Anxiety Disorders: What They Are And What To Do

By Cristiano Antonino On Nov 17, 2022

Anxiety Disorders belong to the category of Affectivity Disorders. Affectivity could be defined as the individual’s ability or willingness to respond with subjective affective-emotional modifications to thoughts or events of external and internal reality (including the body): that is, it is the ability to experience emotions of highly variable meaning, duration, intensity and tone (fear, pain, sympathy, love, anger, etc.)

The emotional response obviously differs from subject to subject in relation to the stimulus caused and even more so in relation to the type of ‘basic’, or habitual, affective availability, which can also be defined as mood or temperament, which is the conscious result of a set of qualities and characteristics intrinsic to the person’s constitution and the sum of experiences, learning, habits acquired in the adaptive regulation of the drive heritage.

The main psychopathological alterations of Affectivity and the definition of Anxiety Disorders

Among the main psychopathological alterations of Affectivity are Anxiety Disorders.

Definition of Anxiety Disorders: they are disorders related to and resulting from excessive anxiety, which – from being physiological, i.e. a normal reaction to emotions – becomes uncontrollable.

In itself, anxiety is a natural species-specific defence of alertness in the face of danger; in fact, the human body is ‘predisposed’ to attack and escape’ whenever the Peripheral Nervous System sends danger signals (= ‘information transduction’) to the Central Nervous System, which – in turn – will respond to the signal by preparing the Muscular System (for the activation of motor neurons) and the Endocrine System (for the release of specific neurotransmitters (catecholamines such as Norepinephine and Acetylcholine).

This response will subjectively vary in intensity depending on the consideration of cognitive and emotional aspects typical of the individual.

History for diagnosis of Anxiety Disorder (risk factors):

Quality of lifestyle and living conditions in general, share of stressors
Impaired mental hygiene (poor diet, sleep disorders, use of harmful or toxic substances, drug abuse etc.).
Anxiety in childhood
Inability or difficulty in keeping one’s emotions at bay
Depressive states
Asthenia

Symptoms of Anxiety Disorders

Altered respiratory rate (so-called ‘doggy’ breathing, with the mouth and not the nose, to bring in more oxygen)
Tachycardia (acceleration of the heartbeat to pump more blood to ‘send’ to the organ or muscle)
Perhydrosis (unusual sweating to dissolve emotional heat)
Hyposcialia or xerostemia (dry mouth)
Uncontrollable shaking and trembling
Feeling of suffocation

Classification of Anxiety Disorders (including DSM 5)

Generalised Anxiety Disorder
Panic Disorder
Post-Traumatic Stress Disorder
Obsessive-compulsive disorder
Social Phobia
Specific Phobia

Anxiety Disorder Categories in the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders)

They are separated from the Anxiety Disorders, as they will become categories in their own right:

Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)

Within Anxiety Disorders they are separated:

Panic Disorder
Panic Attack
Agoraphobia

Within Anxiety Disorders are included:

Separation anxiety
Selective mutism

Within OCD are included:

Hoarding Disorder (hoarding: hoarding, hoarding, hoarding)
Skin excoriation disorder
Trichotillomania (impulse to pull and tear hair)

Diagnosis of Anxiety Disorders

Anxiety attacks with an onset of at least six months
Presence of at least three symptoms
Comorbidity with Depression
Absence of organic cause
Difficulty in emotional control
Difficulty in describing the symptomatology (“as if….”)
Lifestyle modification/inhibition

Aetiology

Cultural factors: environment, education. personality structure
Genetic factors: predisposition not scientifically confirmed

Epidemiology

Approximately 5-6% of the world population, with onset in youth (around the age of 20).

Distribution of disorders in Italy in 2010 (source ESEMeD):

Generalised Anxiety Disorder, Post-Traumatic Stress Disorder, Social Phobia: present >2% lifetime
Panic attack disorder, agoraphobia: present to an extent of
Gender: women are much more at risk. Causes: female hormone characteristics; greater susceptibility to stressful life events.