Anxiety is an unpleasant emotion characterized by a feeling of vague, unspecified harm. Like fear, it can cause a state of physical disturbance; unlike fear, it is characterized by the absence of an apparent causeÑthe circumstance that precipitates anxiety is hidden and unknown to the person. Evidence exists that some persons may be biochemically vulnerable to an extreme form of anxiety known as "panic attacks."
Anxiety itself is a powerful physical experience that may involve rapid or pounding heartbeat, difficult breathing, tremulousness, sweating, dry mouth, tightness in the chest, sweaty palms, dizziness, weakness, nausea, diarrhea, cramps, insomnia, fatigue, headache, loss of appetite, and sexual disturbances. These symptoms may easily be mistaken for physical illness. In addition, anxiety results in a narrowing of one's time perspective so that only the present matters. It also results in an inability to attend to more than one task at a time or to organize thoughts and plans effectively. Low levels of anxiety may temporarily increase a person's ability to do a simple task, because of the greater vigilance and narrowing of attention associated with anxiety, but as anxiety increases, behavior becomes more disorganized and ineffective.
In learning theory, anxiety is seen both as a response to learned cues and as a drive, or motivator, of behavior. Most learning theorists maintain that anxiety is derived from reaction to pain. Anxiety can thus be reduced by removing or avoiding the source or sources of the situations that have produced pain. Avoidance may become firmly established and lead to constricted or bizarre behavior (see phobia). A better way to reduce anxiety is to pair a strong, positive reinforcer such as food with the frightening situation so that the stimulus that formerly elicited anxious responses becomes associated with positive feelings.
In the control of anxiety, some psychologists have focused on the role of cognition as the origin of anxiety (see cognitive therapy). Cognitive theories emphasize the process of appraisal and the often unnoticed internal dialogue that amplifies emotional response. Experiments have shown that the interpretation of a situation determines whether a person feels anxiety or some other emotion.
Learning to substitute benign reappraisals for unrealistically negative "self-talk" reduces anxiety.
Some medications, called anxiolytics, lead to the hope that anxiety can be understood physiologically. The exact metabolic pathways remain incompletely known, however, and appear to be quite complex. Among the currently most used chemicals are the later benzodiazepines (see tranquilizer) and the serotonin-reuptake inhibitors (see antidepressants). Much safer to use than the previous generation of tranquilizers, these medicines are popular, although some of them are habit-forming. A combination of medication and therapies, including relaxation training, provides the best treatment for anxiety and panic attacks.
Two types of anxiety are recognized in psychoanalysis. The first, traumatic anxiety, results from overstimulation. Events happen faster than the mind can comprehend them. This produces a feeling of crisis. Sigmund Freud believed that this feeling has a physical basis in the capacity of the nervous system and that birth throws every child into a state of traumatic anxiety. In his view, this birth trauma becomes the template for later episodes of anxiety. The second type of anxiety, signal anxiety, is believed to arise from a person's need to guard against traumatic anxiety. The ego appraises its ability to cope with external demands and the push of internal drives. When normal methods of coping with these pressures threaten to fail, the ego responds with anxiety, which then mobilizes the person to take new action. The small-scale discomfort of signal anxiety helps to avoid a more devastatinxperience.