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Finitions of anxiety and symptoms

Marks  suggests that fear can be seen as a ‘usually unpleasant response to realistic danger’, whereas anxiety is ‘similar to fear but without objective source of danger’. A phobia is fear of a situation, which is out of proportion to the actual danger and cannot be explained or reasoned away.

Panic is a sudden upsurge of acute intense fear, often associated with frantic attempts to escape. These definitions give a useful indication that a distinction is made between realistic and unrealistic responses to situations. These characteristics are important to note as fear and anxiety are sometimes referred to in alternative ways (for example, Beck et al. 1985), or may be used synonymously. The important thing to recognize is that sources of danger (that may or may not be realistic), give rise to a set of unpleasant responses. Beck et al. have listed the following main physical, behavioural, cognitive and affective responses (symptoms) that comprise the anxiety response.

Physiological symptoms

Cardiovascular: Palpitations, heart racing, increased blood pressure, faintness (and/or actual fainting);

Respiratory: rapid breathing, shortness of breath, shallow breathing, lump in throat, choking sensation;

Neuromuscular: Increased reflexes, muscle spasms, tremors, rigidity, f idgeting, wobbly legs;

Gastrointestinal: abdominal discomfort, nausea, vomiting;

Urinary tract: Pressure to urinate, frequency of urination; and

Skin: Face flushed or pale, localized and/or generalized sweating, itching, ‘hot and cold spells’.

Behavioural symptoms

These include: Inhibition, tonic immobility, flight, avoidance, restlessness, impaired coordination, speech dysfluency (for example, stammering) and hyperventilation.

Cognitive symptoms

Sensory-perceptual: hazy, cloudy, foggy ‘mind’, feelings of unreality, hypervigilance; Thinking difficulties: confusion, difficulty concentrating, distractibility, unable to control thinking; and Conceptual: fear of losing control, fear of mental disorder, repetitive fearful ideation.

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