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Fear and anxiety are a normal--even essential--part of life. They prepare us for danger, creating physiological changes that enable us to effectively respond to a threat. Fear is very straightforward. It arises in response to immediate danger, so it is usually unexpected, very intense, and limited to the situation at hand. Your response to the fear, such as jumping out of the path of an oncoming car, quickly resolves the situation. Anxiety, on the other hand, is more general and complex. It is felt in anticipation of danger, and is associated with the ability to predict, prepare for, and adapt to change. Often, it lasts a long time, and its cause remains ill-defined. For example, someone uneasy about public speaking may experience a tightness in the stomach for days before a scheduled talk. Both fear and anxiety send signals through the body that prepare all systems for possible danger. Hormones, such as adrenaline and catecholamine, are released in what is known as the "fight or flight" response. The sudden increase in hormone levels speeds up the heart and increases the amount of blood being pumped. At the same time, the muscles tighten, increasing the individual's ability to fight or flee from danger. The intensity of these physiological responses varies according to the seriousness of the event or thought that sparked the emotion, the strength of the individual's fear or anxiety, and his or her previous experience and genetic makeup.
Depressed people will seem sad, or "down," or may be unable to enjoy their normal activities. They may have no appetite and lose weight (although some people eat more and gain weight when depressed). They may sleep too much or too little, have difficulty going to sleep, sleep restlessly, or awaken very early in the morning. They may speak of feeling guilty, worthless, or hopeless; they may lack energy or be jumpy and agitated. They may think about killing themselves and may even make a suicide attempt. Some depressed people have delusions (false, fixed ideas) about poverty, sickness, or sinfulness that are related to their depression. Often feelings of depression are worse at a particular time of day, for instance, every morning or every evening. The hallmark of this problem is chronic worry and tension with no apparent cause. People suffering from generalized anxiety disorders may worry excessively about health, money, family, or work, often anticipating disaster. Although they are usually aware that their anxiety is more intense than necessary, they can't seem to let it go. Constant worrying contributes to trouble sleeping and relaxing. People with anxiety disorders may startle easily and have trouble concentrating. Generalized anxiety disorder often leads to depression. Physical symptoms of this disorder include: trembling, twitching, muscle tension, headaches, irritability, sweating, nausea, hot flashes, light-headedness, and difficulty breathing. GAD is diagnosed when psychological and physical symptoms of anxiety last more than a month and are not accompanied by the symptoms of other anxiety disorders.
Learning theory views anxiety as a learned behavior that can be unlearned. This theory posits that a person's anxiety can be reduced by persistently confronting the feared situation or object. And some people do, in fact, change their thinking and experience significant relief without any medication. There's little doubt that all our thoughts and feelings are rooted in transmissions between nerve cells in the brain. These signals are passed from cell to cell by chemical neurotransmitters released at the synapse (tiny gap) between one cell and the next. An imbalance in these neurotransmitters can cause a corresponding shift in our thoughts. But is the reverse also true? Can a determined change in our thinking alter the chemistry in the brain? Many experts are convinced this is true; and behavioral therapy aimed at changing our reactions does, in fact, cure many problems. Indeed, for some disorders, such as phobias, this type of therapy remains the most effective alternative. 1. Remember that though your feelings and symptoms are very frightening, they are not dangerous or harmful.
2. Understand that what you are experiencing is an exaggeration of your normal bodily reactions to stress.
3. Do not fight your feelings or try to wish them away. The more you are willing to face them, the less intense they will become.
4. Do not add to your panic by thinking about what "might" happen.
5. Stay in the present. Notice what is really happening to you as opposed to what you think might happen.
6. Label your fear level from zero to 10 and watch it go up and down. Notice that it does not stay at a very high level for more than a few seconds.
7. When the fear begins to trigger "what if" thinking, focus on and carry out a simple and manageable task such as counting backwards from 100 by threes or snapping a rubber band on your wrist.
8. Notice that when you stop adding frightening thoughts to your fear, it begins to fade.
9. When the fear comes, expect and accept it. Wait and give it time to pass without running away from it.
10. Be proud of the progress you make, and think about how good you will feel when you succeed this time.
Alcohol is a well-known yet consistently underdiagnosed cause of anxiety. Both excessive consumption of alcohol and withdrawal from it can lead to anxiety. The problem often goes unrecognized because people may minimize or omit their alcohol intake when talking with the doctor, and doctors may neglect to ask. Interestingly, alcohol does not appear to increase the risk of anxiety disorders in later life. The anxiety associated with taking or discontinuing medications and other substances can usually be easily relieved once the cause is recognized. It's therefore essential to provide your doctor with a complete run-down of your medicines--including over-the-counter products and of your eating and drinking habits.
Other research focuses on the hippocampus, another brain structure that is responsible for processing threatening or traumatic stimuli. The hippocampus plays a key role in the brain by helping to encode information into memories. Studies have shown that the hippocampus appears to be smaller in people who have undergone severe stress because of child abuse or military combat. This reduced size could help explain why individuals with PTSD have flashbacks, deficits in explicit memory, and fragmented memory for details of the traumatic event. Also, research indicates that other brain parts called the basal ganglia and striatum are involved in obsessive-compulsive disorder. In addition, with new findings about neurogenesis (birth of new brain cells) throughout life, perhaps a method will be found to stimulate growth of new neurons in the hippocampus in people with post-traumatic stress disorder. Scientists are also conducting clinical trials to find the most effective ways of treating anxiety disorders. For example, one trial is examining how well medication and behavioral therapies work together and separately in the treatment of obsessive-compulsive disorder. Another trial is assessing the safety and efficacy of medication treatments for anxiety disorders in children and adolescents with co-occurring attention deficit hyperactivity disorder. For more information about clinical trials, for example the National Library of Medicine's clinical trials database.
Although there are numerous chemicals that perform vital functions within the brain, three basic chemicals, or neurotransmitters, seem most critical in regulating this process and maintaining balance: serotonin, which is related to anxiety, depression, and aggression; dopamine, which affects reality perception and pleasurable experiences; and norepinephrine, which affects attention, concentration, and mood. Medication is most helpful when there is clear disorder or, sometimes, a specific target symptom for a particular drug. Usually, a pattern of symptoms point to a specific chemical imbalance. Whenever an imbalance appears evident through a person's disordered behavior and emotional state, medication centers on modifying the strength of the signal or readjusting the balance among them.
Definition explainingAnxiety
- A state of uneasiness and apprehension, as about future uncertainties.
- Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.
Anxiety disorder
- A psychiatric disorder involving the presence of anxiety that is so intense or so frequently present that it causes difficulty or distress for the individual.
Anxiety disorders
- Any of various disorders in which anxiety is either the primary disturbance or is the result of confronting a feared situation or object; they include obsessive-compulsive disorder and posttraumatic stress disorder.
Fear
- Fear is an unpleasant feeling of perceived risk or danger, whether it be real or imagined.
Depression
- In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.
Mental health
- A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life.
- The psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment.
Stress
- A state of extreme difficulty, pressure, or strain.
- A physical and psychological response that results from being exposed to a demand or pressure.
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