ANXIETY DISORDERS

Anxiety is a distressing, unpleasant emotional state of nervousness and uneasiness; its causes are less clear. Anxiety is less tied to the exact timing of a threat; it can be anticipatory before a threat, persist after a threat has passed, or occur without an identifiable threat. 

Anxiety is often accompanied by physical changes and behaviors similar to those caused by fear.Some degree of anxiety is adaptive; it can help people prepare, practice, and rehearse so that their functioning is improved and can help them be appropriately cautious in potentially dangerous situations. 

However, beyond a certain level, anxiety causes dysfunction and undue distress. At this point, it is maladaptive and considered a disorder.Anxiety occurs in a wide range of physical and mental disorders, but it is the predominant symptom of several. 

Anxiety disorders are more common than any other class of psychiatric disorder. However, they often are not recognized and consequently not treated. Left untreated, chronic, maladaptive anxiety can contribute to or interfere with treatment of some physical disorders.

Anxiety disorder is divided into generalized anxiety, phobic, and panic disorders; each has its own characteristics and symptoms and they require different treatment.

Generalized anxiety disorder (GAD) is a common chronic disorder characterized by long-lasting anxiety that is not focused on any one object or situation. Those suffering from generalized anxiety experience non-specific persistent fear and worry and become overly concerned with everyday matters. Generalized anxiety disorder is the most common anxiety disorder to affect older adults. Anxiety can be a symptom of a medical or substance abuse problem, and medical professionals must be aware of this. A diagnosis of GAD is made when a person has been excessively worried about an everyday problem for six months or more. A person may find they have problems making daily decisions and remembering commitments as a result of lack of concentration/preoccupation with worry. Appearance looks strained, skin is pale with increased sweating from the hands, feet and axillae (armpit). May be tearful which can suggest depression. Before a diagnosis of anxiety disorder is made, nurses and physicians must rule out drug-induced anxiety and medical causes.

In panic disorder, a person suffers from brief attacks of intense terror and apprehension, often marked by trembling, shaking, confusion, dizziness, nausea, difficulty breathing. These panic attacks, defined by the APA as fear or discomfort that abruptly arises and peaks in less than ten minutes, can last for several hours and can be triggered by stress, fear, or even exercise; the specific cause is not always apparent.A person experiences an unexpected panic attack, then has substantial anxiety over the possibility of having another attack. The person fears and avoids whatever situation might induce a panic attack. The person may never or rarely leave their home to prevent a panic attack they believe to be inescapable,extreme terror.

The single largest category of anxiety disorders is that of phobic disorders, which includes all cases in which fear and anxiety is triggered by a specific stimulus or situation. Between 5% and 12% of the population worldwide suffer from phobic disorders. Sufferers typically anticipate terrifying consequences from encountering the object of their fear, which can be anything from an animal to a location to a bodily fluid to a particular situation. Sufferers understand that their fear is not proportional to the actual potential danger but still are overwhelmed by the fear.

Agoraphobia is the specific anxiety about being in a place or situation where escape is difficult or embarrassing or where help may be unavailable. Agoraphobia is strongly linked with panic disorders and is often precipitated by the fear of having a panic attack. A common manifestation involves needing to be in constant view of a door or other escape route. In addition to the fears themselves, the term agoraphobia is often used to refer to avoidance behaviors that sufferers often develop. For example, following a panic attack while driving, someone suffering from agoraphobia may develop anxiety over driving and will therefore avoid driving. These avoidance behaviors can often have serious consequences; in severe cases, one can be confined to one's home.

Social anxiety disorder  (SAD; also known as social phobia) describes an intense fear and avoidance of negative public scrutiny, public embarrassment, humiliation, or social interaction. This fear can be specific to particular social situations (such as public speaking) or, more typically, is experienced in most (or all) social interactions. Social anxiety often manifests specific physical symptoms, including blushing, sweating, and difficulty speaking. Like with all phobic disorders, those suffering from social anxiety often will attempt to avoid the source of their anxiety; in the case of social anxiety this is particularly problematic, and in severe cases can lead to complete social isolation.

Obsessive–compulsive disorder (OCD) is a type of anxiety disorder primarily characterized by repetitive obsessions (distressing, persistent, and intrusive thoughts or images) and compulsions (urges to perform specific acts or rituals). It affects roughly around 3% of the population worldwide. The OCD thought pattern may be likened to superstitions in so far as it involves a belief in a causative relationship where, in reality, one does not exist. Often the process is entirely illogical; for example, the compulsion of walking in a certain pattern may be employed to alleviate the obsession of impending harm. And in many cases, the compulsion is entirely inexplicable, simply an urge to complete a ritual triggered by nervousness.

Post-traumatic stress disorder (PTSD) is an anxiety disorder which results from a traumatic experience. Post-traumatic stress can result from an extreme situation, such as combat, natural disaster, rape, more serious kinds of child abuse, or even a serious accident. It can also result from long term (chronic) exposure to a severe stressor,for example soldiers who endure individual battles but cannot cope with continuous combat. Common symptoms include hyper-vigilance, flashbacks, avoidant behaviors, anxiety, anger and depression. There are a number of treatments which form the basis of the care plan for those suffering with PTSD. Such treatments include  cognitive behavioral therapy (CBT), psychotherapy and support from family and friends. These are all examples of treatments used to help people suffering from PTSD.

Separation anxiety disorder (SepAD) is the feeling of excessive and inappropriate levels of anxiety over being separated from a person or place. Separation anxiety is a normal part of development in babies or children, and it is only when this feeling is excessive or inappropriate that it can be considered a disorder. Separation anxiety disorder affects roughly 7% of adults and 4% of children, but the childhood cases tend to be more severe, in some instances even a brief separation can produce panic.