According to the World Health Organization (WHO), 1 in 13 globally suffers from anxiety. The WHO reports that anxiety disorders are the most common mental disorders worldwide with specific phobia, major depressive disorder and social phobia being the most common anxiety disorders.
Anxiety is a mental illness that can impact an individuals daily life. It is the most common mental illness in the U.S, affecting 40 million adults in the United States age 18 and older, or 18% of the population. Approximately 8% of children and teenagers experience an anxiety disorder with most people developing symptoms before age 21. About 12% of people are affected by an anxiety disorder in a given year and between 5-30% are affected at some point in their life. Anxiety disorders occurs about twice as often in women than they do in men, and generally begin before the age of 25. The most common are specific phobia which affects nearly 12% and social anxiety disorder which affects 10% at some point in their life. They affect those between the ages of 15 and 35 the most and become less common after the age of 55. Rates appear to be higher in the United States and Europe. Only about one-third of those suffering from an anxiety disorder receive treatment, even though the disorders are highly treatable.
How to define anxiety? Anxiety is an overwhelming long term subjective unpleasant emotion, often accompanied by nervous behavior and symptoms of worries, phobias, physical symptoms such as muscular tension, restlessness, fatigue, etc. Anxiety however is not the same as fear, which is a our immediate response to a real life danger and threats, whereas anxiety is the expectation of future threat. Sometimes due to long term exposure to life threatening events, anxiety can be appropriate reactions, but when experienced regularly the individual may suffer from an anxiety disorders.
Acute anxiety refers to sporadic, stressful panic attacks which dramatically influence our life’s. Chronic anxiety on the other hand refers to general - long, drawn out daily symptoms that reduce quality of life of individuals. It is important to note the risk of anxiety has a tendency to transform to depression and possibly even lead to a suicide.
Anxiety causes an individual to be fearful, worried, or stressed about daily activities that we may feel are normal. For me anxiety is an interesting topic. In my 10+ years clinical practice, majority of my patients were diagnosed with anxiety disorders. The diagnosis and treatment of anxiety disorders has changed rapidly in the past century. Modern medicine has produced diagnostic criteria, pharmaceuticals, and different therapies, increasing public awareness of these conditions.
Researchers are finding that genetic and environmental factors, frequently in interaction with one another, are risk factors for anxiety disorders. The heritability of anxiety is still a toss up, but research of this illness has stated that roughly one-third of the underlying causes of social anxiety come from your genetics. Also ecological approach can have an impact on anxiety. Factors like culture, humans, and political ecology can play an important role for anxiety. Having an anthropological approach of anxiety will help increase our understanding of this illness and help the improvement of an individual with anxiety. Knowing that anxiety can be passed through genetics could help the ongoing research of how to help patients born with anxiety.
The ethno medical approach as cultural aspect of anxiety deals with perceived and treated differences in many cultures. In western culture, anxiety can be treated through psychoanalysis or antidepressants. Anxiety is not perceived as a weakness, but as an illness. In eastern Asian cultures in contrary, it is a sign of weakness. Physical symptoms of different mental illnesses such as anxiety in most Asian cultures tend to be explained as manifestations of spiritual or moral weakness. That is why many Asian healthcare systems doesn't treat anxiety as a mental illness, but as a physical disorder.
Psycho-Dynamic perspective of anxiety is experienced when a person feels himself in impending danger. This is a viewpoint shared by most theoretical persuasions but there is a particular vantage point which owes most to the psycho-analytical tradition established by Freud.
An evolutionary psychology explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats.
Variations of anxiety disorders burden humans for thousands of years, but actual classification of anxiety conditions as mental illnesses is confined to the last century. Development and use of antidepressant and anti-anxiety drugs to treat these anxiety are even more recent. We searched for pharmaceutical remedies, hoping for the ‘magic bullet’— the penicillin for depression or anxiety. The accepted treatment for this conditions was the institutionalization of the patient in one of the oppressive and isolating asylums that had dominated mental healthcare in America and Europe for centuries.
As a global leader in healthcare, the United States in early years after World War II utilized scientific method and advances in technology to find specific diseases, and equally specific treatments for them. The first volume of the Diagnostic and Statistical Manual for Mental Diseases was published in 1952, the same year the first antipsychotic was developed, and contained 106 disorders. With each subsequent update, new research findings resulted in the addition and subtraction of various conditions and potential treatments. Though psychotherapy, electroshock therapy, and even neurosurgery were treatment options, the pharmaceutical remedies seemed to hold the most potential.
The cost of keeping institutions for the mentally ill operational was extremely taxing to the United States’ budget, and Congress began investing in the development of psychiatric pharmaceuticals in the late 1950’s. Very soon it was invested generously in pharmaceutical drugs to “cure” anxiety and depressive disorders. We can't ignore the influence of American capitalism in medical field. The market economy relies on efficiency and cost reduction for increased profits that can be reinvested into future growth.
The World Health Organization, Center for Disease Control, and American media outlets have been more vocal about the prevalence and signs of these disorders, and more recently, advertisements for psychotropic drugs have appeared on TV’s which in turn has questionable outcome. Unlike alternative treatments, which cannot be advertised as distinct products in sixty-second sound bytes, pills can be marketed towards consumers in between segments of their favorite programs. Ads for antidepressants and anti-anxiety medications are also a source of information for the public and have been shown to affect perceptions of prevalence, lifetime risk, and treatment choice in both mentally ill and healthy members of the American population.
There is no surgery for anxiety but many people are prescribed with antidepressants to treat anxiety. Antidepressants do not always work. It takes sometimes up to a year for antidepressants to take effect. In short-term studies, the medicines increased the risk of suicidal tendencies in some children and young adults with depression or psychiatric disorders. The critical approach for anxiety and the use of antidepressants is not really relied on and should be heavily consolidated with the patients healthcare professional. There are many alternative treatments that rely on patient to professional interactions.
Nowadays we have many researchers and practitioners to assess the current methods of diagnosis and treatment, and argues that the employment of a more personal, investigative diagnostic and treatment process, would result in a dramatic increase in the effectiveness and adherence to treatment plans. The present reality for mental health patients worldwide and in the United States, is a limited scope of treatment options, often with expensive price tags and serious side effects.
Our busy lifestyles limit the opportunity for alternative treatments that are more longitudinal, and thus time-consuming, such as psychotherapy, exercise, or even hobbies and pastimes that provide respite and distraction from the daily stress of careers, family, and relationships. The healthcare system is, of course, a cultural product, based on the American ideals of efficiency, independence, and cost-effectiveness. The economic system of contemporary American capitalism was directly responsible for the initial investment in psychopharmacological research. The evidence of the further involvement of the American government in the testing and marketing of anxiety and depressive medications is reflected in analysis on advertisements and their role in the perceptions the population has towards the symptoms, etiology, and treatment of affective disorders.
Scientists now understand anxiety disorders to be developmental disorders that begin in childhood. They also are often gateway illnesses: depression, substance abuse and even suicidal behavior often begin as out-of-control anxiety. Anxiety disorders can also interfere with normal development, sabotaging the acquisition of social skills and achievement in school and in the workplace.
Anxiety risk factors include a history of child abuse, family history of mental disorders, and poverty. Anxiety disorders often occur with other mental disorders, particularly major depressive disorder, personality disorder, and substance use disorder. To be diagnosed symptoms typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning. Without treatment, anxiety disorders tend to remain. Treatment may include lifestyle changes, counselling, and medications. Besides medications, counselling has been proved to be effective and with more than plausible effects. Typically counseling type is cognitive behavioral therapy.
The pervasiveness of anxiety disorders and their resistance to treatment suggest a need for a deeper understanding of the sources of anxiety. We argue that to make some progress understanding clinical anxiety disorders, we need to start by obtaining a better understanding of the normal anxiety response: What is it for, and why does it have the features that it does? As evolution by natural selection is the source of all complex physiological—including neural—organization in nature, this necessarily means taking an evolutionary perspective.