Anxiety is a common, normal, and sometimes useful response that may improve performance for those facing life's challenges and dangers. But in some people, anxiety spins out of control. Anxiety disorders are characterized by either recurrent or persistent psychological and physical symptoms-such as intense fear, worry, dizziness, and palpitations-that interfere with normal functioning, continue in the absence of obvious external stresses, or are excessive responses to these stresses. Anxiety disorders may result from hyperactivity in certain areas of the brain or decreased activity of a neurotransmitter (a chemical messenger) called gamma-aminobutyric acid (GABA), which suppresses the action of neurons. Luckily, effective treatments are available, including psychotherapy, medication, and coping behaviors.
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The cardinal features of panic disorder are short-lived, sudden attacks of terror and fear of losing control. Attacks begin without warning during non-threatening activities. Affected individuals often go to the emergency room or consult a cardiologist because their physical symptoms-severe difficulty in breathing; a pounding, rapid heart rate; and a choking sensation-may appear to be a heart attack. (Patients who suspect that they are having a heart attack should see a doctor immediately.) Panic attacks generally peak within 10 minutes and dissipate within 20 to 30 minutes. They are characterized by some combination of the following symptoms:
Symptoms of depression and anxiety are frequent in persons with panic disorder and in members of their family. Although both panic attacks and symptoms of depression or anxiety may respond to antidepressant medications for some patients, others may require separate medications for the panic disorder and for the depression and anxiety. The prevalence of panic disorder is 1 to 2 percent in both men and women. Attacks commonly begin in the late teens or early 20s and often go undiagnosed and untreated.
The most common complication of panic disorder is agoraphobia-fear of being in public places, especially when alone-which develops as a result of trying to avoid situations that have triggered panic attacks in the past. Left untreated, panic attacks and agoraphobia can markedly restrict an individual's lifestyle. Panic disorder is also associated with an increased frequency of major depression, alcohol and drug dependency, and suicide.
GAD affects 2 to 3 percent of the population. Although people with GAD know that the intensity, duration, or frequency of their anxiety and worry are well out of proportion to the actual likelihood or impact of the feared event, they still have difficulty controlling their emotions. Perpetual anxiety may impair concentration, memory, and decision-making ability; decrease attention span; and lead to a loss of confidence. Normal activities, such as working, socializing with friends, or maintaining intimate relationships, may become difficult or impossible.
GAD may also produce a range of physical symptoms, including heart palpitations, sweating, headaches, and nausea. Some GAD sufferers, not realizing that GAD is a treatable illness, become accustomed to their condition and assume that it is normal to feel on edge all the time. But the constant anxiety can also lead to alcohol or drug abuse.
OCD is marked by recurrent, repetitive thoughts (obsessions), behaviors (compulsions), or both that a person recognizes as unreasonable, unnecessary, or foolish yet are intrusive and cannot be resisted. People with OCD do not necessarily have both obsessions and compulsions, but either one often interferes with day-to-day activities and relationships with others.