Anxiety is often a totally normal sensation. So is fear in many cases. Both sensations, like stress, helps us to stay alert and to fight or flight, in cases where we e.g. are attacked by someone, and to fight for our lives if we are in a threatening situation, if we are seriously injured or sick. A soldier wthout fear would be a bad soldier, one that would not be able to take proper care of him-/herself in a dangerous situation. Courage is controlling ones fears.
The psychologic term anxiety, as in anxiety neurosis, sometimes referred to as nervous fear or phobia, describes a feeling that does not correspond within reasonable limits to the provoking factor. Examples are phobia towards mice, or fear of suddenly being run over by a car, while walking on the side-walk. Nervous fear can be deprived of provoking factors or it can be elicited in specific situations, in closed spaces for example. This is called claustrophobic fear or claustrophobia. We are all alert to a certain degree, and most people are afraid of something.
Symptoms of nervous fear
Nervous fear is accompanied by nerval symptoms, because the sensation of fear is transmitted through the body by the nervous system, both the autonomic nervous system and the conscious somato-sensorial system. This can result in trembling, sweating or gastro-intestinal manifestations like diarrhea (before travelling or finals for example), sleeplessness or a lump in the throat. Many cases of muscle infiltrations or myosis are physical manifestations of an underlying chronic, nervous fear. Nervous fear can also cause damage to our internal organs and cause disease. The result can be backpains or ulcerative colitis. In this case, the disease is referred to as psycho-somatic, because of the projection from the psyche or mental life to the body.
Anxiety may be caused by underlying neurosis, but as mentioned earlier, anxiety is often a totally normal sensation that often follows from traumatic experiences, like a death in the family or severe accidents, where we are reminded of our own mortality. However, there is a certain, often genetic condition that is characterized by appearence of sudden violent attacks of fear, anxiety attacks or nervous fear. These attacks are caused by sudden release of stress hormones that push the whole body into a state of maximum alert, it has violent symptoms and often there is mortal dread. Between attacks there are often long periods without nervous fear. In this case, medical anti-depressive treatment is often called for.
Another type of anxiety attack hits the affected person with a sudden feeling of not being able to breathe. He or she therefore starts breathing more and more rapidly (hyperventilation). This results in changes in blood chemistry (acidity) that affects the concentration of active calcium in the blood stream, which results in increased excitability of the nervous system, with resulting pricking sensation of the lips, hands, and feet and increasing stiffness of the hands and whole body, accompanied by violent fear. These kinds of panic attacks can result in regular convulsive fits. However, the treatment is straight-forward: The hyperventilating person must breathe into a plastic back that firmly covers the nose and mouth, so that he or she can breathe the carbon dioxide in his or her own expirations. This restores the normal acidity of the blood, and the calcium balance, and relaxes the person.
Anxiety is also seen in relation to low blood sugar, typically a few hours after a meal, rich in carbohydrates. The importance of this connection may have been exaggerated in the past, but there are undoubtetly examples of people, who have been labled with a psychiatric diagnosis when the underlying etiology of the panic attacks is low blood sugar.
Certain physical conditions, like increased metabolic rate and cardiospasm are often accompanied by anxiety and fear. Therefore, it is important to arrange for a full physical examination at your doctor in case of a sudden development of a tendency for anxiety attacks. One should bear in mind that an unhealthy or insufficient diet can elicit psychological symptoms. This is the case in food allergy or -intolerance were psychological symptoms are elicited by the consumption of certain food groups or additives. Coffee, alcohol, amfetamine (speed), cocaine, and ecstasy can provoke anxiety and panic attacks. Some are more susceptible than others.
Chronic anxiety disorders
There are many different kinds of chronic anxiety disorders. They can be very stressfull, both to the person, who experiences them and to his or her close relatives. People suffering from chronic anxiety disorders often have compulsive ideas about nobody really caring about them, for example, and will therefore often try to control their sorroundings, and deliberately or subconsciously try to be the center of attention, and thereby be "rewarded" for their way of being. This is called secondary reward. This type of behaviour can also be used as a defence mechanism against unresolveable conflicts, which are often rooted in experiences from childhood. A person may blame himself for his parents divorce, for example. The feelings of guilt may be so pronounced that the person does not allow him- or herself to experience joy, but reacts with migraine or other physical illness to joyfull or rewarding experiences.
There are different kinds of anxiety and compulsive disorders, and the conditions have many different expressions. The patient may perform washing and cleaning rituals, have a mania for turning out the rooms, or have organic symptoms without physical explanation, symptoms of cardiac disease, for example. Another typical expression is phobia, as in e.g. claustrophobia and agoraphobia. Agoraphobia can find expression in fear of being in open spaces. People with phobias will try to avoid the object of their fears, and when this cannot be accomplished, they respond with psychological and physical symptoms which are often difficult for them to handle. This can lead to dependence on alcohol or tranqualizers and abuse and thereby cause more problems and stronger feelings of anxiety.
