Have You Fed Your Anxiety Today?
Anxiety disorders are the most common mental health problem,
and include panic disorders, agoraphobia, generalized anxiety
disorder, social anxiety, and post-traumatic stress disorder.
Anxiety disorders are caused by both a genetic predisposition
and environmental factors.
Generalized anxiety disorder,a relatively common disorder
affecting 3-4% of the population, turns daily life into a state
of worry, anxiety, and fear. This disorder is characterized by
excessive worry and rumination over everyday events which even
the sufferer recognizes as being excessive. Physical symptoms
include of generalized anxiety may include headaches, trembling,
twitching, irritability, frustration, inability to concentrate,
and insomnia. Mild symptoms of social phobia and/or panic may
sometimes occur, such as feelings of self-consciousness and fear
of being trapped in enclosed spaces. Symptoms can vary from hour
to hour or day to day.
Social anxiety disorder,or social phobia, affects 7-8% of the
population. This type of anxiety disorder affects 15 million
Americans in any given year. Sufferers feel as though they are
being watched and judged in every social interaction, and become
so fearful that they avoid people altogether. Sufferers know
that their fear is irrational, but they cannot overcome it, and
often become reclusive.
People with panic disorders have acute physical symptoms which
can lead them to believe that they have a serious physical
disease. They may fear that they are having a heart attack, that
they're about to lose control, or that they're going crazy.
Patients with panic disorders may have sensations of
breathlessness, suffocation, dizziness, and lightheadedness.
Often these patients make repeated use of emergency medical
facilities, convinced they are having heart attacks or that
their lives are danger from some acute physical disorder.
Agoraphobia is a reaction to panic attacks that occur
unpredictably and frequently in many places, thus making the
person with agoraphobia feel unsafe when leaving the familiarity
of their homes. Panic/agoraphobia affects approximately 5-6% of
the population.
Posttraumatic stress disorder (PTSD) is an anxiety disorder
usually occurs after an individual experiences or witnesses
severe or life-threatening trauma. In the US, Post Traumatic
Stress Disorder has a lifetime prevalence of 8-10% and accounts
for considerable disability and morbidity. One study found the
prevalence of PTSD in a sample of adolescent boys to be 3.7% and
adolescent girls to be 6.3%. Approximately 30% of men and women
who have spent time in a war zone experience PTSD.
The individual initially responds to the precipitating event
with intense fear, helplessness, or horror. The patient later
develops a disorder characterized by persistently
re-experiencing the event, with symptoms of numbness, avoidance,
and hyperarousal, resulting in significant distress or
functional impairment. To meet the full criteria for PTSD, these
symptoms should be present for a minimum of 1 month following
the initial traumatic event.
Events which cause PTSD include natural disasters, violent
personal or sexual assaults, war, or severe accidents. PTSD can
be acute (symptoms lasting <3 mo), chronic (symptoms lasting >3
mo), or of delayed onset (6 mo elapses from event to symptom
onset).
PTSD is associated with brain changes in the amygdala, a
structure in the brain which processes primitive emotions such
as fear and the fight/flight response. Traumatic events can lead
to fear conditioning with resultant activation of the amygdala
and associated structures such as the hypothalamus, locus
ceruleus, periaqueductal gray, and parabrachial nucleus. This
activation and the accompanying autonomic neurotransmitter and
endocrine activity produce many of the symptoms of PTSD. The
orbitofrontal cortex exerts an inhibiting effect on this
activation. The hippocampus also may have a modulating effect on
the amygdala. However, in people who develop PTSD, the
orbitofrontal cortex appears less capable of inhibiting this
activation.
Females may be at a higher risk than males because of higher
rates of traumatic events, such as being victims of crimes and
abuse in personal relationships. Sexual assault probably has the
most impact on women, and trauma from combat is more likely to
cause the disorder in men. PTSD can occur at any age, including
during childhood.
The National Center for Post-Traumatic Stress Disorder (PTSD)
was created within the Department of Veterans Affairs created
the National Center for PTSD in 1989, in response to a
Congressional mandate to address the needs of veterans with
military-related PTSD. Their website provides an educational
resource concerning PTSD and other enduring consequences of
traumatic stress, for both military and non-military audiences.
In all anxiety disorders, cognitive behavioral therapy is often
helpful, combined with anxiolytic drugs to ease acute symptoms.
Patients with anxiety often also suffer from depression, and
antidepressants are often also used.