Anxiety and Panic Disorders

Anxiety is an unpleasant emotion that everyone experiences at some or the other time, and is often accompanied by physical sensations such as palpitations, dizziness, and/or a feeling of lightheadedness. Rather than a concrete emotion, it is usually a vague sense of unease, but it serves to trigger our attention and caution. The level of anxiety one feels is related to both the magnitude of the stress and the individual’s ability to cope with it. If the stress is perceived as overwhelming and difficult to handle, the feeling of anxiety increases; if the stress seems small and manageable, the feeling of anxiety decreases. Therefore, not only the actual magnitude of the stress, but also personal traits, such as coping ability, affect how anxiety is experienced. In response to anxiety, along with the physical sensations and heightened alertness, one also tries to detect danger and respond appropriately. However, in many cases, people feel incapable of handling anxiety-inducing situations, which leads to further anxiety. This recognition of anxiety can lead to a vicious cycle, where increased anxiety distorts one’s perception of stress, leading to further physical reactions such as tension or dizziness, which, in turn, heighten the feeling of anxiety. Anxiety is an unpleasant feeling that could also be unconsciously repressed as a defense mechanism. However, repressed anxiety can manifest in physical symptoms. Proper recognition and assessment of anxiety are crucial. Various disorders related to anxiety have been defined, and both subjective and objective evaluations are conducted through various questionnaires. Common tools include the CMI and GAD-7 used for screening, MAS, STAI, and HARS used for evaluation of general anxiety, PDSS and PAS for evaluation of panic symptoms, and LSAS for evaluation of social anxiety. Understanding the appropriate use, strengths, and weaknesses of these tools is essential for accurate assessment.