Anxiety

Anxiety
Classification and external resources
ICD-9 300

Anxiety is a physiological and psychological state characterized by cognitive, somatic, emotional, and behavioral components.[1] These components combine to create an uncomfortable feeling that is typically associated with uneasiness, apprehension, or worry.

Anxiety is a generalized mood state that occurs without an identifiable triggering stimulus. As such, it is distinguished from fear, which occurs in the presence of an external threat. Additionally, fear is related to the specific behaviors of escape and avoidance, whereas anxiety is the result of threats that are perceived to be uncontrollable or unavoidable.[2]

Anxiety is a normal reaction to stress. It may help a person to deal with a difficult situation, for example at work or at school, by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder.[3]

Contents

Symptoms

Anxiety can be accompanied by physical effects such as heart palpitations, nausea, chest pain, shortness of breath, stomach aches, or headaches. Physically, the body prepares the organism to deal with a threat. Blood pressure and heart rate are increased, sweating is increased, bloodflow to the major muscle groups is increased, and immune and digestive system functions are inhibited (the fight or flight response). External signs of anxiety may include pale skin, sweating, trembling, and pupillary dilation. Someone suffering from anxiety might also experience it as a sense of dread or panic.

Although panic attacks are not experienced by every anxiety sufferer, they are a common symptom. Panic attacks usually come without warning, and although the fear is generally irrational, the perception of danger is very real. A person experiencing a panic attack will often feel as if he or she is about to die or pass out. Panic attacks may be confused with heart attacks.

Biological basis

Neural circuitry involving the amygdala and hippocampus is thought to underlie anxiety[4]. When confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala.[5][6] In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors.

Varieties

Existential anxiety

Theologian Paul Tillich characterized existential anxiety[7] as "the state in which a being is aware of its possible nonbeing" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), moral (guilt and condemnation), and spiritual (emptiness and meaninglessness). According to Tillich, the last of these three types of existential anxiety is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be accepted as part of the human condition or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by tradition and authority" even though such "undoubted certitude is not built on the rock of reality".

According to Viktor Frankl, author of Man's Search for Meaning, when faced with extreme mortal dangers the very basic of all human wishes is to find a meaning of life to combat this "trauma of nonbeing" as death is near and succumbing to it (even by suicide) seems attractive. The "father" of existentialism, Søren Kierkegaard, regarded all humans to be born into despair by default (in The Sickness Unto Death). Such despair was created by having a false conception of the self. He regarded the mortal self which can exist relatively, and therefore be born or die, as the false self. The true self was the relationship of self to God, rather than to any relative object. For more information see angst and existential crisis.

Test anxiety

Main article: Test anxiety

Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. Students suffering from test anxiety may experience any of the following: the association of grades with personal worth, fear of embarrassment by a teacher, fear of alienation from parents or friends, time pressures, or feeling a loss of control. Emotional, cognitive, behavioral, and physical components can all be present in test anxiety. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, and drumming on a desk are all common. An optimal level of arousal is necessary to best complete a task such as an exam; however, when the anxiety or level of arousal exceeds that optimum, it results in a decline in performance. Because test anxiety hinges on fear of negative evaluation, debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia. In 2006, approximately 49% of high school students were reportedly experiencing this condition. While the term "test anxiety" refers specifically to students, many adults share the same experience with regard to their career or profession. The fear of failing a task and being negatively evaluated for it can have a similarly negative effect on the adult.

Stranger and social anxiety

Main articles: Stranger anxiety and Social anxiety

Anxiety when meeting or interacting with unknown people is a common stage of development in young people. For others, it may persist into adulthood and become social anxiety or social phobia. "Stranger anxiety" in small children is not a phobia. Rather it is a developmentally appropriate fear by toddlers and preschool children of those who are not parents or family members. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety.

Trait anxiety

Anxiety can be either a short term "state" or a long term "trait." Trait anxiety reflects a stable tendency to respond with state anxiety in the anticipation of threatening situations.[8] It is closely related to the personality trait of neuroticism.

See also

References

  1. Seligman, M.E.P., Walker, E.F. & Rosenhan, D.L. (2001). Abnormal psychology, (4th ed.) New York: W.W. Norton & Company, Inc.
  2. Ohman, A. (2000). Fear and anxiety: Evolutionary, cognitive, and clinical perspectives. In M. Lewis & J. M. Haviland-Jones (Eds.). Handbook of emotions. (pp.573-593). New York: The Guilford Press.
  3. National Institute of Mental Health Retrieved September 3, 2008.
  4. Rosen JB, Schulkin J (1998). "From normal fear to pathological anxiety". Psychol Rev 105 (2): 325–50. PMID 9577241. 
  5. Zald, D.H.; Pardo, J.V. (1997). "Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation". Proc Nat'l Acad Sci (USA) 94 (8): 4119–24. doi:10.1073/pnas.94.8.4119. PMID 9108115. 
  6. Zald, D.H.; Hagen, M.C. & Pardo, J.V. (2002). "Neural correlates of tasting concentrated quinine and sugar solutions". J. Neurophysiol 87 (2): 1068–75. PMID 11826070. http://jn.physiology.org/cgi/content/full/87/2/1068. 
  7. Tillich, Paul, (1952). The Courage To Be, New Haven: Yale University Press, ISBN 0-300-08471-4
  8. Schwarzer, R. (December 1997). "Anxiety". Retrieved on 2008-01-12.