anxiety a negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future feelings that one cannot predict or control upcoming events can be a subjective sense of unease a set of behaviors or a physiological response originating in the brain and reflected in elevated heart rate muscle tension we perform better when we are a little anxious social physical intellectual performances are driven and enhanced by anxiety when does anxiety become abnormal when it impairs functioning causes clinically significant distress and or leads to avoidance fear an immediate and intense emotional alarm reaction to danger accompanied by a surge of energy in the autonomic nervous system that motivates us to flee from danger panic attack an abrupt experience of intense fear or acute discomfort accompanied by at least 4 physical symptoms that can include heart palpitations chest pain shortness of breath dizziness derealization feeling like your surroundings aren t real and depersonalization feeling like you are getting detached from yourself 2 types of panic attacks 1 expected cued panic attacks in response to specific situations like going in an elevator associated w specific phobias or social phobia 2 unexpected uncued panic attacks at a random time when there is nothing to be afraid of associated w panic disorder fear and anxiety reactions differ psychologically and physiologically we inherit a tendency to be tense uptight anxious tendency to panic runs in families the corticotropin releasing factor CRF system is central to the expression of anxiety area of the brain most often associated w anxiety is the limbic system the behavioral inhibition system BIS within the limbic system is related to anxiety when it is activated we freeze experience anxiety apprehensively evaluate the situation to confirm that danger is present the BIS is different from the circuit involved in panic this panic circuit is called the fight flight system FFS factors in the environment can change the sensitivity of these circuits making you more or less susceptible to developing anxiety its disorders ex smoking as a teen increases your chances of developing anxiety disorders as an adult in people w anxiety disorders the limbic system is overly responsive to stimulation and controlling functions of the cortex that would regulate the hyperexcitable amygdala are deficient amygdala overly active a sense of control or lack of control in childhood is the psychological factor that makes us more or less vulnerable to anxiety later in life our emotional response due to fear becomes associated w a variety of internal external cues and later on these cues provoke the fear response and an assumption of danger even if the danger is not actually present the triple vulnerability theory says that there are 3 vulnerabilities that contribute to the development of anxiety disorders 1 biological vulnerability inherited tendency to be uptight or high strung 2 generalized psychological vulnerability grow up believing that the world is dangerous uncontrollable and you might not be able to cope when things go wrong based on your early experiences 3 specific psychological vulnerability learning from your parents that some situations or objects are dangerous even if they aren t there is a high rate of comorbidity among anxiety and related disorders and depression most common additional diagnosis for all anxiety disorders is major depression anxiety disorders also often co occur w physical disorders like arthritis the anxiety disorder usually precedes the physical disorder having any anxiety or related disorder increases the chances of having suicidal thoughts esp if you have panic disorder or PTSD Anxiety Disorders generalized anxiety disorder GAD excessive anxiety worry apprehensive expectation about everything even very minor things can t control the worry turn it off have to have 3 or more 1 or more for children physical symptoms for at least 6 months including restlessness on edge easy fatigue difficulty concentrating or mind going blank irritability muscle tension sleep disturbance most ppl w GAD seek help from their primary care doctor rather than from an anxiety clinic more females than males are affected 2 3 but as ppl get older the divide isn t as pronounced 1 of adolescents 3 of adults anxiety worry runs in families as opposed to one specific anxiety disorder being passed down GAD has early origins but a later and more gradual onset than most anxiety disorders it is chronic meaning it usually doesn t go away but rather waxes wanes more severe symptoms in young adults the elderly are largely affected by GAD but it is often dismissed in older people ppl w GAD have less responsiveness on physiological measures than ppl w other anxiety disorders which is why they are called autonomic restrictors this is b c they expend so much energy thinking about upcoming problems that they don t have the attentional capacity to create images of the potential threat which would elicit a physiological response not processing emotional component of thoughts images they restrict their thinking to thoughts but don t process negative affect models of GAD avoidance model avoiding more painful anxiety or more negative emotions by worrying about more superficial things ineffective way to problem solve intolerance of uncertainty someone w GAD has a difficult time not having a plan they experience chronic worry in reaction to potential uncertainty they believe that worrying about trivial things will give them control over the future therapy helps ppl tolerate uncertainty emotion disregulation ppl w GAD have difficulty regulating their emotions poor understanding of their emotions as a result they experience worry more intensely than other ppl all 4 models emphasize avoiding internal experiences avoiding larger worries cognitive avoidance emotional avoidance avoiding uncertainty therapy focuses on exposure to ppl s larger underlying worries emotions ppl w GAD are highly sensitive to threat esp personal threat typical course of action of GAD generalized psychological vulnerability generalized biological vulnerability stress due to life events worry process intense cognitive processing inadequate problem solving skills avoidance of imagery restricted autonomic reponse GAD GAD is difficult to treat not as concrete in terms of symptom reduction no one treatment that always works for majority of people benzodiazepines are often