WHAT IS IT?
This describes a very broad range of disorders, characterized by anxiety and distress over some circumstance. There is typically an effort to avoid the uncomfortable situation, with the distress experienced as something unacceptable and unwanted. In neurotic disorders, the person's general sense of reality is intact, without the characteristics of psychotic disorders such as hallucinations, delusions, or highly unusual and socially abnormal behavior. Nevertheless, the neurosis usually impairs functioning in some important area of life (incidentally, the terms "neurosis" and "neurotic" are becoming obsolescent in psychiatry, being replaced by more specific diagnoses).
There is no known organic cause of neurotic disorders. The traditional view is that neurotic symptoms are due to an unconscious psychological conflict that is unacceptable to the individual's concept about him or herself. If the conflict were acknowledged, it would threaten some aspect of their psychological life. So, a defense mechanism keeps the deeper conflict from entering awareness.
Neurotic (anxiety) disorders are by far the most common kind of mental disorder.
Several types of anxiety are recognized: Acute situational anxiety,
adjustment disorders, generalized anxiety
disorder,
panic disorder,
post-traumatic stress disorder,
phobias,
obsessive-compulsive disorder.
HOW IS IT DIAGNOSED?
History can be of many possible troublesome symptoms. The anxiety may be a fear of a specific situation or object (phobia), fear of harm unless a ritual is performed repeatedly (obsessive-compulsive disorder), fear of bodily illness (hypochondriasis), or fear of impending doom (panic disorder). A neurosis may also manifest as a sexual dysfunction, slipping into a trance state (dissociative disorder), a
generalized anxiety disorder, or as irritability, mental and physical fatigue, sleep disturbances, and a general sense of instability (neurasthenia).
Physical exam might note a skin disorder or high blood pressure. Observation of the individual's orientation, dress, mannerisms, behavior and content of speech provide essential signs to diagnose the illness.
Tests are not helpful in these diagnoses.
FREQUENT SIGNS AND SYMPTOMS
Feeling that something undesirable or harmful is
about to happen.
Dry mouth; swallowing difficulty or hoarseness.
Rapid breathing and heartbeat, palpitations.
Twitching or trembling.
Muscle tension; headaches; backache.
Sweating.
Difficulty concentrating.
Dizziness or faintness.
Nausea; diarrhea; weight loss.
Sleeplessness.
Irritability.
Fatigue.
Nightmares.
Memory problems.
Sexual impotence.
HOW IS IT TREATED?
Individual and group psychotherapy are used to bring the unconscious conflict into awareness and/or to develop coping skills. Anti-anxiety medication may be prescribed temporarily or long-term.
DIET
No special diet. Avoid caffeine and other stimulants, as
well as alcohol.
WHAT MIGHT COMPLICATE IT?
Complications include alcohol or prescription anti-anxiety drug abuse, an
eating disorder,
irritable bowel syndrome,
peptic ulcers, or
high blood pressure.
PREDICTED OUTCOME
Outcome will depend on a specific diagnosis.
ALTERNATIVES
Caffeine or amphetamine/cocaine intoxication can resemble an anxiety disorder. Medical conditions such as low blood sugar (hypoglycemia), an overactive thyroid gland (hyperthyroidism), or chronic lung disease (emphysema) can cause episodes of anxiety. Avoidant personality disorder is another possibility.
APPROPRIATE SPECIALISTS
Psychiatrist, psychologist, or other mental health professionals.
For additional information, contact Anxiety Disorders Association of America, 6000 Executive Blvd., Suite 513, Rockville, MD 20852; (301) 231-9350
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