ANXIETY

a feeling of dread, fear, or apprehension, often with no clear justification. Anxiety is distinguished from true fear because the latter arises in response to a clear and actual danger, such as one affecting a person's physical safety. Anxiety, by contrast, arises in response to apparently innocuous situations or is the product of subjective, internal emotional conflicts the causes of which may not be apparent to the person himself. Some anxiety inevitably arises in the course of daily life and is normal. But persistent, intense, chronic, or recurring anxiety not justified in response to real-life stresses is usually regarded as a sign of an emotional disorder. When such an anxiety is unreasonably evoked by a specific situation or object, it is known as a phobia (q.v.). A diffuse or persistent anxiety associated with no particular cause or mental concern is called general, or free-floating, anxiety. There are many causes (and psychiatric explanations) for anxiety. Sigmund Freud viewed anxiety as the symptomatic expression of the inner emotional conflict caused when a person suppresses from conscious awareness experiences, feelings, or impulses that are too threatening or disturbing to live with. Anxiety is also viewed as arising from threats to an individual's ego or self-esteem, as in the case of inadequate sexual or job performance. Behavioral psychologists view anxiety as an unfortunate learned response to frightening events in real life; the anxiety produced becomes attached to the surrounding circumstances associated with that event, so that those circumstances come to trigger anxiety in the person independently of any frightening event. An anxiety disorder may develop where anxiety is insufficiently managed, characterized by a continuing or periodic state of anxiety or diffuse fear that is not restricted to definite situations or objects, and is generally classed as one of the psychoneuroses (neuroses). The tension is frequently expressed in the form of insomnia, outbursts of irritability, agitation, palpitations of the heart, and fears of death or insanity. Fatigue is often experienced as a result of excessive effort expended in managing the distressing fear. Occasionally the anxiety is expressed in a more acute form and results in physiological concomitants such as nausea, diarrhea, urinary frequency, suffocating sensations, dilated pupils, perspiration, and rapid breathing. Similar symptoms occur in several physiological disorders and in normal situations of stress or fear, but they may be considered neurotic when they occur in the absence of any organic defect or pathology and in situations that most people handle with ease. Other types of anxiety-related disorders include hypochondriasis, hysteria, obsessive-compulsive disorders, phobias, and schizophrenia.