Everybody experiences stressful situations that can cause uncertainty, tension, fears, or worry. However, not everyone acquires symptoms and signs of anxiety disorders. They relate to specific mental illnesses that may considerably compromise human life and transform a person into a social outcast unless preventive actions are taken. Such mental and behavioral abnormalities can deteriorate the psychological health status of a person and complicate social communication and interaction. Currently, this medical condition has become a mental health concern in American society considering that nowadays approximately 18% of the Americans suffer from anxiety disorders. They may affect people predisposed to such conditions due to certain biological, genetic, or other factors. The wide range of anxiety disorders illustrates a variety of mental blocks that trigger mental malfunction. The combination of psychotherapy and medication is the most efficient and appropriate in managing anxiety disorders. Psychotherapy can provide a solution to a psychological problem, whereas medication assists in decreasing symptoms of an anxiety disorder. Both modalities are helpful in preventing disorders from becoming chronic and life-threatening. Different health care organizations and medical facilities contribute to the identification and management of anxiety disorders as well as promoting further research and clinical trials.
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Anxiety disorders became one of “the most common health concerns in the USA” (National Alliance on Mental Illness, 2016). However, the issue attracts attention of various psychologists and medical scientists worldwide. Earlier anxiety disorders were not scrutinized because nobody considered them seriously. Eventually, psychiatrists and practitioners noticed that the presence of long-lasting excessive anxiety and fear lead to the deterioration of mental as well as physical health. Unawareness of anxiety disorders caused further research and study on the issue. Nowadays, everyone may receive sufficient information regarding anxiety disorders, their symptoms and signs, and the methods of disorder management, which is crucial for early diagnosis of mental instability. This paper provides a broad overview of various anxiety disorders, emphasizing their causes and clinical manifestation, the available therapeutic modalities, and possible consequences of non-treatment.
Anxiety disorders are characterized by “fear, consisted of escape behaviors, psychological arousal, and thoughts of imminent threat” as well as “anxiety manifested in avoidant behaviors, tension, and thoughts about potential threats” and belong to the most common psychiatric conditions (Graske et Al., 2009). They are identified by excessive discomfort and unease caused by psycho-emotional overstrains. Considering that anxiety disorders frequently share the features of anxiety and fear, they are united in one group of mental illnesses. The physiological aspect of anxiety disorders lies in the impaired modulation inside the central nervous system and misbalance of certain neurotransmitters inside the brain. The indicated states can strike any individual physically and mentally and may transform into anxiety-caused disorders of any kind. Anxiety disorders commonly interfere with daily activities such as the fulfillment of employment duties, school work, family obligations and others. Such mental impairments are generally associated with intensity, fears and overwhelming distress that prevent a person from leading a normal life. Nowadays, the statistics report approximately 40 million of adult population suffering anxiety disorders, which is why it is becoming a significant issue for overall public health care. Anxiety disorders, such as dysregulation, heavily impact socialization and communication of AD-affected people and thwart establishment of social contacts. All mental and behavioral impairments caused by anxiety, stress and fear reveal similar symptoms and signs that impede normal social functioning and affect the personality totally destructively.
The conducted observations and most family histories were helpful in identifying genetic and environmental causes of anxiety disorders. The more family members experience any type of anxiety disorders, the higher are perspectives of acquiring similar mental dysfunctions for future generations. Repetitive stress loads or traumatic events such as violence, sexual harassment, death of the closest people, protracted or terminal diseases relate to environmental or external causes of mental instability and, consequently, lead to the development of the scrutinized disorders. Scientists assume that “many factors combined cause anxiety disorders” (National Alliance on Mental Illness, 2016). However, primarily, environmental and genetic factors may trigger anxiety-based disorders. It is important to note that females, young people, the elderly and people with incurable or long-lasting illnesses are more susceptible to anxiety disorders. Thus, “interaction of biopsychosocial factors interacting with situations, stress or trauma” contributes to a significant set of symptoms (Bhatt & Bienenfeld, 2016).
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General Clinical Manifestations of the Anxiety Disorders
Clinical manifestations of anxiety disorders vary depending on the specific type. However, the presence of insistent, overwhelming fear and anxiety in unthreatening life situations is a common feature for all types of anxiety disorders. Anxiety-affected people may experience breathlessness or rapid heartbeat, excessive sweating, tremors, indigestion, and insomnia. Repetitive headaches, a feeling of exhaustion, defecation urgency and frequent calls for urination may accompany the described mental illnesses. Considering that anxiety disorders relate to psychiatric disturbances, they manifest in muscle tension, excitement, irritability, vigilance, prediction of the worst and apprehension. Anxiety disorders are associated with thoughts of immediate danger, avoidance and escape behavior patterns. Therefore, such mental instability entails a wide range of physical and mental impairments. For anxiety disorders, physical abnormality is a consequence, whereas excessive mental disturbance is a trigger. The distinctive clinical manifestations serve as primary criteria for classification of the studied dysfunctions into various subcategories. According to the latest edition of Diagnostic and Statistical Manual of Mental Disorders, generalized anxiety disorder, social anxiety disorder or social phobia, separation anxiety disorder, panic disorder, selective mutism, specific phobia and agoraphobia create the group of anxiety disorders (Bhatt & Bienenfeld, 2016). It also involves medication induced anxiety disorder as well as anxiety disorder due to another medical condition. However, the indicated manual differentiates obsessive-compulsory, acute stress disorder and posttraumatic stress disorder from the list of the earlier-defined anxiety-based irregularities though they are considered as closely-related ones.
The Classification of Anxiety Disorders
The classification of anxiety disorders demonstrates various types of the prevailing mental illness, which are differentiated due to the available clinical manifestations, their severity and duration. Generalized anxiety disorder (GAD) refers to the most common anxiety disorder that affects from 3 to 5 percent of American citizens (Bushak, 2016). It is manifested in chronic and excessive fear about everyday life and may continue for a considerably long time. The indicated kind of mental disturbance frequently remains active even without the actual stressors. It causes considerable deterioration of memory, poor concentration and prevents from completing routine tasks. Generalized anxiety disorder is manifested in fatigue, debilitation, muscle tension, sleep loss and restlessness. The symptoms of GAD are distressful and affect normal living and functioning.
Separation anxiety disorder commonly occurs in children who experience exaggerated anxiety and misery due to parents’ divorce or separation from other significant family members. Thus, marital separation or divorce can trigger the indicated anxiety disorder. People affected by separation anxiety disorder undergo extreme distress, considerable worry about any potential harm that can be inflicted to close people. It is manifested in persistent and excessive fear or unwillingness to be alone or without any close surroundings. It is also associated with groundless unrest and fear of being lost and kidnapped, reluctant school attendance, and repeated complaints about physical health problems, such as headache, sickliness, vomiting, and stomachache. Social anxiety disorder is sometimes called social phobia and is characterized by “an intense fear of becoming extremely anxious and possibly humiliated in social situations” (Bressert, 2016). The evident fear to experience embarrassment, judgement, rejection or a frightful fear to offend somebody is specific to social phobia. People with social anxiety disorder are scared of receiving negative responses or judgments from the society. “A significant and persistent fear of social or performance situations” involving public exposure to unfamiliar people is associated with social anxiety disorder (Bressert, 2016). People with social phobia feel extreme discomfort related to any possible humiliation or embarrassment and have difficulties in making friends or any contacts. They are likely to avoid any social or performance situations. In case such situations occur, they proceed with overwhelming distress or worry. The development of such mental abnormality can lead to further isolation and turn a person into a social outcast. “The avoidance, anxious anticipation, or distress” caused by social phobia significantly interfere with the person’s normal lifestyle, occupational functioning, career, social activities or any other relationships (Bressert, 2016). Staying among people can cause blushing, trembling, or sweating in a person with social phobia.
Panic disorders are particularly associated with recurrent sudden attacks of anxiety and terror that “typically develop in late adolescence or early adulthood” (Ulifeline Project 2016). Such panic attacks are inherent in almost all anxiety disorders. However, severity, unexpectedness, and recurrent cases of the described attacks made the researchers distinguish them into a separate kind of anxiety disorders. Combination of certain intensive emotional and physical symptoms may result in panic attacks, and consequently in panic disorder. The indicated condition generally demonstrates intense fear or discomfort accompanied by a wide range of physical impairments. Clinical manifestations of panic attacks include shortness of breath, rapid heartbeat, pain in the chest, sweating, trembling, dizziness, and numbness. People affected by panic disorders “worry about having subsequent attacks” or are afraid “of losing one’s mind” (Katon, 2006). They may have a choking feeling, nausea, disorientation and hot flashes. Some of the described symptoms and signs are more peculiar to women and others are specific to men. Such attacks occur either spontaneously or in response to a certain situation. Recall or recurrence of events or circumstances that accompanied a previous attack may provoke a subsequent panic attack (University of Maryland Medical Center, 2016).
Specific phobias also belong to anxiety disorders that are characterized by extreme irrational, unreasonable fear of specific objects or situations (University of Maryland Medical Center, 2016). Such psychological abnormalities are rather common. The majority of cases proceed mildly without causing severe afflictions. They are mostly short-term and proceed till the object of threat and thus a threatening situation intimidate. The most common specific phobias are the fear of animals, flying, heights, water, injections, confined spaces, public transportation, dentists, storms, bridges and tunnels (University of Maryland Medical Center, 2016). Phobic people as well as people affected by analogous anxiety disorders experience physical irregularities such as panicky feelings, heart palpitations, sweating, dizziness, and rough breathing. Avoidance behavior is typical of specific phobias. The most phobic people realize their behavioral abnormality but tolerate it rather than disclose the described condition.
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The latest edition of Diagnostic and Statistical Manual of Mental Disorders alternatively specifies agoraphobia as a separate kind of mental disorders. Tremendous fear of being in public places or open spaces, which can turn into “paralyzing terror” with apparent “neither escape nor accessible help,” precisely characterizes agoraphobia (University of Maryland Medical Center, 2016). Although agoraphobia is successfully treatable, the affected patients prefer to complicate their lifestyle rather than confront locations or situations they are afraid of. It resembles specific phobias when patients are afraid to face their own fears. This condition can be a “result of repeated, unexpected panic attacks, which can be connected with “cognitive distortions, conditioned responses, and abnormalities in noradrenergic, serotonergic, or GABA-related neurotransmission” (Bhatt & Bienenfeld, 2016).
Selective mutism is a complex “childhood anxiety disorder” characterized by “a tremendous amount of fear about speaking in certain situations” (Lunceford, 2016). Alternatively, it occurs in school settings or after a child starts attending school. Selective mutism can manifest itself in consistent communicative failures observed at schools despite preserved abilities to speak in other places or social environment (The American Speech-Language-Hearing Association, 2016). It is associated with ignorance of communication caused by unknown factors. Children affected by selective mutism do not demonstrate educational deficiency or lack of comfort as well as no communication disorder triggers the scrutinized mental impairment. It is a fact of great concern “that selective mutism (SM) is frequently misdiagnosed as autism or Asperger’s disorder” (Lunceford, 2016). Thus, selective mutism requires further observation and comprehensive research. It is crucial to diagnose the indicated disorder at the onset considering since non-speaking can hinder normal socialization of a person and affect his or her educational level.
Substance/medication-induced anxiety disorder is characterized by spontaneous “severe anxiety or panic” triggered “by alcohol, drugs, or medication” usage (Hartney, 2016). Alcohol or drug-caused intoxication or withdrawal from them may develop panicky or paranoiac feelings that are present in substance-medication anxiety disorder. As a matter of fact, some drugs used for certain disease treatment may have adverse effect, including the development of the outlined anxiety disorder.
Anxiety disorder due to another medical condition involves symptoms and signs that are common for other studied mental illnesses, but intense, overwhelming anxiety and panic due to concrete health problem prevail. The indicated disorder can have variable manifestations, demonstrating features of panic disorder, generalized disorder or closely-related obsessive-compulsive symptoms.
Treatment of Anxiety Disorders
Psychotherapy, medication or combination of both psychotherapy and medication relate to specific therapies for management of anxiety disorder. Psychotherapy is the most efficient treatment modality that enables to identify and consequently rectify mental impairments caused by previously undetected inner anxieties and fears. Psychotherapists actively practice cognitive behavioral therapy (CBT), engage patients in self-help and supportive groups, and apply stress-management techniques. Cognitive behavioral therapy assumes availability of “cognitive and exposure therapies” (The National Institute of Mental Health, 2016). Cognitive therapy helps to recognize, challenge and neutralize destructive thoughts that are rooted in anxiety dysfunctions. Exposure therapy largely “focuses on confronting the fears” that cause the scrutinized anxiety disorders (The National Institute of Mental Health, 2016). Such tactic is beneficial for involving affected people in prior avoidant activities. Cognitive behavioral therapy can be conducted in groups or individually and is considered the most effective for managing social phobia. People with anxiety disorders can benefit from participating in self-help or supportive groups that are designed for “sharing one’s problems and achievements” (The National Institute of Mental Health, 2016). Anxiety disorders treatment frequently involves stress-management techniques that are mostly effective in combination with psychotherapy. Another mode of anxiety dysregulations management assumes medication that is considerably helpful as the initial treatment to receive an adequate response from a patient. The most common medications designed for “combating anxiety disorders are antidepressants, anti-anxiety drugs and beta-blockers” (The National Institute of Mental Health, 2016). Administration of these drugs is considerably helpful in relieving or reducing symptoms of the discussed disorders and consequently can improve patients’ physical and emotional health condition. However, they cannot provide full recovery. Selective mutism Anti-anxiety drugs reduce the “symptoms of anxiety, panic attacks, or extreme fear or worry,” whereas beta-blockers successfully decrease physical impairments caused by anxiety disorders (The National Institute of Mental Health, 2016). The disadvantage of medication is its limited effect, in other words, drugs are helpful as long as they are taken; otherwise the symptoms may recur. Thus, medication along with psychotherapy can be significantly efficient in achieving remission or preventing relapse of anxiety disorders. Moreover, all indicated therapies reduce destructive symptoms of anxiety disorders, readjust and improve cognitive and communicative abilities as well as social behavior of the affected people.
Possible Mental and Physical Complications of Anxiety Disorders
Disregard of symptoms of anxiety disorders and their treatment can lead to deterioration of mental and physical health condition. People with anxiety disorders might acquire serious complications, which are alternatively caused by depression, bipolar disorder, substance abuse, obesity or anorexia. There is a high possibility of suicides if the symptoms of anxiety disorders intensify and remain untreated. Furthermore, the medical condition of a person greatly affects the quality of life in all aspects: occupational and educational levels as well as socialization and the establishment of any kind of relationship. Anxiety disorders also deteriorate physical health and can provoke serious illnesses.
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The Contribution of Various Supportive Organizations
Various social supportive medical centers, educational settings and other non-profit organizations, such as Mayo Clinic, the Cleveland Clinic, the National Institute of Mental Health, the National Alliance on Mental Illness address the issue of anxiety disorders with due diligence, considering it an issue of mental health of the society. They pursue the aim of educating and improving the life of anxiety-affected people. Furthermore, they conduct different trials, study causative factors and promote further research on efficiency of the existing treatment modalities.
In conclusion, all types of anxiety disorders relate to psychiatric illnesses that prevent people from normal existence and functioning in the society. Practically all types of anxiety disorders are specified by tremendous fear and unreasonable irrational anxiety. Various psychological, genetic, and environmental factors can trigger the aforesaid medical conditions. The described mental dysfunctions manifest in variable physical and mental impairments, such as persistent overwhelming worry, lack of concentration, paranoid feelings, panic attacks that are accompanied by breathlessness, heart palpitations, headaches, muscle tension, sweating and trembling. Anxiety-affected behavior patterns significantly decline social interaction and interfere with daily functioning. Various modes of psychotherapeutic approach and medication can effectively manage the described mental disorders. However, medication is mostly designed for relieving or reducing the symptoms and signs, whereas cognitive behavioral therapy along with medication shows the best outcomes. All modes of anxiety disorder management can normalize social interaction and improve cognitive as well as communicative skills. Many social organizations and medical facilities provide health communication, inform people about anxiety disorders, and contribute to further comprehensive research on the issue.