What is Anxiety?

A Normal and Adaptive Response to Threat
All animals (including, of course, humans) are equipped with an internal signal that alerts us to the possibility of danger. Physical signs such as a pounding heart, sweating, a nervous or upset stomach, increased breathing rate, trembling or shaking, and feeling lightheaded or dizzy warn us of the possibility of danger and prepare our bodies if we need to fight back or run away. Mental symptoms such as feelings of dread and hyper-alertness (or "hypervigilance") also keep us ready to respond in case of danger. This innate response (which is sometimes termed the “fight-or-flight” reaction) can be triggered by a wide range of situations, including the threat of being attacked, anticipation over an important exam, or even asking someone out on a date. It is generally an adaptive response since it motivates us to work hard and protect ourselves.

Anxiety Disorders
Some people, however, cannot control their anxiety. They may repeatedly experience inappropriate fear in situations that are not actually dangerous. They might have episodes of extreme anxiety or "panic attacks" that occur seemingly from "out of the blue." When anxiety intensifies to levels that are painful or disruptive, we call this an anxiety disorder. Episodes of panic, intense worry about one's health, obsessive-compulsive behaviors, post-traumatic stress, and phobias are all signs of anxiety disorders. These disorders are also characterized by physical arousal, feelings of dread, and avoidance, compulsive rituals, or other types of behaviors intended to reduce the anxious feelings and keep one safe..

The Significance of Anxiety Disorders
Anxiety disorders are the most common psychological conditions. In fact, 15% to 20% of the adult population will have symptoms of an anxiety disorder at some point during their lives. These disorders often result in severe emotional distress and they often interfere with social, occupational, academic, and leisure functioning. Anxiety disorders are also associated with increased medical problems. For these reasons studying the nature of anxiety problems, and how best to treat them, is very important.


Types of Anxiety Disorders

The major anxiety disorders are briefly summarized below.

Obsessive Compulsive Disorder (OCD).
Individuals with OCD suffer from unwanted, senseless, yet distressing intrusive thoughts called obsessions (e.g., thoughts of germs, accidents, violence, or immorality) and senseless behaviors done to control these thoughts called compulsions (e.g., frequently washing hands, checking locks repetitively). OCD can take many forms. The intrusions can be thoughts, images or impulses that bother or scare the person. The compulsions are typically aimed at reducing the likelihood that something bad will happen, or are sometimes an attempt to get things “just right.”

Panic Attacks, Panic Disorder, and Agoraphobia
Panic attacks are characterized by a rush of intense physical symptoms (e.g., increased heart rate, sweating, dizziness) that seem to come from "out of the blue" and peak rapidly (e.g., within a few minutes). During a panic attack, the person might fear that he or she is losing control, having a heart attack, fainting, or dying.

Panic disorder is characterized by the persistent fear of about having a panic attack and the consequences of such an attack. Panic disorder is often accompanied by agoraphobia, which involves avoidance of situations in which escape might be difficult or where help may be difficult to find (e.g., large crowds, being alone).

Intense Health Anxiety
From time to time everyone experiences unexplained aches or pains. Intense health anxiety is characterized by the tendency to misinterpret these nonthreatening bodily sensations as symptoms of a serious medical disease (e.g., appendicitis, cancer). Individuals with this problem often repetitively check with doctors or other medical sources (e.g., textbooks, the Internet) for information and reassurance about their feared problem. Doctors often cannot pin down the exact explanation or diagnosis, leading to further distress and uncertainty.

Social Phobia (Social Anxiety Disorder)
Social phobia is characterized by painful anxiety in social situations, or the avoidance of such situations altogether. Typically, the person is afraid of being embarrassed or humiliated in front of others. The following situations might cause severe anxiety or panic: giving presentations in front of groups, talking in meetings or classes, starting conversations, speaking to authority figures (e.g., teachers or bosses), eating in front of others, and interacting with strangers or members of the opposite sex.

Generalized Anxiety Disorder (GAD)
GAD is characterized by excessive worry about everyday life situations such as relationships, finances, work, or school. The worry is hard to control and is accompanied by physical symptoms such as headaches, nausea, or trouble sleeping.

Post Traumatic Stress Disorder (PTSD)
People who live through or witness a traumatic event such as a natural disaster, serious accident, rape, or physical assault sometimes re-experience these events in the form of flashbacks, nightmares, or other intrusive memories. When a traumatic event is followed by one month or more of these symptoms along with mood changes, a heightened startle response, feeling detached from others, and avoiding reminders of the trauma, the person meets criteria for PTSD.

Specific Phobia
A specific phobia is an excessive fear of a certain object or situation. Common phobias include the fear of animals, storms, driving, the dark, closed-in spaces, flying, needles, and the sight of blood. If the phobic situation cannot be avoided, the person becomes anxious and experiences physical symptoms such as a racing heart, sweating, or trouble catching his/her breath. A phobia diagnosis is only given when the anxiety results in significant distress and/or interference in daily functioning.

Want More Information?

Additional information about anxiety, anxiety disorders, and effective treatments can be found on Dr. Abramowitz’s personal website and the website for the Anxiety Disorders Association of America.