near animals. For more information about Symptoms and Treatments
- Social phobia, or Social Anxiety Disorder, is the intense fear, anxiety, and avoidance of social situations where there is the potential of being negatively judged by others. For more information about Symptoms and Treatments
- People with Generalized Anxiety Disorder (GAD) have uncontrollable, excessive anxiety and excessive worry. For more information about Symptoms and Treatments
What types of therapy are generally used to treat Anxiety Disorders?
- Anxiety disorders are one of the most treatable psychiatric conditions.
- Research consistently finds that cognitive behavioral therapy (CBT) is the most effective treatment strategy for treating a variety of conditions including anxiety disorders.
- Supportive psychotherapy (often thought of as "talk therapy") and psychodynamic or psychoanalytic therapy tends to be ineffective for anxiety disorders.
- A common type of behavioral therapy used in the treatment of Anxiety Disorders is called exposure and response prevention therapy (ERP). Exposure means facing or confronting one's fears repeatedly until the fear subsides. Response prevention means not engaging in avoidance or escape behaviors when faced with a feared situation.
- Acceptance and Commitment Therapy (ACT) recognizes that words (and the thoughts formed with words) have individual and unique meanings. Because language allows us to attribute meaning to thoughts, it is possible for us to allow thoughts to enter our minds without giving them importance. ACT teaches people how to accept their emotional distress.
- Dialectical behavior therapy (DBT) teaches participants skills that enable them to: 1) better regulate their intense emotions; 2) become more effective in their interpersonal relationships; 3) improve their ability to cope with emotional crises; and, 4) decrease their reliance on unhealthy coping behaviors such as substance abuse, self-injury, and suicidal behaviors. Dialectical behavior therapy may be beneficial for persons who are reluctant to engage in exposure and response prevention therapy (ERP).
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Resources
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Articles
- What is Anxiety?
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The Biopsychosocial Model of Anxiety
- The Biopsychosocial Model: Causes of Pathological Anxiety
- Biological Explanations of Anxiety Disorders
- Biological Explanations of Anxiety: Part II
- Biological Explanations of Anxiety: Part III
- Biological Explanations of Anxiety: Part IV
- Psychological Explanations of Anxiety Disorders
- Psychological Explanations: Part II
- Social Explanations of Anxiety Disorders
- Development & Maintenance of Anxiety Disorders
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Classification & Diagnosis of Anxiety Disorders
- The Classification and Diagnosis of Anxiety Disorders
- Panic Attacks: A Classic Symptom of Several Anxiety Disorders
- Panic Disorder
- Separation Anxiety Disorder
- Selective Mutism
- Agoraphobia
- Specific Phobias and Social Anxiety Disorder (Social Phobia)
- Generalized Anxiety Disorder (GAD)
- Other Anxiety-Related Disorders
- Anxiety and Other Psychiatric Disorders
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Anxiety Disorder Theories and Therapies
- Anxiety Disorders: Theories and Therapies
- Behavioral Learning Theory and Associated Therapies
- Operant Conditioning
- Operant Conditioning and Avoidance Learning
- Contemporary Views of Behavioral Learning Theory
- Behavioral Therapies for Anxiety Disorders
- Cognitive Theory and Associated Therapies
- Cognitive Therapy
- Cognitive-Behavioral Therapy
- Adjunct Therapies
- Pharmacologic Treatments (Medication)
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Treatment of Anxiety Disorders
- Treatment for Separation Anxiety Disorder
- Treatment for Selective Mutism
- Treatment for Panic Disorder
- Treatment for Specific Phobias and Treatment for Social Anxiety Disorder (Social Phobia)
- Treatment for Generalized Anxiety Disorder (GAD)
- Treatment for Obsessive-Compulsive Spectrum Disorders (OCSDs)
- Conclusion
- Anxiety Disorder References & Additonal Resources
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News
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Questions and Answers
- Anxious About Opinions
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- Fear
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- Is My Anxiety a Normal Reaction?
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- Social Anxiety, Depression and More...
- Do I Have Just Social Anxiety or Other Diagnoses Combined with SA?
- Need To Ask Someone
- False Memories
- Help! Please!
- Two Year Old Son Wandered
- Infections and The Brain
- Are Personality Disorders For Life?
- I am Terrified of Death.
- Anhedonia
- Our 23 Year Old Son Refuses to Get Help for His Anxiety Attacks and Depression.
- Anxiety
- Anxiety Disorder vs. Personality Disorder: Differences?
- Restroom Phobia
- I'm Afraid I'm Going Crazy
- Post Brain Surgery Mental Problems
- Would Medication Help?
- obsessive strange thoughts about life and existentialism
- Am I Crazy?
- Is it Anxiety? Is it Normal to Be Like That?
- Depressed 19 year old college student
- Depression helps to contribute to my unemployment! - Paula
- Relationship Anxiety
- Disconnected
- I'm Scared
- Please help fix my mom. - Kenny
- OCD?
- Saving my Son
- Scary thoughts, dark feelings, help?
- Swallowing fear
- Is there something wrong with me?
- I have PTSD and I feel nothing
- OCD Cure
- Repressed Memory
- I have OCD. Will this increase my child's chance of developing Autism?
- Crazy Thoughts
- 20 Year Old Female: no friends, depressed, what should I do?
- unwanted thoughts!
- crazy thoughts... all the time
- A very low threshold for stress tolerance
- Why can't I get gross images out of my head?
- fear of expiration
- SPECIFIC PHOBIA
- anxiety or going crazy?
- OCB
- visions of what could have been
- about depersonalization
- obsessive compulsive disorder
- OCD/ANXIETY while pregnant
- Amnesia
- Social Phobia
- Constant Counting Disorder
- Anxiety
- Is this OCD?
- Worried about my therapist
- No Friends
- Teenager...angst vs. mental health issue
- phobia regarding uncertainty
- Obsessed with running out of things
- Do I Have OCD?
- Do environmental factors hold a person back?
- Never Had a Relationship
- Shy Rural Student
- Nursing Student's Anxiety
- I'm Afraid They Are Judging Me
- Part Time Work and Stress
- Anxiety
- Panic
- Bathroom Phobia
- Anxiety?
- Mastery Of Anxiety And Panic
- Very Determined Panicker In The South
- Panicking Boyfriend
- Alternatives For Anxiety Treatment
- Is Anxiety A Hereditary Factor?
- Unable To Keep Eye Contact
- Is It Really Panic? And How Do We Get Help
- A Cure For Claustrophobia?
- Panic Attacks
- Shyness And The Post Partum Blues
- Klonopin
- Alternative Treatment
- Can't Afford Therapy
- Driving Phobia
- Indecisive
- Agoraphobia?
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- A Cure For Anxiety?
- Panic Attacks
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- Anxiety?
- Social Anxiety
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Book & Media Reviews
- 8 Keys to Stress Management
- A Brief History of Anxiety
- Anxiety
- Anxiety
- Anxiety Disorders
- Anxiety, Phobias, and Panic
- Been There, Done That? DO THIS!
- Calm Beneath the Waves
- Elsewhere
- Exercise for Mood and Anxiety
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- Getting Control
- Helping Students Overcome Depression and Anxiety
- Just Checking
- Mind-Body Workbook for Anxiety
- Monkey Mind
- My Age of Anxiety
- Overcoming School Anxiety
- Panic Disorder
- Passing for Normal
- Phobic and Anxiety Disorders in Children and Adolescents
- Repressed Spaces
- Self-Coaching
- Stress
- Stress Survival Guide
- Textbook of Anxiety Disorders
- The 10 Best Anxiety Busters
- The Age of Anxiety
- The Anxieties of Affluence
- The Dutiful Worrier
- The Emotional Eater's Repair Manual
- The Male Stress Survival Guide
- The Places That Scare You
- The Stress Cure
- The SuperStress Solution
- Treating Affect Phobia
- Under Pressure and Overwhelmed
- Viniyoga Therapy for Anxiety
- When Words Are Not Enough
- Wish I Could Be There
- Yoga for Anxiety
- Yoga Journal's Yoga for Stress
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Self-Help Groups
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Links
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Videos
- How to Manage ADHD and Anxiety
- What You Need to Know about Students with ADHD and Anxiety
- How To Make Room For Gratitude In An Anxious Brain
- How to Stay Calm When You Know You'll Be Stressed
- Anxiety and Teen Girls with Lisa Damour, PhD
- Is it Anxiety or a Heart Condition?
- Identifying and Treating Anxiety in Kids and Teens
- Child Anxiety, It’s Real
- Helping Children Cope with Anxiety
- Anxiety, Trauma and How Prolonged Exposure Therapy Works For PTSD
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- OCD, Phobias and Anxiety
- How Weighted Blankets May Lift Anxiety
- Controlling Anxiety
- Too Scared: Social Anxiety Disorder
- Panic Disorders Video
- Phobias Video
- Treating Anxiety Disorders: A Unified Protocol
- Treating Youth Anxiety and Social Phobia
- Overcoming Anxiety in Children and Teens
- Treating Anxiety in Children and Teens with ASD
- Back-to-School Anxiety
- No More Shame: My life with Anxiety and Depression
- Adolescent Depression and Anxiety
- What is Social Anxiety Disorder?
- Living Without Fear
- What is Generalized Anxiety Disorder?
- What is Generalized Anxiety Disorder?
- School Anxiety! Activities To Help Kids and Teens Manage It
- Recognizing and Treating Problematic Fear and Anxiety in Children
- How To Stop Overthinking When You Have Anxiety
- My Anxiety Is Making Me Anxious!
- Evidence-Based Treatment Planning for Generalized Anxiety Disorder Video
- Managing Anxiety in Youth: More Action Than Talk
- Treatment of Social Anxiety Disorder
- Cognitive Behavioral Therapy for Anxiety
- Recent Advances in Anxiety - Children/Adolescents
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More Information
- Wise Counsel Interview Transcript: An Interview with David Barlow, Ph.D. on the Nature and Treatment of Anxiety and Panic Disorders
- Wise Counsel Interview Transcript: An Interview with Dr. Michelle Craske on Anxiety Disorders Research and Treatment
- Wise Counsel Interview Transcript: An Interview with Richard Heimberg, Ph.D. on Anxiety Research and Treatment
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