Definition

Anxiety is the uncomfortable feeling of dread that occurs in response to extreme or prolonged
periods of stress (Smeltzer and Bare, 2000). It is commonly ranked as mild, moderate, severe, or
panic. It is believed that a mild amount of anxiety is a normal part of the human being and that
mild anxiety is necessary to change and develop new ways of coping with stress. Anxiety is a
reaction to an internal threat, such as an unacceptable impulse or a repressed thought that is
straining to reach a conscious level or a real, threatened, or imagined threat to the patient’s self-
esteem. Overwhelming anxiety can result in a generalized anxiety disorder (GAD) –
uncontrollable, unrealistic worry that is persistent. Risk Factors/Incidence Onset is usually before
age 20, and the patient usually has a history of childhood fears. It’s equally common in men and
women. More than 80% of patients with GAD suffer from major depression, arrhythmias, or
social phobia (Smeltzer and Bare, 2000). Physiological Process/Etiology of the Disease or
Condition Anxiety can indicate a primary psychiatric condition, be related to a primary medical
disease, or be related to a medication adverse effect. In GAD, an alteration in benzodiazepine
receptor regulation is thought to occur (Smeltzer and Bare, 2000). Serotonin abnormalities also
appear to play a part in anxiety (Smeltzer and Bare, 2000). Increased serotonin levels have been
associated with obsessive compulsive disorders.

Etiological Theories
Psychoanalytical theory says that anxiety is a conflict between the id and the superego, which
was repressed in early development but which emerges again in adulthood (Smeltzer and Bare,
2000). Biological theory looks at this situation differently. Biological theories consider the
sympathoadrenal responses to stress and observe the blood vessels constrict because epinephrine
and norepinephrine have been release (Smeltzer and Bare, 2000). Blood pressure rises. If the
body adapts to the stress, hormone levels adjust to compensate for epinephrine-norepinephrine
release, and the body functions return to homeostasis(Smeltzer and Bare, 2000). If the body does
not adapt to the stress, the immune system is challenged, lymph nodes swell, and risk for
physical illness increases (Smeltzer and Bare, 2000).

Signs & Symptoms

The patient admits to worrying excessively about minor matters, with life-disturbing effects.
Physical examination of the patient with GAD may reveal symptoms of muscle tension,
including trembling, muscle aches and spasms, headaches, and an inability to relax. Autonomic
signs and symptoms include shortness of breath, tachycardia, and sweating, and abdominal
complaints are rare. The patient may startle easily and complain of feeling apprehensive, fearful,
or angry and of having difficulty sleeping, eating, or concentrating. Other signs and symptoms
may be a feeling of restlessness or feeling “on edge”, shaking, palpitations, dry mouth, nausea or
vomiting, hot flashes, chills, polyuria, and difficulty swallowing.

Diagnostic Criteria
When the patient’s symptoms match the following criteria documented in the DSM-IV, the
diagnosis of GAD is confirmed:
* The patient has an unrealistic or excessive anxiety and worry about two or more events or
activities for 6 months, during which he has been bothered most days by these concerns.
*The patient finds it difficult to control the worry.
*The focus of the anxiety and worry doesn’t have the features of an Axis disorder.
*The disturbance doesn’t occur only during the course of a mood disorder, psychotic disorder, or
pervasive development disorder; nor is it due to direct physiologic effects of a substance ( drug
abuse or medication) or a general medical condition (such as hyperthyroidism).
*Anxiety and worry are linked with three or more of the following symptoms present over the
past 6 months (only one is required in a child): -restlessness or feeling keyed up or on edge -
being easily fatigued -difficulty concentrating or mind going blank -irritability -muscle tension -
sleep disturbance.

*The anxiety, worry, or symptoms cause significant distress or impairment in social,

occupational, or other important areas of functioning. Because anxiety is the central feature of
other mental disorders, psychiatric evaluation is necessary to rule out phobias, obsessive-
compulsive disorders, depression, and acute schizophrenia.

Treatment
Treatment is individualized for the patient and may include one or more of the following:
psychopharmacology, individual psychotherapy, group therapy, systematic desensitization
hypnosis, imagery, relaxation exercises, and biofeedback (Smeltzer and Bare, 2000). Drug
treatment and psychotherapy is most effective in treating a patient with this disorder. Complete
symptomatic relief is rare, however. The benzodiazepine antianxiety drugs relieve anxiety but
should only be prescribed for 4 to 6 weeks because of the potential for abuse (Smeltzer and Bare,
2000). Buspirone, an antianxiety drug, causes less sedation and less risk of physical and
psychological dependence than the benzodiazepine (Smeltzer and Bare, 2000). However, it takes
several weeks to take effect. Psychotherapy can help the patient identify and deal with the cause
of anxiety, anticipate his reactions, and plan effective response strategies to deal with the
anxiety. The patient may learn relaxation techniques, such as deep breathing, progressive muscle
relaxation, focused relaxation, and visualization (Smeltzer and Bare, 2000). Complications
Anxiety can impair social or occupational functioning; effects can range from mild to severe and
incapacitating. GAD patients often abuse substances. Alcohol or sedative and hypnotic abuse is
common.

Nursing Process
Assessment: Head to toe nursing assessment to identify the signs and symptoms of the disease
and potential presence of complications described above. Areas of focus: psychological status
(on edge, easily startled, sad, fatigue easily, fearful, angry, mood, any changes in behavior,
altered thought processes, including patient’s explanation of problem, onset, duration,
participating events, past coping, present coping, insight, motivation to change, anxiety level
(+1,+2,+3,+4),Current stressors, results of mental status examination, and personal abilities,
talents, and strengths, ect.), nutritional status ( nausea, vomiting, intake, output, IBW, weight
loss, weight gain, anorexia, ect.), immune status (fatigue, malaise, vague underlying complaints,
delayed healing, ect.), respiratory status (vital signs, SOB, ect.), skin status (rash, lesions, ect.),
cardiovascular status (tachycardia, palpitations, rapid pulse, ect.). History of panic symptoms
(choking feeling in throat, hyperventilation, light-headedness, dizziness, and other physical signs
and symptoms of anxiety). Medication history (response, effectiveness, and adverse effects),
sociologic status, including support systems, hobbies, interests, work history, family makeup,
family roles, family coping mechanisms, lifestyle, ect.
Problems:
*Anxiety related to unexpected panic attacks
* Decisional conflict (excessive worry) related to anxiety level
* Impaired social interaction related to embarrassment and shame associated with symptoms
* altered thought process related to inability to function Interventions: Interventions include the
assessments identified above and may also include the following: Establish relationship with
unconditional positive regard and respect (Miller, 1992) Competently maintain universal
precautions Maintain strict confidentiality Administer medications as prescribed by MD Refer to
appropriate agencies (related to health, finances, support groups,, ect.) Active listening/allow
time for expression of feelings (empowerment)

Teaching (Medication actions and their adverse effects, relaxation techniques, ect.) Stay with
patient when he is anxious, and encourage him to discuss his feelings, reduce environmental
stimuli, and remain calm. Help patient develop effective coping mechanisms to manage his
anxiety Suggest activities that distract patient from anxiety.

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Anxiety Disorder Term Paper

Posted on October 5 2009 by Todd Hale

Your heart is racing, your muscles are tightening, and the room is closing in around you? You
back up slowly, and try to make a hasty retreat. This is what it is like for people who are
suffering from social anxiety disorder. Anxiety is defined as a state or cause of uneasiness and
apprehension; worry, or intense fear resulting from the anticipation of a threatening event.
Anxiety often causes a person to feel agitated and anxious. Many people are faced with social
phobias such as nervousness during an interview, giving speeches or seeing their highschool
sweetheart for the first time in twenty years. These illustrations seem small to the average
individual, but to a social phobic person, these events can seem like life or death. Panic attacks
are distinct episodes of acute fear. People who experience these attacks describe them as a
suddenly overwhelming feeling of doom, as if they are going to die on the spot. They have
problems breathing and they may even hyperventilate.

Research by Dr. Zal (2003) reveals that social anxiety disorder is the third most common mental
health problem in the United States (Zal, p. 75). According to Dewan (2001), this life long
disorder affects more that ten million Americans, men and women equally (Dewan, p. 1795). Dr.
Zal also found that this disorder affects children starting between the ages of fourteen and sixteen
(Zal, p.75). He also ascertained that only a small proportion (5.4%) of individuals with
uncomplicated social anxiety disorder seek psychiatric help (Zal, p. 75). These individuals are
two times more likely to have alcohol problems, and if they have an alcohol problem are nine
times more likely to exhibit social anxiety disorder symptoms (Zal, p. 76). Dr. Zal’s findings also
revealed that suicide attempt rate is 1% for primary social anxiety disorder, with an increase to
16% for comorbid social anxiety disorder (Zal, p.75). Comorbid social anxiety disorder occurs
when another disorder worsens or increases the symptoms of the social anxiety disorder. Dr.
Zal’s findings suggest that in 70% to 80% of social anxiety disorder cases patients show
comorbid conditions, such as 37% have depression, 23.9% have alcohol dependence, 14.8%
have drug dependence, 23.3% have agoraphobia, and 15.8% have posttraumatic stress disorder
(Zal, p. 76). The statistics clearly show that this disorder opens the doorway for other
incapacitating disorders; that destroys a person’s ability to interact with society.

Social anxiety disorder is significant in our sociological world because it has a direct correlation
with the way its sufferers feel society views them. We know that social anxiety disorder, also
known as social phobia, results from an acute fear of scrutiny from other people. This relates to
the symbolic-interaction paradigm, which sees society as the product of everyday interactions of
individuals. Throughout our lives, from childhood to adulthood, we try to live by the norms of
our society avoid social marginality, but with the growing cases of social phobia we are seeing
more and more people pull away from society. These people may end up depresses, suicidal, or
suffer from other disorders such as alcoholism, resulting in their social and economic burden on
our society. The added pressures of seeing individuality in social context, along with the
expectations to confirm to our “in” groups, succeed in school, and achieve occupational prestige
could have a potentially overwhelming effect. As it stands now, we know that social phobia is
the third most common psychiatric disorder and it seems to be growing continuously.

Most people in the United States with social anxiety disorder (SAD) do not get mental healthcare
for illness. Several studies have examined associations between socio-demographic
characteristics and the treatment of health problems (Olfson, Guardino, Struening, & Schneier,
2000). People that did not get treatment were younger, less eduacated, and less likely to be white.
A problem in living is a person-environment transaction that blocks an individual experience of
satisfactory social functioning. Social anxiety is usually thought to have genetic and biological
causes adolescents and young adult consumer of medication may not develop motivation to
make behavioral changes for combating their anxiety. Adolescents usually turn to drugs to help
their problems. People with social phobia usually have a low self-esteem and depression. Some
people have other anxiety disorders such as panic disorder. Almost one in four people with social
anxiety have had thoughts of committing suicide. SAD is more common in females, people with
low educational attainment, people with a lack of social supports, and people with a lack of
social supports, and people who use psychiatric medications.

One of the most common differences of opinion experienced concerning social anxiety is that
people often discount the mental illness social anxiety disorder simply as extreme shyness. In
fact, social anxiety disorder has been called “the neglected anxiety disorder.”(www.social-
anxiety.org) for this reason. Social anxiety is a genuine mental disorder categorized in the DSM-
IV, being one of five anxiety disorders listed. (www.socialphobia.org) Seeing that social phobia
wasn’t categorized as an illness in itself until the 1990’s, it’s not surprising that many people
have misconceptions about the illness. Whereas shyness is a simple personality trait that isn’t
necessarily problematic, social anxiety disorder can have severe consequences for the sufferer,
including suicide attempts or prevalent suicidal thoughts, nervous breakdowns, or panic attacks.
Shy people experience a far lower level of anxiety than those with social anxiety. Sufferers of
social anxiety feel anxious due to certain triggers and as a result, completely withdraw from that
social situation. According to the book Anxiety and Depression: A Natural Approach, mental
health institutions often treat “mild to moderate states of [social] anxiety”(p. 3) less seriously
compared to mental disorders such as schizophrenia, bipolar disorder, or depression. Sufferers of
social anxiety are often treated like hypochondriacs and not taken seriously. Anxiety is very
complicated in that physical ailments can cause it, while similarly anxiety can cause physical
ailments. Thus it can be very difficult to tell whether someone suffers as the root of his or her
problems from anxiety, or a physical condition. Chronic pain can result from nervous exhaustion
for example. Thus often the chronic pain is treated but the anxiety, the root of the problem, is
not. Often the sufferer isn’t taken seriously until they’ve had a complete mental breakdown or
have attempted suicide, and as a result need to be hospitalized (p. 57). Like most mental
disorders, social anxiety is often coupled with depression as people lose hope in their ability to
function in the social world. Therefore it isn’t totally surprising that 90% of the time, someone
who suffers from social anxiety is misdiagnosed as being “schizophrenic, manic-depressive,
clinically depressed, manic disordered, or personality disordered”(www.socialphobia.com).
Despite the downplay received within the mental health community, social anxiety is a mental
disorder as real and as dangerous as any other.

As we can see from all of the information listed above General Anxiety Disorder is not to be
taken lightly. Since General Anxiety Disorder was not categorized as an illness until
approximately ten years ago, there are many misunderstandings about this disorder.

People who do not have it and cannot relate to it simply think the subject is extremely shy or
withdrawn. “r. Richard G. Heimberg of Temple University notes that people with social phobia
experience many negative life experiences as a result of their social anxiety:
1. They are less likely to marry than others
2. They have additional occupational difficulties” (www.angelfire.com/biz/socialphobia.)

Despite all of these negative effects of social phobia, there are ways to combat it and since it is
such a newly diagnosed disorder, that in the near future there should be more ways to treat it.
There are ways to treat it now. Some of these ways include the most common way, medication
and psychological therapy.

Most people see medication as black and white, either you are for it or against it, there is not
really an in-between. The most effective way to treat social phobia is a type of psychological
therapy called cognitive-behavioral therapy. In this group therapy, “participants work on their
anxieties in a hierarchical, step-by-step fashion, working toward a goal they can reach in the
future.” (www.angelfire.com/biz/socialphobia/) The cognitive (thinking and belief) changes must
accompany the behavioral therapy to be effective.

In summation, SAD or GAD as it is commonly called is a growing disorder that affects people
around the world. It is extremely evident in those people who have other psychological disorders,
as mentioned above. With a little bit of time, and some more good old-fashioned research, SAD
should become a tolerable disorder in no time.

________________________

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Introduction To Anxiety Disorders

Mark Dombeck, Ph.D. Nov 6, 2001

Everybody knows what it's like to feel anxious -- the butterflies in your stomach before a first
date, the tension you feel when your boss is angry, and the way your heart pounds if you're in
danger. Anxiety rouses you to action. It gears you up to face a threatening situation. It makes you
study harder for that exam, and keeps you on your toes when you're making a speech. In general,
it helps you cope.

But if you have an anxiety disorder, this normally helpful emotion can do just the opposite -- it
can keep you from coping and can disrupt your daily life. There are several types of anxiety
disorders, each with their own distinct features.

An anxiety disorder may make you feel anxious most of the time, without any apparent reason.
Or the anxious feelings may be so uncomfortable that to avoid them you may stop some
everyday activities. Or you may have occasional bouts of anxiety so intense they terrify and
immobilize you.

Anxiety disorders are the most common of all the mental health disorders. Considered in the
category of anxiety disorders are: Generalized Anxiety Disorder, Panic Disorder, Agoraphobia,
Social Phobia, Obsessive Compulsive Disorder, Specific Phobia, Post-Traumatic Stress
Disorder, and Acute Stress Disorder. Anxiety disorders as a whole cost the United States
between 42-46 billion dollars a year in direct and indirect healthcare costs, which is a third of the
yearly total mental health bill of 148 billion dollars. In the United States, social phobia is the
most common anxiety disorder with approximately 5.3 million people per year suffering from it.
Approximately 5.2 million people per year suffer from post-traumatic stress disorder. Estimates
for panic disorder range between 3 to 6 million people per year, an anxiety disorder that twice as
many women suffer from as men. Specific phobias affect more than 1 out of every 10 people
with the prevalence for women being slightly higher than for men. Obsessive Compulsive
disorder affects about every 2 to 3 people out of 100, with women and men being affected
equally.

Many people still carry the misperception that anxiety disorders are a character flaw, a problem
that happens because you are weak. They say, "Pull yourself up by your own bootstraps!" and
"You just have a case of the nerves." Wishing the symptoms away does not work -- but there are
treatments that can help.
Anxiety disorders and panic attacks are not signs of a character flaw. Most importantly, feeling
anxious is not your fault. It is a serious mood disorder, which affects a person's ability to
function in every day activities. It affects one's work, one's family, and one's social life.

Today, much more is known about the causes and treatment of this mental health problem. We
know that there are biological and psychological components to every anxiety disorder and that
the best form of treatment is a combination of cognitive-behavioral psychotherapy interventions.
Depending upon the severity of the anxiety, medication is used in combination with
psychotherapy. Contrary to the popular misconceptions about anxiety disorders today, it is not a
purely biochemical or medical disorder.

There are as many potential causes of anxiety disorders as there are people who suffer from
them. Family history and genetics play a part in the greater likelihood of someone getting an
anxiety disorder in their lifetime. Increased stress and inadequate coping mechanisms to deal
with that stress may also contribute to anxiety. Anxiety symptoms can result from such a variety
of factors including having had a traumatic experience, having to face major decisions in a one's
life, or having developed a more fearful perspective on life. Anxiety caused by medications or
substance or alcohol abuse is not typically recognized as an anxiety disorder.

We have developed the information here to act as a comprehensive guide to help you better
understand anxiety disorders and find out more information about them on your own. Choose
from among the categories at left to begin your journey into recovery from this treatable
disorder.

Mark Dombeck, Ph.D. was Director of Mental Help Net from 1999 to 2011: An Introduction to
Anxiety Disorder. 2011, https://www.mentalhelp.net/articles/introduction-to-anxiety-disorders/

Anxiety: A Common Human Emotion

Ask anyone to define anxiety and you will quickly realize there is no shortage of examples that people
can provide. Although anxiety is a very common human experience, the descriptions that people provide
are quite varied.

Anxiety is a human emotion. Everyone experiences it. Yet, each person experiences this
emotion in unique ways. The following case examples illustrate these various experiences of
anxiety.
 Examples of Anxiety

Sally is a 24-year-old sales associate in a highly prestigious pharmaceutical firm. She constantly
works under a great deal of pressure. She says it's "no big deal." She even believes she thrives
off this stress. However, she recently walked into her local grocery store and began to sweat.
Her heart began to race. She felt like she was losing control. This happened on several
occasions. She became so distressed she decided to order her groceries online to avoid another
repeat episode.

Bill is a 47-year-old hardware store owner. Bill is constantly "worrying" about (what seems to
him) just about everything. Whether he is concerned about his business not doing well…or, what
if that mole on his back is not just a beauty mark?...or, how on earth is he ever going to drive to
Michigan all by himself to see his son (even with the brand new navigation system)?…Bill just
cannot seem to "control" his worry.

 00

K0im is a 36-year-old, part-time, freelance web-designer. She is ordinarily calm and low-key. This
0is true until she has to go over a bridge, or travel in an airplane. For Kim, she hates places
where she feels she cannot escape. She finds that she will often worry for days or even months
in advance of these situations. As a result, she makes it a habit to avoid these situations at all
costs; or, she "barely gets through them."


 Lastly, we have Pete. He is a 32-year-old law student. Pete cannot quite explain why he is
anxious; however, he wakes up every morning feeling a sense of "dread." His anxiety usually
lingers until about mid-day. At that point, he finally gets into the swing of his normal, daily
routine.

So who is right? Are they all describing the same thing? Simply stated, yes they are. The reason
behind this paradox is that anxiety is best considered a complex, subjective experience. Anxiety
is produced by multiple causes. It is expressed by a diverse set of symptoms. These symptoms
include physical, emotional, behavioral, and cognitive components. This is why we can ask
many different people about a very common experience; yet, get totally different definitions of
what it means to be anxious.

Different Levels and Degrees of Impairment

People also differ in how often, and how intensely, they experience anxiety. For most people,
anxiety is a normal and even adaptive occurrence. A normal degree of anxiety is part of the

everyday human experience. Unfortunately,

other people may experience anxiety to such a heightened degree that it causes them great
distress. Sadly, this level of anxiety can interfere with people's ability to function well. It
may affect many important areas of their lives such as work, school, and relationships.
When anxiety reaches this level of distress, and results in impaired functioning, we begin to
speak of an anxiety disorder. Luckily, experts in the field have come a long way in understanding
and treating anxiety problems.

What's to Come in This Section

In the following article, we examine the many facets of anxiety.

 We will begin with a more in-depth understanding of both the beneficial and harmful aspects of
anxiety.
 Next, we'll talk about what happens when anxiety becomes "pathological" or disordered.
 We describe and explain the many different types of anxiety disorders.
 We will present relevant research about what experts believe are the reasons behind the
development, and maintenance of anxiety disorders.
 This same body of research has developed highly effective treatments for the different types of
anxiety disorders.
  With this information, we confidently conclude there is hope and relief for the millions of people
who struggle with anxiety.

Normal And Abnormal Anxiety: What's The

Difference?
Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen
Neziroglu, Ph.D. of the Bio Behavioral Institute Aug 9, 2013

At the most basic level, anxiety is an emotion. Simply stated, an emotion is a subjective state of
being. It is often associated with changes in feelings, behaviors, thoughts, and physiology.
Anxiety, like all emotional states, can be experienced in varying degrees of intensity. For
instance, we might say we are happy. A more intense expression of this same emotion might be
an experience of joy. But unlike the emotion "happiness," which has several different words to
convey these differing levels of intensity (e.g., intensity ranging from happiness to joy), anxiety
is a single word that represents a broad range of emotional intensity. At the low end of the
intensity range, anxiety is normal and adaptive. At the high end of the intensity range, anxiety
can become pathological and maladaptive. While everyone experiences anxiety, not everyone
experiences the emotion of anxiety with the same intensity, frequency, or duration as someone
who has an anxiety disorder. Let's look more closely at some of the differences between the
normal emotion of anxiety, and anxiety as a disorder.

The normal emotions of anxiety and fear

Anxiety, and its close cousin fear, are both considered emotions. While there is considerable
overlap between these two terms, there are some important differences. Fear is generally
considered a primary emotion. In contrast, anxiety is considered a secondary emotion that
represents the avoidance of fear (including the avoidance of fear-producing stimuli). Primary
emotions refer to emotions that are recognizable through facial expressions. Primary emotions
can easily be interpreted by an observer and exist across different cultures. These primary
emotions are: happiness, anger, sadness, fear, surprise, disgust. Secondary emotions, such as
anxiety, are not readily recognizable to an outside observer. Secondary emotions are generally
considered an internal, private experience.

The most important distinction between fear and anxiety is the timeframe. Fear is the response to
a danger that is currently detected in the immediate, present moment of time. In contrast, anxiety
refers to the anticipation of some potential threat that may, or may not, happen in the future. In
other words, fear is a response to an immediate danger in the present moment of time, while
anxiety is associated with a threat that is anticipated in a future moment of time. Anxiety reflects
the anticipation of fear and represents an adaptive attempt to prevent the fear-provoking
circumstance from occurring. In an anxious state, people are readying themselves and preparing
themselves to cope with a future problem or dilemma that they anticipate will cause some kind of
harm if not prevented from occurring. In this respect, anxiety is a normal, beneficial emotion.
Emotions are simply a normal part of the human experience. As such, they are neither good nor
bad. What happens afterwards determines whether we experience a particular emotion as good or
bad; i.e., the changes in our feelings, behaviors, thoughts, and physiology. At this point, you may
be wondering, "What could possibly be good about fear and anxiety? Don't these emotions just
make people feel miserable?" Well, the answer may come as a quite a shock, but fear and anxiety
are actually very important emotions. When it comes to human survival and achievement,
anxiety and fear actually motivate us to take necessary action. For example, picture a young
mother and her child are crossing the street. The mother suddenly realizes they are in the direct
path of an oncoming car. Imagine what would happen if she did not feel the least bit afraid. Now
imagine a law student preparing to take his bar exam so that he can become an attorney. What if
he didn't have any anxiety over whether he passed or failed his bar exam? Clearly, without fear
and anxiety to prepare their minds and bodies for automatic action, these individuals would be at
risk for some very serious, negative consequences. So, while the experience of fear or anxiety
may at times be an unpleasant one, we can see that without these important emotions we'd
actually be far worse off.

Fear and survival: The fight-or-flight response

When people speak of fear, they are often referring to the body's physiological response to fear.
This is known as the fight-or-flight response. More specifically, when we are in the presence of
an immediate danger, our bodies will automatically begin to prepare us to either attack the threat
(i.e., fight) or more often, to escape from the danger (i.e., flight). Clearly, the ability to perform
these necessary actions ensures our survival. This ability is made possible by the fight or flight
response. For example, when we are faced with danger our hearts begin to beat very fast. The
reason behind this increased heart rate is that the emotion of fear signaled our body and mind to
prepare for action. The nervous system responds to the signal of danger by attempting to increase
blood flow throughout the body. This increased blood flow ensures extra oxygen is delivered to
our muscles. This extra oxygen is needed for energy during a fight or an escape from danger
(e.g., running really fast). This increased blood flow requires the heart to work harder, and beat
faster. Similarly, because increased oxygen is beneficial when faced with danger, there is a
natural tendency for people to begin breathing more rapidly and more deeply to meet the demand
for extra oxygen. This extra oxygen enables the body to rise to the challenge of fight-or-flight.
These physical responses are discussed in more detail in the section, Biological Explanations of
Anxiety.

Like many adaptive mechanisms, the fight-or-flight response has evolved over time to help
ensure our survival. In ancient times, our ancestors came into constant contact with many types
of very real dangers in their environment (lions and tigers and bears, OH MY!). Over time, with
repeated exposure to these threats, our ancestors' nervous systems began to evolve in a manner
that made the fight-or-flight response automatic and immediate. This adaptation was very
beneficial. It ensured the necessary physical responses, (such as increased heart rate and
respiration) would occur without wasted time (immediate) and without having to think about it
(automatic). This adaptation makes sense because human beings would be at a significant
disadvantage if they had to stop and rationally determine best course of action whenever they
were in danger. Consider again the example of the mother and her child crossing the street when
she realizes they are in the direct path of an oncoming car. Clearly, she does not have time to
stop and weigh out all her options. Her response must be immediate.

In modern times, we may not encounter the same sorts of danger our ancestors had to face.
Nonetheless, we still encounter threats in our daily lives that make the fight-or-flight response
useful. Present day examples include physical threats (being attacked by a mugger); social
threats (being ridiculed or embarrassed); and mental threats ("blanking-out" on a difficult exam).
Unfortunately, a problem arises when the fear response is triggered but there is no actual threat
in our environment. Thus, the response serves no useful purpose. This is called a false alarm.
False alarms are discussed in more detail in another section. For now, it is simply important to
recognize that without a certain amount of fear in our lives, our survival becomes more difficult.

The Symptoms Of Anxiety

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen
Neziroglu, Ph.D. of the Bio Behavioral Institute Aug 9, 2013 Updated Jun 5, 2017

There are common symptoms of anxiety that people experience in terms of feelings, behaviors,
thoughts, and physical sensations. Nonetheless, it is important to remember that anxiety is a highly
subjective experience. Not everyone will experience the same symptoms, nor will each person
experience the same intensity of a symptom. Still, it is helpful to provide some examples of the common
physical, emotional, cognitive, and behavioral symptoms of anxiety.

Physical symptoms of anxiety

The physical symptoms of anxiety refer to how we experience anxiety in our bodies. Examples
include:

 A feeling of restlessness, feeling "keyed up," or "on-edge;"

 Shortness of breath, or a feeling of choking;
 Sweaty palms;
 A racing heart;
 Chest pain or discomfort;
 Muscle tension, trembling, feeling shaky;
 Nausea and/or diarrhea;
 "Butterflies" in the stomach;
 Dizziness, or feeling faint;
 Hot flashes;
 Chills;
 Numbness, or tingling sensations;
 An exaggerated startle response; and,
 Sleep disturbance and fatigue.

These symptoms are caused by the physiological changes that occur in the body during a fight-
or-flight response. Unfortunately, our bodies do not distinguish between a real and present
danger in the environment (fear), and an imagined or anticipated danger in the future (anxiety).
For more information about why these symptoms occur, please refer to section on Biological
Explanations of Anxiety

For people who experience panic attacks, the above symptoms are all too familiar. However, as
previously stated, a person does not need to develop a full-blown anxiety disorder to be able to
relate to any of the above symptoms. For these symptoms to be considered a "disorder" they
must reach a certain level of intensity, duration, and frequency such that the symptoms cause
significant distress and interfere with someone's functioning.

Behavioral symptoms of anxiety

The behavioral symptoms of anxiety refer to what people do (or don't do) when they are anxious.
Behavioral responses reflect attempts to cope with the unpleasant aspects of anxiety.

Typical behavioral responses to anxiety may include:

 Avoidance behaviors such as avoiding anxiety-producing situations (e.g., avoiding social

situations) or places (e.g., using the stairs instead of an elevator).
 Escaping from an anxiety-producing situation (like a crowded lecture hall).
 Engaging in unhealthy, risky, or self-destructive behaviors (such as excessive drinking or drug
use to deal with the anxiety).
 Feeling compelled to limit the amount and scope of one's daily activities to reduce the overall
level of anxiety (e.g., remaining in the safety of one's home).
 Becoming overly attached to a safety object or person (e.g., refusing to go out, away from
home, to school, or to work in order to avoid separation).

Ironically, these coping strategies often worsen and maintain an anxiety disorder. This is
discussed in more detail in the section, Maintenance of anxiety disorders: Maladaptive coping
strategies

Emotional symptoms of anxiety

As we mentioned earlier, anxiety in its most basic form is an emotion. However, this emotion
produces a set of feelings. Common words used to describe the feelings of anxiety include:

 apprehension,
 distress,
 dread,
 nervousness,
 feeling overwhelmed,
 panic,
 uneasiness,
 worry,
 fear or terror,
 jumpiness or edginess.
Some individuals, especially children, may not even be able to describe their feelings and may at
times simply answer, "I don't know what I feel." Interestingly, many people find the emotional
component of anxiety most distressing. However, the other symptoms of anxiety, such as
thoughts, behaviors, and physical responses cause the greatest disturbance in terms of their daily
functioning.

Cognitive symptoms of anxiety

Finally, there are the cognitive symptoms of anxiety. Whether we realize it or not, it is often
quite common to have thoughts running through our mind when we feel anxious. Even when we
do not feel anxious, we have thousands of thoughts every day! The thoughts people experience
when anxious are commonly referred to as worry (Bourne, 2000). Although the content of the
thoughts may vary depending on the person and situation, common themes include:

 "What if _ happens?"
 "I must have certainty."
 "I can't possibly tolerate not knowing_."
 "What do these physical symptoms mean?"
 "People will laugh at me."
 "I won't be able to escape."
 "I am going crazy."
 "Oh my God, what's happening to me?"

Depending on the nature of the specific anxiety disorder, and a person's own unique anxiety
history, the possible worrisome thoughts may vary.

The psychological symptoms of anxiety may include:

 Problems with concentration, or difficulty with staying on task;

 Memory difficulties; and,
 Depressive symptoms such as hopelessness, lethargy, and poor appetite.

Notwithstanding, what is often found at the heart of pathological anxiety is an inaccurate

cognitive appraisal of a situation. This usually means overestimating the amount of threat in a
given situation, while at the same time underestimating one's ability to cope with these threats.
These concepts are discussed in more detail in the Psychological Explanations of Anxiety
Disorders section.

The cost of anxiety

These physical, behavioral, cognitive, and emotional symptoms of anxiety can certainly take
their toll.

The "cost" of unidentified and/or untreated anxiety can be quite high:

1. Lost social and professional opportunities because of excessive shyness or social anxiety;
2. Dysfunctional relationships because of a fear of asserting oneself;
3. Increased risk for cardio-vascular disease and suicide;
4. Other health-related problems such as irritable bowel syndrome, headaches, teeth grinding,
and other jaw-related disorders;
5. Drug and alcohol problems; and,
6. High rates of absenteeism, reduced work performance, reduced productivity, unemployment,
under-employment, and disability.

In more concrete terms, the cost of anxiety disorders in the United States is more than $46 billion
a year. This represents nearly a third of the US's mental health cost! Of note, less than one fourth
of these costs, represent the cost of treatment (DuPont, et al. 1996). Clearly, the cost of untreated
anxiety disorders is very high. This is particularly disturbing since there are highly effective
treatments for anxiety disorders.
Anxiety Disorders

Anxiety is a feeling of tension associated with a sense of threat of danger when the source of the danger
is not known. In comparison, fear is a feeling of tension that is associated with a known source of
danger. I believe it is normal for us to have some mild anxiety present in our daily lives. Everyday that I
can think of I have some kind of anxiety though out that day. Anxiety warns us and enables us to get
ready for the "fight or flight" response. However, heightened anxiety is emotionally painful. It disrupts a
person's daily functioning.
Anxiety can be seen with several other emotional disorders including the following:
Acute Stress Disorder
Panic Attack
Agoraphobia
Phobia
Anxiety Disorder Due to Medical Condition
Post-traumatic Stress Disorder
Generalized Anxiety Disorder
Substance-Induced Anxiety Disorder
Obsessive-Compulsive Disorder

There are many characteristics associated with anxiety. Frequently, people with anxiety experience
tightness in their chest, a racing or pounding heart, and a pit in their stomach. Anxiety causes some
people to get a headache, to sweat, and even make them have the urge to urinate.
Severe anxiety, which can be described as an episode of terror, is referred to as a panic attack. Panic
attacks can be extremely frightening. People who experience panic attacks over a prolonged time period
may become victims of agoraphobia, which is a psychiatric disorder that is closely associated with the
panic disorder. Patients with Agoraphobia avoid certain places or situations such as airplanes, crowded
theaters, a grocery store or anyplace from which escape might be difficult. It is said that Agoraphobia
can be so severe that it has made certain individuals housebound.
Some people argue that there is a genetic basis for these anxiety disorders. Research shows that there is
strong evidence for a genetic basis for anxiety. If a person has anxiety, more than ten percent of his or
her relatives will also suffer form some form of anxiety if not the same form that they have.
It has been found that anxiety disorder affect males and females differently. Females are

known to be twice as likely to suffer from anxiety than males. On the other hand, an equal

number of males and females are both seen for the treatment of their anxiety.

The ages that the people have anxiety attacks vary but, anxiety problems commonly begin when people
are in their twenty"s. This is something really great to know when you are only a year a way from being
twenty. When will my anxiety start? Or has it already? There some known cases of anxiety at early ages
but these are rare. Still again people of any age can suffer from anxiety and require the treatment for it.
I wondered to myself how common are anxiety disorders in our society today. Then I found out how
common they really are. They end up being very common. At least three percent of the population in
the untied states has had or will eventually be diagnose with some form of abnormal anxiety. Being a
college student I am almost positive that I am in that three percent. How lucky am I?
Knowing now that I am almost at the right age to have anxiety who would diagnose a type of disorder
like these? I found out that a mental health professional may diagnoses the anxiety disorder after taking
a careful look at my personal history. It will be important to the therapist to learn the details of my life.
It is also very important not to overlook a physical illness that might mimic or contribute to this
psychological disorder since some medical illnesses can cause anxiety like symptoms. Take for instance,
a person with an overactive thyroid, known as hyperthyroidism, may have symptoms similar to anxiety.
This is something that the professional would pick up and diagnose you accordingly. If there would be a
question whether the individual might have a physical problem, the mental health professional would
recommend a complete physical examination by a medical doctor. People examined during an anxiety
attack usually have rapid pulse, rapid breathing, dry mouth, and sweating palms. They might also
complain of dizziness or numbness or tingling in their extremities. Laboratory tests are also a necessary
part of the physical work up and check out.
Anxiety disorders can be treated in several ways. The first is being Psychotherapy. This is recommend for
someone with a moderate to severe anxiety problem. Secondly, antianxiety medications can be used to
reduce severe anxiety. Take for example when people sometimes start experiencing a panic attack they
think that they are having a heart attack, and they begin to worry that they might die. Therefore, they
go to a hospital emergency room to be evaluated. Once they are evaluated and diagnosed with anxiety,
they are given reassurance that they are not going to die, and they may be treated with medications to
lessen their anxious symptoms. The third way that a anxiety disorder can be treated is with the help of
your family. If you have a friend, family member or a loved relative they can help you cope with your
hard time and make you life a little easier just with them being there and them giving you
encouragement.
What could happen if a person had a type of anxiety disorder? Well some forms of anxiety are sort lived.
However, many people with anxiety battle the disorder for years.
The prognosis for the recovery from anxiety is variable. However, with treatment many people learn to
live with or control their anxiety so that they can continue to be fully functioning.
I have learned through my own situations in life that anxiety can be very stressful. . Doing this paper
how made me realize how really messed up I really am. I have many anxiety problems. I guess I can say
though who doesn"t is the world today.
Not only have I learned a lot about anxiety but thorough out this semester in psychology I have learned
different problems people face and what they do to help themselves get better. There are problems that
I never knew existed.
With the help of God may I never have any more anxiety problems.

https://www.dreamessays.com/customessays/Psychology/10841.htm
Q: How can I stop anxiety from affecting my job?

A: Having anxiety doesn’t mean you will never be able to hold down a job. There are many
treatments available for anxiety, such as medication or cognitive behavioral therapy, that can
help you through the anxiety. If you haven’t done so yet, talk with your doctor about your
anxiety and find out more about what treatments would be best for you.

Q: How can I help my spouse overcome anxiety challenges?

A: Learn all you can about anxiety. Offer support and ask how you can help, but remember there
is a fine line between helping and enabling. Be patient, as it can take months or years to
overcome symptoms of anxiety. Always remember to take care of you. Don’t give up all the
activities you enjoy or you will just end up resenting your spouse.

Q: Can anxiety cause other illnesses?

**A: **Chronic stress can contribute to illnesses such as heart disease and digestive problems.
High levels of stress can cause deficiencies in your immune system, which can lead to illness.
When you are having physical symptoms, it is always important to see your doctor, even if you
believe it is caused by stress. Your doctor will do an examination and determine if there are
underlying medical conditions.

Q: How do you know if you have an anxiety disorder?

**A: **There are many different types of anxiety, each with specific symptoms. Because anxiety
is a medical condition, it must be diagnosed by a medical professional. If your fears are keeping
you from looking for work, holding a job or any other daily activities, it is probably time to talk
with your doctor and find out if you do have anxiety.
This questionnaire assesses the degree of social anxiety that you experience.

The questions in this scale are intended to indicate various emotional personality traits. It is not a
test in any sense because there are no right nor wrong answers to any of the questions. Choose
the response that best describes how you would feel or respond.

No login required to obtain results.

Question 1: Do you get anxious if you have to speak or perform in any way in front of a group of
strangers?

Never
Somewhat
Half the time
Usually
Always

Question 2: Do you worry if you make a fool of yourself, or feel you have been made to look
foolish?

Never
Somewhat
Half the time
Usually
Always

Question 3: Are you afraid of falling when you are on a high place from which there is no real
danger of falling – for example, looking down from a balcony on the tenth floor?

Never
Somewhat
Half the time
Usually
 Always

Question 4: Are you easily hurt by what other people do or say to you?

Never
Somewhat
Half the time
Usually
Always

Question 5: Do you keep in the background on social occasions?

Never
Somewhat
Half the time
Usually
Always

Question 6: Do you have changes of mood that you cannot explain?

Never
Somewhat
Half the time
Usually
Always

Question 7: Do you feel uncomfortable when you meet new people?

Never
Somewhat
 Half the time
Usually
Always

Question 8: Do you day-dream frequently, i.e., indulge in fantasies not involving concrete
situations?

Never
Somewhat
Half the time
Usually
Always

Question 9: Do you get discouraged easily, e.g., by failure or criticism?

Never
Somewhat
Half the time
Usually
Always

Question 10: Do you say things in haste and then regret them?

Never
Somewhat
Half the time
Usually
Always

Question 11: Are you ever disturbed by the mere presence of other people?
 Never
Somewhat
Half the time
Usually
Always

Question 12: Do you cry easily?

Never
Somewhat
Half the time
Usually
Always

Question 13: Does it bother you to have people watch you work even when you do it well?

Never
Somewhat
Half the time
Usually
Always

Question 14: Does criticism hurt you badly?

Never
Somewhat
Half the time
Usually
Always
Question 15: Do you cross the street to avoid meeting someone?

Never
Somewhat
Half the time
Usually
Always

Question 16: At a reception or tea do you go out of your way to avoid meeting the important
person present?

Never
Somewhat
Half the time
Usually
Always

Question 17: Do you often feel just miserable?

Never
Somewhat
Half the time
Usually
Always

Question 18: Do you hesitate to volunteer in a discussion or debate with a group of people
whom you know more or less?

Never
Somewhat
Half the time
 Usually
Always

Question 19: Do you have a sense of isolation, either when alone or among people?

Never
Somewhat
Half the time
Usually
Always

Question 20: Are you self-conscious before ‘superiors’ (teachers, employers, authorities)?

Never
Somewhat
Half the time
Usually
Always

Question 21: Do you lack confidence in your general ability to do things and to cope with
situations?

Never
Somewhat
Half the time
Usually
Always

Question 22: Are you self-conscious about your appearance even when you are well-dressed
and groomed?
 Never
Somewhat
Half the time
Usually
Always

Question 23: Are you scared at the sight of blood, injuries, and destruction even though there is
no danger to you?

Never
Somewhat
Half the time
Usually
Always

Question 24: Do you feel that other people are better than you?

Never
Somewhat
Half the time
Usually
Always

Question 25: Is it hard for you to make up your mind?

Never
Somewhat
Half the time
Usually
Always
College Student Stress Survey
* 1. On a scale from 1 to 10, 1 being not stressed at all and 10 being the most stressed, how stressed do you
feel on a daily basis during the school year?
1

10

* 2. How do you relieve your stress, select all that apply:

Eating

Sleeping

Drinking

Drugs

Talking With Someone

Shopping

Exercise

Computer Games / Social Media

Other (please specify)

* 3. What are the effects you feel from stress, select all that apply:
Anxiety

Depression

Mood Swings

Insomnia

Over Eating

Lower / Failing Grades

Other (please specify)

* 4. What are the causes of stress in your life, select all that apply:
School

Family & Friends

Significant Other

Sports / Athletics

Clubs and Organizations

Money

Work

Health Related Issues

Other (please specify)

* 5. On a scale of 1 to 10, 1 being not well at all and 10 being very well, how well do you think you handle
your stress?
1
 2

10

* 6. On a scale of 1 to 10, 1 being there are no helpful resources and 10 being there are plenty of helpful
resources, would you say there are a lot of resources on campus to help you when you are feeling
distressed?
1

10
* 7. On a scale of 1 to 10, 1 being it wouldn’t benefit at all and 10 being it would benefit greatly, do you
think our campus would benefit from having lower stress among students?
1

10

* 8. What is something that the school could do to help lower stress?