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For other uses, see Anxiety (disambiguation).
Emperor Traianus Decius (Mary Harrsch).jpg
A marble bust of the Roman Emperor Decius from the Capitoline Museum. This portrait "conveys an impression of anxiety and weariness, as of a man shouldering heavy [state] responsibilities".[1]
MedlinePlus 003211 000917
MeSH D001007

Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, somatic complaints and rumination.[2] It is the subjectively unpleasant feelings of dread over something unlikely[citation needed] to happen, such as the feeling of imminent death.[3] Anxiety is not the same as fear, which is a response to a real or perceived immediate threat;[4] whereas anxiety is the expectation of future threat.[4] Anxiety is a feeling of fear, worry, and uneasiness, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing.[5] It is often accompanied by muscular tension,[4] restlessness, fatigue, and problems in concentration. Anxiety can be appropriate, but when it is too much and continues too long, the individual may suffer from an anxiety disorder.[4]


A job applicant with a worried facial expression

Anxiety is distinguished from fear, which is an appropriate cognitive and emotional response to a perceived threat and is related to the specific behaviors of fight-or-flight responses, defensive behavior or escape. Anxiety occurs in situations only perceived as uncontrollable or unavoidable, but not realistically so.[6] David Barlow defines anxiety as "a future-oriented mood state in which one is ready or prepared to attempt to cope with upcoming negative events,"[7] and that it is a distinction between future and present dangers which divides anxiety and fear. Another description of anxiety is agony, dread, terror, or even apprehension.[8] In positive psychology, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.[9]

Fear and anxiety can be differentiated in four domains: (1) duration of emotional experience, (2) temporal focus, (3) specificity of the threat, and (4) motivated direction. Fear is defined as short lived, present focused, geared towards a specific threat, and facilitating escape from threat; while anxiety is defined as long acting, future focused, broadly focused towards a diffuse threat, and promoting excessive caution while approaching a potential threat and interferes with constructive coping.[10]

A young woman bites her fingernails.
Nervous habits such as biting fingernails

The behavioral effects of anxiety may include withdrawal from situations which have provoked anxiety in the past.[11] Anxiety can also be experienced in ways which include changes in sleeping patterns, nervous habits, and increased motor tension like foot tapping.[11]

The emotional effects of anxiety may include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind's gone blank"[12] as well as "nightmares/bad dreams, obsessions about sensations, deja vu, a trapped in your mind feeling, and feeling like everything is scary."[13]




Further information: Angst, Existential crisis and Nihilism




Test and performance[edit]

According to Yerkes-Dodson law, an optimal level of arousal is necessary to best complete a task such as an exam, performance, or competitive event. However, when the anxiety or level of arousal exceeds that optimum, the result is a decline in performance.[16]

Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. Students who have test anxiety may experience any of the following: the association of grades with personal worth; fear of embarrassment by a teacher; fear of alienation from parents or friends; time pressures; or feeling a loss of control. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, uncontrollable crying or laughing and drumming on a desk are all common. Because test anxiety hinges on fear of negative evaluation,[17] debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia.[18] The DSM-IV classifies test anxiety as a type of social phobia.[19]

While the term "test anxiety" refers specifically to students,[20] many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult.[citation needed] Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.[20]

Stranger, social, and intergroup[edit]

Main articles: Stranger anxiety and Social anxiety

Humans generally require social acceptance and thus sometimes dread the disapproval of others. Apprehension of being judged by others may cause anxiety in social environments.[21]


Social anxiety varies in degree and severity. For some people it is characterized by experiencing discomfort or awkwardness during physical social contact (e.g. embracing, shaking hands, etc.), while in other cases it can lead to a fear of interacting with unfamiliar people altogether. Those suffering from this condition may restrict their lifestyles to accommodate the anxiety, minimizing social interaction whenever possible. Social anxiety also forms a core aspect of certain personality disorders, including Avoidant Personality Disorder.[23]


As is the case in the more generalized forms of social anxiety, intergroup anxiety has behavioral, cognitive, and affective effects. For instance, increases in schematic processing and simplified information processing can occur when anxiety is high. Indeed, such is consistent with related work on attentional bias in implicit memory.[25][26][27] Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction.[28] Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or otherwise antagonistic, behavior such as hostility.[29] Furthermore, when compared to anxiety levels and cognitive effort (e.g., impression management and self-presentation) in intragroup contexts, levels and depletion of resources may be exacerbated in the intergroup situation.


Anxiety can be either a short term 'state' or a long term "trait". Trait anxiety reflects a stable tendency to respond with state anxiety in the anticipation of threatening situations.[30] It is closely related to the personality trait of neuroticism. Such anxiety may be conscious or unconscious.[31]

Choice or decision[edit]

Anxiety induced by the need to choose between similar options is increasingly being recognized as a problem for individuals and for organizations.[32]

"Today we're all faced with greater choice, more competition and less time to consider our options or seek out the right advice."[33]

In a decision context, unpredictability or uncertainty may trigger emotional responses in anxious individuals that systematically alter decision-making.[34] There are primarily two forms of this anxiety type. The first form refers to a choice in which there are multiple potential outcomes with known or calculable probabilities. The second form refers to the uncertainty and ambiguity related to a decision context in which there are multiple possible outcomes with unknown probabilities.[34]

In some Buddhist meditation literature, this effect is described as something which arises naturally and should be turned toward and mindfully explored in order to gain insight into the nature of emotion, and more profoundly, the nature of self.[35]


Anxiety disorders are a group of mental disorders characterized by feelings of anxiety and fear,[36] where anxiety is a worry about future events and fear is a reaction to current events.[36] These feelings may cause physical symptoms, such as a racing heart and shakiness.[36] There are various forms of anxiety disorders, including generalized anxiety disorder, phobic disorder, and panic disorder. While each has its own characteristics and symptoms, they all include symptoms of anxiety.[37]

Anxiety disorders are partly genetic but may also be due to drug use including alcohol and caffeine, as well as withdrawal from certain drugs. They often occur with other mental disorders, particularly major depressive disorder, bipolar disorder, certain personality disorders, and eating disorders. The term anxiety covers four aspects of experiences that an individual may have: mental apprehension, physical tension, physical symptoms and dissociative anxiety.[38] The emotions present in anxiety disorders range from simple nervousness to bouts of terror.[39] There are other psychiatric and medical problems that may mimic the symptoms of an anxiety disorder, such as hyperthyroidism.

Common treatment options include lifestyle changes, therapy, and medications. Medications are typically recommended only if other measures are not effective.[40] Anxiety disorders occur about twice as often in females as males, and generally begin during childhood.[36] As many as 18% of Americans and 14% of Europeans may be affected by one or more anxiety disorders.[41]


Early life experiences[edit]

Anxiety risk factors include family history (e.g. of anxiety)[42] and parenting factors including parental rejection, lack of parental warmth, high hostility, harsh discipline, high maternal negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, and child abuse (emotional, physical and sexual).[43]

Biological vulnerabilities[edit]

Research upon adolescents who as infants had been highly apprehensive, vigilant, and fearful finds that their nucleus accumbens is more sensitive than that in other people when deciding to make an action that determined whether they received a reward.[44] This suggests a link between circuits responsible for fear and also reward in anxious people. As researchers note, "a sense of 'responsibility', or self agency, in a context of uncertainty (probabilistic outcomes) drives the neural system underlying appetitive motivation (i.e., nucleus accumbens) more strongly in temperamentally inhibited than noninhibited adolescents".[44] Anxiety is also linked and perpetuated by the person's own pessimistic outcome expectancy and how they cope with feedback negativity.[45] Temperament and attitudes (e.g. pessimism) have been found to be risk factors for anxiety.[42]

Some writers believe that excessive anxiety can lead to an overpotentiation of the limbic system, giving increased future anxiety, but this does not appear to have been proven.[46][47]

Social issues - gender[edit]

Contextual factors that are thought to contribute to anxiety include gender socialization and learning experiences. In particular, learning mastery (the degree to which people perceive their lives to be under their own control) and instrumentality, which includes such traits as self-confidence, independence, and competitiveness fully mediate the relation between gender and anxiety. That is, though gender differences in anxiety exist, with higher levels of anxiety in women compared to men, gender socialization and learning mastery explain these gender differences.[citation needed] Research has demonstrated the ways in which facial prominence in photographic images differs between men and women. More specifically, in official online photographs of politicians around the world, women's faces are less prominent than men's. Interestingly enough, the difference in these images actually tended to be greater in cultures with greater institutional gender equality.[48]

Evolutionary psychology[edit]


Neural circuitry involving the amygdala and hippocampus is thought to underlie anxiety.[50] When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala.[51][52] 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.[original research?]


Although single genes have little effect on complex traits and interact heavily both between themselves and with the external factors, research is under-way to unravel possible molecular mechanisms underlying anxiety and comorbid conditions. One candidate gene with polymorphisms that influence anxiety is PLXNA2.[53]


Anxiety can be a symptom of an underlying health problems such as chronic obstructive pulmonary disease (COPD), heart failure, or heart arrythmia.[54]

See also[edit]


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External links[edit]