Is it anxiety or something else?

What should we be looking for when we think we may be feelinganxious or under stress? How many of you remember feeling nervousbefore a test in school? How often did you get that sick sensationas the door opened to your job interview? what happens when youfeel you might have “lost it” under what seemed to be normalcircumstances? How do we distinguish generalized anxiety from otherdisorders such as panic attacks, social anxiety disorder orpost-traumatic stress disorder? Let’s take a quick look at thedifferences.

Anxiety, as Dr. Sigmund Freud, might have viewed it in Austria morethan 100 years ago, included clinical presentations of generalirritability, anxiety attacks, apprehension/anxious expectationsand sometimes phobic avoidance.

General anxiety, today, is described frequently as excessive worry,irritability, restlessness, inability to relax, nervousness,expecting bad things to happen or perceiving bad things are aboutto happen, and the physical manifestation of agitation. Sometimesthese symptoms can lead to feelings of dizziness, free floating,increased perspiration, increased sensitivity to pain, higherstress levels and avoidance type behaviors.

Anxiety is a set of symptoms that can often form a condition, leadto the development of mood disorders such as depression or isconcurrent with other medical conditions. Anxiety was initiallythought of as learned. However, research illustrates that it’s moreoften inherited.

The following are guidelines from the “Diagnostic and StatisticalManual of Mental Disorders-IV-TR” to help you make the distinctionbetween a few of the more recognized types of anxiety conditions,as well as to help you navigate the medical landscape:

• Generalized anxiety is excessive anxiety and worry. the personfinds it difficult to control their worry. This type of anxiety canbe associated with restlessness or feeling keyed up or on edge,being easily fatigued, difficulty concentrating or your mind goingblank and irritability.

• Panic attacks are a discrete period of intense fear ordiscomfort. Symptoms might include palpitations, pounding heart,sweating, trembling or shaking, sensations of shortness of breath,feelings of choking, chest pain, nausea or abdominal stress,feeling dizzy, unsteady, lightheaded, feelings of unreality, fearof losing control or going crazy, fear of dying, numbness ortingling sensations, and chills or hot flashes.

• Social anxiety disorder is avoidance and fear of one or moresocial or performance situations, generally in a publicsetting.

• Post-traumatic stress disorder is a more distant event that is aresult of a person witnessing or experiencing an imminent threat ofdeath or serious injury of self and others. the response of theperson at that moment involved intense fear, helplessness orhorror. as a result, the traumatic occurrence is persistentlyre-experienced.

If you have any or all of the above symptoms and feel you are in aphysical emergency situation, it is better to rule out a physicalcrisis and head to the emergency room. If it isn’t a medicalemergency, check with your mental health care provider to find outmore about treating your specific anxiety symptoms.

For example, most of us remember having experienced those butterflyfeelings as a child before performing in a school play. there is noshame in seeking help for a better quality of life for thosepersistent butterflies.

Phillip Holman is the medical director of psychiatricservices at Community Physician Group at Community MedicalCenter.