Anxiety is a normal feeling of uneasiness, concern and apprehension that, when carried to an extreme, can become worry or outright terror.
Some amount of anxiety and worrying is a normal and necessary part of life. It is because we are concerned about our children’s safety, for example, that we watch them carefully when we are at the beach. It is because we are concerned about our own well-being that we fasten our seatbelts when we get into a car. These kinds of concerns help keep us aware and alert, but don’t interfere with our daily life in any way. On the contrary, worry on this level means that our internal protective systems are doing what they are supposed to do.
Anxiety rooted in stress is what is commonly known as “fight-or-flight.” It is a physical and emotional response to real or perceived danger. This kind of anxiety, although it can be very uncomfortable, is still very useful in that it helps us respond to a crisis. Intense worry about a sick child prompts us to prepare for any eventuality, for better or for worse.
Stress anxiety is caused by a clearly identifiable event and fades as soon as the crisis is over. (Amusement parks make a great deal of their money by provoking this kind of anxiety. The jolt in your stomach when you speed down a roller coaster or when something jumps out at you is the fight-or-flight response in action. The rush of adrenaline feels so good, you want to take another ride.)
When Does Normal Anxiety Become an Anxiety Disorder?
Anxiety disorders take normal anxiety responses to another level. For people with anxiety disorders, worrying (or worrying about worrying) disrupts the flow of daily life. These worries and even the fight-or-flight adrenaline rush are not necessarily connected to any specific event. Often they happen for no apparent reason, and disappear as mysteriously as they started. What best characterizes an anxiety disorder is that it is out of proportion and out of the individual’s control.
Anxiety disorders are divided into six major categories:
- generalized anxiety disorder (GAD);
- panic disorder;
- obsessive-compulsive disorder;
- acute stress disorder; and
- post-traumatic stress disorder.
Because the symptoms of each category overlap somewhat, it is not uncommon for someone to be diagnosed with more than one anxiety disorder at any given time. These disorders are collectively relatively common; at least three percent of the U.S. population has experienced an anxiety disorder.
Here’s a table comparing the characteristics of different types of anxiety:
|Worry||Normal, low-grade concern|
|Stress Anxiety||Brief alarm, then back to normal|
|Generalized Anxiety Disorder||Constant low-grade worry. Constant yellow alert|
|Panic Attacks||Sudden, inexplicable panic. Red alert|
What Causes an Anxiety Disorder?
No one knows for sure. There is evidence that some people are born more prone to anxiety than others, and evidence that societal factors play a large role as well. Parents with a tendency to be overly anxious can pass that tendency on to their children. Unsupportive or abusive family lives can cause the development of anxiety disorders as well. Still others develop anxiety disorders because they are exposed to a traumatic event like an accident, natural disaster, or severe abuse that makes them question their basic safety in the world. As a general rule, studies indicate that women are twice as likely to develop anxiety disorders as men.
Finally, there are some physical conditions that make people act like they are having panic attacks or anxiety. Among these are hypoglycemia, hypothyroidism, hyperthyroidism, a mitral valve prolapse, inner ear problems, congestive heart failure, deficiencies of certain minerals and vitamins, withdrawal (like nicotine withdrawal), and PMS.
For more information on specific anxiety disorders, continue with Part 2 of this series.
On 3 Oct 2005
By John M. Grohol, Psy.D.