From the Guidelines
Anxiety is a complex emotional response characterized by excessive, uncontrollable worry, and fear that interferes with daily activities, involving a combination of genetic, environmental, psychological, and developmental factors. According to the most recent evidence from 1, anxiety disorders comprise several related conditions, including generalized anxiety disorder, panic disorder, social or school anxiety disorder, and other specific types. These disorders are the most prevalent and among the most consequential biological health disorders in the United States, with a lifetime prevalence of approximately 40% in women, twice that in men. Key characteristics of anxiety disorders include:
- Excessive, uncontrollable worry or fear that's difficult to control
- Physical symptoms such as rapid heartbeat, sweating, trembling, shortness of breath, and sleep problems
- Interference with daily activities, social settings, and personal relationships
- Associated somatic symptoms that can lead to extensive evaluations and healthcare visits
- Frequent comorbidity with other conditions, such as substance use and posttraumatic stress disorder, particularly depressive disorders. As noted in 1, anxiety confers an immense burden, including functional impairment and reduced quality of life, highlighting the need for effective treatment approaches, such as psychotherapy, medication, or a combination of both, along with lifestyle changes. The most effective treatment approach typically involves a combination of cognitive-behavioral therapy and medication, such as SSRIs, starting at low doses and gradually increasing, along with lifestyle changes like regular exercise, adequate sleep, and stress management techniques.
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
- Anxiety is characterized by unrealistic or excessive anxiety and worry about life circumstances.
- The definition of anxiety in this context is related to generalized anxiety disorder, which is marked by apprehensive expectation about two or more life circumstances for a period of 6 months or longer 2.
From the Research
Definition of Anxiety
- Anxiety disorders are characterized by excessive fear and anxiety or avoidance of perceived threats that are persistent and impairing 3
- The essential features of anxiety disorders are excessive and enduring fear, anxiety or avoidance of perceived threats, and can also include panic attacks 4
- Anxiety disorders involve dysfunction in brain circuits that respond to danger, and are influenced by genetic factors, environmental factors, and their epigenetic relations 3
Key Characteristics
- Symptoms of anxiety disorders include worry, social and performance fears, unexpected and/or triggered panic attacks, anticipatory anxiety, and avoidance behaviors 5
- Physical symptoms associated with anxiety disorders include palpitations, shortness of breath, and dizziness 5
- Anxiety disorders can be chronic and significantly impair quality of life and functioning, with a lifetime prevalence of approximately 34% in the US 5
Diagnostic Criteria
- The diagnostic criteria for anxiety disorders vary for individual disorders, but are generally similar across the two most common classification systems: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, Tenth Edition (ICD-10) 4
- Brief screening measures, such as the Generalized Anxiety Disorder-7, can aid in diagnosis of anxiety disorders 5
- A U.S. Preventive Services Task Force (USPSTF) draft statement recommends screening for anxiety in adults 64 years and younger, including pregnant and postpartum women 6