Anxiety Health Article

Learned associations

Some aspects of anxiety appear to be unavoidable byproducts of the human developmental process. Humans are unique among animals in that they spend an unusually long period of early life in a relatively helpless condition, and a sense of helplessness can lead to anxiety. The extended period of human dependency on adults means that people may remember, and learn to anticipate, frightening or upsetting experiences long before they are capable enough to feel a sense of mastery over their environment. In addition, the fact that anxiety disorders often run in families indicates that children can learn unhealthy attitudes and behaviors from parents. Also, recurrent disorders in families may indicate that there is a genetic or inherited component in some anxiety disorders. For example, there has been found to be a higher rate of anxiety disorders (panic) in identical twins than in fraternal twins.

CHILDHOOD DEVELOPMENT AND ANXIETY. Researchers in early childhood development regard anxiety in adult life as a residue of childhood memories of dependency. Humans learn during the first year of life that they are not self-sufficient and that their basic survival depends on the care of others. It is thought that this early experience of helplessness underlies the most common anxieties of adult life, including fear of powerlessness and fear of being unloved. Thus, adults can be made anxious by symbolic threats to their sense of competence and/or significant relationships, even though they are no longer helpless children.

SYMBOLIZATION. The psychoanalytic model gives considerable weight to the symbolic aspect of human anxiety; examples include phobic disorders, obsessions, compulsions, and other forms of anxiety that are highly individualized. The length of the human maturation process allows many opportunities for children and adolescents to connect their experiences with certain objects or events that can bring back feelings in later life. For example, a person who was frightened as a child by a tall man wearing glasses may feel panicky years later by something that reminds him of that person without consciously knowing why.

PHOBIAS. Phobias are a special type of anxiety reaction in which the person's anxiety is concentrated on a specific object or situation that the person then tries to avoid. In most cases, the person's fear is out of proportion to its "cause." Prior to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), currently the model text for diagnostic criteria, these specific phobias were called simple phobias. It is estimated that 10%-11% of the population will develop a phobia in the course of their lives. Some phobias, such as agoraphobia (fear of open spaces), claustrophobia (fear of small or confined spaces), and social phobia, are shared by large numbers of people. Others are less common or unique to the patient.

Social and environmental stressors

Anxiety often has a social dimension because humans are social creatures. People frequently report feelings of high anxiety when they anticipate—and therefore fear—the loss of social approval or love. Social phobia is a specific anxiety disorder that is marked by high levels of anxiety or fear of embarrassment in social situations.

Another social stressor is prejudice. People who belong to groups that are targets of bias are at higher risk for developing anxiety disorders. Some experts assert, for example, that the higher rates of phobias and panic disorders among women reflect their greater social and economic vulnerability.

Some controversial studies indicate that the increase in violent or upsetting pictures and stories in news reports and entertainment may raise the anxiety level of many people. Stress and anxiety management programs often suggest that patients cut down their exposure to upsetting stimuli.

Anxiety may also be caused by environmental or occupational factors. People who must live or work around sudden or loud noises, bright or flashing lights, chemical vapors, or similar nuisances that they cannot avoid or control, may develop heightened anxiety levels.

Existential anxiety

Another factor that shapes human experiences of anxiety is knowledge of personal mortality. Humans are the only animals that appear to be aware of their limited life span. Some researchers think that awareness of death influences experiences of anxiety from the time that a person is old enough to understand death.