What is the susceptibility to anxiety?

From the Guidelines

Susceptibility to anxiety is increased in individuals with a familial history of anxiety, comorbid psychiatric disorders, history of alcohol or substance use or abuse, and presence of other chronic illnesses 1.

Key Factors

• Familial history of anxiety is a significant risk factor, as individuals with a family history of anxiety are more likely to experience anxiety themselves 1.
• Comorbid psychiatric disorders, such as mood disorders, can also increase the susceptibility to anxiety 1.
• History of alcohol or substance use or abuse can contribute to the development of anxiety, and individuals with a history of substance use or abuse should be screened for anxiety symptoms 1.
• Presence of other chronic illnesses can also increase the risk of anxiety, and individuals with chronic illnesses should be monitored for anxiety symptoms 1.

Screening and Assessment

• Screening for anxiety should be done using a valid and reliable tool, such as the GAD-7 scale, which can help identify individuals with generalized anxiety disorder (GAD) 1.
• Assessment of anxiety should include a diagnostic assessment to identify the nature and extent of anxiety symptoms, as well as the presence or absence of an anxiety disorder or disorders 1.
• Medical and substance-induced causes of anxiety should be diagnosed and treated, and individuals with severe anxiety symptoms should be referred to a psychiatrist, psychologist, or equivalently trained professional 1.

From the FDA Drug Label

Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. Generalized anxiety disorder is characterized by unrealistic or excessive anxiety and worry (apprehensive expectation) about two or more life circumstances, for a period of 6 months or longer, during which the person has been bothered more days than not by these concerns At least 6 of the following 18 symptoms are often present in these patients: Motor Tension (trembling, twitching, or feeling shaky; muscle tension, aches, or soreness; restlessness; easy fatigability); Autonomic Hyperactivity (shortness of breath or smothering sensations; palpitations or accelerated heart rate; sweating, or cold clammy hands; dry mouth; dizziness or light-headedness; nausea, diarrhea, or other abdominal distress; flushes or chills; frequent urination; trouble swallowing or 'lump in throat'); Vigilance and Scanning (feeling keyed up or on edge; exaggerated startle response; difficulty concentrating or 'mind going blank' because of anxiety; trouble falling or staying asleep; irritability)

The susceptibility to anxiety is characterized by unrealistic or excessive anxiety and worry about two or more life circumstances, for a period of 6 months or longer. Key symptoms include:

• Motor Tension: trembling, twitching, or feeling shaky; muscle tension, aches, or soreness; restlessness; easy fatigability
• Autonomic Hyperactivity: shortness of breath or smothering sensations; palpitations or accelerated heart rate; sweating, or cold clammy hands; dry mouth; dizziness or light-headedness; nausea, diarrhea, or other abdominal distress; flushes or chills; frequent urination; trouble swallowing or 'lump in throat'
• Vigilance and Scanning: feeling keyed up or on edge; exaggerated startle response; difficulty concentrating or 'mind going blank' because of anxiety; trouble falling or staying asleep; irritability 2

From the Research

Susceptibility to Anxiety

The susceptibility to anxiety can be influenced by various factors, including genetic predisposition, brain chemistry, and life experiences.

• Studies have shown that individuals with a family history of anxiety disorders are more likely to develop anxiety themselves 3, 4, 5.
• Research has also identified certain brain chemicals, such as serotonin and noradrenaline, as playing a crucial role in the development of anxiety disorders 3, 6, 7.
• Additionally, life experiences, such as trauma or stress, can contribute to the development of anxiety in susceptible individuals 3, 5, 6.

Neurotransmitters and Anxiety

• Serotonin and noradrenaline are two neurotransmitters that have been implicated in the development of anxiety disorders 3, 6, 7.
• Selective serotonin reuptake inhibitors (SSRIs), which increase the levels of serotonin in the brain, have been shown to be effective in treating anxiety disorders, including generalized anxiety disorder, panic disorder, and social phobia 4, 5, 6, 7.
• Noradrenaline has also been shown to play a role in the development of anxiety, with increased levels of noradrenaline metabolites found in individuals with anxiety disorders 3.

Treatment of Anxiety Disorders

• SSRIs are commonly used to treat anxiety disorders, including generalized anxiety disorder, panic disorder, and social phobia 4, 5, 6, 7.
• Other treatments, such as cognitive-behavioral therapy and exposure therapy, have also been shown to be effective in reducing anxiety symptoms 6.
• Combination therapy, which involves the use of medication and psychotherapy, may be more effective than either treatment alone in reducing anxiety symptoms 6.