Anxiety Health Article

Definition

Anxiety is a multisystem response to a perceived threat or danger. It reflects a combination of biochemical changes in the body, the patient's personal history and memory, and the social situation at hand. Human anxiety involves an ability to use memory and imagination and to move backward and forward in time; a large portion of human anxiety is produced by anticipation of future events. Without a sense of personal continuity over time, people would not have the "raw materials" of anxiety.

It is important to distinguish between anxiety as a feeling or experience, and an anxiety disorder as a psychiatric diagnosis. A person may feel anxious without having an anxiety disorder.

Short-term anxiety can be considered within the range of normal human experience. It is only when anxiety presents with great intensity or long duration that it is classified as a pathological state. Particular manifestations of anxiety, such as a flashback experience, the development of a phobia, or the sudden onset of a panic attack, are suggestive of a serious anxiety problem.

Description

Although anxiety is something that everyone experiences from time to time, it is difficult to describe concretely because it has so many different potential causes and degrees of intensity. Doctors sometimes categorize anxiety as either an emotion or an affect, depending on whether it is being described by the person having it (emotion) or by an outside observer (affect). The word "emotion" is generally used for the biochemical changes and feeling state that underlie a person's internal sense of anxiety. The term "affect" is used to describe the person's emotional state from an observer's perspective. If a doctor says that a patient has an anxious affect, he or she means that the patient appears outwardly nervous or anxious, or responds to others in an anxious manner.

Although anxiety is related to fear, it is not the same thing. Fear is a direct, focused response to a specific event or object, and the person is consciously aware of it. Anxiety, on the other hand, is often vague and unfocused. In this form it is called free-floating anxiety. Sometimes anxiety being experienced in the present may stem from an event or person that produced pain and fear in the past, but the anxious individual is not consciously aware of the original source of the feeling. It is anxiety's aspect of remoteness that makes it hard for people to compare their experiences of it. Whereas most people will be fearful in physically dangerous situations, and can agree that fear is an appropriate response in the presence of danger, anxiety is often triggered by objects or events that are unique and specific to an individual. An individual might be anxious because of a unique meaning or memory being stimulated by present circumstances, not because of some immediate danger. Another individual looking at the anxious person from the outside may be truly puzzled as to the reason for the person's anxiety.

Generalized anxiety disorder (GAD) is the common name for a clinically confirmed diagnosis of anxiety. GAD is defined as a state in which an individual has significant worry, fear, and anxiety for a majority of the time for a period of at least six months. The anxiety present in such an individual must produce at least three significant somatic symptoms, such as impaired concentration, sleep disturbance, muscle tension, irritability, increased fatigue, or restlessness.

GAD has been estimated to occur in 4% to 7% of the population at any given time in the United States. Females are about twice as likely as males to develop GAD. Nearly one-third of cases of GAD present before 11 years of age. Half of all cases have onset before 18 years of age.