Anxiety Symptoms
Anxiety-the Commonest Psychiatric Disorder
1. What Anxiety Disorder is
Anxiety is a normal phenomenon characterized by a state of unease or apprehension arising out of anticipation of danger. Anxiety is different from fear. Whereas fear is generally a response to a known external danger, in case of anxiety the danger is generally a vague unknown entity- in the sense that ‘something is going to happen’.
This normal anxiety assumes pathological dimensions and becomes an anxiety disorder when it starts causing significant distress to the subject leading to impairment of the normal functioning of the individual in the day to day life.
2. Two Types of Anxiety
Experts classify general anxiety in two classes:
- State Anxiety: This is the anxiety felt only in a particular state of circumstances only & then goes away.
- Trait Anxiety: Here the subject has a habitual tendency to be anxious in general & it is a continual condition.
3. Types of Anxiety Disorders
I. Generalized Anxiety Disorder - This type of disorder is characterized by an insidious onset followed by a stable & chronic course which may be punctuated by repeated episodes of acute anxiety. As the anxiety is the common feature of most of the psychiatric disorders, it is imperative to exclude other diagnoses before confirming the condition as a generalized anxiety disorder.
II. Panic Disorder – This type of disorder is characterized by sudden & discrete episodes of severe anxiety. The panic-attacks begin unexpectedly even without any apparent precipitating factor and occur repeatedly every few days. This type of anxiety disorder needs to be differentiated from organic anxiety disorder as well as the cardiac disorders.
4. Causative factors
Many theories are put forward to explain the causes of anxiety disorders. Some of these are:
a) Psychodynamic theory – According to this theory anxiety syndrome is a signal that something is disturbing the subject’s psychological equilibrium. This level of anxiety is called a signal anxiety whose purpose is to arouse the ego to take defensive action. However if the secondary defensive mechanisms fail to be activated, the anxiety comes to the forefront & exhibits as anxiety disorder.
b) Biological theory – As per this theory, anxiety disorders are based solely in biological factors, such as genetic lineation, reaction of certain chemicals on the body, neurotransmitter dysfunction and certain neuroanatomical factors,among others.
c) Behavioral theory - According to this approach, the normal anxiety is explained as an unconditioned inherent response of the organism to any painful or dangerous stimuli. In case of persons with anxiety disorders this response gets attached to even neutral stimuli by conditioning of mind.
In view of a variety of causes being responsible for causing this disorder, the treatment of the condition too necessarily has to be multi-modal & differs from patient to patient.
5. Symptoms
Anxiety Symptoms are broadly classified under two groups.
1. Physical symptoms
Physical symptoms are again of two types as under:
Motor Symptoms- These include the following symptoms:-
- Tremors of limbs, especially hands
- Muscle twitches, generally of eye muscles
- Feeling of restlessness
- Fearful facial expressions
Autonomic & Visceral Symptoms- This category of symptoms include:-
- Uncontrollable palpitations
- Excessive sweating
- Flushes- rushing of blood to the face giving a reddish glow
- Hyperventilation-quickened breathing
- Feeling of dry mouth
- Tachycardia- more than normal rate of heart-beat
- Feeling of dizziness
- Diarrhea
- Dyspnea ( breathlessness)
2. Psychic Symptoms
Psychic symptoms can be further divided into following categories:
Cognitive symptoms – These include:-
- Lack of concentration
- Hyper arousal
- Distractibility
- Enhanced vigilance
- Constant scanning of the surroundings
Perceptual symptoms – Some examples of these are:-
- Depersonalization
- Derealization
Affective symptoms – These include:-
- A vague sense of apprehension
- Inability to relax
- Fearfulness
- Unpleasant feelings
- Sense of impending doom
- Insomnia
- Heightened startle response
The list of symptoms discussed above is only illustrative and not exhaustive.