Anxiety is one of the most common emotional states. For example, if you are about to take an exam, you will be nervous and worried if you feel that you have not revised well. At this point, it is common to make a point of revising for the exam and actively doing what you can to reduce your anxiety. This anxiety is a protective response, also known as physiological anxiety. When the severity of the anxiety and the objective event or situation clearly do not match, or when it lasts too long, it becomes pathological anxiety, called anxiety symptoms, and if it meets the relevant diagnostic criteria, it is diagnosed as anxiety disorder, also known as anxiety disorder. Causes Why do you get anxiety disorders? The cause of the disease is still unclear. Studies have shown that anxiety disorders are related to personality traits, genetic factors, personality traits, adverse events, stressors, and physical illnesses, which can lead to disruptions in the body’s neuro-endocrine system and imbalances in neurotransmitters, resulting in the appearance of symptoms such as anxiety. Patients with anxiety disorders often have imbalances in 5-HT (5-hydroxytryptamine), NE (norepinephrine) and other neurotransmitters, and anxiolytics can normalize the imbalanced neurotransmitters, so that anxiety symptoms disappear and emotions return to normal. Experts remind: the function of the brain is achieved through the transmission of various neurotransmitters, which are like letter carriers, and different letter carriers transmit different information and perform different physiological functions. The neurotransmitters closely related to mood are 5-HT (5-hydroxytryptamine), NE (norepinephrine), DA (dopamine) and so on. Personally, I believe that personality factors may be a key factor in the disease. Disease Classification There are many types of anxiety disorders. According to the clinical manifestations of patients, anxiety is often classified as follows: 1. Generalized anxiety: In the absence of obvious triggers, patients often appear to be excessively worried and nervous and afraid, but the nervousness and fear often have no clear object or content. In addition, patients are often accompanied by dizziness, chest tightness, panic, shortness of breath, dry mouth, frequent urination, urgent urination, sweating, tremors and other somatic symptoms, and this anxiety usually lasts for several months. 2, acute anxiety attacks (also known as panic attacks): in the normal daily life environment, there is no fearful situation, the patient suddenly appears extreme fear of tension, accompanied by a sense of near death or loss of control, while there are obvious symptoms of the vegetative nervous system, such as chest tightness, panic, difficulty in breathing, sweating, shaking, etc., generally lasting a few minutes to a few hours. The seizure starts suddenly, reaches its peak rapidly, and the consciousness is clear during the attack. Attention! The appearance of this type of anxiety is episodic and unpredictable. Because the clinical presentation of an acute anxiety attack is so similar to that of a coronary attack, patients often call the “120” emergency number to see a cardiology emergency room. Although the patient appears to have severe symptoms, most of the relevant tests are normal, so the diagnosis is often unclear, making the misdiagnosis rate of acute anxiety attacks high, which not only delays treatment but also causes a waste of medical resources. 3, phobias (including social terror, place terror, specific terror): the core manifestation of phobias and acute anxiety attacks are the same as panic attacks. The difference is that the anxiety attack of phobia is caused by some specific places or situations, the patient is not in these specific places or situations will not cause anxiety. Examples include fear of social or interpersonal situations, or fear of specific environments such as airplanes, plazas, or crowded places. The onset of anxiety in phobias is often predictable, and patients tend to adopt avoidance behaviors to avoid anxiety attacks. One patient is afraid of riding the subway or bus. As long as she takes the above-mentioned means of transportation, she has anxiety attacks and is extremely distressed. To avoid anxiety attacks, she takes a cab to and from work, because she is fine when she takes a cab. There is another classification that you can understand: the American diagnostic criteria for mental disorders, anxiety disorders include: generalized anxiety, acute anxiety attacks, phobias, post-traumatic stress disorder, acute stress disorder, and obsessive-compulsive disorder. Because these disorders have one thing in common, that is, prominent anxiety symptoms. Clinical manifestations Anxiety disorders are arguably the most common mood disorder in the population. Research by the World Health Organization shows that the lifetime prevalence of anxiety disorders in the population is 13.6%-28.8%, with 90% of anxiety disorders developing before the age of 35, and women tend to have more than men. China is currently conducting a national survey on anxiety disorders. Surveys in Hebei, Zhejiang and several other provinces show that the prevalence of anxiety disorders is 5%-7%, and it is estimated that there are about 50 million or more people with anxiety disorders nationwide. Symptoms of the disease First of all, let’s talk about the definition of anxiety disorder. Anxiety is an unpleasant, painful emotional state accompanied by a somatic experience of discomfort. Anxiety disorders are a group of mood disorders in which anxiety symptoms are the main clinical phase, and often contain two groups of symptoms: 1. Emotional symptoms: The patient feels that he or she is in a nervous, anxious, fearful, frightened, and worried internal experience. What is the nervousness and fear? Some people may clearly say what they are afraid of, while others may not be able to say what they are afraid of, but they just feel afraid. 2. Physical symptoms: Patients who are nervous are often accompanied by autonomic hyperactivity, such as panic, shortness of breath, dry mouth, sweating, trembling, flushing, etc. Sometimes they also have a sense of near-death, feeling uncomfortable, feeling like they are going to die, and in severe cases, they may feel out of control. If the disease is not diagnosed and treated in a timely and correct manner, patients with anxiety disorders will repeatedly seek medical treatment, which will seriously affect their normal life and work, and will also cause a huge waste of medical resources, with some studies showing that the medical costs of patients with anxiety disorders are nine times higher than those of the general population. One patient, who had an acute anxiety attack, repeatedly called “120” for emergency treatment because the performance of anxiety attacks is very similar to that of coronary heart disease, and patients who had anxiety attacks were mistaken for coronary heart disease attacks and underwent cardiac imaging. It can be said that anxiety disorders bring great pain and burden to individuals and families. Is the treatment situation for anxiety disorders good? Unfortunately, due to a general lack of general knowledge about mental health, including anxiety disorders, the vast majority of people with anxiety disorders do not receive timely and proper treatment. World Health Organization studies show that only 6.1% of people with anxiety disorders in China receive proper treatment, compared to 42% in the United States. As a psychiatrist, I hope that more patients will receive treatment.