Anxiety

Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry.

Anxiety is a generalized mood condition that occurs without an identifiable triggering stimulus. As such, it is distinguished from fear, which occurs in the presence of an observed threat. Additionally, fear is related to the specific behaviors of escape and avoidance, whereas anxiety is the result of threats that are perceived to be uncontrollable or unavoidable.

Another view is that anxiety is "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 that divides anxiety and fear.

Anxiety is considered to be a normal reaction to stress. It may help a person to deal with a difficult situation, for example at work or at school, by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder.

Description

Physical effects of anxiety may include heart palpitations, fatigue, nausea, chest pain, shortness of breath, stomach aches, or headaches. Physically, the body prepares the organism to deal with a threat. Blood pressure and heart rate are increased, sweating is increased, bloodflow to the major muscle groups is increased, and immune and digestive system functions are inhibited (the fight or flight response). External signs of anxiety may include pale skin, sweating, trembling, and pupillary dilation. Someone suffering from anxiety might also experience it as a sense of dread or panic. Although panic attacks are not experienced by every anxiety sufferer, they are a common symptom. Panic attacks usually come without warning, and although the fear is generally irrational, the 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 pass out. Panic attacks may be confused with heart attacks therefore only a doctor can be the only right person to differentiate between panic attack or the heart attack.

Anxiety does not only consist of physical effects, there are many emotional ones as well. They include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) or danger, and, feeling like your mind's gone blank" as well as "nightmares/bad dreams, obsessions about sensations, deja vu, a trapped in your mind feeling, and feeling like everything is scary."

Cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may fear that the chest pains [a physical symptom of anxiety] are a deadly heart attack or that the shooting pains in your head [another physical symptom of anxiety] 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."

Biological basis

Neural circuitry involving the amygdala and hippocampus is thought to underlie anxiety. When confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala. 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.

Research upon adolescents that were as infants highly apprehensive, vigilant, and fearful finds that their nucleus accumbens is more sensitive than that in other people when they selected 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."

Although single genes have little effect on complex traits and interact heavily both between themselves and with the external factors, research is underway to unravel possible molecular mechanisms underlying anxiety and comorbid conditions. One candidate gene with polymorphisms that influence anxiety is PLXNA2.

Pre-existing health issues including chronic obstructive pulmonary disease (COPD), heart failure, and arrythmia can be the cause of anxiety or anxiety symptoms.

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