We cannot help but experience some level of anxiety in response to common sources of stress. Anxiety has a protective effect, by forcing us to put more attention and effort in those things which have impact on our well-being. But it becomes a serious problem when it turns into the dominant force of a person’s day-to-day life. It can have the severity to be considered a clinical problem by mental health workers. The difficulty for most is in recognizing when anxiety crosses the threshold from normal to abnormal and overwhelming. In fact, the casual use of the term anxiety belies its complexity as a whole category of disorders recognized by mental health physicians and classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The conditions range in degree of severity, ranging from milder variants (e.g. generalized anxiety disorder or GAD), to more severe ones (e.g. obsessive compulsive disorder or OCD). Understanding the nature, source and type of anxiety will bring a person much closer to a way of mitigating or eliminating intense anxiety.

Examples of sources of everyday stress include events such as moving, taking a test or exam, or getting a divorce. Regular levels of anxiety in response to these events are characterized by nervousness, jittery feelings, and extra attention to detail.

In contrast, those suffering from an anxiety disorder will experience much more intense versions of these feelings. In addition, people with anxiety disorders are also overcome with persistent worry and feelings of dread, to the extent that they also suffer physical symptoms such as fatigue, headaches, trembling and sweating.

The DSM-IV lists a large number of conditions that are categorized under the umbrella term “anxiety.” A few are given here to illustrate the complexity of the disease and the need for sufferers to gain insight into the condition. People with a condition called “panic attack” are prone to sudden onset of panic accompanied by profuse sweating and chest pains with apparently little trigger. Those with the condition of OCD do not experience punctuated attacks, but instead feel a continuous, persistent fear which compels them to repeat actions in an attempt to dampen the fear. A final example: people who are afflicted with “social anxiety disorder” are unable to interact with other people in a natural setting, instead feeling fear and embarrassment when among these people. Such fears typically center on the possibility of being a target for ridicule or laughter.

Diagnosis and classification of an anxiety disorder relies on visual examination, interview answers to questions, and a list of symptoms associated with the disorder. The mental health worker or physician will ask for presence or absence of particular symptoms, such as nightmares, problems sleeping, intensity and persistence of feelings of fear. The list of seemingly subjective criteria suggests such a diagnosis is not an easy task. It is true while each symptom alone does not signal unequivocal diagnosis of anxiety disorder, the sum effect of several symptoms can convince the mental health worker of the case and type of an anxiety disorder.

Finally, many will ask for the root causes of all these anxiety disorders. As is the case for many psychiatric disorders, the answer is unclear because of our limited understanding of the nature and biology of the mind. The three major beliefs for the root causes divide (and overlap) into three kinds: environmental, neurochemical, and genetic. Those who believe anxiety to be mainly rooted in environmental causes think it is like diabetes. Many who acquire Type II diabetes live a lifestyle the habits of which make them prone to obesity. Insulin resistance and hence diabetes are thought to be a response of the body to the lifestyle environment. Similarly, permanently stressful situations can generate long term bodily responses that transform into anxiety disorder. Relatedly, some believe that anxiety disorders are mainly rooted in brain chemistry. Under normal circumstances, the brain releases chemicals that stimulate stress responses or chemicals that suppress “calm” signals. If the release of chemical become misregulated, the brain may be subjected to continuous stimulation and anxiety levels can spiral out of control. Finally, some believe that anxiety disorders to arise out of genetic background. Some evidence lies in the fact that anxiety seems to run in close family members. The complexity of anxiety disorders suggest proper diagnosis can make a difference in procuring the right solution.

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