Anxiety is a
psychologicalPsychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
and
physiologicalPhysiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
state characterized by
somaticThe somatic nervous system is the part of the peripheral nervous system associated with the voluntary control of body movements via skeletal muscles...
,
emotionalEmotion is a complex psychophysiological experience of an individual's state of mind as interacting with biochemical and environmental influences. In humans, emotion fundamentally involves "physiological arousal, expressive behaviors, and conscious experience." Emotion is associated with mood,...
,
cognitiveIn science, cognition refers to mental processes. These processes include attention, remembering, producing and understanding language, solving problems, and making decisions. Cognition is studied in various disciplines such as psychology, philosophy, linguistics, and computer science...
, and
behavioralBehavior or behaviour refers to the actions and mannerisms made by organisms, systems, or artificial entities in conjunction with its environment, which includes the other systems or organisms around as well as the physical environment...
components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness, and dread. Anxiety is considered to be a
normalIn behavior, normal refers to a lack of significant deviation from the average. The phrase "not normal" is often applied in a negative sense Abnormality varies greatly in how pleasant or unpleasant this is for other people.The Oxford English Dictionary defines "normal" as "conforming to a standard"...
reaction to a stressor. It may help an individual to deal with a demanding situation by prompting them to cope with it. When anxiety becomes excessive, it may fall under the classification of an
anxiety disorderAnxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
.
Description
Anxiety is a generalized
moodA mood is a relatively long lasting emotional state. Moods differ from emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event....
condition that can occur without an identifiable triggering
stimulusIn psychology, stimuli are energy patterns which are registered by the senses. In behaviorism and related stimulus–response theories, stimuli constitute the basis for behavior, whereas in perceptual psychology they constitute the basis for perception.In the second half of the 19th century, the...
. As such, it is distinguished from
fearFear is a distressing negative sensation induced by a perceived threat. It is a basic survival mechanism occurring in response to a specific stimulus, such as pain or the threat of danger...
, which is an appropriate emotional response to a perceived threat. Additionally, fear is related to the specific behaviors of
escapeThe fight-or-flight response was first described by Walter Bradford Cannon....
and avoidance, whereas anxiety is related to situations perceived as uncontrollable or unavoidable. Another view defines anxiety as "a future-oriented mood state in which one is ready or prepared to attempt to cope with upcoming negative events", suggesting that it is a distinction between future vs. present dangers which divides anxiety and fear. In a 2011 review of the literature, fear and anxiety were said to be differentiated in four domains: (1) duration of emotional experience, (2) temporal focus, (3) specificity of the threat, and (4) motivated direction. Fear was defined as short lived, present focused, geared towards a specific threat, and facilitating escape from threat; while anxiety was defined as long acting, future focused, broadly focused towards a diffuse threat, and promoting caution while approaching a potential threat.
The
physical effects of anxiety may include. As the body prepares to deal with a threat, blood pressure, heart rate, perspiration, blood flow to the major muscle groups are increased, while
immuneAn immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...
and
digestiveDigestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food molecules to smaller ones....
functions are inhibited (the
fight or flightThe fight-or-flight response was first described by Walter Bradford Cannon....
response). External signs of anxiety may include
pallorPallor is a reduced amount of oxyhaemoglobin in skin or mucous membrane, a pale color which can be caused by illness, emotional shock or stress, stimulant use, lack of exposure to sunlight, anaemia or genetics....
, sweating, trembling, and
pupillary dilationMydriasis is a dilation of the pupil due to disease, trauma or the use of drugs. Normally, the pupil dilates in the dark and constricts in the light to respectively improve vividity at night and to protect the retina from sunlight damage during the day...
. Someone who has anxiety might also experience it subjectively as a sense of dread or panic.
Although panic attacks are not experienced by every person who has anxiety, they are a common symptom. Panic attacks usually come without warning and although the fear is generally irrational, the subjective perception of danger is very real. A person experiencing a panic attack will often feel as if he or she is about to die or lose consciousness.
The
emotional effects of anxiety may include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind's gone blank" as well as "nightmares/bad dreams, obsessions about sensations,
deja vuDéjà vu is the experience of feeling sure that one has already witnessed or experienced a current situation, even though the exact circumstances of the prior encounter are uncertain and were perhaps imagined...
, a trapped in your mind feeling, and feeling like everything is scary."
The
cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can’t get it out of your mind."
The
behavioral effects of anxiety may include withdrawal from situations which have provoked anxiety in the past. Anxiety can also be experienced in ways which include changes in sleeping patterns, nervous habits, and increased motor tension like foot tapping.
Causes
An
evolutionary psychologyEvolutionary psychology is an approach in the social and natural sciences that examines psychological traits such as memory, perception, and language from a modern evolutionary perspective. It seeks to identify which human psychological traits are evolved adaptations, that is, the functional...
explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats. This may cause false positive reactions but also avoid real threats. This may explain why anxious people are less likely to die due to accidents.
The psychologist David H. Barlow of Boston University conducted a study that showed three common characteristics of people suffering from chronic anxiety, which he characterized as "a generalized biological vulnerability," "a generalized psychological vulnerability," and "a specific psychological vulnerability." While chemical issues in the brain that result in anxiety (especially resulting from genetics) are well documented, this study highlights an additional environmental factor that may result from being raised by parents suffering from chronic anxiety themselves.
Research upon adolescents who as infants had been highly apprehensive, vigilant, and fearful finds that their
nucleus accumbensThe nucleus accumbens , also known as the accumbens nucleus or as the nucleus accumbens septi , is a collection of neurons and forms the main part of the ventral striatum...
is more sensitive than that in other people when selecting to make an action that determined whether they received a reward. This suggests a link between circuits responsible for fear and also reward in anxious people. As researchers note "a sense of ‘responsibility,’ or self agency, in a context of uncertainty (probabilistic outcomes) drives the neural system underlying appetitive motivation (i.e., nucleus accumbens) more strongly in temperamentally inhibited than noninhibited adolescents."
Neural circuitry involving the
amygdalaThe ' are almond-shaped groups of nuclei located deep within the medial temporal lobes of the brain in complex vertebrates, including humans. Shown in research to perform a primary role in the processing and memory of emotional reactions, the amygdalae are considered part of the limbic system.-...
and
hippocampusThe hippocampus is a major component of the brains of humans and other vertebrates. It belongs to the limbic system and plays important roles in the consolidation of information from short-term memory to long-term memory and spatial navigation. Humans and other mammals have two hippocampi, one in...
is thought to underlie anxiety. When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes,
PET-scansPositron emission tomography is nuclear medicine imaging technique that produces a three-dimensional image or picture of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide , which is introduced into the body on a...
show increased bloodflow in the
amygdalaThe ' are almond-shaped groups of nuclei located deep within the medial temporal lobes of the brain in complex vertebrates, including humans. Shown in research to perform a primary role in the processing and memory of emotional reactions, the amygdalae are considered part of the limbic system.-...
. In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors.
Although single genes have little effect on complex traits and interact heavily both
between themselvesIn genetics, epistasis is the phenomenon where the effects of one gene are modified by one or several other genes, which are sometimes called modifier genes. The gene whose phenotype is expressed is called epistatic, while the phenotype altered or suppressed is called hypostatic...
and with the external factors, research is underway to unravel possible molecular mechanisms underlying anxiety and comorbid conditions. One candidate gene with
polymorphismPolymorphism in biology occurs when two or more clearly different phenotypes exist in the same population of a species — in other words, the occurrence of more than one form or morph...
s that influence anxiety is
PLXNA2Plexin-A2 is a protein that in humans is coded by the PLXNA2 gene.This gene encodes a member of the plexin-A family of semaphorin co-receptors. Semaphorins are a large family of secreted or membrane-bound proteins that mediate repulsive effects on axon pathfinding during nervous system development...
.
In Medicine
Anxiety can be a symptom of an underlying health issue such as chronic obstructive pulmonary disease (COPD), heart failure, or heart arrythmia.
Abnormal and pathological anxiety or fear may itself be a medical condition falling under the blanket term "anxiety disorder". Such conditions came under the aegis of psychiatry at the end of the 19th century and current psychiatric diagnostic criteria recognize several specific forms of the disorder.
Recent surveys have found that as many as 18% of Americans may be affected by one or more of them.
Standardized screening tools such as
Zung Self-Rating Anxiety ScaleThe Zung Self-Rating Anxiety Scale was designed by William W. K. Zung, a psychiatrist from Duke University, to quantify a patient's level of anxiety....
,
Beck Anxiety InventoryThe Beck Anxiety Inventory , created by Dr. Aaron T. Beck and other colleagues, is a 21-question multiple-choice self-report inventory that is used for measuring the severity of an individual's anxiety.-BAI:...
, and HAM-A (Hamilton Anxiety Scale) can be used to detect anxiety
symptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s and suggest the need for a formal diagnostic assessment of anxiety disorder.
The HAM-A (Hamilton Anxiety Scale) measures the severity of a patient's anxiety, based on 14 parameters, including anxious mood, tension, fears, insomnia, somatic complaints and behavior at the interview.
Existential Anxiety
The philosopher
Søren KierkegaardSøren Aabye Kierkegaard was a Danish Christian philosopher, theologian and religious author. He was a critic of idealist intellectuals and philosophers of his time, such as Georg Wilhelm Friedrich Hegel, Friedrich Wilhelm Joseph Schelling and Karl Wilhelm Friedrich Schlegel...
, in
The Concept of Anxiety, described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In
Art and Artist (1932), the psychologist
Otto RankOtto Rank was an Austrian psychoanalyst, writer, teacher and therapist. Born in Vienna as Otto Rosenfeld, he was one of Sigmund Freud's closest colleagues for 20 years, a prolific writer on psychoanalytic themes, an editor of the two most important analytic journals, managing director of Freud's...
wrote that the psychological trauma of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation and differentiation.
The
theologianTheology is the systematic and rational study of religion and its influences and of the nature of religious truths, or the learned profession acquired by completing specialized training in religious studies, usually at a university or school of divinity or seminary.-Definition:Augustine of Hippo...
Paul TillichPaul Johannes Tillich was a German-American theologian and Christian existentialist philosopher. Tillich was one of the most influential Protestant theologians of the 20th century...
characterized existential anxiety as "the state in which a
beingBeing , is an English word used for conceptualizing subjective and objective aspects of reality, including those fundamental to the self —related to and somewhat interchangeable with terms like "existence" and "living".In its objective usage —as in "a being," or "[a] human being" —it...
is aware of its possible nonbeing" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death),
moralMorality is the differentiation among intentions, decisions, and actions between those that are good and bad . A moral code is a system of morality and a moral is any one practice or teaching within a moral code...
(
guiltGuilt is the state of being responsible for the commission of an offense. It is also a cognitive or an emotional experience that occurs when a person realizes or believes—accurately or not—that he or she has violated a moral standard, and bears significant responsibility for that...
and condemnation), and
spiritualSpirituality can refer to an ultimate or an alleged immaterial reality; an inner path enabling a person to discover the essence of his/her being; or the “deepest values and meanings by which people live.” Spiritual practices, including meditation, prayer and contemplation, are intended to develop...
(emptiness and
meaninglessnessIn existentialism, meaning is understood as the worth of life. Meaning in existentialism is unlike typical conceptions of "the meaning of life", because it is descriptive. Due to the method of existentialism, prescriptive or declarative statements about meaning are unjustified. Meaning is only...
). According to Tillich, the last of these three types of existential anxiety, i.e. spiritual anxiety, is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be accepted as part of the
human conditionThe human condition encompasses the experiences of being human in a social, cultural, and personal context. It can be described as the irreducible part of humanity that is inherent and not connected to gender, race, class, etc. — a search for purpose, sense of curiosity, the inevitability of...
or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by
traditionA tradition is a ritual, belief or object passed down within a society, still maintained in the present, with origins in the past. Common examples include holidays or impractical but socially meaningful clothes , but the idea has also been applied to social norms such as greetings...
and
authorityThe word Authority is derived mainly from the Latin word auctoritas, meaning invention, advice, opinion, influence, or command. In English, the word 'authority' can be used to mean power given by the state or by academic knowledge of an area .-Authority in Philosophy:In...
" even though such "undoubted certitude is not built on the rock of
realityIn philosophy, reality is the state of things as they actually exist, rather than as they may appear or might be imagined. In a wider definition, reality includes everything that is and has been, whether or not it is observable or comprehensible...
".
According to
Viktor FranklViktor Emil Frankl M.D., Ph.D. was an Austrian neurologist and psychiatrist as well as a Holocaust survivor. Frankl was the founder of logotherapy, which is a form of Existential Analysis, the "Third Viennese School of Psychotherapy"...
, the author of
Man's Search for MeaningMan's Search for Meaning is a 1946 book by Viktor Frankl chronicling his experiences as a concentration camp inmate and describing his psychotherapeutic method of finding a reason to live...
, when a person is faced with extreme mortal dangers, the most basic of all human wishes is to find a
meaning of lifeThe meaning of life constitutes a philosophical question concerning the purpose and significance of life or existence in general. This concept can be expressed through a variety of related questions, such as "Why are we here?", "What is life all about?", and "What is the meaning of it all?" It has...
to combat the "trauma of nonbeing" as death is near.
Test and Performance Anxiety
According to
Yerkes-Dodson lawThe Yerkes–Dodson law is a claimed empirical relationship between arousal and performance, originally developed by psychologists Robert M. Yerkes and John Dillingham Dodson in 1908. The "law" asserts that performance increases with physiological or mental arousal, but only up to a point. When...
, an optimal level of arousal is necessary to best complete a task such as an exam, performance, or competitive event. However, when the anxiety or level of arousal exceeds that optimum, the result is a decline in performance.
Test anxiety is the uneasiness, apprehension, or nervousness felt by students who had a fear of failing an exam. Students who have test anxiety may experience any of the following: the association of
gradesGrades are standardized measurements of varying levels of comprehension within a subject area. Grades can be assigned in letters , as a range , as a number out of a possible total , as descriptors , in percentages, or, as is common in some post-secondary...
with
personal worthSelf-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...
; fear of embarrassment by a teacher; fear of
alienationThe term social alienation has many discipline-specific uses; Roberts notes how even within the social sciences, it “is used to refer both to a personal psychological state and to a type of social relationship”...
from parents or friends; time pressures; or feeling a loss of control. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, and drumming on a desk are all common. Because test anxiety hinges on fear of negative evaluation, debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia.
While the term "test anxiety" refers specifically to students, many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult.
Stranger and Social Anxiety
Anxiety when meeting or interacting with unknown people is a common stage of development in young people. For others, it may persist into adulthood and become social anxiety or social phobia. "
Stranger anxietyStranger anxiety is a form of distress that children experience when exposed to people unfamiliar to them. Symptoms may include: getting quiet and staring at the stranger, verbally protesting by cries or other vocalizations, and hiding behind a parent. Stranger anxiety is a typical part of the...
" in small children is not considered a phobia. In adults, an excessive fear of other people is not a developmentally common stage; it is called
social anxietySocial anxiety is anxiety about social situations, interactions with others, and being evaluated or scrutinized by other people...
. According to Cutting, social phobics do not fear the crowd but the fact that they may be being judged negatively.
Social anxietySocial anxiety is anxiety about social situations, interactions with others, and being evaluated or scrutinized by other people...
varies in degree and severity. Whilst for some people it is characterized by experiencing discomfort or awkwardness during physical social contact (Embracing, Shaking Hands, etc.), in other cases it can lead to a fear of interacting with unfamiliar people altogether. There can be a tendency among those suffering from this condition to restrict their lifestyles to accommodate the anxiety, minimizing social interaction whenever possible. Social Anxiety also forms a core aspect of certain personality disorders, including
Avoidant Personality DisorderAvoidant personality disorder is a personality disorder recognized in the Diagnostic and Statistical Manual of Mental Disorders handbook in a person characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of...
.
Generalized Anxiety
Overwhelming anxiety, if not treated early, can consequently become a generalized anxiety disorder (GAD), which can be identified by symptoms of exaggerated and excessive worry, chronic anxiety, and constant, irrational thoughts. The anxious thoughts and feelings felt while suffering from GAD are difficult to control and can cause serious mental anguish that interferes with normal, daily functioning.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) includes specific criteria for diagnosing generalized anxiety disorder. The DSM-IV states that a patient must experience chronic anxiety and excessive worry, almost daily, for at least 6 months due to a number of stressors (such as work or school) and experience three or more defined symptoms, including, “restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep).”
If symptoms of chronic anxiety are not addressed and treated in adolescence then the risk of developing an anxiety disorder in adulthood increases significantly. “Clinical worry is also associated with risk of comorbidity with other anxiety disorders and depression” which is why immediate treatment is so important.
Generalized anxiety disorder can be treated through specialized therapies aimed at changing thinking patterns and in turn reducing anxiety-producing behaviors. Cognitive behavioral therapy (
CBTCBT can mean:* CBT, a CBC Radio One station in Grand Falls-Windsor, Newfoundland and Labrador* Ceneri Base Tunnel, a railway tunnel under construction in Switzerland...
) and short-term psychodynamic psychotherapy (STPP) can be used to successfully treat GAD with positive effects lasting 12 months after treatment. There are also other treatment plans that should be discussed with a knowledgeable health care practitioner, which can be used in conjunction with behavioral therapy to greatly reduce the disabling symptoms of generalized anxiety disorder.
Trait Anxiety
Anxiety can be either a short term 'state' or a long term "trait." Trait anxiety reflects a stable tendency to respond with state anxiety in the anticipation of threatening situations. It is closely related to the personality trait of
neuroticismNeuroticism is a fundamental personality trait in the study of psychology. It is an enduring tendency to experience negative emotional states. Individuals who score high on neuroticism are more likely than the average to experience such feelings as anxiety, anger, guilt, and depressed mood...
. Such anxiety may be conscious or unconscious.
Choice or Decision Anxiety
Anxiety induced by the need to choose between similar options is increasingly being recognized as a problem for individuals and for organisations:
"Today we’re all faced with greater choice, more competition and less time to consider our options or seek out the right advice."
Paradoxical Anxiety
Paradoxical anxiety is anxiety arising from use of methods or techniques which are normally used to reduce anxiety. This includes relaxation or meditation techniques as well as use of certain medications. In some Buddhist meditation literature, this effect is described as something which arises naturally and should be turned toward and mindfully explored in order to gain insight into the nature of emotion, and more profoundly, the nature of self.
Positive Psychology
In
Positive psychologyPositive psychology is a recent branch of psychology whose purpose was summed up in 1998 by Martin Seligman and Mihaly Csikszentmihalyi: "We believe that a psychology of positive human functioning will arise, which achieves a scientific understanding and effective interventions to build thriving in...
, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.
See Also
- Arousal
Arousal is a physiological and psychological state of being awake or reactive to stimuli. It involves the activation of the reticular activating system in the brain stem, the autonomic nervous system and the endocrine system, leading to increased heart rate and blood pressure and a condition of...
- Catastrophization
- Panic attack
Panic attacks are periods of intense fear or apprehension that are of sudden onset and of relatively brief duration. Panic attacks usually begin abruptly, reach a peak within 10 minutes, and subside over the next several hours...
- Paranoia
Paranoia [] is a thought process believed to be heavily influenced by anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself...
- Social anxiety
Social anxiety is anxiety about social situations, interactions with others, and being evaluated or scrutinized by other people...
External Links