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Anxiety, a term used recklessly in society and it can be unclear what is a normal physiological response compared to an debilitating condition that makes it hard to live a normal life rooted in a medical condition. These conditions could be the reason.

Although the exact criteria which constitutes a diagnosis of anxiety has changed constantly in the last decades, one thing that remains constant is the fact that anxiety is a common occurrence of daily living. Stress, grief and tension are all basic ingredients necessary for the recipe of life and push us to complete tasks on time or study for upcoming exams out of fear of failure. A little stress and anxiety does the body good and helps push you from being complacent but in 14 percent of the population, this anxiety can become overbearing and instead of propelling you towards greatness, it can leave you frozen and miserable [1]. Chronic conditions and psychological disorders are some of the most common reasons patients complain of a subjective increase in their level of anxiety. Many patients are left with no choice but to begin complex pharmacological concoctions or rely on relaxation techniques for anxiety [2].  

Number 1: Chronic Conditions 

Pain is a natural response that has aided the survival of human-kind. A noxious stimulus causes the body to react accordingly to avoid the danger and prolong survival. We are programmed with the same responses even today and you may have experienced this sensation first-hand if you have ever accidentally touched the hot surface of a stove. Your hand will instantly recoil and you will be able to protect your body from any further damage. This same response also signals that there is something wrong within ourselves and can often be the first indicator of a more serious condition like cancer, problems with your gallbladder or hemorrhaging. Catecholamines act as messengers to your brain to alert you that something is wrong and that you need to seek help because of this new signal. [3]

A well-accepted concept of medicine is that chronic pain conditions will lead to anxiety. When trying to rehabilitate patients from surgery or immunological disorders, it is paramount to make sure that a patient has a positive attitude in order to ensure that there will be noticeable improvement [4]. In essences, physicians are hoping that patients will "trick" their brain into thinking the pain is lower than it is in order to begin rehabilitation so that they will be able to tolerate it and mute it out.  

Research demonstrates that there is a high correlation between pain and depression and these normally go hand-in-hand with any chronic condition that a patient must endure. It can be psychologically exhausting for patients to have to deal with difficult symptoms for a long-term period. A study found that 87 percent of patients with depression notice high pain levels [5]. A separate and more extensive investigation was launched by the World Health Organization (WHO) and the study concluded showing that patients do not have reactions to physical distress with just anxiety or depression, but instead, will have a statistically significant manifestation of both depression and anxiety linked with their chronic condition [6]. Pain can be part of the symptoms associated with any long-term condition like diabetes, chronic heart failure, rheumatoid arthritis and cancer to name just a few conditions [7].

Number 2: Psychiatric Disorders

Another spectrum of diseases that are often associated with anxiety would be underlying psychiatric conditions. Often treated with a combination of psychotherapy and relaxation techniques, these disorders are common in society and can be as high as 36 percent globally when defining a psychiatric disorder as one composed of mood, anxiety or substance abuse imbalances [8]. 

A generalized anxiety disorder (GAD) is one such disease that is prevalent in our society and can be found in as high as 12 percent of the US population and 6 percent of the European population currently [9]. GAD is defined as a condition associated with persistent worrying to the point of being unable to carry out their normal life. Patients are aware that they are excessively worrying about minor incidents but they unable to control their impulses and comment about being often "hand-cuffed" without any way to find relief [10]. 

An interesting model proposed to define anxiety in this realm of patients is referred to as the "ABC Model of Anxiety." This model provides a basis to understand the rationale that occurs in the patient's mind as they face an anxious situation. "A" refers to alarms and are emotional or physiological responses to triggers. "B" represents beliefs and are based on how an individual responds to the stimulus. This component relies heavily on cultural and memory responses in the past to mold how the patient will respond in the future. If you crash-landed on an airplane last time you flew, you have a logical response to be wary of flying again based on your past experience.  At last, "C" corresponds to coping strategies. These are techniques that the brain tries to establish to rationalize a response to the fear and can be adaptive or maladaptive. When a negative event happens, one can interpret it positively or negatively. How one interprets it affects how one feels, thinks and behaves.[11

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