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| - | '''Anxiety''' refers to a complex combination of negative emotions that includes [[fear]], apprehension and worry, and is often accompanied by physical sensations such as [[palpitation]]s, nausea, chest pain and/or shortness of breath.
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| | + | [[Image:The Scream.jpg|thumb|left|"The Scream" (1893) by [[Edvard Munch]].]] |
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| - | Anxiety is often described as having [[cognitive]], [[somatic]], [[emotion]]al and [[behavior]]al components (Seligman, Walker & Rosenhan, 2001). The cognitive component entails expectation of a diffuse and uncertain danger. Somatically the body prepares the organism to deal with threat (known as an emergency reaction); [[blood pressure]] and [[heart rate]] are increased, sweating is increased, bloodflow to the major muscle groups is increased, and [[immune system|immune]] and [[Digestion|digestive]] system functions are inhibited. Externally, somatic signs of anxiety may include pale skin, sweating, trembling and [[Mydriasis|pupillary dilation]]. Emotionally, anxiety causes a sense of dread or panic, nausea and chills. Behaviorally, both voluntary and involuntary behaviors may arise directed at escaping or avoiding the source of anxiety. These behaviors are frequent and often maladaptive, being most extreme in [[anxiety disorder]]s. However, anxiety is not always pathological or maladaptive: it is a common emotion along with fear, anger, sadness and happiness, and it has a very important function in relation to survival.
| + | '''''Angst''''' is a [[German language|German]], [[Dutch language|Dutch]] and [[North Germanic language|North Germanic]] word for [[fear]] or [[anxiety]]. It is used in English to describe an intense feeling of emotional strife. |
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| - | Neural circuitry involving the [[amygdala]] and [[hippocampus]] is thought to underlie anxiety (Rosen & Schulkin, 1998). When confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, [[Positron emission tomography|PET-scans]] show increased bloodflow in the amygdala (Zald & Pardo, 1997; Zald, Hagen & Pardo, 2002). In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors such as feeding on rotten food.
| + | A different but related meaning is attributed to [[Denmark|Danish]] philosopher [[Søren Kierkegaard]] ([[1813]]–[[1855]]). Kierkegaard used the word ''angst'' (Danish, meaning "dread") to describe a profound and deep-seated [[spirituality|spiritual]] condition of insecurity and [[despair]] in the free [[human being]]. Where the animal is a slave to its God-given instincts but always confident in its own actions, Kierkegaard believed that the freedom given to mankind leaves the human in a constant fear of failing its responsibilities to [[God]]. Kierkegaard's concept of angst is considered to be an important stepping stone for 20th-century [[existentialism]]. |
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| - | A chronically recurring case of anxiety that has a serious effect on a person's life may be clinically diagnosed as an anxiety disorder. The most common are [[generalized anxiety disorder]], [[panic disorder]], [[social anxiety disorder]], [[phobia]]s, [[obsessive-compulsive disorder]], and [[posttraumatic stress disorder]] (PTSD).
| + | While Kierkegaard's feeling of angst is fear of actual responsibility to [[god (monotheism)|God]], in modern use, angst is broadened to include general frustration associated with the conflict between actual responsibilities to self, one's principles, and others (possibly including God). Still, the angst in alternative music may be more accessible to most audiences than the esoteric tradition of [[existentialism]]. The term "angst" is now widely used with a negative and derisive connotation that mocks the expression of a common adolescent experience of malaise; in this sense it has become one of the most debased words in the current vocabulary. |
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| - | ==Diagnosis== | + | ==Angst in contemporary music== |
| - | A good assessment is essential for the initial diagnosis of an anxiety disorder, preferably using a standardised interview or questionnaire procedure alongside expert evaluation and the views of the person themselves. There should be a medical examination in order to identify possible medical conditions that can cause the symptoms of anxiety. A family history of anxiety disorders is suggestive of the possibility of an anxiety disorder.
| + | Angst, in contemporary connotative use, most often describes the intense frustration and other related emotions of [[teenager]]s and the mood of the music with which they identify. [[Punk rock]], [[grunge]], [[emo (music)|emo]], and virtually any [[Alternative Rock]] dramatically combining elements of discord, [[melancholy]] and excitement may be said to assert angst. There is an obvious connection to this music and the various subjugation of its proponent youth or racial or sociopolitical minority [[subculture]]. |
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| | + | Angst was probably first discussed in relation to contemporary music in the mid to late 1980s and 1990s. In the 1980s "teen angst" was expressed in music to a certain extent in the rise of [[punk]] and [[post punk]] with bands such as [[The Smiths]]. The word "angst" is currently more associated with, and was probably first used in reference to, the grunge movement and the band [[Nirvana (band)|Nirvana]]. Nirvana themselves seem to have been aware of this, as evidenced by the first line of [[Serve the Servants]] in which [[Kurt Cobain]] describes the success of writing songs dealing with the subject (''Teenage angst has paid off well | Now I'm bored and old...''). |
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| | + | ==See also== |
| | + | {{wiktionarypar|angst}} |
| | + | * [[List of English words of German origin|English words of German origin]] |
| | + | * [[Anxiety]] |
| | + | * [[Suffering]] |
| | + | * [[Anomie]] |
| | + | * [[Alienation]] |
| | + | * [[Ennui]] |
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| - | ==Generalized anxiety disorder==
| + | {{Emotion-footer}} |
| - | {{main|General anxiety disorder}} | + | |
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| - | Generalized anxiety disorder is a common chronic disorder that affects twice as many women as men and can lead to considerable impairment (Brawman-Mintzer & Lydiard, 1996, 1997). As the name implies, generalized anxiety disorder is characterized by long-lasting anxiety that is not focused on any particular object or situation. In other words it is unspecific or free-floating. People with this disorder feel afraid of something but are unable to articulate the specific fear. They fret constantly and have a hard time controlling their worries. Because of persistent muscle tension and autonomic fear reactions, they may develop headaches, heart palpitations, dizziness, and insomnia. These physical complaints, combined with the intense, long-term anxiety, make it difficult to cope with normal daily activities.
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| | + | [[Category:Existentialism]] |
| | + | [[Category:German loanwords]] |
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| - | ==Panic disorder==
| + | [[fr:Angoisse]] |
| - | {{main|Panic disorder}}
| + | [[io:Angoro]] |
| - | | + | [[it:Angoisse]] |
| - | In panic disorder, a person suffers brief attacks of intense terror and apprehension that cause trembling and shaking, dizziness, and difficulty breathing. One who is often plagued by sudden bouts of intense anxiety might be said to be afflicted by this disorder. The American Psychiatric Association (2000) defines a panic attack as fear or discomfort that arises abruptly and peaks in 10 minutes or less.
| + | [[sv:Ångest]] |
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| - | Although panic attacks sometimes seem to occur out of nowhere, they generally happen after frightening experiences, prolonged stress, or even exercise. Many people who have panic attacks (especially their first one) think they are having a heart attack and often end up at the doctor or ER. Even if the tests all come back normal the person will still worry, with the physical manifestations of anxiety only reinforcing their fear that something is wrong with their body. Extreme awareness of every little thing that happens or changes with their body can make for a stressful time.
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| - | Normal changes in heartbeat, such as when climbing a flight of stairs will be noticed by a panic sufferer and lead them to think something is wrong with their heart or they are about to have another panic attack. Some begin to worry excessively and even quit jobs or refuse to leave home to avoid future attacks. Panic disorder can be diagnosed when several apparently spontaneous attacks lead to a persistent concern about future attacks. A common complication of panic disorder is [[agoraphobia]] -- anxiety about being in a place or situation where escape is difficult or embarrassing (Craske, 2000; Gorman, 2000).
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| - | ==Phobia==
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| - | {{main|Phobia}}
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| - | This category involves a strong, irrational fear and avoidance of an object or situation. The person knows the fear is irrational, yet the anxiety remains. Phobic disorders differ from generalized anxiety disorders and panic disorders because there is a specific stimulus or situation that elicits a strong fear response. A person suffering from a phobia of spiders might feel so frightened by a spider that he or she would try to jump out of a speeding car to get away from one.
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| - | People with phobias have especially powerful imaginations, so they vividly anticipate terrifying consequences from encountering such feared objects as knives, bridges, blood, enclosed places, or certain animals. These individuals recognize that their fears are excessive and unreasonable but are generally unable to control their anxiety.
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| - | In addition to specific phobias, such as fears of knives, rats or spiders, there is another category of phobias known as social phobias. Individuals with this disorder experience intense fear of being negatively evaluated by others or of being publicly embarrassed because of impulsive acts. Almost everyone experiences "stage fright" when speaking or performing in front of a group. But people with social phobias become so anxious that performance is out of the question. In fact, their fear of public scrutiny and potential humiliaton becomes so pervasive that normal life can become impossible (den Boer 2000; Margolis & Swartz, 2001). Another social phobia is [[love-shyness]], which most adversely affects certain men. Those afflicted find themselves unable to initiate intimate adult relationships (Gilmartin 1987).
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| - | ==Obsessive-compulsive disorder==
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| - | {{main|Obsessive-compulsive disorder}}
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| - | Obsessive compulsive disorder is a type of anxiety disorder characterized by obsessions and/or compulsions. Obsessions are distressing, repetitive thoughts or images that the individual often realizes are senseless. Compulsions are repetitive behaviors that the person feels forced or compelled into doing, in order to relieve anxiety. One example would be the obsession of extreme cleanliness and fear of contamination, which may lead to the compulsion of having to wash one's hands hundreds of times a day. Another example may be the obsession that one's door is unlocked, which may lead to the constant checking and rechecking of doors.
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| - | ==Treatment overview==
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| - | Mainstream treatment for anxiety consists of the prescription of [[anxiolytic]] agents and/or referral to a [[Cognitive therapy|cognitive-behavioral]] therapist. There are indications that a combination of the two can be more effective than either one alone.
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| - | ===Prescription medication===
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| - | The acute symptoms of anxiety are most often controlled with anxiolytic agents such as [[benzodiazepine]]s. [[Diazepam]] (valium) was one of the first such drugs. Today there are a wide range of anti-anxiety agents that are based on benzodiazepines, although only two have been approved for panic attacks, [[Clonazepam|Klonopin]] and [[Alprazolam|Xanax]]. All benzodiazepines are physically addictive, and extended use should be carefully monitored by a physician, preferably a psychiatrist. It is very important that once placed on a regimen of regular benzodiazepine use, the user should not abruptly discontinue the medication.
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| - | Some of the [[Selective serotonin reuptake inhibitor|SSRIs]] (selective serotonin reuptake inhibitors) have been used with varying degrees of success to treat patients with chronic anxiety, the best results seen with those who exhibit symptoms of clinical depression and non-specific anxiety or general anxiety disorder concurrently. [[Beta blockers]] are also sometimes used to treat the somatic symptoms associated with anxiety, especially the shakiness of "stage fright."
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| - | Many scientists believe that the benzodiazepines and other antianxiety drugs are greatly overprescribed and potentially addictive. See, for example, [[Fred Leavitt]]'s ''The REAL Drug Abusers'' (Rowman & Littlefield, 2003). The addicitive nature of the benzodiazepine class became apparent in the mid 1960's when Valium (Diazepam), the first drug in the class to win FDA approval, resulted in thousands of people who quickly showed the classic symptoms of addiction when used for more than a week or two consistently.
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| - | The most addictive of the benzodiazepines appears to be [[Alprazolam|Xanax]] due to its rapid onset and short half life in the blood stream. Xanax also has the dubious distinction of being the only benzodiazepine that often requires hospitalization for discontinuation as a precaution against dangerous and sometimes fatal seizures as part of the detoxification process. No other medications in this class have shown this fatal side effect, although abrupt discontinuation of virtually any benzodiazepine can result in cravings, stomach pains, cramps, increased anxiety, insomnia and other signs of withdrawal.
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| - | ===Cognitive-behavioral therapy ===
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| - | [[Cognitive-behavioral therapy]] (CBT) is the most popular and effective form of [[psychotherapy]] used to treat anxiety. The goal of the cognitive-behavioral therapist is to decrease avoidance behaviors and help the patient develop coping skills. This
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| - | may entail:
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| - | * Challenging false or self-defeating beliefs.
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| - | * Developing a positive self-talk skill.
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| - | * Developing negative thought replacement.
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| - | * Systematic [[desensitization]], also called ''exposure'' (used for [[agoraphobia]] and [[OCD]] mainly).
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| - | * Providing knowledge that will help the patient cope. (For example, someone who suffers from panic may be informed that fast, prolonged, heart palpitations are in themselves harmless).
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| - | Unlike prescription medication, the effectiveness of cognitive-behavioral therapy depends on various subjective factors, such as therapist competence. In addition to conventional therapy, there are at-home cognitive-behavioral programs sufferers can use as part of their treatment.
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Angst, in contemporary connotative use, most often describes the intense frustration and other related emotions of teenagers and the mood of the music with which they identify. Punk rock, grunge, emo, and virtually any Alternative Rock dramatically combining elements of discord, melancholy and excitement may be said to assert angst. There is an obvious connection to this music and the various subjugation of its proponent youth or racial or sociopolitical minority subculture.
Angst was probably first discussed in relation to contemporary music in the mid to late 1980s and 1990s. In the 1980s "teen angst" was expressed in music to a certain extent in the rise of punk and post punk with bands such as The Smiths. The word "angst" is currently more associated with, and was probably first used in reference to, the grunge movement and the band Nirvana. Nirvana themselves seem to have been aware of this, as evidenced by the first line of Serve the Servants in which Kurt Cobain describes the success of writing songs dealing with the subject (Teenage angst has paid off well | Now I'm bored and old...).
