Epidemiology

Anxiety disorders are the most common psychiatric illness in the world. One in four Americans suffer from at least one anxiety disorder. Medical research shows the rate of occurrence is slightly higher in women (30%) than it is in men (20%).

anxiety

Symptoms

The core symptoms of anxiety disorders are nervousness, worry and fear persistent enough to cause some level of functional impairment. Anxiety produces feelings of shame and confusion that distort perception, which can interfere with learning by lowering concentration and reducing recall.

Specific symptoms vary depending on the type of anxiety disorder. Generalized Anxiety Disorder (GAD) is characterized by restlessness or edginess, becoming easily fatigued, difficulty concentrating, irritability and sleep disturbance. Physical symptoms include sweating, rapid heartbeat, dry mouth, frequent urination, lightheadedness and an upset stomach.

Panic Disorder is when similar symptoms culminate in a panic attack. Individuals may be engaged in a routine activity and taken completely by surprise. All of a sudden they will have difficulty breathing, feel lightheaded or dizzy, and start to sweat, tremble and shake. A common initial reaction is to believe they are experiencing a heart attack. Panic attacks usually last about ten minutes.

Posttraumatic Stress Disorder (PTSD) causes recurrent, intrusive and distressing flashbacks or dreams of a particular traumatic event. A person with PTSD can feel vulnerable, helpless, depressed or emotionally numb. Episodes will trigger both psychological distress and physical symptoms (e.g. sweating and rapid heartbeat).

Phobias are the most common anxiety disorder and include agoraphobia, social phobia and specific phobia. Agoraphobia is the fear of being separated from home and family; many psychiatrists believe it is the same illness as panic disorder. Social phobia is the fear of being judged or embarrassed when with others. Nerves before giving a speech for strangers are normal; nerves before a small social gathering with friends may be indicative of the disorder. Specific phobias are the fear of animals, objects, places or situations (e.g. constricted spaces or heights).

The Neurobiology of Anxiety

Studies show there is at least some genetic component to the development of anxiety disorders. Almost half of patients with panic disorder have at least one affected relative. The figures for other anxiety disorders are slightly lower but still significant.

The three major neurotransmitters associated with anxiety are norepinephrine, serotonin and GABA. The general theory regarding norepinephrine is that patients with an anxiety disorder often have a poorly regulated noradrenergic system, the cell bodies of which are primarily localized in the area of the brain stem that controls alertness (locus coeruleus). Serotonin and GABA are identified because medications altering their levels have been routinely successful in the treatment of anxiety disorders.

The Diagnosis

The Center offers in-house genetic and neurocognitive testing to determine the extent of the above biological influences. If the results show the brain and body are fertile for the anxiety disorder the symptoms are indicative of, Dr. Ahmad will make a diagnosis and the treatment process will progress from there.

The Plan

While specific medications and therapies are prescribed depending on the type of anxiety disorder, most treatment plans include a combination of psychopharmacology and psychotherapy (particularly behavior therapy). These options are all available at the Center for Integrative Wellness and will be tailored to your personal needs and preferences as a patient.

Further Reading

The following links may be helpful in addressing some of your concerns about anxiety disorder. As always, Dr. Ahmad is available to clarify any questions that you may have.