The Biology of Anxiety

By Brandon Riesenmy, M.D.

Millions of Americans suffer from anxiety disorders and can benefit from treatment.

The various anxiety disorders include generalized anxiety, panic attacks, and social anxiety. Post-traumatic stress disorder is another form of anxiety disorder. Symptoms of generalized anxiety disorder involve a state of excessive worry, even over things that others would consider trivial. The excessive worrying can lead to a state of motor tension, which may lead to headaches, or muscle aches. Problems sleeping are often associated with this condition. The person with generalized anxiety is often referred to as a �worry wort� and may have relationship problems as a result. Panic attack disorder is marked by sudden attacks of anxiety or fear and associated symptoms include a rapid heartbeat, shortness of breath, and shakiness. It is not uncommon for those afflicted to present in emergency rooms thinking they are having a heart attack, and after evaluation are told there is nothing physically wrong with them. People with social anxiety disorder feel very uncomfortable in social situations, or wherever there may be crowds of people such as a store or shopping mall.

In these situations those with social anxiety
feel very nervous, may sweat excessively,
and have a sensation of panic.

Often times, these individuals feel that others are staring at them or are thinking badly of them. As a result of these symptoms, people with social anxiety tend to avoid social situations and will avoid leaving their home. If they have to go shopping, they will tend to go at odd hours when the stores will be less crowded. Post-traumatic stress disorder (PTSD) is a constellation of symptoms, which come on after the individual has experienced a traumatic event.

Common symptoms include nightmares related to the traumatic event, flashbacks (vivid recollections of the event), and will tend to startle very easily; also, individuals with PTSD will tend to avoid things that may remind them of the traumatic event. Women who have been the victim of a rape may fear men in general as a result of the rape or may have difficulty trusting a man. People who have witnessed or been the victim of a shooting may panic if they hear a loud bang such as the sound of a car back-firing.

Some of these conditions
involve a genetic defect and
are inherited.

Underlying defects in brain chemicals and receptors cause the symptoms of anxiety. Two of the major brain chemicals involved are serotonin and gaba amino butyric acid (GABA). Medications that raise serotonin levels and enhance GABA transmission can alleviate the symptoms of anxiety; a certain type of talk therapy (cognitive psychotherapy) can positively effect these brain chemicals also. Examples of medications that raise serotonin levels are Lexapro, Paxil, Prozac, and Zoloft. Medications that can enhance GABA transmission are Xanax, Valium, Ativan, and Gabapentin. If you or someone you know is suffering from an anxiety disorder then seek treatment through a qualified mental health professional as safe, effective treatments are available. There are several websites available with information on anxiety disorders and related topics. One such website is www.mhsource.com.

Brandon Riesenmy, M.D.

Board Certified Psychiatrist
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