Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Problem anxiety may be caused by a mental condition, a physical condition, the effects of drugs, or from a combination of these. The doctor's initial task is to see if your anxiety is caused by a medical condition. Conditions as varied as anemia, asthma attack,
infection, drug intoxication or withdrawal, or a number of heart conditions are just a few examples of medical problems that can be associated with anxiety.
Common types of anxiety include these mental conditions:
Panic disorder: In addition to attacks of anxiety, called panic attacks,
common symptoms of panic disorders are stomach upset, palpitations (feeling your heart beat), dizziness, and shortness of breath. These same symptoms also can be caused by caffeine
consumption, amphetamines ("speed" is the street slang for amphetamines when
they are not prescribed by a doctor), an overactive thyroid, abnormal heart rhythms, and other heart abnormalities (such as mitral valve prolapse). The panic attack sufferer may experience their mind going
blank or that they somehow do not feel real, in that they feel as if they
are looking at themselves from outside of themselves. In order to qualify
for the diagnosis of panic disorder, the individual would experience
repeated panic attacks rather than just one episode.
Generalized anxiety disorder: Those who endure this condition experience numerous worries that are more often on the mind of the sufferer than not. Those worries interfere with the person's ability to sleep or otherwise function.
Phobic disorders: People with phobias experience irrational fear that may rise to the level of panic attacks in response to a specific thing or situation. Examples of phobias include fears of spiders, insects in general, open spaces, closed-in spaces, air travel, heights, and social anxiety.
Obsessive compulsive disorder: Individuals with this condition either suffer from intrusive and distressing thoughts (obsessions) or engage in irresistible, often repetitive behaviors (compulsions). Examples of obsessions include worries about germs or having items in a particular order. Examples of compulsions include counting items or activities, avoiding walking on cracks, or avoiding touching doorknobs.
Separation anxiety disorder: Considered a disorder of children, separation anxiety
disorder can be diagnosed when a child becomes extremely anxious in response to anticipating or being separated from one or more caregiving adults (usually a parent). The separation may come with the child's going to school each day or going to bed each evening, for example.
These common external factors can cause anxiety:
Stress at work
Stress from school
Stress in a personal relationship such as marriage or friendships
Stress from an emotional trauma such as the death of a loved one, a natural disaster, victimization by crime, physical abuse or sexual abuse (for
example, acute stress disorder or post traumatic stress disorder)
Stress from a serious medical illness
Side effects of medication
Intoxication (being "high" on) with an illicit drug, such as cocaine or amphetamines
Withdrawal from an illicit drug, such as opiates (for example, heroin) or from
prescription drugs like Vicodin, benzodiazepines, or barbituates
The doctor has the often difficult task of determining which symptoms come from which causes. For example, in a study of people with chest pain that could be heart disease but turned out not to be heart related, 43% were found to have a panic disorder-a common form of anxiety.