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Anxiety (cont.)

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What is anxiety?

Anxiety can be described as the response to a future or possible threat. Anxiety is closely related to fear, which is the response to a real or perceived immediate threat. Fear and anxiety are normal evolved responses in both humans and animals, and physical responses are linked to the "fight-or-flight" system. The autonomic nervous system controls the fight-or-flight response in the body, and this response generally includes dilation of the pupils in the eyes, increased heart rate, and increased respiration/breathing. Anxiety responses can include increased vigilance (paying attention to one's surroundings) and muscle tension. Anxiety can be constructive, such as improving performance on a test, sporting event, or public speaking. Although these are normal responses and often helpful responses to danger, anxiety can cause problems when it is turned on too easily, not turned off when danger is absent, or when the response is too strong. Excessive anxiety that causes distress or impairment, or that interferes with normal function, is considered an anxiety disorder.

What are the types of anxiety disorders?

Anxiety disorders are differentiated based on the type of object or situation that causes fear, anxiety, or avoidance as well as the thought patterns associated with the fear or anxiety. To be considered an anxiety disorder, the fear or anxiety also has to be persistent (lasting usually six months or more), and not a normal developmental phase (for example, a young child being afraid of being away from their parent). Anxiety disorders commonly start in childhood but persist into adulthood.

The most common anxiety disorders are specific phobias. Specific phobias are an excessive fear of a specific object or situation, such as spiders, heights, flying, or closed spaces. In social anxiety disorder (social phobia or performance anxiety), people are excessively fearful or anxious about social interactions or situations that may involve being observed or scrutinized.

Generalized anxiety disorder (GAD) is characterized by persistent and excessive anxiety and worry about many different areas that are hard to control. Other anxiety disorders include separation anxiety disorder, selective mutism, agoraphobia (fear of being outside of the home in various situations), and panic disorder (recurring unexpected panic attacks and fear of having more panic attacks).

Anxiety disorders may also be caused by drugs, medications, or other substances (including stimulants, caffeine, and corticosteroids). Withdrawal from alcohol and certain drugs (including benzodiazepines and barbiturates) can also cause anxiety-like symptoms. Medical conditions (such as thyroid conditions or rare adrenal gland tumors [pheochromocytoma]) can also cause anxiety disorders and/or anxiety-like symptoms.

With the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), some diagnoses that used to be considered anxiety disorders have been recategorized into new sections. Obsessive compulsive disorder (OCD) is now grouped with other compulsive disorders, like hoarding and trichotillomania (hair pulling). Similarly, posttraumatic stress disorder (PTSD) has been reclassified with other trauma-related disorders. OCD and PTSD often have anxiety-related symptoms, and some treatments overlap with those for anxiety disorders.

Medically Reviewed by a Doctor on 12/7/2015


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