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Anxiety Disorders

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Suzanne M. Sutherland, M.D.

The term anxiety refers to many states in which the sufferer experiences a sense of impending threat or doom that is not well defined or realistically based.

Anxiety can be adaptive or pathologic, transient or chronic, and has a variety of psychological and physical manifestations. Anxiety disorders are a heterogeneous group of disorders in which the feeling of anxiety is the major element. They are the most prevalent group of psychiatric disorders; according to the Epidemiological Catchment Area study, 7.3% of all Americans meet the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III; the DSM version used at the time) criteria at a given point in time (so-called point prevalence). Anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) are shown in Table 3-1.

Anxiety disorders, the most prevalent psychiatric illnesses in the general community, are present in 15 to 20% of medical clinic patients. Anxiety, defined as a subjective sense of unease, dread, or foreboding, can indicate a primary psychiatric condition or can be a component of, or reaction to, a primary medical disease. The primary anxiety disorders are classified according to their duration and course and the existence and nature of precipitants.

When evaluating the anxious patient, the clinician must first determine whether the anxiety antedates or postdates a medical illness or is due to a medication side effect. Approximately one-third of patients presenting with anxiety have a medical etiology for their psychiatric symptoms, but an anxiety disorder can also present with somatic symptoms in the absence of a diagnosable medical condition.

 
Anxiety Disorders



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Failed college dreams don’t spell depression,…

High school seniors, take note: A wise person once said, “It is better to shoot for the stars and miss than aim at the gutter and hit it.”

That’s right on, says Florida State University Sociology Professor John R. Reynolds, who just completed a study to determine whether unrealized educational expectations are associated with depression among adults. Reynolds also is the director of the Pepper Institute on Aging and Public Policy at Florida State.

He and co-author Chardie L. Baird, an assistant professor of sociology at Kansas State University, found no long-term emotional costs of aiming high and falling short when it comes to educational aspirations, despite several social psychological theories that would seem to suggest otherwise. The researchers’ conclusion: Society should not discourage unpromising students who have dreams of earning a college degree.

   
Worried all the Time: Treatment Options…

A little worry is normal, but people who constantly worry about daily concerns, even when times are good, may have generalized anxiety disorder (GAD).

GAD is excessive worry that lasts at least six months and disrupts daily activities, according to the March issue of Mayo Clinic Women’s HealthSource. Typically starting during middle age and more common in older adults, GAD affects an estimated 4 to 7 percent of adults 65 and older and often goes hand in hand with depression or other anxiety disorders, such as phobias.

It’s believed that people with GAD have abnormal levels of brain chemicals that affect the response to stressful or uncertain situations. This overactive fear circuitry in the brain can cause a person to view many situations, even harmless ones, as threats. 

   

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