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~ Anxiety: A Complication of Grief ~

Anxiety is one of the most common complaints seen in medical practice. Anxiety disorders as a group affect more than 19 million adults in the United States. Children and adolescents can also develop anxiety disorders. People who are anxious report a subjective feeling of apprehension, uneasiness, tension or terror in response to danger. Other terms used by patients to describe anxiety are nervousness or worried.

Most people experience feelings of anxiety before an important event such as a big exam, business presentation, or first date; this anxiety is generally brief and relatively mild. Anxiety disorders, in contrast, are chronic, relentless, and can become progressively worse if not treated that fill people's lives with overwhelming anxiety and fear. Tormented by panic attacks, obsessive thoughts, flashbacks of traumatic events, nightmares, or countless frightening physical symptoms, some people with anxiety disorders even become housebound.

Anxiety disorders, in particular post traumatic stress disorder may occur after experiencing or witnessing a traumatic event such as rape assult, child abuse, natural or human-caused disasters or accidents. Events such as the recent September 11th attack can precipitate an anxiety disorder.

Different Types of Anxiety Disorders
Each anxiety disorder has its own distinct features, but they are all bound together by the common theme of excessive, irrational fear and dread.

  • Panic Disorder—Repeated episodes of intense fear that strike often and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality, and fear of dying.
  • Obsessive-Compulsive Disorder—Repeated, unwanted thoughts or compulsive behaviors that seem impossible to stop or control.
  • Post-Traumatic Stress Disorder—Persistent symptoms that occur after experiencing or witnessing a traumatic event such as rape or other criminal assault, war, child abuse, natural or human-caused disasters, or crashes. Nightmares, flashbacks, numbing of emotions, depression, and feeling angry, irritable or distracted and being easily startled are common. Family members of victims can also develop this disorder.
  • Phobias—Two major types of phobias are social phobia and specific phobia. People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of many potentially pleasurable and meaningful activities. People with specific phobia experience extreme, disabling, and irrational fear of something that poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives unnecessarily.
  • Generalized Anxiety Disorder—Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.
Anxiety Disorders can Co-Exist with Other Physical or Mental Disorders
Anxiety disorders may accompany almost any illness such as cancer, arthritis, diabetes or heart disease. It is common for an anxiety disorder to accompany depression, eating disorders, substance abuse, or another anxiety disorder.  Therefore it is important that the accompanying disorders are also treated. Before beginning any treatment, however, it is important to have a thorough medical examination to rule out other possible causes of symptoms.

Common Symptoms Associated with Anxiety
People experiencing anxiety can manifest a wide variety of signs and symptoms. Common symptoms of anxiety disorders include unrealistic or excessive worry, sleep disturbances, dizziness, jitteriness, racing or pounding heart, upset stomach, numbness in hands, face or feet, and fatigue. a listing of potential complaings include:

  • Giddiness
  • Shakiness
  • Restlessness
  • Trembling
  • Fatigue
  • Dry-mouth
  • Dizziness
  • Lightheadedness
  • Frequent urination
  • Nausea
  • Stomach upset
  • Diarrhea
  • Chest pain
  • Palpitations
  • Tightness in chest
  • Hyperventilation
  • Tingling in hands or   feet
  • Cold, clammy hands
  • Muscle aches
  • Additional Information:
    The National Institute of Mental Health has a other information about anxiety.

    Screening for Mental Health Inc. also offers information and questions as part of their ongoing National Anxiety Disorders Screening Day. Sources:
    National Institute of Mental Health. Facts About Anxiety Disorders. Publication No. OM-99 4152 Printed January 1999. Available at:
    National Institute of Mental Health. Anxiety Disorders. Updated June 4, 2001. Available at:
    Friedman HH. (ed) Problem-Oriented Medical Diagnosis. 4th Ed. Boston, MA: Little, Brown and Company, 1987.

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    Last update Sept. 11, 2002