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Anxiety is an emotional state commonly caused by the perception of real or potential danger that threatens the security of the individual. Everyone experiences a certain amount of nervousness and apprehension when faced with a stressful situation. Usually, the response is reasonable and adaptive, and contains a built-in control mechanism to return to a normal physiologic state.(1) It is when anxiety states become excessive or prolonged, particularly if it produces such psychological and physical stress that the patient cannot perform the activities of daily living, that medical help should be sought.
Anxiety disorders are among the most frequent mental disorders encountered in clinical practice. Approximately 8% of the population will experience at least one anxiety disorder in their lifetime.(2)Unfortunately, the majority of patients with anxiety disorders receive no professional treatment.(3) In general, anxiety disorders are a heterogeneous group of illnesses that develop before age 30 and are more common in women and those with a family history of anxiety and depression. Patients often develop another anxiety disorder, major depression, or substance abuse.(4, 5)
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) classifies anxiety disorders into several categories. The characteristics of these illnesses are anxiety and avoidance behavior and include: generalized anxiety disorder, panic disorder (with or without agoraphobia), agoraphobia without history of panic disorder, phobic disorders (social phobia or specific phobia), obsessive-compulsive disorder, post-traumatic stress disorder, and acute stress disorder.(6)
Research studies have shown that the difference between normal anxiety and pathologic anxiety states involves multiple brain structures and neurotransmitter systems including norepinephrine, gamma aminobutyric acid (GABA), and serotonin (5-HT).Current pharmacologic therapy centers around drugs which alter activity of one or more neurotransmitters, or act at the neurochemical receptor site.
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