Anxiety

Anxiety vs. fear

A person might experience both fear and anxiety at the same time. It doesn’t mean that we can use these terms interchangeably. Both conditions share a significant amount of symptoms, but it is the context that distinguishes between the experience of fear and anxiety. 

Fear is a response to an understood or known threat, while anxiety arose from an unknown, unexpected, or poorly defined risk. Both conditions produce a similar stress response. Various experts think that there are significant differences between the two. The dissimilarities can determine how a person reacts to multiple stressors in their environment.

Anxiety

What is Anxiety?

It is an unpleasant, diffuse, vague sense of apprehension. It is often just a response to an unknown threat like the uneasiness a person might experience while walking down a dark street alone.

The possibility of something terrible happening can contribute to the feeling of uneasiness in such situations. For instance, the thought of getting harmed by a stranger can increase anxiety. It usually stems from a person’s interpretation of the possible dangers.

What is Fear?

Fear is the mind’s response to a definite or known threat. For instance, if someone pulls a gun at you and says, “it’s a robbery,” you will experience fear. The danger in this particular situation is definite, real, and immediate. 

Though a person’s response is different, fear and anxiety are interrelated. On facing fear, most people might experience the same physical reactions that are also present under anxiety attack.  

Symptoms

The symptoms of anxiety can vary among individuals. Usually, the body reacts in a specific way to anxiousness. When a person experiences anxiousness, their body goes on high alert. It looks for possible danger and activates the fight or flight response.

some of the common anxiety symptoms include:

  • Accelerated heart rate
  • Chest pain
  • Cold chills’hot flushes
  • Depersonalization
  • Derealization
  • Dizziness
  • Feeling faint
  • Excessive sweating
  • A feeling of going insane
  • Headaches
  • Muscle pain
  • Muscle tension
  • Numbness or tingling
  • Rining or pulsing in ears
  • Shaking and trembling
  • Shortness of breath
  • Sleep disturbances
  • Tightness throughout the body
  • Upset stomach

Types of Anxiety disorders

There are different types of anxiety-related disorders that a person can get. These disorders include

Agoraphobia

People with this condition might find that certain situations or places make them feel trapped, embarrassed, or powerless. These feelings can result in a person having a panic attack. People with this condition often try to avoid public places and stressful situations to decrease the chances of having a panic attack.

Generalized anxiety disorder (GAD)

This condition makes a person always anxious and worried about every activity and event, even those that are nothing more than ordinary or routine. They worry so much that causes physical symptoms in their body, including stomach pain, headaches, or insomnia.

Obsessive-compulsive disorder (OCD)

People with OCD face continuous unwanted or intrusive thoughts and worries that result in increased anxiousness. They might know that these thoughts are trivial, but they will have to perform certain things to let loose their anxiety. The behavior of people with OCD might include repeated hand washing, counting, checking things such as whether they locked their house or not.

Panic disorder

People with this condition might experience sudden and repeated bouts of fear, severe anxiety, or terror that peak in minutes. People who face a panic attack can experience the following symptoms:

  • Shortness of breath
  • A feeling of looming danger
  • A rapid or irregular heartbeat that feels like pounding or fluttering, also known as palpitations
  • Chest pain

People who have this condition might stay worried about the occurring of the next attack and try to avoid situations where they believe these attacks can occur.

Post-traumatic stress disorder (PTSD)

A person might develop PTSD after experiencing a traumatic event, such as:

  • Assault
  • Accident
  • War
  • Natural disaster

These people can experience various symptoms, including disturbing dreams, trouble relaxing, flashbacks of the traumatic event. People with this condition might also avoid things and places related to their trauma.

Selective mutism

This situation usually found in children. It is an ongoing inability to talk in specific cases or places. For instance, a child might refuse to speak at school though they might not have any problem communicating in other scenarios, such as at home. Selective mutism can prove very difficult for a person, as it can interfere with everyday activities of life, including work, social life, and school.

Separation anxiety disorder

It is also a condition prominently seen in children. The symptoms of this anxiety disorder usually occur when a child gets separated from their parents or guardians. This condition is a standard part of childhood development. Most of the children who suffer from this disorder typically outgrow it. However, some people might experience variants of this disorder that might disrupt their daily life.

Specific phobias

Phobias are the fear of some specific object, situations, or events that might lead to severe anxiety. People with this condition might have a strong desire to avoid the things and places that might trigger their anxiety. Phobias like arachnophobia – the fear of spiders, or claustrophobia – the fear of small areas, might cause a person to experience a panic attack when exposed to such things.

Comorbidity

People who have anxiety might also develop some other medical issues over time. These conditions, when combined, are called comorbidity. The most common comorbidities that a person with generalized anxiety disorder can face are major depressive disorder (MMD), substance use disorder (SUD), and bipolar disorder (BD) because all these conditions share most of their symptoms with GAD.

Risk factors

The ultimate cause behind anxiety disorders is still unknown, but experts identified some of the factors that may contribute to maximizing the risk of a person developing an anxiety disorder. These factors include:

Genetics

A person’s genetics can play a vital role in determining whether they will develop GAD. Like with many other mental health issues, the chances of developing these symptoms can be highly influenced by their genes.

While the researchers are still unaware of which specific gene is responsible for promoting this condition’s development, the overall part that your genetic code plays is undeniable. Doctors can determine if a person is vulnerable to anxiety disorder based on analyzing their genetic markers. This vulnerability, when combined with particular environmental factors, can promote the development of anxiety symptoms.

Genetics also tells us that women are more susceptible to anxiety disorder than men. While the condition typically starts to develop in people around 30 years old, many people who get diagnosed might be struggling with symptoms for years before contacting a professional.

Brain structure

A brain structure collection called the limbic system is involved in regulating many of the underlying emotional reactions. Though it is usually under the control of the thinking part of the mind, it can respond to stimuli and contribute to the problem of anxiety.

Amygdala

The amygdala is the part of the limbic system that controls the automatic fear response and integration of emotion and memory. This part of the limbic system can cause PTSD and OCD, but some brain structure and function patterns are similar for patients with GAD.

Amygdala is an essential component in people’s ability to feel fear, and the studies of people diagnosed with anxiety disorder do show increased amygdala activity while processing negative emotions.

Gray Matter

The gray matter’s volume in a person’s brain might be another factor that researchers attribute to the development of anxiety and mood disorders. People with anxiety have an increased amount of gray matter at some specific locations in their brains.

The right putamen are of the brain in people with anxiety disorder have an increased amount of gray matter.

Life experiences

While the genetic factors significantly contribute to the development of anxiety disorders, factors, such as psychology, environment, and social issues, also increases the risk of a person developing an anxiety disorder.

Trauma

Researchers found that trauma in childhood can translate in the increased chances of a person developing anxiety issues. Physical and mental abuse, death of a loved one, neglect divorce, isolation, abandonment, etc., can all play a role in making a person prone to anxiety disorders.

Learned behavior

Several behavioral scientists think anxiety is a learned behavior, indicating that if a person grows up with someone who shows anxiety symptoms, they might exhibit the same anxious behavior.

Children usually learn from their elders, the essential things like how to handle stressful situations. When elders choose less effective methods to manage their stress, children will often do the same. This social learning experience can encourage the development of long-lasting anxiety disorder. 

Societal factors

With the number of social media apps on the rise, many people spend up to more than 15 hours per week just plugged into social media. Researchers believe that the excess use of social media can significantly impact a person’s mental health and might also result in anxiety and depression.

People who have anxiety might interpret interaction through social media incorrectly, as the essential non-verbal cues are missing in communication like facial expressions and body language, which can increase their anxiety.

Lifestyle factors

Lifestyle factors, such as substance use, relationships, etc., can also increase the risk of a person developing anxiety.

People using addictive substances like caffeine might get heighten feelings of nervousness or worry that can contribute to anxiety. Relying on caffeine can make a person feel restless and anxious, mainly if they use it in large quantities.

Relationships can be a good source of comfort, but it can also be a thing that causes pain. Women, in general, are more susceptible to develop a feeling of anxiousness because of a relationship.

In addition to substance use and relationships, work can also contribute significantly to the development of anxiety disorders. Some employers expect incredibly high levels of productivity and performance to make a person feel threatened about their employment security.


Treatment

Once your doctor diagnoses you with anxiety, they can explore treatment options. The doctor might suggest either medical treatment or lifestyle changes or both, depending on your condition’s severity.

We can categorize the treatment under two categories – medication and psychotherapy. 

Medications

A doctor might prescribe various medications for treating anxiety disorder. These can include:

Benzodiazepines – These medications are available on a doctor’s prescription, and can be highly addictive. These medicines do not cause many side effects. The adverse impacts a person could feel after using these drugs are drowsiness and potential for building dependency. Alprazolam, Valium, and Diazepam are some of the most common drugs belonging to the benzodiazepine category that doctors recommend to people with anxiety. 

Tricyclics – Drugs in this class show positive effects on almost all the anxiety disorders except obsessive-compulsive disorder (OCD). These medicines can cause side effects like drowsiness, weight gain, dizziness, etc. Some of the popular medications in this category include imipramine and clomipramine.

Anti-depressants – As it is clear from the name, these drugs help people with depression manage their symptoms. Doctors often prescribe these medicines for treating various types of anxiety disorders. SSRI (serotonin reuptake inhibitors) are effective in treating anxiety, and these have fewer side effects than other anti-depressants. These drugs might still result in side effects, such as nausea and sexual dysfunction at the beginning of the treatment.

In addition to these, some other medications might also help reduce anxiety symptoms; these include:

  • Buspirone
  • Monoamine oxidase inhibitors (MAOIs)
  • Beta-blockers

If you abruptly stop using these medications, you might experience withdrawal symptoms. It is especially true in the case of benzodiazepine and anti-depressants. If you feel you no longer require the treatment, ask your doctor to gradually reduce the dosage over a few weeks to minimize the risk of withdrawal symptoms.

Counseling and therapy

Your doctor might also recommend psychological therapy and counseling for your anxiety. Cognitive-behavioral therapy (BCT) is the most common psychological treatment for people with anxiety.

This therapy tries to recognize and change the harmful thought patterns responsible for triggering an anxiety disorder and negative feelings. It also seeks to limit distorted thinking and manage the scale and intensity of reactions to a stressful environment.

People who undergo psychotherapy work carefully with a trained mental health professional to find the root cause of an anxiety disorder and develop a routine to minimize anxiety.

Prevention

For people with anxiety disorder, it might feel like the anxiousness is a part of their daily life. But, there are various ways through which they can reduce the risk of developing a full-blown anxiety disorder. 

You can do the following things to keep a check on your anxiety and minimize the chances of developing a disorder.

  • Avoid consuming substances like alcohol, marijuana, and other recreational drugs.
  • Decrease the consumption of coffee, tea, chocolate, soda, and other caffeinated beverages.
  • Maintain a balanced and nutritious diet.
  • Consult a doctor before using non-prescription medications or herbal remedies that might worsen your anxiety.
  • Maintaining a regular sleeping schedule can also be extremely helpful in controlling anxious feelings.

Pathophysiology

The pathophysiology of anxiety is how the pathology of anxiety disorder manifests itself in a person. You can imagine it as a path that anxiety follows through the body that causes the feeling of anxiousness.

We understand some of the components in the development of the anxious feelings in the system. Some of it remains hidden because of the complexity of the system. The scientists are learning how anxiety works, but it will take a lot more research before getting the complete picture of the pathophysiology of anxiety.


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