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body tightens. Both worry and body tension are central features of a
Generalized Anxiety Disorder (GAD).
As the result of research, fear reactions are now seen by
psychologists as quite different from anxiety responses, although they
may feel similar. In the past, fear and anxiety were usually seen as a
very similar physiological response, except that fear was set off by a
specific triggering external situation and anxiety was a persistent
autonomic response to a vague general external situation or to an
unknown internal trigger. Today, however, fear and panic reactions are
thought to result largely from primitive animal reflexes to danger, i.e.
the old fight, flight, or freeze responses that have helped us and our
primitive animal ancestors survive for millions of years.
Panic is, in part, like an automated fear reaction, except we don't
usually understand what sets off a panic attack. Panic attacks have a
cognitive aspect too. Barlow, while explaining panic attacks, has
described "false alarms" that contribute to major panic reactions. Panic
disorders--the feeling of impending doom--seem to be a complex
result of (a) primitive innate biological alarm reactions (emotionality)
which generally evolved over eons but also "run in families," (b) our
learned psychological coping mechanisms (such as learning that a
panic attack gets the attention of others or gets us back to a safe
place), and (c) the life stresses we are experiencing (such as a concern
that one might lose his job or a lover might leave). Panic may be
complex but it is not an uncommon experience--between 10% and
15% of Americans have reported a panic reaction within the last year.
So, while the primitive, automatic response may be the crux of fears
or panic, they often also have a cognitive part too.
In the 1980's, the general concept of neurotic disorders was
discarded and replaced with more specific labels, such as anxiety,
mood, somatoform and other disorders. Yet, central to all these
disorders is negative affect (fear, sadness, disappointment); the same
medicines work on all or most of them; the same behavioral
treatments work with most of them; the disorders tend to increase or
are relieved together. So, now Barlow argues that anxiety and
depression have so many of the same features that both
disorders need to be studied and understood together (back to a
broad, general neurotic label?). He maintains that anxiety and
depression both result from (1) genetic contributions (about 1/3 to 1/2
of the total causes; commonly, families are seen as nervous, tense,
high strung), (2) early childhood experiences, like rejection or abuse,
that sensitize us to certain adolescent or adult stresses, and (3)
psychological vulnerabilities or personality tendencies that direct
certain individuals toward a specific disorder, like social anxiety, panic
disorder, phobias, obsessions or compulsions, suspiciousness,
aggressiveness and irritability, unhappiness, pessimism,
disorganization and impulsivity, and many others. Of course, each of
these specific disorders has unique characteristics, but they have a
similar basic underlying emotion, namely, strong negative and tense
feelings.
