Introduction to Anxiety Disorders

Welcome to Module 3,

anxiety disorders. This is Lecture 1, our

introductory lecture. If you recall, we

began Module 2, mood disorders with a discussion

of emotions and the way they fluctuate in

normal predictable ways in our daily lives. In this lecture, we're going to have the same discussion

about anxiety. What anxiety is, as well as how we experience

it in normative, predictable ways in our lives. Then we will finish

up this lecture with an overview of

anxiety disorders. What is anxiety?

Anxiety is defined as a very specific

negative mood state. Anxiety can take many forms, but it is always

characterized by physical sensations and

a feeling of concern, worry, or apprehension

about the future. I'm sure all of us are

familiar with this experience, anxiety is a part of our everyday lives

and emotional worlds. In fact, research has shown that moderate amounts of anxiety

is actually good for us. If you're anxious about an exam, you study harder and

you focus better. If you're anxious about a job

interview or a dinner date, you work harder to make

a good impression. If you experience little or no anxiety in any of

those situations, chances are good

you will not try as hard and you will

not do as well. The research evidence is clear. Moderate levels of anxiety

improve performance. What happens in these

situations, however, if you experience extremely

high levels of anxiety, research tells us that

excessively high anxiety, like excessively low anxiety, leads to poor performance. If you're too anxious

about an exam, you may be unable to settle down and focus on

studying for it. When you take the exam, your heart may race, your mind may go blank

and you may fail it. Similarly, extremely

high anxiety in a job interview or on a dinner date may lead you

to make a poor impression. You may feel physically sick, your mind may go blank. You may be unable to focus on the other person and maintain the flow of

the conversation. As a result, you're

unlikely to be offered the job or to

have another date. Moderate levels of

anxiety are helpful, while very low and very

high anxiety are harmful. Anxiety disorders

are characterized by extremely high

levels of anxiety that show up in particular ways causing very specific

problems for people. We're going to conclude this introductory

lecture with a few words about fear and how fear is

different from anxiety. Fear is defined as our immediate reaction to the presence of danger

in the here and now. If you're hiking

in the mountains and you come around the bend in the trail and you find yourself

face to face with a bear, you will experience fear. The emotional and

physical reaction to the presence of

immediate danger. Your heart rate and blood

pressure will shoot up. You may feel terrified. You may feel an overwhelming

impulse to flee or escape, or possibly to fight. How does fear differ

from anxiety? Remember our original

definition of anxiety. Anxiety involves the future. Fear, on the other hand, is the response to thepresence of a current danger. What happens if a person experiences a strong

fear response? Yet there's nothing in the immediate environment

that poses a threat. In this situation,

the fear response is considered a type of

anxiety called panic. A panic episode or panic attack, occurs when a person

experiences a fear response. A feeling of intense

terror accompanied by physical symptoms and

the overwhelming urge to flee or escape yet there is no danger in the

surrounding environment that causes the reaction. Sometimes people

know what situations will activate a panic response, such as crossing a bridge or being in a large crowd of people. These are expected or

cued panic episodes. Other times, people experience

panic as if from nowhere, they have no idea

what brings it on. These are known as unexpected

or uncued panic episodes. We will talk more about these

experiences in lecture 2, when we have a more

detailed discussion about the various types

of anxiety disorders.