Anxiety

Anxiety is one of the most common of all emotions. In some situations such as one involving physical danger, anxiety is an appropriate response. In others, either the degree of anxiety or the apprehensive response itself is not warranted by the situation.

Appropriate and Inappropriate Anxiety

Anxiety is a natural response to something that threatens health or well being. Throughout life, most of us are subjected to many stressful situations that provoke anxiety. However, if the degree of anxiety is inappropriate to its cause, is exaggerated beyond reason or is brought on by unlikely events, the response is usually considered abnormal and may require treatment.

Appropriate anxiety is chiefly characterized by worry. For example, if your job is threatened, you might be constantly thinking of where else you might find employment and be planning steps for obtaining a new position. In this situation, the anxiety serves a useful purpose: It causes enough stress to send you in search of a constructive solution to the problem.

If, however, the dread of job loss is not realistic, then the anxiety breeds more anxiety. This type of anxiousness that has no identifiable cause very often impairs the individual's ability to function.

The origins of such internal emotional problems are still not fully understood. In some instances, they may be traced to childhood experiences. This is often true of phobias, such as a fear of dogs that can be traced to a childhood dog bite. Another common example of a phobia is agoraphobia (fear of open spaces), in which anxiety is aroused when a person tries to leave the familiar setting of the home. Outside the home--in crowded shops, subways or theaters--anxiety is heightened; the person usually hovers near a door in order to get away if necessary. Since the painful anxiety is diminished when fear-producing situations are avoided, withdrawal to familiar surroundings is reinforced and, in severe cases, the person may become completely housebound. Certain organic illnesses, such as low blood sugar (hypoglycemia) also may produce feelings of anxiety. In about half of all cases of clinical anxiety, however, there is no discernible cause.

Anxiety States

In most people, anxiety is a temporary feeling. In some, however, anxious feelings and thoughts are almost constantly present in what is called an anxiety state. This chronic state occasionally peaks in a "panic attack," which can occur without any apparent reason at any time. The physical symptoms of fear increase to such a frightening extent that the victim may, in fact, think that he or she is suffering a heart attack. Hyperventilation, or over-breathing, is common during panic attacks and may lead to light-headedness and even to fainting.

Anxiety

Generalized Anxiety

Common signs of clinical anxiety include:

• Jitteriness
• Twitching
• Sweating
• Palpitations
• Apprehensive expectations, vigilance
• Insomnia

Panic Attacks

Recurrent, unpredictable panic attacks are characterized by the following:

• Feelings of intense terror
• Feelings of impending doom
• Breathlessness, chest pain
• Dizziness, faintness
• Hot or cold flashes

Physical Symptoms

When an individual is anxious, certain body processes speed up. These are the normal "fight or flight" reactions that help us cope with emergencies. The physical symptoms include breathing irregularities, particularly hyperventilation; muscle tension; sweating, and an increased pulse rate. Other manifestations of severe anxiety may include gastrointestinal symptoms such as diarrhea and symptoms related to the cardiovascular or the pulmonary system: vague chest pains, irregular heartbeats, fatigue or dizziness. Any of these symptoms should be reported to a physician and carefully evaluated.

Treatment of Anxiety

There are a number of approaches to consider in treating anxiety. In some instances, practicing relaxation techniques such as meditation, or taking a warm bath or exercising may help in overcoming mild anxiety. If hyperventilation is a problem, breathing into a paper bag will help overcome the over-breathing and feelings of light-headedness.

Medication may also be recommended to help the patient cope more effectively with anxiety, particularly the unwarranted anxiety that has no apparent cause. Most commonly, the medication prescribed is one of the tranquilizing drugs. These drugs, like any medication, should be taken only according to your doctor's instructions. They should not be taken in combination with alcohol, and your doctor should be aware of any other medication you may be taking.

Behavior modification therapy, including desensitization, is often helpful in treating phobic anxiety states. For example, an agoraphobic undergoing desensitization would be helped, in a series of graduated steps, to encounter the crowds and public spaces that cause anxiety. A number of other therapies, including psychotherapy, are used in treating anxiety. Your doctor is the best judge of which ones are most appropriate for your type of anxiety.

Summing Up

Most anxiety is normal and most emotional conflicts can be discussed with family or friends with good results. However, if these usual means of dealing with problems do not prove adequate, and if anxiety produces undue distress, professional help is advisable. A number of effective treatments, which may include the use of tranquilizing drugs, can help those who suffer anxiety to live more comfortable and productive lives. Remember, no one is immune from anxiety. The important thing is to recognize anxiety as a medical problem, and to work with your doctor or counselor to relieve it entirely or, at best, to reduce it to manageable levels.