Pathological, Abnormal Anxiety
Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D.As noted previously, normal anxiety is actually beneficial. However, anxiety becomes a problem when it overstays its welcome (duration), and/or is of an intensity or frequency which begins to interfere with a person's functioning and overall well-being. These three factors- duration, intensity, and frequency- distinguish normal, adaptive anxiety from abnormal, pathological anxiety. As such, abnormal anxiety is different from normal anxiety because it is disproportionate to the situation that elicited the anxious response. When the intensity, duration, and/or frequency of anxiety become distressful and chronic, such that it interferes with a person's functioning, it is often referred to as pathological anxiety. Anxiety disorders represent variant forms of this pathological anxiety.
Therefore, the difference between normal anxiety and abnormal anxiety is this: anxiety is considered normal and adaptive when it serves to improve peoples' functioning or wellbeing. In contrast, abnormal anxiety is a chronic condition that impairs peoples' functioning and interferes with their well-being. This impairment causes them significant distress. There are specific symptoms that accompany each anxiety disorder. However, the main criteria used to distinguish normal anxiety from an anxiety disorder is that it results in significant distress, or impairs social, occupational, or other important areas of functioning (APA, 2013). This distinction is important. For instance, I may have a phobia about going to see the dentist. I may even have panic attacks prior to a dental visit. Nonetheless, I still go to see the dentist regularly and it does not create health problems or enormous distress for me. Therefore, I do not meet criteria for a phobia disorder. More information about the diagnosis and classification of anxiety disorders is provided in another section.
According to the National Institute of Mental Health (NIMH, 2008), approximately 40 million American adults (i.e., 18.1 %) have an anxiety disorder in a given year, with their first episode occurring before the age of 21.5. This prevalence rate is really quite astonishing: roughly one person in five will have experienced an anxiety disorder during that year. Interestingly, these estimates are not unique to the United States. Similar prevalence rates are reported for the global population. Moreover, evidence suggests that women tend to experience anxiety disorders more frequently than men do; approximately a 2:1 ratio (APA, 2013).
There are several reasons it is important to make this distinction between normal, adaptive anxiety, versus anxiety as a disorder. First, it would be incorrect to conclude someone is suffering from an anxiety disorder simply because they are experiencing some degree of anxiety. As explained above, anxiety as an emotion is a normal reaction to certain situations and even serves a useful purpose. Thus, it is neither necessary, nor beneficial, to attempt to rid ourselves of all anxiety.
Second, it is important for each of us to recognize that our own normal experiences of ordinary anxiety are qualitatively different from a person experiencing an anxiety disorder. Often, well-intentioned family and friends will offer advice to people attempting to recover from anxiety disorders. Unfortunately, these well-meaning friends and family cannot understand why the person-in-recovery reacts so negatively to their genuine efforts to help them "get over it." These sorts of techniques may be useful for coping with ordinary anxiety, but are not effective once anxiety has reached a pathological level. Indeed, without proper information about anxiety disorders, people-in-recovery and their loved ones may find themselves becoming increasingly frustrated with each other. This is why education for family and loved ones can be very beneficial.
Resources
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Articles
- What is Anxiety?
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The Biopsychosocial Model of Anxiety
- The Biopsychosocial Model: Causes of Pathological Anxiety
- Biological Explanations of Anxiety Disorders
- Biological Explanations of Anxiety: Part II
- Biological Explanations of Anxiety: Part III
- Biological Explanations of Anxiety: Part IV
- Psychological Explanations of Anxiety Disorders
- Psychological Explanations: Part II
- Social Explanations of Anxiety Disorders
- Development & Maintenance of Anxiety Disorders
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Classification & Diagnosis of Anxiety Disorders
- The Classification and Diagnosis of Anxiety Disorders
- Panic Attacks: A Classic Symptom of Several Anxiety Disorders
- Panic Disorder
- Separation Anxiety Disorder
- Selective Mutism
- Agoraphobia
- Specific Phobias and Social Anxiety Disorder (Social Phobia)
- Generalized Anxiety Disorder (GAD)
- Other Anxiety-Related Disorders
- Anxiety and Other Psychiatric Disorders
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Anxiety Disorder Theories and Therapies
- Anxiety Disorders: Theories and Therapies
- Behavioral Learning Theory and Associated Therapies
- Operant Conditioning
- Operant Conditioning and Avoidance Learning
- Contemporary Views of Behavioral Learning Theory
- Behavioral Therapies for Anxiety Disorders
- Cognitive Theory and Associated Therapies
- Cognitive Therapy
- Cognitive-Behavioral Therapy
- Adjunct Therapies
- Pharmacologic Treatments (Medication)
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Treatment of Anxiety Disorders
- Treatment for Separation Anxiety Disorder
- Treatment for Selective Mutism
- Treatment for Panic Disorder
- Treatment for Specific Phobias and Treatment for Social Anxiety Disorder (Social Phobia)
- Treatment for Generalized Anxiety Disorder (GAD)
- Treatment for Obsessive-Compulsive Spectrum Disorders (OCSDs)
- Conclusion
- Anxiety Disorder References & Additonal Resources
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News
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Questions and Answers
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- Depression helps to contribute to my unemployment! - Paula
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- unwanted thoughts!
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- A very low threshold for stress tolerance
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- anxiety or going crazy?
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- Worried about my therapist
- No Friends
- Teenager...angst vs. mental health issue
- phobia regarding uncertainty
- Obsessed with running out of things
- Do I Have OCD?
- Do environmental factors hold a person back?
- Never Had a Relationship
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- Panic
- Bathroom Phobia
- Anxiety?
- Mastery Of Anxiety And Panic
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- Alternatives For Anxiety Treatment
- Is Anxiety A Hereditary Factor?
- Unable To Keep Eye Contact
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- A Cure For Claustrophobia?
- Panic Attacks
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- Anxiety?
- Social Anxiety
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Book & Media Reviews
- 8 Keys to Stress Management
- A Brief History of Anxiety
- Anxiety
- Anxiety
- Anxiety Disorders
- Anxiety, Phobias, and Panic
- Been There, Done That? DO THIS!
- Calm Beneath the Waves
- Elsewhere
- Exercise for Mood and Anxiety
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31 more
- Getting Control
- Helping Students Overcome Depression and Anxiety
- Just Checking
- Mind-Body Workbook for Anxiety
- Monkey Mind
- My Age of Anxiety
- Overcoming School Anxiety
- Panic Disorder
- Passing for Normal
- Phobic and Anxiety Disorders in Children and Adolescents
- Repressed Spaces
- Self-Coaching
- Stress
- Stress Survival Guide
- Textbook of Anxiety Disorders
- The 10 Best Anxiety Busters
- The Age of Anxiety
- The Anxieties of Affluence
- The Dutiful Worrier
- The Emotional Eater's Repair Manual
- The Male Stress Survival Guide
- The Places That Scare You
- The Stress Cure
- The SuperStress Solution
- Treating Affect Phobia
- Under Pressure and Overwhelmed
- Viniyoga Therapy for Anxiety
- When Words Are Not Enough
- Wish I Could Be There
- Yoga for Anxiety
- Yoga Journal's Yoga for Stress
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Self-Help Groups
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Links
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Videos
- How to Manage ADHD and Anxiety
- What You Need to Know about Students with ADHD and Anxiety
- How To Make Room For Gratitude In An Anxious Brain
- How to Stay Calm When You Know You'll Be Stressed
- Anxiety and Teen Girls with Lisa Damour, PhD
- Is it Anxiety or a Heart Condition?
- Identifying and Treating Anxiety in Kids and Teens
- Child Anxiety, It’s Real
- Helping Children Cope with Anxiety
- Anxiety, Trauma and How Prolonged Exposure Therapy Works For PTSD
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26 more
- OCD, Phobias and Anxiety
- How Weighted Blankets May Lift Anxiety
- Controlling Anxiety
- Too Scared: Social Anxiety Disorder
- Panic Disorders Video
- Phobias Video
- Treating Anxiety Disorders: A Unified Protocol
- Treating Youth Anxiety and Social Phobia
- Overcoming Anxiety in Children and Teens
- Treating Anxiety in Children and Teens with ASD
- Back-to-School Anxiety
- No More Shame: My life with Anxiety and Depression
- Adolescent Depression and Anxiety
- What is Social Anxiety Disorder?
- Living Without Fear
- What is Generalized Anxiety Disorder?
- What is Generalized Anxiety Disorder?
- School Anxiety! Activities To Help Kids and Teens Manage It
- Recognizing and Treating Problematic Fear and Anxiety in Children
- How To Stop Overthinking When You Have Anxiety
- My Anxiety Is Making Me Anxious!
- Evidence-Based Treatment Planning for Generalized Anxiety Disorder Video
- Managing Anxiety in Youth: More Action Than Talk
- Treatment of Social Anxiety Disorder
- Cognitive Behavioral Therapy for Anxiety
- Recent Advances in Anxiety - Children/Adolescents
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More Information
- Wise Counsel Interview Transcript: An Interview with David Barlow, Ph.D. on the Nature and Treatment of Anxiety and Panic Disorders
- Wise Counsel Interview Transcript: An Interview with Dr. Michelle Craske on Anxiety Disorders Research and Treatment
- Wise Counsel Interview Transcript: An Interview with Richard Heimberg, Ph.D. on Anxiety Research and Treatment
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