Anxiety – normal or not?

Ask the Experts by Christina Zachar, M.D.

Q: My daughter is away from home in her first year of college and is having what I think are signs of anxiety. She has started calling home frequently, is having a lot of physical symptoms and frequent crying spells. What is normal and what may be a sign of something more serious?

A: Anxiety is something we can all relate to. We can react to stress in physical and emotional ways. Anxiety Disorders include panic attacks, excessive worry, phobias, fear of negative scrutiny and separation fears. They are the most common psychiatric disorders and occur twice as commonly in women.

To be diagnosed with a disorder, the fear/anxiety is (1) excessive and out of proportion to the actual threat, (2) persistent (3) associated with impairment in everyday functioning.

To determine "normal" versus "abnormal" anxiety requires an evaluation of the severity, frequency, duration, degree of distress and impairment in functioning. Medical problems, major mood disorders and substance abuse can present itself as anxiety and therefore should be ruled out.

Treatment for anxiety disorders can include providing information about typical/atypical anxiety and general coping strategies, medication and therapy. A combination of medication and therapy may be most beneficial and have a longer lasting effect. Medications that act on brain chemicals serotonin and norepinephrine are typically thought of as first line medication treatment for anxiety disorders. Benzodiazepine medications can be used short term or to augment treatment.

There is new technology for more personalized treatment with medications acting on the brain - pharmacogenomics testing. This test doesn't tell us what medication will work for that individual, but provides information about which medicines are more likely to cause side effects and if the dose of the medication needs to be higher or lower than usual.

Christina Zachar, M.D., is the medical director for Rose Hill Center. Rose Hill Center is a residential treatment facility in Holly, MI, dedicated to helping adults with mental illness achieve a better way of life. Dr. Zachar can be reached at 248-634-7754 and email is This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Rose Hill Center is a member of The Family Center's Association of Professionals.

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