Anxiety overview
|
Anxiety Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Anxiety overview On the Web |
|
American Roentgen Ray Society Images of Anxiety overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Overview
Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create the feelings that we typically recognize as fear, apprehension, or worry. Anxiety is often accompanied by physical sensations such as heart palpitations, nausea, chest pain, shortness of breath, or headache.
Historical Perspective
Sigmund Freud recognized anxiety as a "signal of danger" and a cause of "defensive behavior". He believed we acquire anxious feelings through classical conditioning and traumatic experiences.
We maintain anxiety through operant conditioning; when we see or encounter something associated with a previous traumatic experience, anxious feelings resurface. We feel temporarily relieved when we avoid situations which make us anxious, but this only increases anxious feelings the next time we are in the same position, and we will want to escape the situation again and therefore will not make any progress against the anxiety.
Classification
According to DSM-5 diagnostic criteria, anxiety is classified as follows:
- Generalized anxiety disorder
- Panic disorder
- Separation anxiety disorder
- Selective mutism
- Specific phobia
- Agoraphobia
- Social anxiety disorder
- Anxiety disorder due to another medical condition
- Substance/medication induced anxiety disorder
- Unspecified anxiety disorder
Pathophysiology
Various theories have been implicated in the pathogenesis of anxiety which are as follows: Biologic( increased sympathetic tone and decreased GABA), psychoanalytic component(Freud described that anxiety is developmentally related to childhood fears of disintegration that derive from the fear of actual or imagined loss of a love object or fear of bodily harm), learning theory ( where anxiety is attributed to continous exposure to stress), bout 5% individuals with anxiety have polymorphic variant of the gene associated with serotonin transporter metabolism.
Causes
Differential diagnosis
Epidemiology and demographics
Risk factors
Natural history, complications and prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Imaging Findings
Treatment
Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies