Anxiety is the mind and body’s reaction to stressful, dangerous, or unfamiliar situations. It’s the sense of uneasiness, distress, or dread you feel before a significant event. A certain level of Anxiety helps us stay alert and aware, but for those suffering from an anxiety disorder, it feels far from normal – it can be completely debilitating.
TYPES OF ANXIETY DISORDER
There are many anxiety-related disorders, and they are divided into three main categories:
- Anxiety disorders: Anxiety disorders are characterized by a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. worrying about a future threat) and can have negative behavioral and emotional consequences.
- Obsessive-compulsive and related disorders: Obsessive-compulsive and related disorders are characterized by obsessive, intrusive thoughts (e.g., constantly worrying about staying clean, or about one’s body size) that trigger related, compulsive behaviors (e.g. repeated hand-washing, or excessive exercise). These behaviors are performed to alleviate the anxiety associated with the obsessive thoughts.
- Trauma- and stressor- related disorders: Trauma- and stressor- related anxiety disorders are related to the experience of a trauma (e.g., unexpected death of a loved one, a car accident, or a violent incident like war or sexual assault) or stressor (e.g., divorce, beginning college, moving).
CAUSES AND RISK FACTORS
It’s important to note that everyone feels anxiety to some degree regularly throughout their life. Fear and anxiety are helpful emotions that can function to help us notice danger or threats that keep us safe and help us adapt to our environment. Anxiety disorders occur when significant distress impairs your ability to function in important facets of life, such as work, school, or relationships.
Comorbidity is more common than not with anxiety disorders, meaning that most individuals who experience significant anxiety experience multiple different types of anxiety. Given this comorbidity, it is not surprising that many risk factors are shared across anxiety disorders, or have the same underlying causes. There is a lot of research identifying risk factors for anxiety disorders, and this research suggests that both nature and nurture are very relevant.
Genetic risk factors have been documented for all anxiety disorders. Clinical genetic studies indicate that heritability estimates for anxiety disorders range from 30-67%. Many studies, past and present, have focused on identifying specific genetic factors that increase one’s risk for an anxiety disorder. To date, an array of single nucleotide polymorphisms (SNPs) or small variations in genetic code, that confer heightened risk for anxiety have been discovered.
environmental factors within the family, parenting behavior can also impact risk for anxiety disorders. Parents who demonstrate high levels of control while interacting with their children has been associated with the development of anxiety disorders. Parental modeling of anxious behaviors and parental rejection of the child has also been shown to relate to greater risk for anxiety potentially.
Experiencing a chronic medical condition or severe or frequent illness, can also increase the risk for anxiety disorders, as well as dealing with a significant illness of a family member or loved one. Given that several medical conditions have been linked to significant anxiety, in some cases, a physician may perform medical tests to rule out an underlying medical condition.
Behavioral choices can also significantly impact risk, as excessive tobacco or caffeine use can increase anxiety, whereas regular exercise can decrease anxiety. Specific temperament and personality traits also may confer risk of having an anxiety disorder. With regards to temperament, shyness, and behavioral inhibition in childhood can increase the risk of developing an anxiety disorder later in life. About personality traits, the Five-Factor Model of Personality consists of five broad trait domains, including Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. An individual higher on trait Neuroticism or low on Conscientiousness is at a higher risk for all anxiety disorders, and an individual low on trait Extraversion is at a higher risk of developing social phobia and agoraphobia.
Demographic factors also impact the risk of anxiety disorders. While there is not a strong consensus, research suggests that risk for anxiety disorders decreases over the lifespan with the lower risk being demonstrated later in life. Women are significantly more likely to experience anxiety disorders. Another robust biological and sociodemographic risk factor for anxiety disorders is gender, as women are twice as likely as men to suffer from anxiety.
Counseling is a form of talk therapy in which a mental healthcare provider helps patients develop strategies and coping skills to address specific issues like stress management or interpersonal problems. Counseling is generally designed to be a short-term therapy.
There are many types of psychotherapies used to treat anxiety. Unlike counseling, psychotherapy is more long-term and targets a broader range of issues such as patterns of behavior. The patient’s particular anxiety diagnosis and personal preference guide what therapies would be best suited to treat them. The ultimate goal with any type of psychotherapy is to help the patient regulate their emotions, manage stress, understand patterns in behavior that affect their interpersonal relationships.
Family Therapy is a type of group therapy that includes the patient’s family to help them improve communication and develop better skills for solving conflicts. This therapy is useful if the family is contributing to the patient’s anxiety. During this short-term therapy, the patient’s family learns how not to make the anxiety symptoms worse and to understand the patient better. The length of treatment varies depending on the severity of symptoms.
Medications are sometimes used in conjunction with psychotherapy. The most commonly prescribed medications are generally safe, although some do have side effects to consider. The specific type of medication administered to patients will be determined by their providers based on the patient’s specific symptoms and other factors like general health.
Antidepressants are medications used to treat symptoms of depression but can also used to treat anxiety symptoms as well. In particular, selective serotonin re-uptake inhibitors (SSRI) and selective norepinephrine re-uptake inhibitors (SNRI) are the primary class of antidepressant used to treat anxiety.
Buspirone is a drug indicated for the treatment of anxiety. This drug has high efficacy for Generalized Anxiety Disorder and is particularly effective at reducing the cognitive and interpersonal problems associated with anxiety.
Complementary and Alternative Therapies
Complementary and Alternative Therapies can be used in conjunction with conventional therapies to reduce the symptoms of anxiety. There is a growing interest in these types of alternative therapies since they are non-invasive and can be useful to patients. They are typically not intended to replace conventional therapies but rather can be an adjunct therapy that can improve the overall quality of life of patients.
A collection of activities focused in which an individual consciously produces the relaxation response in their body. This response consists of slower breathing, resulting in lower blood pressure and overall feeling of well-being. These activities include: progressive relaxation, guided imagery, biofeedback, and self-hypnosis and deep-breathing exercises.
A mind and body practice in which individuals are instructed to be mindful of thoughts, feelings and sensations in non-judgmental way. It has been shown to be useful in reducing the symptoms of psychological stress in patients with anxiety.
A mindfulness practice that combines meditation, physical postures, breathing exercises and a distinct philosophy. It has been shown to be useful in reducing some symptoms of anxiety and depression.
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