Talk:Anxiety/Archive 1

Archive 1

Archive 2

Stranger & Social Anxiety

The person who wrote that piece clearly lacks knowledge of the fact that social anxieties are not unique to children, let alone just to young children. That is misinformation. 1. It implies such people grow out of it, which we do not. 2. It implies one should ignore it in adults and not treat adults with the same problem as sympathetically as a child under the false belief that adults are magically not allowed to suffer from things like social anxiety, shyness, social phobia, etc. Simply put, one never grows out of these things, one simply learns over time how to get by as best one can with it. Further, there are various kinds of social anxieties besides just strangers and general social anxiety. Another magor one is "love shyness," where one feels especially anxious when around and/or interacting with members of the opposite sex. Further still, this section could include the various causes. Many are afraid of things like rejection or disapproval, and many are High Sensitives and take in excessive data which can cause nervousness as one tries to keep up with the sensory data input. (The latter is the cause of Selective Mutism.) — Preceding unsigned comment added by 174.26.235.132 (talk) 18:55, 9 November 2011 (UTC) (I don't recall my login... Even if I did, I hate that Wikipedia is trying to require logging in. It's not necessary.)

Differentiation between state and trait anxiety

It seems that this article lacks any information on the difference between state and trait anxiety, which, from the articles I'm looking at elsewhere, seems essential to the concept. I'll come back and try to include the information, but if anyone would like to help in the meantime, I would appreciate it. --Natsirtguy (talk) 13:04, 12 January 2008 (UTC)

Merge

I think this article should be mooved to the Anxiety Disorder page and the content currently on that page merged in. The Anxiety page should not just be merged into this one, (1)It doesn't have any meaningful content on its own, and (2)this article is more accurately named the Anxiety Disorder page.

Thoughts from people who have worked on these pages? I haven't worked on either but think something should be done. --Banana04131 03:04, 17 August 2005 (UTC)

Anxiety is a symptom, anxiety disorder is a disorder. You can have anxiety without having an anxiety disorder, though I guess you can't have an anxiety disorder without anxiety. I don't agree that they should be merged in that this page still deserves to exist. Perhaps just some of the content should go to anxiety disorder Alex.tan 14:42, August 17, 2005 (UTC)

Anxiety itself is a complicated concept in psychology and psychiatry. Anxiety in itself is not a psychiatric disorder. Anxiety is one of the basic emotions, and it plays a major role in classical fear conditioning. Debilitating anxiety can be present as a symptom of a mental health disorder (not the least of which are the anxiety disorders), but anxiety is not merely an emotion of abnormal mental processes. When a psychiatrist says someone's problem is anxiety, that is only shorthand for an anxiety disorder (i.e., an overreaction of anxiety; the emotion of anxiety is in disorder for the patient). By and large, this article currently covers anxiety disorders and not the pure emotion; the current contents should be moved to Anxiety disorder and an article dealing with anxiety per se should replace it.--24.217.183.224 08:33, 19 August 2005 (UTC)

A gifted American psychologist said,’ Worry is a spasm of the emotion of mind; The mind catches hold of something and will not let it go.’ It is useless to argue with the mind in this condition. The stronger the will, the more futile the task. One can only gently insinuate something else into its convulsive grasp. And if this something else is rightly chosen, if it is really attended by the illumination of another field of interest, gradually, and often quite swiftly, the old undue grip relaxes and the process of recuperation and repair begins.

The cultivation of a hobby and new forms of interest if therefore a policy of first importance to a public man. But this is not a business that can be undertaken in a day or swiftly improvised by a mere command of the will. The growth of alternative mental interests is a long process. The seeds must be carefully chosen; they must fall on good ground; they must be sedulously tended, if the vivifying fruits are to be a hand when needed.

To be really happy and really safe, one ought to have at least two or there hobbies, and they must all be real. It is no use starting late in life to said:’ I will take an interest in this or that.’ Such an attempt only aggravates the strain of mental effort. A man may acquire great knowledge of topics unconnected with his daily work, and yet hardly get any benefit or relief. It is no use ding what you like; you have got to like what you do. Broadly speaking, human beings may be divided into three classes: those who are toiled to death, those who are worried to death, and those who are bored to death. It is no use offering the manual laborer, tired out with a hard week’s sweat and effort, the chance of playing a game of football or baseball on Saturday afternoon. It is no use inviting the politician or the professional or business man, who has been working or worrying about serious things for six days, to work or worry about trifling things at the week-end.

As for the unfortunate people who can command everything they want, who can gratify every caprice and lay their hands on almost every object of desire – for them a new pleasure, a new excitement is only an additional satiation. In vain they rush frantically round from place to place, trying to escape from avenging boredom by mere clatter and motion. For them discipline in one form or another is the most hopeful path.

It may also be said that rational, industrious, useful human beings are divided into two classes: first, those whose work is work and whose pleasure is pleasure, and secondly, those whose work and pleasure are one. Of these the former are the majority. They have their compensations. The long hours in the office or the factory bring with them as their reward, not only the means of sustenance, but a keen appetite for pleasure even in its simplest and most modest forms. But Eortune’s favored children belong to the second class. Their life is a natural harmony. For them the working hours are never long enough. Each day is a holiday, and ordinary holidays when they come are grudged as enforced interruptions in an absorbing vocation. Yet to both classes the need of an alternative outlook, of a change of atmosphere, of a diversion of effort, is essential. Indeed, it may well be that those whose work is their pleasure are those who most need the means of banishing it at intervals form their minds.

--kaiseralexander (E-mail:chocolate_ye@yahoo.com.cn) File:Yefan 1.jpg 16:15, 14 August 2007 (UTC)

Anxiety is an emotional state. Anxiety disorder is a symptomatic manifestation of that psycho-physiological state. The two are completely different. --EmpacherPuppet 21:45, 15 August 2007 (UTC)

Alternative medicine

Is palliative care really an alternative medicine? Considering one of the oldest, most mainstream centre's in the world, Memorial Sloan-Kettering Cancer Center, has had a Integrative Medicine Service for close to 5 years now. Where do we draw the line between alternative and mainstream medicine? AstroBlue 14:55, 22 Jun 2004 (UTC)

First, palliative care is about complementary medicine rather than alternative medicine. Second, it is 'where do you' draw the line rather than where mainstream medicine draws a line. Clearly many physicians are in favor of it. And, clearly some are not.

This survey exists. It is not hot air. It is reality. It is factual. And, it is the best survey to date. It is also 100% online and in the public domain. -- [[User:Mr-Natural-Health|John Gohde | Talk]] 04:21, 23 Jun 2004 (UTC)

I'm not discounting the validity of the survey (my point was not in regard to the survey at all). I was questioning the semantics of "The strongest connection can be found in complementary medicine which is well known for using palliative care to treat cancer patients. Some research has strongly suggested that treating anxiety in cancer patients improves their quality of life." and putting it under the title of Anxiety and alternative medicine. When palliative care encompasses far more than just previously alternative medicines. A low dose of radiation to the spine of a patient with a cord-compression is seen as palliative care, a visit to a counsellor or psychologist regarding anxiety is considered palliative care. Would you consider them alternative or complementary? And considering mainstream Oncology's mantra has been "holistic care" for a good 10 years now, and "complementary medicine" has been practiced in one of the most conservative and "old school" centres in the world. Can you really put that under the title of alternative medicine? It's complementary medicine at the least, and integrative medicine at the most. AstroBlue 08:16, 23 Jun 2004 (UTC)

LOL! An Alternative Medicine Section is precisely that, a section or portion of the article. -- [[User:Mr-Natural-Health|John Gohde | Talk]] 11:32, 23 Jun 2004 (UTC)

I understand that, again, I wasn't questioning the title of the section. I was questioning the placement of the italicised quote in the section, I think it belongs outside of the alternative medicine section. Because it's not an alternative medicine.

Interpretation of survey percentages

According to the survey itself, "The denominators used in the calculation of percents [in table 3] are the estimated number of adults who used CAM (excluding megavitamin therapy and prayer) within the past 12 months, excluding persons with unknown information about whether CAM was used to treat the specific condition" (footnote, p 9). I believe this means that 4.5 percent of CAM-using adults used CAM to treat anxiety (not "4.9 percent of the population" as currently stated in this article). Any comments before I fix this and other references to this survey?

Since no one has objected, I am going to begin correcting the references to this survey. I will link to this page from the edit summary in case anyone has further comments.

This thing is annoying cuz i look for anxious and i get disorder stuff! 125.253.35.144 08:08, 13 August 2007 (UTC)Gamer Gus

References

Thank you to user 67.125.168.127 for the additions. If you come back to this page, please insert the citations for the references at the bottom of the article. If you are not sure how to format them then just put them in and I will do it. Thanks again. Have you had a look at the other articles leading from here on those disorders? GAD in particular needs a lot of work. --CloudSurfer 05:01, 9 Oct 2004 (UTC)

OCD an anxiety disorder?

Is obsessive-compulsive disorder really considered an anxiety disorder? I realize it often goes with PAD, SAD, et al., due to the often-found seratonin link between them, but I'm not sure OCD should be included here. (If it is, then depression should as well.) --Joe Sewell 16:33, 13 Oct 2004 (UTC)

OCD is currently classified under the DSM as an anxiety disorder. Yes, there is an overlap with depression but for the moment that is how it is generally viewed. I am not familiar with the ICD to tell you how they classify it. --CloudSurfer 10:30, 14 Oct 2004 (UTC)

I are now edumacated (which is the whole point of Wikipedia, isn't it? :) ). Thanks, 'surfer! --Joe Sewell 11:57, 20 Oct 2004 (UTC)

Yes, it is an anxiety disorder. When sufferers do not do the compulsion, they report a feeling of anxiety. Or they use the compulsions to manange anxiety. It's a bit like phobias in a way - sufferers of phobias feel they must get away. --Nervous neuron 05:46, 9 October 2006 (UTC)

From a psychonutritional point of view OCD is part of the complex of anxiety disorders because when you test them with the Medical Test for Hypoglycemia they usually test positive to hypoglycemia. Thus OCD patients tend to be hypoglycemic and therefore tend to overproduce adrenaline. Adrenaline can be considered a focusing hormone, compelling people to focus on something.This is part of being compulsive Jurplesman 05:06, 9 March 2006 (UTC)

It may well not

There is an ongoing controverse in the scientific community about wheter OCD is to be classified as an anxiety.

DSM sais it to be, ICD (by the united nations) sais it does not.

From practice, we have a lot of parallels not only in the feelings of people suffering from OCD and anxiety but in the (possible) medication as well. So we may conclude that there are similar neurochemical processes in those deseases.

There may be a sub-group of anxieties that are quite close to OCD. At least that's what I see in my practice.

Nevertheless, I wouldn't include OCD in the anxieties. Rather create sort of an related-topics-link.

Geraldstiehler 10:49, 24 Nov 2004 (UTC)

Link suggestions

An automated Wikipedia link suggester has some possible wiki link suggestions for the Anxiety article, and they have been placed on this page for your convenience.
Tip: Some people find it helpful if these suggestions are shown on this talk page, rather than on another page. To do this, just add {{User:LinkBot/suggestions/Anxiety}} to this page. — LinkBot 10:39, 17 Dec 2004 (UTC)

External links

The following external links have been removed from the article twice:

• Anxiety-help.com: Topics about curing anxiety and related problems
• Yahoo Anxiety Health Center: Helpful Explantions of anxiety and anxiety treatment

WP:EL tells us the following:

1. Official sites should be added to the page of any organization, person, or other entity that has an official site.
2. Sites that have been cited or used as references in the creation of a text. Intellectual honesty requires that any site actually used as a reference be cited. To fail to do so is plagiarism.
3. If a book or other text that is the subject of an article exists somewhere on the Internet it should be linked to.
4. On articles with multiple Points of View, a link to sites dedicated to each, with a detailed explanation of each link. The number of links dedicated to one POV should not overwhelm the number dedicated to any other. One should attempt to add comments to these links informing the reader of what their POV is.
5. High content pages that contain neutral and accurate material not already in the article. Ideally this content should be integrated into the Wikipedia article at which point the link would remain as a reference.

Information from these sources has been used in the article. Items 2, 3, and 5 apply here. We may wish to move them from external links to references section once more content from them is included. Please do not remove them from the article on the basis that they provide information that should be in the article - that they provide information (whether we use it or not) is exactly why they belong there. Thanks Scott Ritchie 06:49, 22 August 2005 (UTC)

The pages linked are not references. The first link is a sad personal account that is not representative, itself not referenced and full of advertisements. The URL has been designed to attract search engine related traffic. The second link is a portal, again full of advertising. There are much better resources than this.

So 2 does not apply, for 3 better material is available, and 5 does not apply (this is not "high content"). JFW | T@lk 10:47, 22 August 2005 (UTC)

Ok, that makes sense. I didn't really read them yet anyway (though I was planning to do so later if I ever get around to putting content in the article.) For some reason your edit summaries made me think that you were removing them because you didn't think they belonged even though they had info. Scott Ritchie 21:32, 23 August 2005 (UTC)

Definition

I added a definition of anxiety trying to stress the normative side. Please feel free to edit it, especially if the language is faulty (I'm danish)130.225.37.97 08:54, 25 October 2005 (UTC).

Article heavily favors drug treatments

In the treatment section there is one line that mentions CBT. The rest of the section is mostly about drugs. I understand it's perhaps more convenient to pop a pill every day for the rest of your life than to go see a shrink. But is there evidence that drugs are considerably more effective than good CBT? Besides there are other benefits to CBT other than recovery, such as learning life skills. There are also very good cognitive-behavioral programs some people swear by, such as the one from the Midwest Center. The great thing about these programs is that if you need a "tune-up" it's very easy to get one. Neurodivergent 22:48, 6 November 2005 (UTC)

Against plain anxiety talk therapies doesn't do anything. It's different if you have an actual disorder, but for acute anxiety only benzo, barbs, booze will do.--Sinus 22:17, 17 November 2005 (UTC)

Is there a scientific way to determine if you have an "actual" disorder or (I suppose) just a made-up one? NVM, I'll take a shot at fixing the section myself. I should do some research on comparative effectiveness. I don't see any clear indications either way. BTW, CBT and talk therapy are not the same. And there are many different kinds of CBT. For example, there's one type of CBT that seems to be particularly effective in treating depression. Neurodivergent 16:43, 18 November 2005 (UTC)

Therapy is sorta pointless when you have anxiety so bad you can't leave the house. As with depression, most studies indicate that the combination of the two is more effective than either one alone. Think of medication as the anesthetic required for the psychic surgery which is therapy, which can take years. 69.17.124.2 02:13, 18 June 2007 (UTC)

Missing references

This article contains a whole bunch of in-text references that aren't actually in the "References" section. Namely:

• Brawman-Mintzer & Lydiard, 1996, 1997
• American Psychiatric Association (2000)
• Craske, 2000
• Gorman, 2000
• den Boer, 2000
• Margolis & Swartz, 2001
• Gilmartin, 1987
• Rowman & Littlefield, 2003

Here are some guesses:

• Brawman-Mintzer O, Lydiard RB. (1996) Generalized anxiety disorder: Issues in epidemiology. Journal of Clinical Psychiatry 57(suppl 7):3-8.)
• Craske, MG, & Barlow, DH (2000). Mastery of your anxiety and panic, 3rd ed
• Gilmartin, 1987: Brian G. Gilmartin (1987) Shyness & Love: Causes, Consequences, and Treatment

...but I don't know, and it doesn't feel very good to add a bunch of references (to articles and books that I haven't read) when I'm not sure what the original author meant. I guess the best would be to include other references that can actually be confirmed... /Skagedal 21:53, 28 November 2005 (UTC)

Unless of course the persons who added the above references are listening now! :-) /Skagedal 21:58, 28 November 2005 (UTC)

That's what happens when people just cut & paste from anywhere. Your suggestions sound reasonable. JFW | T@lk 01:00, 29 November 2005 (UTC)

Nervousness?

Is nervousness the same thing as anxiety?

I guess someone who is constantly nervous could be said to have generalized anxiety. But there's quite a bit more to anxiety, such as aprehension about an impending doom. Neurodivergent 20:58, 1 December 2005 (UTC)

The Psychonutritional Treatment of Anxiety and Panic Attacks

I'm a little skeptical of this section. I think it's OK to mention legit "alternative" treatments, but they should be clearly labeled as such. Stephen Barrett's Quackwatch has this to say about it:

Today's "fad" diagnoses used to explain various common symptoms are chronic fatigue syndrome, hypoglycemia, food allergies, parasites, "environmental illness," "candidiasis hypersensitivity," "Wilson's Syndrome," "leaky gut syndrome," and "mercury amalgam toxicity." The first four on this list are legitimate conditions that unscientific practitioners overdiagnose. OhNoitsJamie^Talk 05:26, 9 March 2006 (UTC)

Well I happen to be very skeptical Dr Stephen Barrett. As a self-appointed defender of organised conventional medicine in America, he is hardly qualified to talk about alternative medicine. I do agree with him when it come to frauds in medicine and medicne that is not suppoirted by scientifif method.. But even Dr Stephen Barrett has approved hypoglycemia as a legitimate illness!!Jurplesman

Alternative views are allowed, but they must be presented in a neutral point of view. Read more about that on the comments already on your talk page. -- Barrylb 08:54, 9 March 2006 (UTC)

I've moved it here from the article. Even if it is legitimate, it needs a rewrite -- Barrylb 05:36, 9 March 2006 (UTC)

How do you propose to rewrite it???Jurplesman 06:47, 9 March 2006 (UTC)

Since you seem to be new here, I would like to politely ask that you read the links in the welcome message and other messages on your talk page. You will learn more about how to contribute here. -- Barrylb 08:51, 9 March 2006 (UTC)

Hi Barry, I see you too come from ozzie. You did not give a link to "Welcome Page". I thought I read that. I find that the instructions given on the Wikipedia "Help:Editing" extremely cumbersome. It is flooded with links, that leads to other links and then another. You can really get lost. I cannot even print out the "Help:Editing" as part of the information is not printed.

Now that you have taken the article off the main page, when are you going to put it back on again. If somebody is going to edit it I would like it to be somebody with some knowledge of nutritional biochemistry. What is the next procedure?? Who is going to edit it? Jurplesman 01:41, 10 March 2006 (UTC)

I was referring to all the information added to your Talk Page. In particular you should read about "neutral point of view" and "spam" mentioned under the header "Wikipedia's policy on adding links". You should also read about What Wikipedia is not. Regarding editing, I think the best person to edit it would be yourself once you are more familiar with what is appropriate. Sorry if this sounds like hard work but these are the established rules... -- Barrylb 04:30, 10 March 2006 (UTC)

I have rewritten the article with a few more external references and posted it on the main page. I hope it is altight this time. Jurplesman 03:50, 11 March 2006 (UTC)

---

Comment I agree with the move, Barrylb. It doesn't seem appropriate to have such a large portion of the article devoted to the "hypoglycemia is the root of all psychological problems" view, not to mention the promotional aspect of the content and links. OhNoitsJamie^Talk 23:55, 14 March 2006 (UTC)

The faceless troglodites seem to be in control here. I have withdrawn the article altogether.Jurplesman 02:18, 19 March 2006 (UTC)

Useful Link

We have just added article and video content created by key opinion leader Physicians as well as government health organizations and would like to be considered as a useful resource for this page. We are hosting an online symposium on mental health and spirituality and think this would also be a valuable contribution to the community.

Thank you,

Ryan

anxietytreatment com Anxiety Treatment—This unsigned comment was added by Ryanandrew (talk • contribs) .

You've already been blocked once for commercial link spamming. What makes you think this is different? OhNoitsJamie^Talk 00:30, 22 March 2006 (UTC)

Anxiety and Insomnia

I found an article that I found helpful.

Anxiety Insomnia

To whoever wrote this, I need to pass this information along to a co worker, who I'm sure will thank you. FireWeed 01:23, 27 January 2007 (UTC)

As of September 26, 2010, the website is temporarily unavailable. CreativeSoul7981 (talk) 01:43, 27 September 2010 (UTC)

[1]

Negative Ion clothing can effectively resolve anxiety related issue —Preceding unsigned comment added by 67.129.150.10 (talk) 00:11, 12 January 2008 (UTC)

Treatment

the article says "Mainstream treatment for anxiety consists of the prescription of anxiolytic agents and/or referral to a cognitive-behavioral therapist." but as far as I know in most cases SSRIs are used as main stream especially in OCD and GAD. anxiolytic agents are used as the first choice when a patient comes to emergency with an attack. Any Psychiatrists around? neurobio 00:36, 5 June 2006 (UTC)

This needs clarification, OCD is classified as GAD and its treatment is in most cases SSRI used in combination or alone to CBT, on the other hand, when anxiety doesn't appear to have sign of obsessive or compulsive behavior anxiolytic agents are tried, but due to the dependence and the need to increase the dosage, CBT is favoured. But those are not the only treatment, in some cases, when in cases of severe social-phobia, uncontrolable depersonalization/derealization and the patient doesn't respond, atypical anti-psychotics at lower dosage might be tried. Anxiety treatment depending on the severity or the type is a case by case matter, but when taken 'anxiety alone' it is generally known that meanstream treatment includes anxiolytic agents and/or CBT. Fad (ix) 16:30, 6 June 2006 (UTC)

Ringxiety

Is it really appropriate to list ringxiety as a "see also" link? Seems kind of silly to me... -- Tim D 02:26, 13 October 2006 (UTC)

It is intensity of a feeling a negative motivation. Emotional state caused by a situation that is seen as threatening (wood 1998) involves worry that failure might accrue. Negative thoughts we may experience.

What are the signs of anxious performer? Body Mind Shaky, cold, sweaty, heart beats faster, feel sick, feel dizzy, breathing heavy, pacing up and down, butterfly’s, sweaty palms Saying things in your mind like I can’t do it, negative thoughts, frighten, mood swings.

What would you feel like if you had to do the following?

1. A bungee jump: nervous and shaky 2. Playing in front of a large crowd: motivated 3. White water rafting: excited 4. Snow boarding: excited 5. Watching your favourite game play: bored 6. Taking a penalty: nervous 7. Reading in front of the class: bored 8. Playing against someone better than you: scared 9. A minute before the match or a race is about to start: tense 10. Being watched by your parents or a relative: calm 11. A training session: relaxed 12. Taking an important exam: nervous shaky worried adrenalin rush scared heart racing ECT.

A note to the individual who posted a response to the comment above

Please, sign your posts. Also, you might want to read up on some of the formatting rules and tricks specific to Wikipedia. Thanks! --Roman à clef 11:12, 15 January 2007 (UTC)

Two factor theory section needs help

I flagged this part of the article as original research because it's very unclear who the content of the section is being attributed to in the article. Do these words belong to Freud or are they coming from an editor? If it's the former, we need a good citation (did Freud write anything about operant conditioning?), and if it's the latter we need to remove it from the article. --Roman à clef 11:12, 15 January 2007 (UTC)

The only two-factor theory of anxiety that I know of was proposed by Mowrer

(Mowrer, O. H. (1960). Learning theory and behavior. New York: Wiley)

(Mowrer, O. H. (1947). On the dual nature of learning: A re-interpretation of "conditioning" and "problem-solving." Harvard Educational Review, 17, 102-148.)

Adding it in would be certainly helpful. —The preceding unsigned comment was added by Eugeneltc (talk • contribs) 22:59, 28 March 2007 (UTC).

Why not just remove this section? It looks like some kid took an intro psych class and thought he'd be cool by putting up "info" onto wiki. It's junk. —Preceding unsigned comment added by 72.130.16.84 (talk) 09:16, 25 October 2007 (UTC)

Test Anxiety

There's a request for an article on stress in school pupils over at Wikipedia:Requested_articles/Natural_Sciences#Physical Chemistry. Now might be a good time to (a) improve this section with some references and (b) link to a more detailed article on the subject - those who are expert in psychology. Sojourner001 18:49, 18 January 2007 (UTC)

This is a very good article

There is room for improvement, but this stands above 90 % of the English language Wikipedia articles. Everybody who contributed owes themselves congratulations. FireWeed 01:24, 27 January 2007 (UTC)

Psychotic Anxiety

Wikipedians, I am being treated for psychotic anxiety, but can find no information on this anywhere on the internet. It is referred to in academic journals, but I have no access to the content. Searches are also complicated by the frequent use of the term "non-psychotic anxiety", which shows up as a hit for "psychotic anxiety". I would really appreciate someone adding information about psychotic anxiety to this article, and also adding information about the use of antipsychotics for treating anxiety (this treatment is becoming more common, even for non-psychotic anxiety, or so I hear). —The preceding unsigned comment was added by 62.195.115.100 (talk) 12:25, 31 March 2007 (UTC).

link suggestion

Hello , Just writing to suggest a useful link www.anxietyaustralia.com.au Anxiety Treatment Australia Information on anxiety disorders, panic attacks, phobias, stress management, insomnia, chronic pain and anxiety59.167.89.244 06:19, 8 June 2007 (UTC)

Maybe split off medical uses of the term?

The concept of anxiety has been around since classical times. It's part of the human condition. The medical conception of it is a fairly new thing. I see that there was a merge request in the past for this and Anxiety disorder. Perhaps all mental health aplications of the term should go there and this article should be more about the expiernced phenomena? I'm a philosophy student with an anxiety disorder. I've got a pretty good understanding of both concepts and don't mean to suggest that one should be favored over the other. The thing Kierkegaard described and the thing described in psychiatric journals may well be two faces of the same coin, but they are very different concepts. I can't remember my password and will make a new login before making any actual changes. 69.17.124.2

Anxiety as an emotion

I've made some bold changes to the article to try to make it more clear this article is about anxiety as an emotion, not a disorder. I've removed the 'treatment' section entirely because emotions do not need treatment (eg we don't have a treatment section in the article on Fear). -- Barrylb 05:06, 1 July 2007 (UTC)

Theories section

Someone really needs to clean up the theories section. It's awful. Freud's idiot ramblings are stated as fact. No biological basis is mentioned. —Preceding unsigned comment added by 69.251.88.4 (talk) 19:20, 18 September 2007 (UTC)

WEED...Are You Kidding Me?

First no source is present second marijuana can cause mental illness so i cant see why it would be here. I want to erase it Kava ok i'll say maybe but most definetly shakey source . Marijuana can cuase axiety in some people .I smoked 4 straight everyday then moved to coke then heroin and heroin works the best but i'm in recovery now on better non-addictive substances.that are not euphoreants and help actual anxiety

Marijuana gives me major anxiety, it should be removed. —Preceding unsigned comment added by 86.134.69.147 (talk) 16:01, 18 May 2008 (UTC)

Viktor Frankl sentence/paragraph

The second paragraph in the "Existential anxiety" section, starting with "According to Viktor Frankl..." is difficultly worded. I didn't change it because I'm not sure what the writer was trying to say, but perhaps someone with a better idea of what it means can make it more reader-friendly? CyclonePredator (talk) 04:23, 18 July 2008 (UTC)

Anxiety & the Bible

Several New Testament scriptures command Christians not to be anxious, e.g., Philippians 4:6, 1 Peter 5:7, Matthew 6:25-34, & Luke 12:22-26. 207.114.25.241 (talk) 02:48, 13 November 2008 (UTC)

Great because people can generally turn it on and off, just like a light switch. Same thing with fear, depression, love, happiness and an other emotion. I need to tell the part of my brain that makes me anxious to stop, because i am not allowed to be according to the bible. —Preceding unsigned comment added by 75.187.83.247 (talk) 19:06, 12 February 2009 (UTC)

I think that the message of the Bible may be to pray about whatever is causing anxiety. “Cast all your anxiety on him [Christ]” (1 Peter 5:7) Captain Dunsel (talk) 06:17, 13 November 2009 (UTC)

Lack of Anxiety is a condition that s/b referenced

I was watching a show on serial criminals and a psychologist mentioned a condition (the name of which I tried to commit to memory, but alas) a person can have that limits their capacity to experience anxiety. These are people who have limited inhibitions, regrets, or capacity to avoid repeating mistakes. Does anyone know the namw of that condition and shouldn't it be referenced here as an antonym? Thx! Vf1100s (talk) 01:49, 17 December 2008 (UTC)

The psychologist was probably referring to psychopathy, but the link may be too theoretical to discuss here. --Jcbutler (talk) 02:44, 17 December 2008 (UTC)

Genes

Added a section on associated genes, I think that might be useful, albeit the association is of course weak in all the studies, AFAIK. Many gene articles are stubs and have little links so starting such sections could bring more attention, and as the list grows it could be forked into a separate page. Best regards, --CopperKettle 16:26, 11 February 2009 (UTC)

I'm not sure, for as you wrote in the section, "single genes have little effect on complex traits". --Jcbutler (talk) 17:33, 11 February 2009 (UTC)

• Feel free to delete if you consider it a bad contribution. I'm not anxious to keep the section. (0: Just thought it would be useful. --CopperKettle 02:49, 12 February 2009 (UTC)

False claim in the introduction

The introduction reiterates a traditional claim, popular in textbooks, that an essential distinction between anxiety and fear is the presence or absence of identifiable cues. "Anxiety is a generalized mood condition that occurs without an identifiable triggering stimulus. As such, it is distinguished from fear, which occurs in the presence of an external threat." This claim is false on two grounds. First, the not-so-recent behavioral (Wolpe, 1958) and cognitive models (Barlow, 1988) of anxiety acknowledge the presence of identifiable, primarly internal, cues preceding the rise of anxiety. Moreover, when prospectively assessed, panic attacks that seem to occur naturally typically appear to have identifiable precipitants, such as an argument at work or passing a pattern of dark and light while driving. Second, fear does not have necessarily external threat. A fear to die often accompanies painful stimuli.

This does not mean that fear cannot be distinguished from anxiety (albeit such claim has been defended), but it does highlight that simple and easy conceptualisation won't do the job.142.85.5.20 (talk) 16:51, 19 May 2009 (UTC)

It seems to come down to what the word "identifiable" means in this context. Can you come up with a different wording that is more correct without being too complicated for general readers to understand? Looie496 (talk) 17:03, 19 May 2009 (UTC)

I agree with this discussion. The current definition of anxiety provided is incorrect. Anxiety is an emotional reaction consisting of cognitive, physiological, and behavioral responses to a future danger. Fear, on the other hand, consists of similar responses to a present danger. Both emotions function to allow the individual to escape or avoid danger. Numerous researchers and clinicians (e.g. David Barlow, 2000) have made this distinction. Also, the DSM-IV-TR makes clear that anxiety is not a mood condition - it is an emotional response, not a relatively stable condition on the continuum between depression and elation (i.e. mood). —Preceding unsigned comment added by Mtukudzi (talk • contribs) 15:15, 3 June 2009 (UTC)

The wording quoted at the top of this section is due to Jcbutler, who seems now to have retired from wikipedia. The question of an "identifiable" stimulus for anxiety seems to be a somewhat difficult one with perhaps part of the problem being to whom the stimulus is identifiable (usually not the anxious person, it seems). As far as anxiety not being a mood, the language used in the article is "generalized mood" which says, I think, something about the temporality of anxiety. I think the present/future danger information above adds something to the discussion and I have included it in the introduction, with a link to the appropriate reference by Barlow. Note that Barlow also uses the language "mood state" for anxiety. Soiregistered (talk) 06:14, 10 June 2009 (UTC)

On fear vs. anxiety

Note: The criteria names coined below constitute original research, but the support for each do not.

1. Uncertainty distinction criterion

According to Krain et al. (2008) the uncertainty of an event is characteristic to anxiety, but not fear.

When a subject knows what to expect while facing a threat, then she will experience fear, else anxiety due to the suspense.

Support: Krain et al. (2008); Researchers study "anticipatory anxiety" using anticipation paradigms.

2. Temporal distinction criterion

Anxiety is a mood, fear is as an emotion. Both are affective responses.

Mood - a prevailing state of mind or feeling (Oxford English dictionary, OED, 1989)

Emotion - a mental state that is neither cognitive nor volitional (OED, 1989)

Support: According to Chua et al. (1999) fear occurs more rapidly than anxiety.

3. Stimulus criterion

Anxiety is less stimulus-bound than fear (Freud).

Support: Questionable.

The third criterion seems to be based on faulty introspection by psychologists such as Freud. Specific phobia (that involves anxiety) requires a specific object as stimulus. Anxiety is triggered by a cue that refers to a stimulus in anticipatory studies, but the cue is nevertheless stimulus-bound. A cue represents a stimulus, and so perceived fulfil sufficient criteria for stimuli.

To distinguish anxiety from fear either criterion 2 or 3 seem feasible from the above. It is important to distinguish the cue as a cause of anxiety available to perception, versus the stimulus that is not present (but threatens to appear) and associated with negative valence. It all comes down to construct validity and operational definitions.

References

• Chua, P., Krams, M., Toni, I., Passingham, R. E., & Dolan, R. (1999). A functional anatomy of anticipatory anxiety. NeuroImage, 9, 563-572.

• Krain, A. L., Gotimer, K., Hefton, S., Ernst, M., Xavier Castellanos, F., Pine, D. S., et al. (2007). A functional magnetic resonance imaging investigation of uncertainty in adolescents with anxiety disorders. Biological Psychiatry, 63, 563-568.

• Oxford English dictionary (2nd ed.) [Electronic version]. (1989). Oxford University Press. http://dictionary.oed.com

Ostracon (talk) 15:36, 16 November 2009 (UTC)

In a recent review paper about anxiety, by a leading researcher in the field, one reads: "Across mammals, "fear" represents a brain state engaged by acute, immediately present "threats", stimuli that the organism will extend effort to avoid; "anxiety" represents a brain state engaged when encountering sustained cues that more ambiguously predict threat." (Pine, Helfinstein, Bar-Haim, Nelson, and Fox; Challenges in developing novel treatments for childhood disorders: Lessons from research on anxiety. Neuropsychopharmacology, 2009, 34, p.213.

We see that the criteria used to distinguish anxiety from fear by Pine et al. use the first two elements underlined by Ostracon. Following criterion 1, the more ambiguous the threat, the more likely that the organism will experience anxiety instead of plain fear. This ambiguity can relate to the valence of the stimuli (Is this group threatening to me?), to the temporal aspect of the stimuli ("will I encounter the threatening stimuli in the future?"), or to uncertainty ("will I have a good mark?". Moreover (criterion 2), fear generally follows acute stimuli, whereas anxiety generally is engaged after encountering sustained cues.

The traditional distinction (presence or absence of identifiable cues) is generally subsumed by the new definition (present cues tend to be acute and less ambiguous), but the innovative distinction by Pine et al. avoids the counter-examples seen above.Marcus wilby73 (talk) 20:17, 26 November 2009 (UTC)

Anxiety in terms of challenge level and skill level.

Why is the graph of anxiety in terms of challenge level and skill level, and its assiated text, being removed? Dr.enh (talk) 06:07, 8 June 2009 (UTC)

Sorry, you just caught me mid-steam. Guess I should be quicker... Soiregistered (talk) 06:28, 8 June 2009 (UTC)

Anxiety is normal

This discussion is being moved here (where it belongs) from two user talk pages. Context is as follows: a paragraph in the introduction of Anxiety read:

Anxiety is considered to be a normal reaction to stress. It may help a person to deal with a difficult situation, for example at work or at school, by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder.

The second and third sentences in the paragraph were edited [2] by NeuroBells123, with edit summary "make the sentence balanced (i.e., anxiety is not 100% good as suggested by old sentence)." His edit changed the text to:

Anxiety is considered to be a normal reaction to stress. Adversarial nature of the feeling aside, anxiety might impel a person to deal with a difficult situation, for example at work or at school, by prompting one to cope with it. When anxiety becomes excessive, it falls under the classification of an anxiety disorder.

This edit was reverted [3] by Soiregistered, with the remark "the sentence was better as it was."

The further discussion follows:

In what way was the previous sentence 'better as it was'? - NeuroBells123 (talk) 15:28, 18 August 2009 (UTC)

...your change made confusing and wrong what had been a clear and correct statement. The two uses of "may" in the sentence were correct and were both important; the word "may" means that a given statement is a possibility and not necessity. You might want to look at may and might in the Wiktionary as well as this article from the editors of the NY Times [4] about usage of "may" and "might". Additionally, your usage of "adversarial" was incorrect, so you might want to look also at the definitions of adversarial and adverse. --Soiregistered (talk) 18:36, 18 August 2009 (UTC)

Would this work for you: [quote]"Unpleasant nature of the feeling aside, anxiety may impel a person to deal with a difficult situation, (...)"[endquote]? As mentioned in the edit summary, the main reason is to 'balance' the sentence - anxiety may impel one to deal with difficult situations, but it is not a pleasant feeling. Further, even without anxiety, one can deal with difficult situations. - NeuroBells123 (talk) 03:13, 19 August 2009 (UTC)

Further note that 'impel' is a more accurate/appropriate word to use here than 'help'. Being anxious, one is required/urged/made/pressurized/pushed (in a word - impelled) to deal with a difficult situation. Whereas the word 'help' suggests that - a feeling merely provides the advantageous conditions for a person to deal with certain situation, but he may or may not act according to it (due to conscious choice). - NeuroBells123 (talk) 03:18, 19 August 2009 (UTC)

The subject of the paragraph being discussed is that normal anxiety is, in fact, normal. You seem to be resisting that. The unpleasant nature of anxiety is stated right at the top of the article (in the second sentence) and it doesn't need to be repeated a few sentences later. I would argue that the point of this paragraph is to actually to "balance" the negativity of that earlier statement. For normal anxiety (which, again, is the subject of the paragraph and much of the article; anxiety disorders are not included in this article) the point you make in your comment above at 03:18, that "help" implies that a person may or may not act on their anxiety is, in fact, quite properly what should be the implication. One has the choice of resisting/denying normal anxiety. And although the mechanism by which anxiety "helps" one cope is left unstated, I would argue that that is a virtue, since the pathways by which anxiety helps/prompts/causes/motivates/impels one to cope often are vague. I say leave it at "help" until someone comes along and properly describes the mechanism (and includes a citation!). --Soiregistered (talk) 08:26, 19 August 2009 (UTC)

If you, along with other Wikipedians, do strongly believe that normality balances negativity (as if normality itself is not a negativity), then I have nothing further to say here. So much for the hallowed normality of stressful feelings, I guess. - NeuroBells123 (talk) 16:01, 19 August 2009 (UTC)

I'm in the middle here. "Unpleasant nature of the feeling aside" leads the reader in the wrong direction -- it doesn't belong in this sentence. However, "impel", although it feels a bit awkward, is a better word than "help". Looie496 (talk) 16:54, 19 August 2009 (UTC)

I agree - 'impel' is certainly a better word. However, just as you feel awkward (Perverse; adverse; difficult to handle) about it, impel also suggests that `there is something wrong with anxiety`, whereas anxiety is a very normal feeling. There is nothing wrong with it. Hence, I vote for 'help'. - NeuroBells123 (talk) —Preceding undated comment added 02:44, 20 August 2009 (UTC).

Just to provide further basis for the existing wording, the word "help" originates in the NIMH document which provides the basis for this paragraph (and is referenced at its end). That document states: Anxiety is a normal reaction to stress. It helps one deal with a tense situation in the office, study harder for an exam, keep focused on an important speech. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder. That would seem to be even more positive sounding that what presently exists in the article. It doesn't mean that it is right (or wrong) but that indeed is what is says. --Soiregistered (talk) 08:19, 20 August 2009 (UTC)

Rearranged

Rearranged per WP:MEDMOS. It makes it easily to get this article up to WP:GA as it highlights topic areas that may be missed. Doc James (talk · contribs · email) 21:13, 18 May 2010 (UTC)

It doesn't make sense to medicalize this article (per WP:MEDMOS or otherwise). There is a separate article on Anxiety disorder which more properly addresses medical aspects. Your edits consisted of re-labeling, per MEDMOS, the "Varieties" section as "Classification", the "Biological basis" section as "Cause", the "Clinical scales" section as "Diagnosis", and moving the Varieties/Classificaion section to a position right after the introduction. But anxiety is not a disease and hence cannot be "diagnosed". Relabeling the biological basis as "cause" ignores the psychological, philosophical, and sociological aspects. And while I would be interested in seeing a "classification" scheme for anxiety, what is contained in the article is simply a list of some varieties of anxiety and not a classification scheme. Therefore, I have undone your edits. Soiregistered (talk) 18:55, 19 May 2010 (UTC)

It may not be a disease but it is a condition. I felt that these changes gave some structure to this group of articles on similar conditions. Depression is half way along these line [5] Maybe what we need is a disambig page such as found here [6] as you are right this article is about the mood rather than the disease which I thought.--Doc James (talk · contribs · email) 20:09, 19 May 2010 (UTC)

Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens (PubMed article)

Changes in Severity of Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens PMID 19430577 PMC 2678838 Free PMC Article

http://ukpmc.ac.uk/articlerender.cgi?tool=pubmed&pubmedid=19430577

"We have recently found a preliminary association between symptoms of upper airway inflammation and depression (23) and between the seasonality of mood and self-reported mood sensitivity to high pollen counts (24). Additionally, in an animal model intended to examine the effects of allergic sensitization to tree pollen on depressive symptoms, we found significant anxiety-like behavior across trials in the sensitized animals following exposure to tree pollen (25). In individuals with allergic sensitization, when mast cell bound IgE antibody is crosslinked by specific allergens, an activating signal is transduced which results in mast cell degranulation and the release of inflammatory mediators and cytokines. Clinical investigation suggests that Th2-type lymphocytes are predominantly activated in allergic diseases. Th2 cells are characterized by their production of IL-4, IL-5, and IL-13.

Cytokines, administered in amounts below the threshold necessary to induce “sickness behaviors,” have been shown to induce anxiety, depression, and cognitive disturbances in healthy subjects (26). An increase in cytokine levels in the blood has been hypothesized as one potential catalyst for the decompensation of depression (27-29). Cytokine-treated patients may also experience an increase in depressive symptoms, including suicidal ideation and attempted suicide (30-33). Even a low dose of cytokine-promoting endotoxins such as lipopolysaccharides (LPS), can trigger depressive symptoms along with anxiety without bringing about other sickness behaviors (26). Certain cytokines released during LPS-induced inflammation are also released during the allergic response. For instance, mast cell degranulation releases TNF-α (34), the administration of which has been shown in animal models to be anxiogenic (33). We have seen that sensitization and subsequent exposure to tree pollen (25) and intranasal LPS administration (35) induce anxiety-like behaviors in sensitized rodents. Additionally, we have reported increased gene expression of cytokines involved with allergic inflammation (36) in the orbital cortex of suicide victims, where histopathological changes in suicide victims have been previously reported (14)."

...

The relationship between anxiety and allergy scores became non-significant when we adjusted for depression scores for covariates. This suggests that the depression and anxiety scores are highly intercorrelated, with anxiety symptoms as a component of the depressive syndrome, or indicative of comorbidity between anxiety and depression. On the other hand, the relationship between depression scores and allergy symptom scores remained significant after adjustment for anxiety symptoms. These data suggest that the relationship between allergic disease and depression is a major phenomenon, and seemingly more robust than the one between allergic disease and measures of anxiety. However, our animal model data point towards a more consistent association between anxiety-like behaviors rather than depressive-like behaviors and with sensitization and exposure to tree pollen allergen (35,52). ... —Preceding unsigned comment added by 66.167.61.217 (talk) 22:25, 23 May 2010 (UTC)

Hypochondria

As a student who had just started drinking, I was suffering palpitations as a result of alcohol withdrawal. I didn't know what it was and palpitations combined with anxiety meant I thought I was dying! I made a right dick of myself in front of a very non-understanding doctor. A better doctor since reassured me.

The link between anxiety and hypochondria should be emphasised. —Preceding unsigned comment added by 86.172.221.47 (talk) 14:35, 30 May 2010 (UTC)

Question about the DSM-IV

I see that this page has not been updated in a few months, but I was wondering, is any clinical definition included in this article from the DSM-IV? I see sources from psychological journals (which I'm sure cite the DSM-IV), but thought a clinical definition somewhere might be helpful. What do other people think? CreativeSoul7981 (talk) 01:48, 27 September 2010 (UTC)

Your concerns regarding clinical definitions should be directed at the Anxiety disorder article, which covers anxiety as a medical condition, rather than this one. Note as well, however, that inclusion of DSM material into wikipedia has led to WP:COPYVIO issues in the past. Soiregistered (talk) 18:43, 15 November 2010 (UTC)

Link suggestion

I would like to suggest the link http://www.mentalhealthy.co.uk/psychology/anxiety this is a page of non-commercial guides to anxiety, each of which are written by BCP registered psychologist and are free. The website is affiliated with Dr's, psychologists and the mental health charity SANE. I believe this link to be reputable and extremely helpful to those suffering anxiety disorders.78.147.184.36 (talk) 10:58, 21 September 2011 (UTC)

I'd have no problem with this being added. --Manicjedi (talk) 22:11, 9 November 2011 (UTC)

Moving image of anxious person

A person feeling anxiety from too much work

This was added to the lead. I think it's cute. Thoughts. --Anthonyhcole (talk) 07:30, 3 November 2011 (UTC)

I hate moving images of any sort in articles. I can't properly focus attention on text when there is a moving image next to it. Looie496 (talk) 17:02, 3 November 2011 (UTC)

The image itself makes me anxious, even just seeing it out of the corner of my eye. :) DaisySaunders (talk) 19:09, 13 November 2011 (UTC)

Remarkably poor scholarship

This article is not only poorly written, it mixes and matches topics, as well as showing a fundamental lack on understanding on the topic.— Preceding unsigned comment added by 72.44.165.181 (talk) 22:00, 9 November 2011 (UTC)

So... fix it. --Manicjedi (talk) 22:10, 9 November 2011 (UTC)

I agree that it mixes and matches topics. Although it mentions neuroscience, it doesn't take into account that the contributions of neuroscience "tweak" previous understandings of anxiety as held by individual disciplines to the point that a biopsychosocial view offers a way of bringing these understandings together and making more sense of each. This will take a lot of work to improve, but the easiest thing may be to do as others have suggested and shorten this so that it deals only with a definition of the popular term "anxiety" and then re-routes to anxiety disorders for further discussion. DaisySaunders (talk) 19:07, 13 November 2011 (UTC)

I've put up a notice to let people know about the issue. This will need attention from experts on the subject. - M0rphzone (talk) 05:05, 2 April 2012 (UTC)

Great Article.... can you help with similar article?

This is a very well written article that covers the subject well. Would anyone like to help with the Fear of Flying article. It is in sad shape. I tried, but do not have the Wikipedia skills. --Mt6617 (talk) 00:43, 8 February 2012 (UTC)

No this article is far from being well-written... The fear of flying article will need expert help as well. - M0rphzone (talk) 05:08, 2 April 2012 (UTC)

No Cure

Perhaps somewhere, it should be discussed that anxiety is a natural process, and there isn't a cure for it, only coping. — Preceding unsigned comment added by 64.5.67.75 (talk) 14:24, 26 February 2013 (UTC)

Hi 64.5.67.75! The article actually says: "Anxiety is considered to be a normal reaction to a stressor. It may help an individual to deal with a demanding situation by prompting them to cope with it. However, when anxiety becomes overwhelming, it may fall under the classification of an anxiety disorder." So it does say that it is a natural process. Lova Falk talk 15:56, 26 February 2013 (UTC)

Need to add medical causes such as Grave Disease

Hyperthyroidism and Graves disease first symptons are anxiety and left untreated the anxiety and other symptons increases to an intolerable level. — Preceding unsigned comment added by 174.101.171.109 (talk) 04:42, 8 March 2013 (UTC)

Hi 174.101.171.109! If you have good, secondary sources - and please also check WP:MEDRS - than please be bold and write a section about it! With friendly regards, Lova Falk talk 13:58, 30 April 2013 (UTC)

Herbal treatments

I replaced the statement "research has been unable to confirm the effectiveness of these herbal remedies" with "evidence of the effectiveness of these herbal remedies varies, depending on the supplement and the particular type of anxiety". The citation abstract (that was present before my modification) says among other things that "data supports the effectiveness of some popular herbal remedies and dietary supplements" and "Although the evidence varies depending on the supplement and the anxiety disorder, physicians can collaborate with patients in developing dietary supplement strategies that minimize risks and maximize benefits." 62.195.45.181 (talk) 09:40, 11 September 2013 (UTC)

Help

Every night I cannot sleep as I get continuous thoughts that the house will get robbed/set on fire, I'll wake up and everyone is dead, that someone will kill me, that someone will crash through our house, it gets me so worked up that I move to the middle of the bed, curl up in a ball and put all of my sheets on me even if it mkes me hot. Does anyone have any tips as to what I can do to lessen or stop this? Stormy Nights (talk) 09:42, 29 December 2013 (UTC)

I'm sorry, but Wikipedia editors are prohibited from giving medical advice. Our purpose here is to write articles about medical topics, but we can't give advice about specific situations. You might consider seeking advice from a doctor or therapist. Looie496 (talk) 17:48, 29 December 2013 (UTC)

Okay thank you anyway. Stormy Nights (talk) 18:32, 29 December 2013 (UTC)

Medication

Hi there! I really enjoyed reading this page on anxiety and I just thought I might propose a few ideas. From what I've read and studied, it may be appropriate to put a little more emphasis on the use of medication as a treatment. I'm suggesting maybe just stating that "Cognitive behavioral therapy and medication are the principal forms of treatment." I know that many different people use many different treatments but from what I have studied as a psychology student, I think this edit may just show that medication is used more than implied on the page. M.K.L.H. (talk) 23:04, 17 April 2014 (UTC)

Hi M.K.L.H.! This article is about anxiety, not about anxiety disorder. I think your suggestion belongs to the latter article! Lova Falk talk 13:47, 14 May 2014 (UTC)

Removal of sections

As you can see, I removed the sections Prevention and Treatment. This article is about anxiety, not about anxiety disorder. Treatment is discussed quite well in our article anxiety disorder; prevention should be discussed there. Lova Falk talk 13:51, 14 May 2014 (UTC)

edit warring on new content about evolutionary biology

Fixler.3 edited a chunk of content here with no sources, and no edit note, which i removed in this dif with edit note "revert unsourced content per WP:VERIFY and no WP:OR" Fixler.3 re-inserted it, again with no edit note. I again removed it, this time with edit note: "2nd time. removing unsouced content. fails WP:VERIFY and appears to be WP:OR - please discuss on Talk per WP:BRD)". fixler.3 please do read those links. For sourcing, we need sources that comply with WP:MEDRS since this is health-related content. Jytdog (talk) 12:34, 18 November 2014 (UTC)

New Edit

I would like to add a line under the "Biological Vulnerabilities" subheading. It would read as follows: People who suffer from anxiety tend to show high activity in response to emotional stimuli in the amygdala. I think this is important to add because it connects the idea that the amygdala is a part of the limbic system and is responsible for many of the effects of anxiety. This will add more of a biological basis to the subheading.

References

References

Embroksch (talk) 19:03, 16 March 2015 (UTC)

Minor edit

I think it is important to stress that although a person's genes may make them particularly susceptible to an anxiety disorder, it doesn't necessarily mean that they will develop this disorder. It should be said that personal and social factors can bring out an anxiety disorder in some cases. The effect that both social and biological factors have on the disorder should be stated. I think this is best placed under the Biological Vulnerabilities subheading. Richardferranti (talk) 03:32, 24 March 2015 (UTC)

Please feel free to edit the article if you see a way to improve it. The worst that can happen is that somebody will revert your edit. Looie496 (talk) 20:39, 24 March 2015 (UTC)

Possible references

I'm a student at Virginia Tech, taking a physiological psychology course. These are my potential references to add information to the page

1. "Anxiety Disorders." Anxiety Disorders. American Psychiatric Association, 2015. Web. 13 Apr. 2015.
2. Anxiety Disorders. Rockville, Md.?: National Institute of Mental Health, 1999. National Institute of Mental Health. US Department of Health and Human Services, 2009. Web. 13 Apr. 2015.
3. Friedman, Richard A. "Why Teenagers Act Crazy." The New York Times. The New York Times, 28 June 2014. Web. 13 Apr. 2015.
4. Smith, Melinda, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. "Anxiety Disorders and Anxiety Attacks." : A Guide to the Signs, Symptoms, and Treatment Options. Helpguide.org, Mar. 2015. Web. 13 Apr. 2015.
5. Stossel, Scott. "Surviving Anxiety." The Atlantic. Atlantic Media Company, 22 Dec. 2013. Web. 13 Apr. 2015.

Psyeconhokie16 (talk) 16:11, 13 April 2015 (UTC)Emily

Hi, Psyeconhokie16; could you please provide us a means of contacting your professor about registering a course, which will make your work more productive and enjoyable? It doesn't look like your prof has shared info with you about Wikipedia's guideline for sourcing medical content. Depending on what text you want to add, the sources you list above may not be compliant.

1. Presumably this is the DSM? If so, we must take great care not to duplicate the DSM criteria here, as the APA guards their copyright stringently.
2. 1999 ??? Dated. Is that a website? What is the URL?
3. Not likely to be useful as a source (pls review WP:MEDRS on laypress sources).
4. Not a good source ... self-help, etc.
5. Laypress.

If Wiki Education staff could contact your professor, they could better orient him or her on sourcing for Wikipedia. SandyGeorgia (Talk) 22:20, 19 April 2015 (UTC)

minor edit

I would like to propose a minor edit under the "Descriptions" subheading. It would read as, "Anxiety can be experienced with long, drawn out symptoms that one lives with every day, reducing their everyday quality of life, known as chronic (or generalized) anxiety, or it can be experienced in short spurts with stressful panic attacks sporadically throughout one's life, known as acute anxiety.

I envision this addition being added to the end of the second paragraph after reference [13]. This information would add to the diversity of the facts included in the article, and allow readers to have a better, well-rounded understanding of anxiety as a mental illness.Akduncan (talk) 21:50, 19 April 2015 (UTC)

Akduncan, welcome to Wikipedia and thanks for proposing your edit on talk. Correcting some minor issues (like how we place punctuation, see WP:FN) in your proposal would yield:

Anxiety can be experienced with long, drawn out or daily symptoms that reduce one's quality of life, known as chronic (or generalized) anxiety, or it can be experienced in short spurts with stressful panic attacks sporadically throughout one's life, known as acute anxiety.

There are a couple of problems. First, I don't find anything verifying these definitions of acute and chronic on the Mayo website (perhaps I've missed it, can you point out where you see it?), and second, please review WP:MEDRS regarding sites like Mayo for sourcing content on Wikipedia. Regards, SandyGeorgia (Talk) 22:49, 19 April 2015 (UTC)

References

Thank you for the help with the minor punctuation issues. In regards to the information on the Mayo website, here is a quote with the information I used for my reference: "Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is usually out of proportion to the actual circumstance, is difficult to control and interferes with your ability to focus on current tasks. It often occurs along with other anxiety disorders or depression." Akduncan (talk) 23:21, 19 April 2015 (UTC)

Yes, but how are you using that page to make this distinction between acute and chronic? I don't see that on the page. Also, if you could locate a secondary review for this info, it would be grand! There is a box at the top of this talk page labeled "Ideal sources ... " ... if you can search those sources, you will surely find something useful. Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches may be helpful in learning how to search PubMed. Mayo Clinic, although not specifically disallowed, is not a great source. SandyGeorgia (Talk) 23:51, 19 April 2015 (UTC)

I understand what you are saying. I found a study on PubMed that focused on the treatment of patients with generalized anxiety disorder which was described as a "chronic illness," and mentioned how the treatment of individuals with chronic anxiety is different than that of individuals with acute anxiety because of their varied characteristics and symptoms. Here is the link to that study. — Preceding unsigned comment added by Akduncan (talk • contribs) 03:09, 20 April 2015 (UTC)

I have correctly indented your talk page post, and please be sure to sign your talk post with four tildes ( ~~~~ ) after them. PMID 15448583 is a secondary review, which is good, but it would be better if you found something less than five years old (that is from 2004, more than a decade old). Did the source specifically mention panic attacks? And please note how to format citations: [7] SandyGeorgia (Talk) 05:22, 20 April 2015 (UTC)

Lancet seminar

doi:10.1016/S0140-6736(16)30381-6 JFW | T@lk 08:26, 2 September 2016 (UTC)

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216.243.12.138

User;216.243.12.138 the refs you are using are not OK per WP:MEDRS and you are removing content that is sourced per MEDRS. Please explain what your goal is here. Thanks. Jytdog (talk) 21:47, 16 December 2016 (UTC)

Recent reversion

About this reversion [8], is not justified.

The previous version included a closed, very limited, and no properly representative list of health disorders which may cause anxiety symptoms. I organized and expanded the list a bit, adding at least some of the most representative disorders, with sources which meet WP:MEDRS. My edit also meets WP:NPOV and WP:RSUW.

The most important approach to people with anxiety symptoms is to confirm or rule out the presence of an underlying organic disorders causing their symptoms, whose diagnosis and treatment should be the main objective. It is the most important point and one that is often forgotten. Increasing evidence confirms that many neuropsychiatric diseases mask an underlying organic disorder.

This reference Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases is very complete, free-access, with demonstrative tables, and better than this other already present [9] (I wonder if we should eliminate it...).

The inclusion of non-celiac gluten sensitivity in the list, possibly what has bothered Jytdog most, is fully justified since its estimated prevalence is very high (rates between 0.5–13% in the general population), higher than that of many of the diseases listed in the previous version and anxiety is one of the most common of its extraintestinal symptoms. The date of the review is 2015 and is published in the journal Best Practice & Research Clinical Gastroenterology, with an impact factor of 3.478. (I extracted a brief quotation because is not free access (edited on November 14: I just found the link to the free full text), to avoid future doubts). We can see the relevance in this table with epidemiological data of some other diseases of the list:

Comparative table

Disease Epidemiology (copied from current versions of Wikpedia articles) Non-celiac gluten sensitivity Rates between 0.5–13% in the general population Asthma Rates vary between countries with prevalences between 1 and 18% Chronic obstructive pulmonary disease Globally, as of 2010, COPD affected approximately 329 million people (4.8% of the population). Diabetes The prevalence of diabetes is 8.5% among adults. Hypotiroidism In large population-based studies in Western countries with sufficient dietary iodine, 0.3–0.4% of the population have overt hypothyroidism. Hyperthyroidism In the United States hyperthyroidism affects about 1.2% of the population. Cardiac arrhythmia In Europe and North America, as of 2014, atrial fibrillation affects about 2% to 3% of the population. Celiac disease Rates vary between different regions of the world, from as few as 1 in 300 to as many as 1 in 40, with an average of between 1 in 100 and 1 in 170 people. Anemia A moderate degree of iron-deficiency anemia affected approximately 610 million people worldwide or 8.8% of the population. Epilepsy It affects 1% of the population by age 20 and 3% of the population by age 75. Multiple sclerosis As of 2010, the number of people with MS was 2–2.5 million (approximately 30 per 100,000) globally, with rates varying widely in different regions Parkinson's disease The proportion in a population at a given time is about 0.3% in industrialized countries. PD is more common in the elderly and rates rises from 1% in those over 60 years of age to 4% of the population over 80. Alzheimer's disease In the United States, Alzheimer prevalence was estimated to be 1.6% in 2000 both overall and in the 65–74 age group, with the rate increasing to 19% in the 75–84 group and to 42% in the greater than 84 group. Prevalence rates in less developed regions are lower.

Jytdog, I repeat that I respect your work very much and I believe that it is very valuable, but I tell you once again that you are confused with me and I ask you once again please stop harassing me with such type of comments [10].

I'm going to restore the edit. And in my opinion, it would be advisable to make a broader listing, perhaps a table.

Best regards. --BallenaBlanca (Talk) 05:25, 12 November 2016 (UTC)

References

Yes the current content is not good. "anxiety" - the emotion - is a common human reaction to bad situations, especially serious medical conditions, especially chronic ones or terminal ones. and especially when there is a lot of uncertainty as there is often is in medicine. the content should be more clear about that. it is also a direct result of things like traumatic brain injury. am looking for sources that deal with this generally and clearly. the laundry-list approach to listing medical conditions "associated" with anxiety is not productive. Jytdog (talk) 05:49, 12 November 2016 (UTC)

I had not read this before my last edit here. Well, we'll continue talking, now I do not have more time. Best regards. --BallenaBlanca (Talk) 06:01, 12 November 2016 (UTC)

Do we have data on how common anxiety is in each of these conditions? Anxiety is a normal human emotion felt by all so would be present in all diseases as well as all healthy people. I guess the question is which ones have significantly higher rates? During an MI or during an asthma exacerbation nearly everyone is seriously anxious. Those with well controlled asthma who are not having a flair are not anxious. Doc James (talk · contribs · email) 23:37, 12 November 2016 (UTC)

True, no one needs to read an encyclopedia to know that being sick can trigger anxiety symptoms. I think the approach is when anxiety may be masking an organic disease, anxiety as one of the first symptoms of an active disease, and focusing on differential diagnosis. We would have the following list:

Endocrine diseases (hypothalamic diseases, hyperprolactinemia, hypo- and hyperthyroidism), metabolic disorders (diabetes), deficiency states (low levels of vitamin D, B2, B12, PP and folate), electrolytes disorders (parathyroid diseases), respiratory diseases (chronic obstructive pulmonary, asthma, pulmonary edema, pulmonary embolism), heart diseases, haematologic diseases (sickle cell, anemia), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease, Crohn’s disease, Whipple‘s disease), inflammatory diseases (systemic lupus erythematosus), infectious diseases (enteric typhoid fever, infectious mononucleosis), cerebral vascular accidents (transient ischemic attack, stroke), brain infectious diseases (meningitis, encephalitis), brain degenerative diseases (Alzheimer‘s disease, Parkinson's disease, dementia, Huntington’s disease, multiple sclerosis, epilepsy)

Extended content / prevalence

Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases Endocrine Diseases The hypothalamic diseases cause most frequently bulimia or anorexia, hypersomnia, impotency, and attacks of anxiety. Effects of hyperprolactinemia on mood and behaviour include depression, eating disorders and anxiety. Metabolic Disorders Reactive hypoglycemia is often considered the cause of anxiety symptoms in diabetic patients. Actually, hypoglycemia presents with symptoms related to autonomic activation, involving the psychic field with behavioural disorders and anxiety (adrenergic symptoms), and related to neuronal suffering (neuro-glycopenic symptoms), with predominant implication of cognitive (speech difficulty), sensorial (visual disorders, dizziness) and neuromuscular (fatigue) sphere. Deficiency states Low levels of vitamin D have been associated with exacerbation of anxiety, depression, psychosis. Low levels of vitamin B2, B12, PP and folate. Electrolytes Disorders Parathyroid diseases often present with psychiatric symptoms, and can be easily recognized through determinations of low calcium levels. The link between anxiety disorders and hypocalcemia is mutual: a panic attack could manifest with tetany by hyperventilation, and hypocalcemia could trigger a panic attack. Medical history can reveal a renal failure or a past thyroidectomy, while electrocardiogram (ECG) shows low and large QRS complex and long QT duration. Moreover, arrhythmia, paresthesia, laryngospasm, muscle cramps and tetany (obstetrician’s hand) can appear. The increased central neuro-excitability produces instead irritability and seizures, but anxiety is the predominant symptom in 20% of patients. Respiratory Diseases Approximately one third of patients with chronic obstructive pulmonary disease meets the criteria for anxiety disorders, and a quarter shows depression, systemic inflammation being implicated in their pathogenesis, other than corticosteroids. An increased prevalence of depression, anger, anxiety disorders, particularly panic attacks, is also reported in patients with asthma, easily identified by thoracic objective alteration and pulse oximetry. Pulmonary edema and pulmonary embolism can present with choking sensation associated to anxiety and agitation, fear, sometimes sensation of forthcoming death. Heart Diseases Mitral valve prolapse can be associated with palpitations and induce anxiety. A significant proportion (about 20%) of ICD patients experiences psychological symptoms including anxiety, depression or both, a rate similar to that in other cardiac populations. Haematologic Diseases Sickle cell disease conveys a high risk of anxiety and depression, due to chronic anemia, hypoxiemia, cerebrovascular ischemia and stroke, Gastrointestinal diseases Neuropsychiatric disorders may precede the diagnosis of Crohn’s disease, including peripheral neuropathy, myopathies, pseudotumor cerebri, papilloedema and psychiatric disorders (anxiety, phobias, depression). Whipple‘s disease, a multisystemic chronic granulomatous disease caused by infection with Tropheryma whipplei, can appear as a primary neuropsychiatric isorder, including cognitive changes and psychi- atric findings (depression, anxiety, psychosis, personality change). Inflammatory and Infectious Diseases The immune system can influence the CNS by cytokines, produced by activated immune cells. Sickness behaviour is a behavioural complex induced by infectious and immune disease, and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behaviour and depression, for example, behavioural inhibition, anorexia, adipsy, increased sleepiness, melancholia (anhedonia), anxiety, and somatic symptoms (fatigue, hyperalgesia, malaise). Recently, depression and sickness behaviour have been proposed as Janus-faced responses to shared inflammatory pathways. Several neuropsychiatric pictures are related to systemic lupus erythematosus, without reliable imaging or laboratory criteria: cognitive deficit, anxiety, mood disorders, confusion, delirium, and psychosis. Psychiatric morbidity can affect about 20% of patients suffering enteric (typhoid) fever, appearing with delirium (73%), generalized anxiety disorder (4%), depressive episode (4%), schizophrenia like disorder (4%) and monosymptomatic neuropychiatric manifestations such as apathy, hallucination, confusion and coma. Anecdotal reports suggest that chronic fatigue, anxiety and depressive disorders may be precipitated by infectious mononucleosis. Cerebral Vascular Accidents Anxiety often accompanies a transient ischemic attack and may be the major symptom of presentation in emergency department. Aphasia, unilateral neglect, anosognosia (deficit disorders), delirium and mood disorders (productive disorders), are the most frequent disorders checked during first examination of stroke in emergency department. Anxiety and depression are associated with lefthemispheric strokes. The left-side neglect and anosognosia are the most widespread neuropsychiatric symtoms after the right cerebral hemisphere lesion, and anxiety alone is commonly associated. Brain Infectious Diseases Brain suffering in meningitis and encephalitis, mainly of viral or bacterial etiology, together with common irritative signs and various neurological deficits, involves consciousness alterations (from sleepiness to coma) and psychiatric symptoms simulating anxiety (restlessness), mood disorders or true psychosis (delirium). Brain Degenerative Diseases Anxiety symptoms, depression and changes in personality are common in Alzheimer‘s disease or other forms of dementia, and sometimes precede the other early clinical manifestations, such as cognitive impairment and mood changes. Psychiatric manifestations are an integral part of Huntington’s disease, including specific symptoms, such as the executive dysfunction syndrome, and not-specific symptoms, such as delirium. Anxiety and major depression have been reported as the most common prodromal symptom. Anxiety disorders are reported in 37% of patients with multiple sclerosis, but depression is the most frequently related disorder. In many cases multiple sclerosis is wrongly diagnosed as pure psychiatric disorder. Mood disorders are the most frequent conditions associated with epilepsy, followed by anxiety, attentiondeficit, psychotic and personality disorders. Patients with focal epilepsy, and mainly those arising from temporal and frontal lobe, have a greater incidence of anxiety (panic attacks), depression, or psychosis. Dementia should be considered in differential diagnosis in elderly patients, complaining psychiatric symptoms like severe anxiety manifestations, depressive or paranoic disorders, acute psychosis and marked agitation (“myxedema madness”) Celiac disease Psychological morbidity of celiac disease: A review of the literature Results: Anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity. Psychological symptoms may affect the quality of life and the dietary adherence. Conclusion: The literature on the effect of treatment in the outcome of depression, anxiety, fatigue and QoL in CD is not consistent. However, it is important to consider that ongoing problems with anxiety and depression in particular may affect dietary adherence and QoL. Thus, health care professionals need to be aware of the ongoing psychological burden of CD in order to support their patients. The lack of clear evidence of improved QoL in asymptomatic CD after treatment makes mass screening, where a majority of patients may be subclinical or asymptomatic, controversial if the aim of screening is to improve QoL. Further studies are required to better understand this specific aspect. Non-celiac gluten sensitivity: Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders The most frequent extra-intestinal features of NCGS include fatigue and lack of well-being together with neurological symptoms, i.e. headache, “foggy mind”, arm / leg numbness and anxiety / depression. Systematic review: noncoeliac gluten sensitivity. Table 3 Extraintestinal manifestations (%): Anxiety 39% (Volta, 2014) Inflammatory bowel disease. Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review. Pooled prevalence estimate for anxiety disorders was 20.5% [4.9%, 36.5%] and 35.1% [30.5, 39.7%] for symptoms of anxiety. IBD patients in active disease had higher prevalence of anxiety of 75.6% [65.5%, 85.7%] compared to disease remission….. Results from this systematic review indicate that patients with IBD have about a 20% prevalence rate of anxiety and a 15% prevalence rate of depression. Chronic obstructive pulmonary disease Strategies to improve anxiety and depression in patients with COPD: a mental health perspective. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Type 1 diabetes: Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis. Symptoms of anxiety were reported for up to 32% of patients. A negative impact on glycemic control was demonstrated. CONCLUSIONS: Our analyses confirmed a high prevalence of symptoms of depression and anxiety in youth with type 1 diabetes that potentially compromise diabetes management and glycemic control. Type 1 or 2 diabetes The association between Diabetes mellitus and Depression There is evidence that the prevalence of depression is moderately increased in prediabetic patients and in undiagnosed diabetic patients, and markedly increased in the previously diagnosed diabetic patients compared to normal glucose metabolism individuals [7]. The prevalence rates of depression could be up to three-times higher in patients with type 1 diabetes and twice as high in people with type 2 diabetes compared with the general population worldwide [8]. Anxiety appears in 40% of the patients with type 1 or 2 diabetes [9]. The presence of depression and anxiety in diabetic patients worsens the prognosis of diabetes, increases the non-compliance to the medical treatment [10], decreases the quality of life [11] and increases mortality [12]. Hypothyroidism and hyperthyroidism Cognitive function in untreated hypothyroidism and hyperthyroidism. Also present are alterations in mood, manifested by increased rates of depressive and anxiety symptoms. SUMMARY: Patients with overt or subclinical thyroid dysfunction commonly complain of decrements in cognitive function, but studies suggest that such decrements are most likely to be minor or not related to the thyroid dysfunction. More common are mood alterations, which often improve with treatment. Epilepsy. Psychiatric comorbidities in epilepsy: identification and treatment. Mood disorders are the more frequent conditions associated with epilepsy, followed by anxiety, attention-deficit, psychotic and personality disorders. Multiple sclerosis. The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION: This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. Parkinson's disease Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies. Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Alzheimer’s disease. The prevalence of neuropsychiatric symptoms in Alzheimer's disease: Systematic review and meta-analysis. The most frequent NPS was apathy, with an overall prevalence of 49% (95% CI 41-57%), followed by depression, aggression, anxiety and sleep disorder, the pooled prevalence estimates of which were 42% (95% CI 37-46%), 40% (95% CI 33-46%), 39% (95% CI 32-46%) and 39% (95% CI 30-47%), respectively.

Best regards. --BallenaBlanca (Talk) 04:48, 13 November 2016 (UTC)

References

This article is not about mood disorders. A bunch of those sources discuss mood disorders and some discuss depression, which is different emotion/mood. Again I do not think the laundry list approach is helpful. General content about how being sick (or dying) causes anxiety; maybe specific organs affected that tend to cause anxiety more commonly (diseases/conditions where it is hard to breathe (COPD, asthma, etc), appear to have high trend to cause anxiety, for example), or kinds of conditions -- for example degenerative conditions that have unpredictable courses (MS, ALS, for example). That sort of thing. Jytdog (talk) 05:13, 13 November 2016 (UTC)

Perhaps we could trim the list a bit. But you can not leave out gastrointestinal diseases, they are some of those that are clearly at the top as causing anxiety symptoms, and sometimes, anxiety is the only manifestation in abscense of digestive symptoms (or identificable digestive symptoms), as commonly occurs in CD and NCGS.

Endocrine diseases (hypothalamic diseases, hyperprolactinemia, hypo- and hyperthyroidism), metabolic disorders (diabetes), deficiency states (low levels of vitamin D, B2, B12, PP and folate), respiratory diseases (chronic obstructive pulmonary disease, pulmonary edema, pulmonary embolism), heart diseases, haematologic diseases (sickle cell, anemia), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease), inflammatory diseases (systemic lupus erythematosus), cerebral vascular accidents (transient ischemic attack, stroke), brain infectious diseases (meningitis, encephalitis), brain degenerative diseases (Alzheimer‘s disease, Parkinson's disease, dementia, multiple sclerosis, Huntington’s disease, epilepsy)

Best regards. --BallenaBlanca (Talk) 13:10, 13 November 2016 (UTC)

We have now arrived at your unfortunately continuing effort to drive celiac into every article in WP. Stop it. Burying it in a laundry list is not acceptable. That said i think there is a pretty well known relationship between gut and anxiety, especially with somaticization of anxiety in various kinds of gut pain. We can discuss that at a high level. Jytdog (talk) 21:08, 13 November 2016 (UTC)

And we have now arrived at your continuing effort to remove mentions to celiac disease, non-celiac gluten sensitivity, and in general the possibility of improving disease symptoms with a diet management in every related disease in WP, specially neurological and psychiatric disorders. Perhaps your COI[11] is a problem and it's conditioning your approach and your edits. Stop pushing your POV, stop pushing against me or those who write about reversible diseases that can cause neurological or psychiatric symptoms, and stop harassing me, as I am asking you again and again and again....

Let's focus on this talk, please. WP:OFFTOPIC

And let's focus on the data and literature, as Doc James said, and let's see if they support my proposal. That's what we have to do.

You said: "That said I think there is a pretty well-known relationship between gut and anxiety, especially with somaticization of anxiety in various kinds of gut pain."

Yes, there is a pretty well-known relationship between gut and anxiety. But thinking about just somatization is a very, very simplistic vision, which does not reflect current knowledge.

Coeliac disease occurs frequently, affecting 1–3% of the Western population. In developed countries 83% of CD cases remain undiagnosed, usually because majority of patients may be subclinical or asymptomatic (non-classic, minimal, or absent digestive symptoms). Prevalence rates for NCGS are 0.5%-13%.

Extra-intestinal symptoms, as anxiety, may be the only manifestation of CD and NCGS in absence of gastrointestinal symptoms. Anxiety is a common complaint in patients with untreated celiac disease and contribute to lower quality of life, which usually improves within a few months after starting a gluten-free diet. Anxiety affects about 39% of people with untreated NCGS and dietary elimination of gluten may lead to complete symptoms resolution.

"There has been a tendency by some to attribute NCGS to placebo effect or somatization, particularly as the diagnosis is based on subjective self-reporting by patients. As well as the initial study confirming NCGS by Gibson et al. [22], however, an interesting study was recently published where groups of patients with CD, NCGS and a control group underwent complete psychiatric assessment and a subsequent gluten challenge [26]. There was found to be no difference between groups in their tendency to somatization, personality traits, or anxiety and depression symptoms. Moreover, patients with NCGS reported more symptoms than CD patients when challenged with gluten, suggesting NCGS to be a credible physical diagnosis [26]. Key Points: • Gluten ingestion in gluten sensitive individuals can lead to a variety of clinical presentations including psychiatric, neurological, gynecological, and cardiac symptoms. • Dietary elimination of gluten may lead to complete symptom resolution. • Health practitioners are advised to consider gluten elimination in patients with otherwise unexplained symptoms. • Nonceliac gluten sensitivity may be a part of a constellation of symptoms resulting from a toxicant induced loss of tolerance' (TILT).

And you're trying to avoid mentioning CD and NCGS and just talking about "somaticization of anxiety in various kinds of gut pain". Two chronic diseases which have such high prevalence in the general population, and such high rates of underdiagnosis, and many CD and NCGS people spend many years calified and managed as simply anxious and even they are not evaluated. There is no justification. We can not stop talking about this just because you do not like it. It's your POV.

We have enough data to support and include the list I proposed.

What I propose you is that you add more gastrointestinal diseases if you consider it and locate data, but in addition to CD and NCGS.

Best regards. --BallenaBlanca (Talk) 09:35, 14 November 2016 (UTC)

References

am not trying to avoid CD at all - a laundrylist is still not helpful and all the walls of text in the universe are not going to change that. i got hung up on several other things this weekend. will come back after looking for general sources on anxiety and disease. Jytdog (talk) 10:02, 14 November 2016 (UTC)

Jytdog I don't understand what this you say "i got hung up on several other things this weekend" means. --BallenaBlanca (Talk) 13:23, 14 November 2016 (UTC)

i wanted to spend time on this; i ended up spending time on other things instead. Jytdog (talk) 20:04, 14 November 2016 (UTC)

Ah, well Jytdog, I understand. You mean that during the week your work does not leave you free time.

"A laundrylist is still not helpful" but it improves the current one[12] and is correctly adjusted and referenced. This more complete list I propose is preferable to what is already present, which is scarce, not representative and insufficiently referenced.

I agree that you improve the content I add, but remember not to delete information properly referenced and note that you do not control articles WP:OWN. Others may add information.

I'm going to edit.

Best regards. --BallenaBlanca (Talk) 04:18, 15 November 2016 (UTC)

What I was saying is that I did not get to this OVER THE WEEKEND. I am NOT saying that I can only edit on the weekends. I am ALSO saying that the laundry list is NOT HELPFUL. It is clutter and doesn't give useful information. Jytdog (talk) 04:23, 15 November 2016 (UTC)

Ah, ok, now I understand! Jytdog, you do not have to yell at me. Keep calm and be patient, please. Remember that English is not my native language.

You said "i wanted to spend time on this" and "will come back after looking for general sources on anxiety and disease" and you do this edit?? [13] You delete a reference that is true general, delete a lot of revisions and sytematic reviews, and do this...?? Is it a joke...?? Please, remember WP:NPOV and WP:OWN.

You say that the content I added (and you have removed [14] ), which is a list of possible causes or differential diagnosis, "is NOT HELPFUL", "doesn't give useful information". It is not your mission to judge whether the information "is useful or it is not". For whom "is NOT HELPFUL", "doesn't give useful information"? This is an encyclopedia and must include encyclopedic content. This content is in fact enciclopedic, and very useful for physicians and lay people, but possibly not please pharmaceutical companies that manufacture drugs for neuropsychiatric diseases. You have to limit yourself to respecting Wikipedia policies and the time and work of other editors. The content I added is correctly referenced, and meets all Wikipedia policies.

With respect to make a list of possible causes or differential diagnosis, this criteria is is followed in hundreds if not thousands of articles in Wikipedia. There is no reason not to do it here. If you think the list is clutter, you may order it. It is not easy to classify, it could be done in several ways, because some types overlap, nor ordering it, since many valid criteria could be followed.

I will trim and reorder a bit according to the prevalence of the main diseases of each block and trying to also considere the age of onset. I hope it improve but I invite you to check it out, following Wikpedia policies.

Best regards. --BallenaBlanca (Talk) 12:30, 16 November 2016 (UTC)

The Testa paper you seem to be pinning a lot of this on, is about (and says it is about) the "pseudopsychiatric emergencies, which represent up to 10% of all psychiatric disorders". This article is about an emotion, not about a psychiatric disorder or any kind of emergency. Jytdog (talk) 18:28, 16 November 2016 (UTC)

"This article is about an emotion, not about a psychiatric disorder" You can not separate the mind from the body. World Health Organization (2009). Pharmacological Treatment of Mental Disorders in Primary Health Care "Anxiety is a condition characterized by the subjective and physiologic manifestations of fear. In anxiety disorders, individuals experience apprehension, but, in contrast to fear, the source of the danger is unknown. The physiologic manifestations of fear include sweating, shakiness, dizziness, palpitations, mydriasis, tachycardia, tremor, gastrointestinal disturbances, diarrhoea, and urinary urgency and frequency. If anxiety is generalized and persistent over months but not restricted to any particular environmental circumstances, the term generalized anxiety disorder is usually used."

And if you read the information that I prepared Extended content / prevalence, you will see that I have chosen the diseases that may cause symptoms of anxiety (I marked in bold and underlined, to highlight it).

"any kind of emergency" No matter the context: anxiety symptoms are anxiety symptoms, both when attending a person at an emergency department or by a general practitioner at a community health center, or when the person does not seek medical attention; here, in your country, and everywhere worldwide.

Best regards. --BallenaBlanca (Talk) 20:22, 16 November 2016 (UTC)

Yes we can, and we do, separate disorders from moods. That is why we have separate articles. We have the same problem with people trying to add stuff about MDD to the Depression (mood) article. Lots of people make this mistake. Few persist in it as long as you are doing here. Jytdog (talk) 00:41, 17 November 2016 (UTC)

I have clear concepts. We can separate disorders from moods, but we can not separate body and mind, also lots of people make this mistake, but we are not a puzzle nor a mecano: all emotions, all moods, have physical manifestations, which are not necessarily disorders, obviously... In fact, this is reflected in the definition of the disambiguation page [15] and the definition of WHO [[16] The point of the question is precisely to distinguish when they are manifestations of a mood, a mental disorder, an underlying disease or the result of the consumption of a substance.

Best regards. --BallenaBlanca (Talk) 19:17, 17 November 2016 (UTC)

I'll retrieve this content, but I'll word a sentence a bit, and replace a ref: [17]

Note that after my edits, Doc James, who is a ER doc, reviewed and maintained the content and references [18] We are two editors who agree. Jytdog, please, remember again WP:OWN.

This reference I have used [19], aprobed by Doc James and I to use on this page, covers both "acute psychic manifestations" (see definitions of psychic [20]) and "mimicking specific psychiatric disorders" (see the abstract). Anxiety symptoms are included in the first case, which are by definition limited in time, derived from reaction to a situation and if intense the person may want to go to an emergency service (acute psychic manifestations or subjective and physiologic manifestations of fear); and anxiety disorders, in which anxiety becomes pathological and maintained over the time, are included in the second group (specific psychiatric disorders). Yes, this article refers to "pseudo-psychiatric" because it speaks about the confusion of symptoms of anxiety, symptoms of anxiety disorders or of other psychiatric disorders, with the symptoms of certain organic diseases. No matter the title of the article, what matters is the content. And I have just listed those diseases mentioned in the article wich may present anxiety symptoms, and trimed those related with anxiety disorders. I explained and documented above.

Jytdog seems to be reverting with preconceived ideas and without reading the arguments nor the data I'm spending time locating and presenting here, at least on a part of the occasions. Let's look for example at the times of these edits:

• Talk: Anxiety

06:26, 12 November 2016‎ BallenaBlanca (talk | contribs)‎ . . (22,077 bytes) (+13,315)‎ . . (Recent reversion not justified)

• Anxiety

06:26, 12 November 2016‎ BallenaBlanca (talk | contribs)‎ . . (47,162 bytes) (+1,433)‎ . . (Undid revision 748846630 by Jytdog (talk) See talk page https://en.wikipedia.org/w/index.php?title=Talk:Anxiety&diff=749068967&oldid=744640978)

06:27, 12 November 2016‎ Jytdog (talk | contribs)‎ . . (45,729 bytes) (-1,433)‎ . . (Undid revision 749069011 by BallenaBlanca (talk) yes, do see the talk page)

My message at talk page was long, detailed, including also a compressed table which needs to pick and expand for showing, and 17 references. Jytdog, in one minute, read my edit in Anxiety [21], read the talk page and reviewed the 17 references,[22], and returned to Anxiety, wrote this edit summary (yes, do see the talk page), and reverted my edit.[23] Can someone really do all this in one minute...? That is the interest and respect Jytodg seems to show for my work.

Also, I think that Jytdog should avoid being so disrespectful and contemptuous [24] (I think the word "gobbledegook" is a derogatory term, correct me if I'm wrong). This content was also approved by Doc James, who did not modify nor deleted it after reviewing my edits [25] because is a correct adaptation of the sources (remember that it is necessary to paraphrase and not copy literally).

And the title of this ref [26] removed by Jytdog at this edit [27] is in fact "The association between Diabetes mellitus and Depression" but is not just "focused on depression in diabetes", because it includes data to the prevalence of anxiety symptoms (40%), citing this systematic review PMID 12479986 (everybody can read it to check because is free access), wich concludes "The subsyndromal presentation of anxiety disorder not otherwise specified and of elevated anxiety symptoms were found in 27% and 40%, respectively, of patients with diabetes.", so there is no reason to remove it. However, I have no problem in replacing it with the systematic review.

Best regards. --BallenaBlanca (Talk) 11:14, 18 November 2016 (UTC)

This "Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases." looks like a good reference. Table two has a nice list of the psychiatric symptoms that each medical disorder can cause. Anxiety is both a symptom of some psychiatric disorders and a symptoms of some medical disorders. Psychiatric disorders include a clause that medical disorders have been first ruled out. I think these details both belong here in the "cause" section of anxiety and in the differential diagnosis section of "anxiety disorder" Doc James (talk · contribs · email) 19:20, 18 November 2016 (UTC)

Bellena the reference on Diabetes and depression is focused on depression. there is a couple of passing mention of anxiety. Do not misrepresent sources. This discussion is difficult enough as it is Jytdog (talk) 19:50, 18 November 2016 (UTC)

It's a good observation, Jytdog, do not misrepresent sources. (This does not matter, but it's Ballena and not Bellena).

I agree, Doc James. The page of Anxiety disorders does not have a specific differential diagnosis section. Do you propose to create it, or to include this information within the diagnostic section?

Best regards. --BallenaBlanca (Talk) 01:44, 20 November 2016 (UTC)

Yes a differential diagnosis section here would be good IMO. Doc James (talk · contribs · email) 01:48, 20 November 2016 (UTC)

All right, Doc James, I agree. And I have been browsing other related pages, in which we should also make it clear, or "more clear", what you say: "Psychiatric disorders include a clause that medical disorders have been first ruled out. This "Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases." looks like a good reference." I'll get on with it when I have time and review it together.

Best regards. --BallenaBlanca (Talk) 19:37, 20 November 2016 (UTC)