焦虑疾患

焦虑症或称焦急症（英文：anxiety disorder）是明显感觉焦虑和恐惧感的一种精神疾病。焦虑是对未来事件的担心，恐惧则是对当前事件的反应，这些感觉可能会导致身体症状，如心跳过速和颤抖。以下为常见的焦虑症：广泛性焦虑症、特异性恐惧症、社交焦虑症、分离焦虑症、广场恐惧症、恐慌症和选择性缄默症。焦虑症会由造成症状的原因来区分，人们往往有不止一种的焦虑症。遗传与环境都可能是造成导致焦虑的原因，孩童时期遭受虐待、家族有精神病史以及贫穷都有可能是焦虑症的危险因子。焦虑症常常和其他精神疾病一同发生，像是：重性抑郁障碍、人格异常或是成瘾症，要诊断焦虑症至少需要六个月的临床观察，在特定状况导致异于常人的过度焦虑，并影响正常生活。另外，甲状腺功能亢进症、心脏病、使用咖啡因、嗜酒、滥用大麻或是处于勒戒某些药物的状态，都有可能出现类似焦虑症的症状。焦虑症如果不治疗，一般不会自行复原。治疗方法包含改变生活型态、寻求咨商，以及药物控制。咨商一般会配合认知行为疗法进行治疗。可改善症状的药物则包含抗抑郁药、抗焦虑药（英语：Anxiolytic）（如现代常用：苯二氮䓬类药物、β受体阻断剂、丁螺环酮）等等。全球大约12%的人口患有焦虑症，5~30%的人在一生中至少患有一次焦虑症女性的发生率约为男性的两倍，且通常自25岁以前就开始发作。最常见的为对于特定事物的恐惧症，将近12%的人在一生中的某个时候曾有此类问题，社交焦虑症则占了10%。患病者通常介于15至35岁之间，且年纪通常不会超过55岁。欧美的发生率较其他地方为高。患者的情绪表现的非常不安与恐惧，患者常常对现实生活中的某些事情或将来的某些事情表现的过分担忧，有时患者也可以无明确目标的担忧。这种担心往往是与现实极不相称的，使患者感到非常的痛苦。还伴有自主神经亢进，肌肉紧张或跳动等自律神经失调的症状。精神心理因素，许多学者认为焦虑症状的形成与思维和认知过程有着密切的、重要的关系。研究表明，一些人更愿把一些普通的事情，甚至是一些良性的事情解释为灾难的先兆。例如，人们高神经质。 这与抑郁情绪的产生也有一些联系。还有就是生化的因素，例如甲状腺的病症或神经化学递质功能失调的因素所致。焦虑症的治疗一为药物治疗，用抗焦虑药物去平静脑中过度活跃的部分。另一方面为认知行为治疗，找出生活中的压力源，避开压力，学习放松技巧，减轻压力。另外维持血糖值的稳定有助于稳定情绪，脑中缺乏血糖作燃料就容易暴躁焦虑。补充营养例如维他命B群、钙，多食用深海鱼油、青菜等，配合适当的运动，都有助于降低焦虑症。不光只有单纯的焦虑症才有这些症状，一些精神病症也可能产生焦虑症状，如精神分裂症、强迫症等，这类疾病的焦虑症状只是症状之一。无论是精神病学上或是单纯的焦虑症，在临床上的症状都没有本质上的差异，但在治疗上也许比单纯的焦虑症要复杂，因为在治疗其焦虑症状的同时，还要同时治疗此类患者的其他症状，所以，此需要与单纯的焦虑症有所区分。广泛性焦虑症（英语：Generalized anxiety disorder，缩写GAD）是一种常见的障碍，特征是持续的焦虑，并不在某一特定的对象或情境中焦虑。罹患此病的人常常经受不特定却持续的恐惧和忧虑，对日常中的很多事情都过度担心。它的具体表现是慢性的过度忧虑，以下症状至少有三种出现：烦躁不安、虚弱、注意力不集中、易怒、肌肉紧张、睡眠问题。 Generalized anxiety disorder is the most common anxiety disorder to affect older adults. 焦虑症可能是药物滥用的症状，请医学专家一定注意这一点。一个人可以被诊断为GAD患者，仅当他对日常问题过度担心，达到了六个月及以上。 有些患者可能会在日常决策和记忆上出现问题，因为过度焦虑使他的注意力降低。 表面上看起来紧张（strained）并伴随手脚及腋窝出汗， 并且时常哭泣，可能是抑郁症的表现。 焦虑症诊断前，医师必须排除是药物摄取造成的焦虑。儿童GAD可能伴随头痛、烦躁不安、腹部疼痛和心悸等症状， 八到九岁时开始最为典型。焦虑症的最大分支是特殊恐惧症，它是指恐惧和焦虑由特定的刺激或情境导致的病症。全世界大概有5%到12%的人罹患特殊恐惧症。 患者遇上特定的对象，会有恐惧的预期。这些对象可以是任何事物，从动物到场所，从流体到特定特定情境等等。常见的恐惧症，包括恐惧飞行、血液、水、高速公路和通道等等。当恐惧症发作时，他们可能遭受颤抖、气短、心跳加快等等。 人们通常知道他们的恐惧出现时，并没有特定的危险，因此也就不需要这样恐惧，但是仍然，很多人遭受着特殊恐惧症。恐慌症患者常常在短时间内出现剧烈的恐惧和焦虑，造成颤抖、认知混乱、头晕、反胃，和/或呼吸困难。美国精神医学学会（APA）将这些恐慌定义为短于十分钟的时间段内出现的急剧恐惧和不安，可以持续数个小时。 这些症状的导火索可能是应激、非理性思维、普遍恐惧或对未知的恐惧、甚至是运动。但是，有时导火索不明，这些症状也可能未加预警就得以出现。患者可以通过避免上述导火索来预防症状，但并非所有症状都能得以预防。除了反复发生意外恐慌外，对恐慌症的诊断还要求上述的发作具有慢性后果：担心症状的潜在影响，持续担心未来的发作，或者是与发作有关的行为发生重大变化。这样，患有恐慌症的人甚至在特定的恐慌发作之外也会经历一些症状。恐慌症患者通常会注意到心跳的正常变化，导致他们认为自己的心脏有问题或即将发生另一次惊恐发作。在某些情况下，在惊恐发作期间会过度增加对身体机能的认识（过度警觉），其中任何感知到的生理变化都被解释为可能危及生命的疾病（即，极端疑病症）。Agoraphobia is the specific anxiety about being in a place or situation where escape is difficult or embarrassing or where help may be unavailable. Agoraphobia is strongly linked with 恐慌症 and is often precipitated by the fear of having a panic attack. A common manifestation involves needing to be in constant view of a door or other escape route. In addition to the fears themselves, the term 广场恐惧症 is often used to refer to avoidance behaviors that sufferers often develop. For example, following a panic attack while driving, someone suffering from agoraphobia may develop anxiety over driving and will therefore avoid driving. These avoidance behaviors can often have serious consequences and often reinforce the fear they are caused by.社交恐惧症 (SAD; also known as social phobia) describes an intense fear and avoidance of negative public scrutiny, public embarrassment, humiliation, or social interaction. This 恐惧 can be specific to particular social situations (such as public speaking) or, more typically, is experienced in most (or all) social interactions. 社交焦虑 often manifests specific physical symptoms, including blushing, sweating, and difficulty speaking. As with all phobic disorders, those suffering from social anxiety often will attempt to avoid the source of their anxiety; in the case of social anxiety this is particularly problematic, and in severe cases can lead to complete social isolation.Social physique anxiety (SPA) is a subtype of social anxiety. It is concern over the evaluation of one's body by others. SPA is common among adolescents, especially females.Post-traumatic stress disorder (PTSD) was once an anxiety disorder (now moved to trauma- and stressor-related disorders in DSM-V) that results from a traumatic experience. Post-traumatic stress can result from an extreme situation, such as combat, natural disaster, rape, hostage situations, child abuse, bullying, or even a serious accident. It can also result from long-term (chronic) exposure to a severe stressor-- for example, soldiers who endure individual battles but cannot cope with continuous combat. Common symptoms include 过度警觉, flashbacks（英语：Flashback (psychological phenomenon)）, avoidant behaviors, anxiety, anger and depression. In addition, individuals may experience sleep disturbances. There are a number of treatments that form the basis of the care plan for those suffering with PTSD. Such treatments include 认知行为疗法 (CBT), psychotherapy and support from family and friends.创伤后压力症候群 (PTSD) research began with Vietnam veterans, as well as natural and non natural disaster victims. Studies have found the degree of exposure to a disaster has been found to be the best predictor of PTSD.Separation anxiety disorder (SepAD) is the feeling of excessive and inappropriate levels of anxiety over being separated from a person or place. Separation anxiety is a normal part of development in babies or children, and it is only when this feeling is excessive or inappropriate that it can be considered a disorder. Separation anxiety disorder affects roughly 7% of adults and 4% of children, but the childhood cases tend to be more severe; in some instances, even a brief separation can produce panic. Treating a child earlier may prevent problems. This may include training the parents and family on how to deal with it. Often, the parents will reinforce the anxiety because they do not know how to properly work through it with the child. In addition to parent training and family therapy, medication, such as SSRIs, can be used to treat separation anxiety.Situational anxiety is caused by new situations or changing events. It can also be caused by various events that make that particular individual uncomfortable. Its occurrence is very common. Often, an individual will experience panic attacks or extreme anxiety in specific situations. A situation that causes one individual to experience anxiety may not affect another individual at all. For example, some people become uneasy in crowds or tight spaces, so standing in a tightly packed line, say at the bank or a store register, may cause them to experience extreme anxiety, possibly a panic attack. Others, however, may experience anxiety when major changes in life occur, such as entering college, getting married, having children, etc.Obsessive–compulsive disorder (OCD) is not classified as an anxiety disorder by the DSM-5（英语：DSM-5） but is by the ICD-10. It was previously classified as an anxiety disorder in the DSM-IV. It is a condition where the person has obsessions (distressing, persistent, and intrusive thoughts or images) and compulsions (urges to repeatedly perform specific acts or rituals), that are not caused by drugs or physical order, and which cause distress or social dysfunction. The compulsive rituals are personal rules followed to relieve the feeling of discomfort. OCD affects roughly 1–⁠2% of adults (somewhat more women than men), and under 3% of children and adolescents.A person with OCD knows that the symptoms are unreasonable and struggles against both the thoughts and the behavior. Their symptoms could be related to external events they fear (such as their home burning down because they forget to turn off the stove) or worry that they will behave inappropriately.It is not certain why some people have OCD, but behavioral, cognitive, genetic, and neurobiological factors may be involved. Risk factors include family history, being single (although that may result from the disorder), and higher socioeconomic class or not being in paid employment. Of those with OCD about 20% of people will overcome it, and symptoms will at least reduce over time for most people (a further 50%).Selective mutism (SM) is a disorder in which a person who is normally capable of speech does not speak in specific situations or to specific people. Selective mutism usually co-exists with 羞怯 or 社交焦虑. People with selective mutism stay silent even when the consequences of their silence include shame, social ostracism or even punishment. Selective mutism affects about 0.8% of people at some point in their life.