Anxiety is an unpleasant complex combination of emotions that includes fear, apprehension and worry, and is often accompanied by physical sensations such as palpitations, nausea, chest pain and/or shortness of breath. Emotion, in its most general definition, is an intense neural mental state that arises subjectively rather than through conscious effort and evokes either a positive or negative psychological response . ... For other uses, see Fear (disambiguation). ... In psychology, apprehension (Lat. ... We dont have an article called Worry Start this article Search for Worry in. ... Definition Palpitation is a sensation in which a person is aware of an irregular, hard, or rapid heartbeat. ... For other uses, see Nausea (disambiguation). ... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ...

Anxiety is often described as having cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). The cognitive component entails expectation of a diffuse and uncertain danger. Somatically the body prepares the organism to deal with threat (known as an emergency reaction): blood pressure and heart rate are increased, sweating is increased, bloodflow to the major muscle groups is increased, and immune and digestive system functions are inhibited. Externally, somatic signs of anxiety may include pale skin, sweating, trembling, and pupillary dilation. Emotionally, anxiety causes a sense of dread or panic and physically causes nausea, and chills. Behaviorally, both voluntary and involuntary behaviors may arise directed at escaping or avoiding the source of anxiety. These behaviors are frequent and often maladaptive, being most extreme in anxiety disorders. However, anxiety is not always pathological or maladaptive: it is a common emotion along with fear, anger, sadness, and happiness, and it has a very important function in relation to survival. Cognitive The scientific study of how people obtain, retrieve, store and manipulate information. ... The term somatic refers to the body, as distinct from some other entity, such as the mind. ... Emotion, in its most general definition, is an intense neural mental state that arises subjectively rather than through conscious effort and evokes either a positive or negative psychological response . ... For the Pet Shop Boys album of the same name see Behaviour Behavior or behaviour (see spelling differences) refers to the actions or reactions of an object or organism, usually in relation to the environment. ... A sphygmomanometer, a device used for measuring blood pressure. ... Heart rate is a term used to describe the frequency of the cardiac cycle. ... ... This article or section does not cite its references or sources. ... Mydriasis is an excessive dilation of the pupil due to disease or drugs. ... Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias and nervous conditions that may come on suddenly or gradually over a period of several years, and may impair or prevent the pursuing of normal daily routines. ...

Neural circuitry involving the amygdala and hippocampus is thought to underlie anxiety (Rosen & Schulkin, 1998). When confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala (Zald & Pardo, 1997; Zald, Hagen & Pardo, 2002). In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors, such as eating faeces. This article or section does not cite its references or sources. ... The hippocampus is located in the medial temporal lobe of the brain. ... Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three dimensional image or map of functional processes in the body. ...

Anxiety disorders

Main article: Anxiety disorder

A chronically recurring case of anxiety that has a serious effect on a person's life may be clinically diagnosed as an anxiety disorder. The most common are generalized anxiety disorder, panic disorder, social anxiety disorder, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD). Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias and nervous conditions that may come on suddenly or gradually over a period of several years, and may impair or prevent the pursuing of normal daily routines. ... General anxiety disorder or generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by uncontrollable worry about everyday things. ... Panic Disorder (also known as cardiac neurosis or neurosis cordis) is a mental condition that causes the sufferer to experience sporadic panic attacks. ... Social anxiety, sometimes known as social phobia or social anxiety disorder (SAD), is a common form of anxiety disorder that causes sufferers to experience intense anxiety in some or all of the social interactions and public events of everyday life. ... This article or section is in need of attention from an expert on the subject. ... It has been suggested that Combat stress reaction be merged into this article or section. ...

Treatment of anxiety

Prescription medication

The acute symptoms of anxiety are most often controlled with anxiolytic agents such as benzodiazepines. Diazepam (valium) was one of the first such drugs. Today there are a wide range of anti-anxiety agents that are based on benzodiazepines, although only two have been approved for panic attacks, Klonopin and Xanax. All benzodiazepines may induce dependency, and extended use should be carefully monitored by a physician, preferably a psychiatrist. It is very important that once placed on a regimen of regular benzodiazepine use, the user should not abruptly discontinue the medication. alprazolam 2mg tablets The benzodiazepines (pronounced , which are considered minor tranquilizers) are a class of drugs with sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ... Diazepam (IPA: ), marketed under brand names Valium, Stesolid, Diazemuls, Seduxen, Bosaurin, Diapam, Antenex and Apozepam)[1] is a drug which is a benzodiazepine derivative. ... Clonazepam (marketed by Roche under the trade-name Klonopin® in the United States and Rivotril® in Europe, Brazil and Canada) is a drug which is a benzodiazepine derivative. ... Alprazolam is a short-acting drug in the benzodiazepine class used to treat anxiety disorders and as an adjunctive treatment for depression. ...

Some of the SSRIs (selective serotonin reuptake inhibitors) have been used with varying degrees of success to treat patients with chronic anxiety, the best results seen with those who exhibit symptoms of clinical depression and non-specific anxiety or general anxiety disorder concurrently. Beta blockers are also sometimes used to treat the somatic symptoms associated with anxiety, especially the shakiness of "stage fright." Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders and some personality disorders. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ...

The addicitive nature of the benzodiazepine class became apparent in the mid 1960s when Valium (Diazepam), the first drug in the class to win FDA approval, resulted in thousands of people who quickly showed the classic symptoms of addiction when used for more than a week or two consistently.^{[citation needed]} However , other scientific research indicates that "the vast majority of the use of benzodiazepines is appropriate".^[1]

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is the most popular and effective form of psychotherapy used to treat anxiety. The goal of the cognitive-behavioral therapist is to decrease avoidance behaviors and help the patient develop coping skills. This may entail: Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ... // Psychotherapy is a range of techniques which use only dialogue and communication and which are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). ...

• Challenging false or self-defeating beliefs.
• Developing a positive self-talk skill.
• Developing negative thought replacement.
• Systematic desensitization, also called exposure (used for agoraphobia, phobias, panic disorder, and OCD mainly).
• Providing knowledge that will help the patient cope. (For example, someone who suffers from panic may be informed that fast, prolonged, heart palpitations are in themselves harmless).

Unlike prescription medication, the effectiveness of cognitive-behavioral therapy depends on various subjective factors, such as therapist competence. In addition to conventional therapy, there are at-home cognitive-behavioral programs sufferers can use as part of their treatment.^{[citation needed]} Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. ... Agoraphobia is an anxiety disorder which primarily consists of the fear of experiencing a difficult or embarrassing situation from which the sufferer cannot escape. ... For other things named OCD, see OCD (disambiguation). ...

Other coping strategies

Supplements

A variety of over the counter supplements and medications are also used for their alleged anti-anxiety properties; however there is little scientific evidence to back up these claims.

• Kava Kava - a popular herbal treatment; small doses either taken regularly through the day or when early symptoms are noticed by the patient.
• Valerian root - also reputed to have anti-anxiety and sedative properties
• passion fruit
• passion flower
• St. John's wort
• hops
• chamomile
• magnesium
• B-complex
• L-Tyrosine
• 5-HTP

Kava is an ancient crop of the western Pacific. ... Binomial name Valeriana officinalis L. & Maillefer Valerian (Valeriana officinalis, Valerianaceae) is a hardy perennial flowering plant, with heads of sweetly scented pink or white flowers. ... The fruit of Passiflora edulis Passion fruit (Portuguese: Maracuj ) comes from passion flower vines, plants of the genus Passiflora, native to tropical and sub-tropical America. ... Species Passiflora amalocarpa Passiflora amethystina Passiflora aurantia Passiflora caerulea Passiflora capsularis Passiflora edulis Passiflora foetida Passiflora helleri Passiflora holosericea Passiflora incarnata Passiflora karwinskii Passiflora mucronata Passiflora murucuja Passiflora tenuifila Passiflora tulae Passiflora vitifolia Passiflora yucatanensis Passion flower refers to vines in the genus Passiflora—flowering plants known for their... Binomial name Hypericum perforatum Linnaeus, St Johns wort used alone refers to the species Hypericum perforatum, also known as Klamath weed or Goat weed, but is used with qualifiers to refer to any species of the genus Hypericum. ... Hop umbel in a Hallertau hopgarden Hops are a flower used primarily as a flavouring and stability agent in beer, as well as in herbal medicine. ... Chamomile flowers The name Chamomile or Camomile is ambiguous and can refer to several distinct species. ... General Name, Symbol, Number magnesium, Mg, 12 Chemical series alkaline earth metals Group, Period, Block 2, 3, s Appearance silvery white Atomic mass 24. ... Vitamin B is a complex of eight water soluble vitamins, active in cell metabolism. ... Tyrosine (from the Greek tyros, meaning cheese, as it was first discovered in 1846 by German chemist Justus von Liebig in cheese[1][2]), 4-hydroxyphenylalanine, or 2-amino-3(4-hydroxyphenyl)-propanoic acid, is one of the 20 amino acids that are used by cells to synthesize proteins. ... 5-HTP (5-Hydroxy-tryptophan) is decarboxylated to the neurotransmitter serotonin (5-HT) by the enzyme aromatic-L-amino-acid decarboxylase. ...

Self-help

Self-help and relaxation techniques also play an important role in relieving anxiety symptoms. Self-help includes: Though the term self-help can refer to any case whereby an individual or a group betters themselves economically, intellectually or emotionally, the connotations of the phrase have come to apply particularly to psychological or psychotherapeutic nostrums, often purveyed through the popular genre of the self-help book. ... This article needs to be cleaned up to conform to a higher standard of quality. ...

• Proper diet – This includes reduction in consumption of caffeine, sugar, and generally an improvement of eating habits. Caffeine reduction should be gradual. Some anxiety sufferers report considerable reductions in their anxiety just from taking these measures.
• Exercise – Some exercise is thought to relieve stress, by reducing the amount of cortisol built up from anxiety. Anxiety sufferers should note that rapid heart palpitations during exercise can trigger a panic attack, so it is probably better to gradually develop an exercise routine while on a cognitive-behavioral program.
• Laughing
• Breathing techniques and proper breathing – A diaphragmatic breathing technique is often recommended (as opposed to chest breathing).
• Proper sleep
• Meditation
• Relaxation techniques – A state of relaxation can be achieved with the help of relaxation tapes, yoga or relaxation therapy.
• Stress management – This may entail changes in lifestyle and time management. There are a number of books specialized in stress management.
• Panic attack coping strategies – Specific strategies for dealing with panic episodes have been proposed, such as slow abdominal breathing and use of reassuring self-talk.
• Search for meaning and purpose – Some experts have indicated that residual generalized anxiety can be the result of a sort of "boredom" about existence. They recommend looking for an occupation the sufferer finds meaningful.
• For people who feel anxious and do not know why, it is worthwhile to sort out whether the anxiety is over a particular circumstance or a more abstract existential worry.

It has been suggested that this article or section be merged into Nutrition. ... Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ... Magnification of typical sugar showing monoclinic hemihedral crystal stucture. ... (for options, see option exercise) U.S. marine emerges from the water upon completing the swimming portion of the triathlon. ... Cortisol is a corticosteroid hormone produced by the adrenal cortex that is involved in the response to stress; it increases blood pressure, blood sugar levels, may cause infertility in women, and suppresses the immune system. ... For the play Breath by Samuel Beckett, see Breath (play). ... Diaphragmatic breathing, or deep breathing is the act of breathing deep into your lungs by flexing your diaphragm rather than breathing shallowly by flexing your rib cage. ... Sleep is the state of natural rest observed in most mammals, birds, fish, as well as invertebrates such as the fruitfly Drosophila. ... A large statue in Bangalore depicting Shiva meditating The term Meditation describes a variety of practices with a variety of goals. ... This article needs to be cleaned up to conform to a higher standard of quality. ... Look up relaxation in Wiktionary, the free dictionary. ... A woman practising hatha yoga Yoga (Devanagari: योग) is a family of ancient spiritual practices originating in India. ... A cluttered environment with too many tasks can lead to stress. ... Boredom is a state of mind in which one interprets ones environment as dull, tedious, and lacking stimuli. ...

Alcohol

Alcoholic drinks are probably the most widely used substance for the alleviation of anxiety. Anxiety sufferers are cautioned that alcohol is also a powerful depressant and has a plethora of dangerous and uncomfortable side effects in addition to being potentially addictive. Some evidence suggests that consuming alcohol to alleviate anxiety may be counter-productive, as it can lead to a higher or irregular heartbeat and lowering of blood sugar which can both add to the unpleasant symptoms of anxiety and panic. Bottles of cachaça, a Brazilian alcoholic beverage. ...

Alternative medicine

A 2002 CDC survey (see table 3 on page 9) found that complementary and alternative methods were used to treat anxiety/depression by 4.5 percent of U.S. adults who used CAM. The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... Alternative medicine broadly describes methods and practices used in place of conventional medical treatments. ... Clinical depression (also called major depressive disorder) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ...

Theories

Two factor theory of anxiety

Sigmund Freud recognized anxiety as a "signal of danger" and a cause of "defensive behavior". He believed we acquire anxious feelings through classical conditioning and traumatic experiences. We maintain anxiety through operant conditioning; when we see or encounter something associated with a previous traumatic experience, anxious feelings resurface. We feel temporarily relieved when we avoid situations which make us anxious, but this only increases anxious feelings the next time we are in the same position, and we will want to escape the situation again and therefore will not make any progress against the anxiety. Sigmund Freud Sigmund Freud (May 6, 1856 – September 23, 1939; IPA pronunciation: []) was an Austrian neurologist and the co-founder of the psychoanalytic school of psychology. ...

Types of anxiety

Existential anxiety

See more under existential crisis.

Theologians like Paul Tillich and psychologists like Sigmund Freud have characterized anxiety as the reaction to what Tillich called, "The trauma of nonbeing." That is, the human comes to realize that there is a point at which they might cease to be (die), and their encounter with reality becomes characterized by anxiety. Religion, according to both Tillich and Freud, then becomes a carefully crafted coping mechanism in response to this anxiety since they redefine death as the end of only the corporal part of human personal existence, assuming an immortal soul. What then becomes of this soul and through what criteria is the cardinal difference of various religious faiths. An existential crisis is a state of panic or feeling of intense psychological discomfort It can result from: A sense of being alone and isolated A realization that ones life has no purpose or meaning The realization of ones own mortality. ... Theology (Greek θεος, theos, God, + λογος, logos, word or reason) means reasoned discourse concerning religion, spirituality and God. ... Paul Johannes Tillich (August 20, 1886 – October 22, 1965) was a German-American theologian and Christian existentialist philosopher. ... Sigmund Freud Sigmund Freud (May 6, 1856 – September 23, 1939; IPA pronunciation: []) was an Austrian neurologist and the co-founder of the psychoanalytic school of psychology. ... The soul, according to many religious and philosophical traditions, is a self-aware ethereal substance particular to a unique living being. ... This article discusses faith in a religious context. ...

Philosophical ruminations are a part of this condition, and this is part of obsessive-compulsive disorder. They are typically about sex and religion or death.

According to Viktor Frankl, author of Man's Search for Meaning, when faced with extreme mortal dangers the very basic of all human wishes is to find a meaning of life to combat this "trauma of nonbeing" as death is near and to succumb to it (even by suicide) seems like a way out. Mans search for meaning Viktor Emil Frankl, M.D., Ph. ... Viktor Frankls 1946 book Mans Search for Meaning chronicles his experiences as a concentration camp inmate and describes his psychotherapeutic method of finding a reason to live. ... Look up life in Wiktionary, the free dictionary. ... Suicide (from Latin sui caedere, to kill oneself) is the act of willfully ending ones own life. ...

Test anxiety

Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. Students suffering from test anxiety may experience any of the following: the association of grades with personal worth, embarrassment by a teacher, taking a class that is beyond their ability, fear of alienation from parents or friends, time pressures, or feeling a loss of control. Emotional, cognitive, behavioral, and physical components can all be present in test anxiety. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, and drumming on a desk are all common. An optimal level of arousal is necessary to best complete a task such as an exam; however, when the anxiety or level of arousal exceeds that optimum, it results in a decline in performance. Because test anxiety hinges on fear of negative evaluation, debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia.

Stranger anxiety

Main article: Stranger Anxiety

Stranger anxiety is not a phobia in the classic sense; rather it is a developmentally appropriate fear by young children of those who do not share a 'loved-one', caretaker or parenting role. Stranger anxiety is a form of distress that young people experience when exposed to people unfamiliar to them. ...

Anxiety in palliative care

Some research has strongly suggested that treating anxiety in cancer patients improves their quality of life. The treatment generally consists of counselling, relaxation techniques or pharmacologically with benzodiazepines. Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to invade other tissues, either by direct growth into adjacent tissue through invasion or by implantation into distant sites by metastasis. ...

See also

• Angst
• Social Anxiety
• General anxiety disorder
• Worry
• Mathematical anxiety
• Ringxiety i.e. Ringtone Anxiety

The Scream (1893) by Edvard Munch. ... Social anxiety is an experience of fear, apprehension or worry regarding social situations and being evaluated by others. ... General anxiety disorder or generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive and uncontrollable worry about everyday things. ... We dont have an article called Worry Start this article Search for Worry in. ... This article or section does not cite its references or sources. ... Ringxiety (alternately also spelled rinxiety) is a familiar and unnerving sensation and the false belief that some wireless-telephone users can hear their mobile phone ringing or feel it vibrating, when in fact that telephone is not doing so. ...

References

1. ^ Woods JH, Winger G (1995). Current benzodiazepine issues. Psychopharmacology 118(2): 107-15.

Sources

• Rosen, J.B. & Schulkin, J. (1998): "From normal fear to pathological anxiety". Psychological Review. 105(2); 325-350.
• Seligman, M.E.P., Walker, E.F. & Rosenhan, D.L. (2001). Abnormal psychology, (4th ed.) New York: W.W. Norton & Company, Inc.
• Zald, D.H., Hagen, M.C. & Pardo, J.V. (2002). "Neural correlates of tasting concentrated quinine and sugar solutions". J. Neurophysiol. 87(2), 1068-75.
• Zald, D.H. & Pardo, J.V. (1997). "Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation." Proc Nat'l Acad Sci USA. 94(8), 4119-24.

External links

• Social Anxiety and Anxiety in general www.socialphobia.org.nz
• Article: Anxiety Disorders Kathryn J. Zerbe, M.D.
• Article: Treating Anxiety and Depression Kathryn J. Zerbe, M.D.
• eMedicine article on anxiety
• Stress and Anxiety Clinical Research Unit at the University of Ottawa Institute of Mental Health Research http://www.imhr.ca/research/stress-anxiety-e.cfm