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September 26, 1977

How Can the Physician Explain Anxiety?

Author Affiliations

From the Norwich Hospital, Norwich, Conn.

JAMA. 1977;238(13):1408-1409. doi:10.1001/jama.1977.03280140086034

WHAT is the best answer when a patient asks, "Why am I so afraid when I have nothing to fear?" What can the physician say to help—particularly if it's someone in good health who is reasonably affluent and in apparently beneficent circumstances?

This sort of patient may have a diagnosis of anxiety, depression, or phobia. Or his diagnosis may be something else, because anxiety has so many manifestations and because it is found in most mental disorders. Further, anxiety may in large part be a reaction to stress, sometimes to stress not recognized as such.

It is hard to find the cause of anxiety. Even with prolonged, expert help, many patients do not achieve functional insight, and of those who do, not every one gets relief. The anxious patient is not a clear entity suitable for research. Sometimes we are talking about a certain type of person, while at other