Psychiatric Disorders/Anxiety disorders

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The anxiety disorders include disorders with symptoms of anxiety or excessive worrying, phobias and panic attack. Specific disorders include Panic Disorder, Agoraphobia without History of Panic Disorder, Specific Phobia, Social Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder, Generalized Anxiety Disorder, and the Secondary Anxiety Disorders.

Anxiety is not, it itself, pathological, and in the right situation, appropriate anxiety is a necessary survival adaptation, motivating an individual to avoid potential or impending harm. One way to think of anxiety is as a warning signal, telling us of potential danger or harmful situations. Anxiety disorders are present when this warning system is not working properly: it may be overly sensitive, and cause the individual to overreact to minor or nonexistent dangers, or it may create so severe a reaction that the individual is too disabled to cope with the potential harm.

Anxiety involves various psychological and physical symptoms. The individual feels anxious and fearful. This is accompanied by various physical manifestations: restlessness, psychomotor agitation, shortness of breath, hyperventilation, stomach upset, chest pain and diaphoresis. Thought and cognition can be affected: a moderate amount of anxiety can actually be good for attention and concentration, however too much tends to make one distracted.

Anxiety disorders are the most prevalent of psychiatric disorders. Community samples, such as the Epidemiological Catchment Area Project, found surprisingly high lifetime prevalences (Figure 1). Clinical samples have shown anxiety disorders to be a very common reason for presentation to primary care doctors and emergency departments.

Anxiety prevalence.jpg

Anxiety disorders seem more common in women. They may decrease with age, and they can present differently at different ages. In children, an anxiety disorder can manifest as separation anxiety (“school phobia”). Elderly patients may tend towards somatic presentations (“stomach problems,” headaches, sleep problems).