That feeling of a looming danger – as though something bad is about to happen – can be crippling and overpowering. But while many of us might feel unease or apprehension when foreshadowing future events, individuals suffering from anxiety might be completely incapacitated by their fear. Characterized by a severe feeling of unease, worry, or fear, anxiety disorder can interfere with occupational and social activities.
Today, it’s estimated that 40 million adults in the United States deal with anxiety disorder. And while the numbers might be overwhelming, there are effective treatments that can help individuals move beyond their anxiety to function in their daily lives without worry and apprehension.
Mentions of anxiety have long appeared in various texts, most notably in the work of Hippocrates and his apprentices. The word anxiety comes from the Latin angor which means ‘to constrict.’ This refers to the tightening of the chest that individuals tend to feel when contemplating a perceived threat.
Throughout the 17th and 18th centuries, some medical authors were able to describe panic attacks, but much of their writings would attribute the symptoms to other named conditions. One such text described a man who was having a panic attack, but labelled the condition as vapors and melancholia. Vapors was a word used to describe a nervous disorder, while melancholia was the term used for depression.
In the late 1700s, anxiety was finally identified as panophobia – a panic terror or fright that is experienced at night in the absence of a real or imminent threat, danger, or cause. Many psychoanalysts and psychologists contributed to the identification of anxiety throughout the years, but most of them would categorize the condition as a symptom rather than a condition of its own.
By the time the Diagnostic and Statistical Manual of Mental Disorders II was released, anxiety had its own category called neuroses. These conditions were described as having anxiety as their main feature, thus making anxiety and neuroses somewhat synonymous.
There are many different conditions that have anxiety as one of their main symptoms. These can be categorized based on the cause of the anxiety or the specific situations when the symptoms manifest. Some of them include:
- Panic disorder – Characterized by sudden attacks of panic or fear with no apparent cause. These episodes can come with a whirlwind of physical and mental symptoms that can incapacitate an individual.
- Phobias – This specific anxiety disorder has a known trigger, but is rarely a true threat. For instance, some individuals might experience claustrophobia – or fear of enclosed spaces – which might not be a real danger.
- Post-traumatic stress disorder – An individual might be triggered by previous traumas, thus causing physiological distress. A good example would be war veterans experiencing panic, fear, or anxiety when confronted with loud noises that remind them of the battlefield.
- Social anxiety disorder – This specific disorder manifests when an individual is faced with a social situation. Social phobias can manifest the symptoms of anxiety when making a phone call, ordering at a restaurant, visiting distant relatives, and any other kind of situation that calls for interaction.
On the other hand, general anxiety disorder or GAD is characterized by symptoms of anxiety with no specific cause. That is, an individual may experience anxiety in a variety of situations and not just one. People who struggle with GAD will typically feel anxious on most days, making it difficult to ease up or relax even when there isn’t anything to cause the feelings.
GAD can cause a variety of symptoms and may even come hand in hand with panic disorder if the symptoms are severe enough. Some of the symptoms include:
- A sense of impending danger
- Increased heart rate
- Increased respiratory rate
- Feeling faint or weak
- Difficulty concentrating
- Difficulty falling asleep
- Stomach pains
- Constipation or diarrhea
- No appetite or overeating
Keep in mind that for these symptoms to qualify under general anxiety disorder, the cause needs to be either unknown or irrational. If the cause for the distress is a known danger that can impose real harm or pain on the individual, then the symptoms would be justified. That brings us to the difference between anxiety and fear. Anxiety happens when an individual feels nervous or worried about a perceived however unreasonable threat, while fear happens when an individual is faced with real danger.
On the one hand, it’s absolutely normal for an individual to experience anxiety. In many ways, it’s actually a survival instinct that kicks in and helps us to avoid situations that could potentially harm us. However, on the other hand, unreasonable anxiety or GAD can interfere with everyday functioning.
A person will likely receive a diagnosis of general anxiety disorder when these symptoms:
- Get in the way of work, relationships, responsibilities, and personal care
- Become too difficult to control
- Persist over long periods of time, making it difficult for the individual to calm his or herself
- Urge an individual to seek alternative methods to remain calm such as illicit drugs and other harmful substances
- Produce suicidal thoughts or attempts
- Are potentially linked to another underlying health condition
Everyone experiences anxiety, but not everyone develops the disorder. Studies have found that some people might be at a higher risk of getting a GAD diagnosis than others, and this can be linked to the number of risk factors that they qualify for. The more of these factors that a person has, the more likely they are to experience problematic anxiety:
- Previous traumas – Individuals who have gone through abuse or neglect are more likely to develop anxiety disorders. Traumatic events like accidents, severe injuries, and other similar, life-threatening encounters can significantly increase an individual’s risk.
- Stress – Whether from an underlying disease or simply from everyday life, mounting stress can make an individual more worrisome and panicky. Stress can stem from one major life event or may build-up over time.
- Personality predisposition – There are certain personality types that are more prone to anxiety. Individuals who are more likely to keep to themselves, those who aren’t as outgoing or personable, and those who tend to act more cautious and careful are at a higher risk.
- Drugs and alcohol use or misuse – As a substance’s concentration wanes, an individual may start to feel the symptoms of withdrawal. During this time, they’re likely to experience worry, fear, and nervousness as a result of their use. Some drugs are also known to cause paranoia, which may induce anxiety disorders.
- Other underlying health conditions – There are a variety of mental health conditions that can make a person feel more anxious than they should. Even health conditions affecting other areas of the body like heart disease or diabetes have been known to trigger anxiety.
- Family history – Individuals with relatives who were diagnosed with anxiety disorders of any kind are more likely to develop an anxiety disorder themselves.
It’s believed that anxiety comes as the result of a chemical imbalance in certain areas of the brain. Serotonin – a neurotransmitter responsible for regulating anxiety among other things – seems to be higher in individuals with the disorder. But more than that, anxiety also impacts brain activity.
Researchers have found that there isn’t one specific area that’s active during an anxiety attack, but several. And while it’s not entirely clear yet, science is showing that anxiety may be the result of improper or faulty communication between the ‘cognitive’ or thinking brain and the ‘emotional’ brain.
This means that individuals with anxiety might not be able to rationalize the absence of a true danger. For example, you might be walking in a well-lit, safe neighborhood at night knowing that there haven’t been any instances of crimes in the area.
But even with this true, rational knowledge, your brain is unable to transmit this information to the areas that regulate emotion like the amygdala. And the result is that you feel anxious, panicked, and worried as you walk. That said, anxiety works as though the emotional areas of the brain overpower the rational ones.
Treatment for anxiety disorder is a twofold process. One aspect is medication, while the other involves therapy and counseling. The most used medications for anxiety are a form of antidepressants called selective serotonin reuptake inhibitors or SSRI’s. These medications aim to regulate serotonin levels which is typically too high in individuals with anxiety.
Behavioral therapies on the other hand work to target underlying issues that might be causing the anxiety. This includes unearthing past traumas that might have a lasting impact on the individual’s psyche. Another type of therapy is a gradual desensitization, in which patients are exposed to stimulation that might induce their anxiety.
Throughout the process, they’re given pointers on what to do, how to react, and how to rationalize in order to prevent their emotions from welling up. Over time, patients learn to adapt certain techniques that they can use in real life situations in order to function without the fear and worry.
Millions of people struggle with anxiety, and the problem seems to be on the rise with newer generations. But while anxiety disorder is one of the most common mental health conditions today, it is treatable. With proper therapy and medication, individuals suffering from the condition can overcome their worry and experience a trouble-free life without the interference of irrational fear.