The ASAP Dictionary of Anxiety and Panic Disorders

Caffeine - an alkaloid substance which is a stimulant and diuretic. Caffeine is generally considered to aggravate anxiety disorders and is found in many foods and beverages; most notably coffee, "energy drinks" and soft drinks (fizzy drinks). Caffeine is also found in chocolate and tea, yet these also contain other substances which help counter the stimulant effects of caffeine.

Calms Forte - a herbal remedy remedy for insomnia which is supposedly helpful in quieting down the nervous system. Ingredients include Avena Sativa, Chamomilla, Humulus Lupulus, Passiflora (passion flower). CAUTION: Consult a doctor when pregnant or nursing.

Cannabis - a plant (Cannabis sativa) whose dried leaves are often smoked for euphoric effect. Though often used as a recreational drug and considered a narcotic, cannabis may have medicinal applications. Synonyms include marihuana, marijuana, pot, weed. CAUTION: Cannabis use can sometimes evoke anxiety attacks and might possibly result in an anxiety disorder.

Carafate - a substance that adheres tightly to eroded gastric (stomach) mucosa, promoting healing and forming a bandage against further damage. Carafate also binds to stomach bile to help maintain proper acidity in the stomach. Helpful in the treatment of GERD and IBS.

Carbon Dioxide (CO2) - a substance which is the product of respiration and other processes. Normal levels of CO2 do not produce panic attacks. However, in carefully conducted lab experiments, high levels of CO2 can trigger suffocation alarm and, consequently, CO2 is used as a challenge agent in anxiety studies. People with panic disorder are more sensitive to CO2 than others, but anyone can experience a panic attack from excessive CO2.

Cardiac Disorder - any disorder of the heart. Such disorders should be considered in the diagnosis of anxiety disorders. Cardiac disorders include arrhythmias and mitral valve prolapse. Also see cardiology.

Cardiac Neurosis - a dated alternate name for panic disorder. The somatic symptoms of a panic attack can be remarkably similar to the symptoms of a heart attack. In past, patients who confused panic attacks with heart attacks were often judged as neurotic. Also see exhausted heart.

Cardiology - the study of the heart. See cardiac disorder, fear bradycardia, palpitation, stress cardiomyopathy, tachycardia, vasovagal syncope.

Catastrophize - excessive preoccupation with worst case scenarios or most dreaded possibilities. Also see cognitive therapy, morbid curiosity.

Catecholamines - a family of monoamine chemical messengers involved in many functions such as autonomic arousal, fight-or-flight stress responses, and reward. These include dopamine, epinephrine, and norepinephrine.

Catharsis - to relieve psychological pain by making its cause conscious and expressable. Also see repression.

Catnip - a plant (Nepeta cataria) used as a herbal remedy. Though known mostly for its stimulant effect on cats, catnip has long been used as a sedative for humans.

CBT - see cognitive behavioral therapy.

CCK - see cholecystokinin.

Central Nervous System (CNS) - a subdivision of the nervous system which includes the brain and spinal cord. Contrast with peripheral nervous system.

Cerebral Cortex - the cerebrum's overall surface layer of gray tissue. The cerebral cortex is also called the neocortex. Specialized regions of the cerebral cortex include the auditory cortex, motor cortex, prefrontal cortex, sensory cortex, visual cortex. Also see extinction.

Cerebrum - the largest part of the brain. The cerebrum is divided into four paired (left and right) lobes; known as frontal lobe, parietal lobe, temporal lobe, and occipital lobe. Conscience intellectual processes are believed to occur in the cerebrum.

CES - see cranial electrotherapy stimulation.

CFIDS - Chronic Fatigue Immune Deficiency Syndrome. See chronic fatigue syndrome.

CFS - see chronic fatigue syndrome.

Challenge Agent - any chemical substance that can produce an anxiety attack. Such agents include carbon dioxide, cholecystokinin, sodium lactate.

Challenge Study - any clinical study in which an attack is induced via a challenge agent.

Chamomile - a plant (Matricaria recutita) whose flowers are used as a herbal remedy; sedative.

Chemical Messenger - a chemical molecule released by one cell that affects another cell. Chemical messengers are how cells communicate and coordinate their functions. Hormones, neurotransmitters and pheromones are collectively known as chemical messengers. Some chemical messengers, known as neurohormones, act as both a hormone and a neurotransmitter. Chemical messengers that stimulate or inhibit the release of other chemical messengers are called agonists or antagonists, respectively. Also see catecholamine, glucocorticoid, indoleamine, re-uptake inhibitor.

Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) - a questionnaire-based measure of obsessive and compulsive symptom frequency (severity), present or past. Designed for ages 6 to 14. Also see YBOCS.

Chiropractic - a form of alternative medicine which claims to adjust nerve pressure through manipulations of the spine or related techniques. Though medical in appearance, there is no scientific basis for such claims and any benefits are likely placebo related.

Chocolate - a preparation made from the roasted and ground seeds of a plant (Cacao) that contains caffeine and phenylethylamine.

Cholecystokinin (CCK) - a chemical messenger related to some forms of anxiety disorders and associated with gastrointestinal disorders. CCK-4 is a potent challenge agent that can induce anxiety or panic attacks even in people with no history of anxiety disorder. CCK induced panic attacks seem best treated with a BDZ medication.

Chronic - descriptive of disorders that are long lasting. Contrast with acute.

Chronic Fatigue Syndrome (CFS) - a medical disorder involving symptoms of persistent fatigue, concentration difficulties, and may sometimes involve an anxiety disorder. Contrast with Epstein Barr Virus and fibromyalgia syndrome.

Classical Conditioning - a trained association between two stimuli. Also known as "Pavlovian" conditioning. Also see conditioning. Contrast with operant conditioning.

Claustrophobia - a phobia of closed spaces or situations which are difficult to escape from. May occur with elevators, escalators, etc.

Clinic - any health care establishment that provides diagnosis and/or treatment in an educational or outpatient context. Clinics sometimes specialize in specific fields of health care. When clinics specialize in "clinician education" or "clinical trials" they may, with apparent irony, not accept patients on a "clinical basis."

Clinical - regarding the diagnosis and/or treatment of patients within established health care guidelines.

Clinical Trial - any program where appropriate volunteers are recruited to participate in the testing of a new therapy (often a new medication). Prior to a clinical trial, research is conducted to rule out most risks to people. Nonetheless, risk can not be ruled out entirely prior to a clinical trial, so volunteers are frequently evaluated for adverse effects over the duration of the trial. Clinical trials are often best at determining short-term effects. Longterm effects are usually noticed after the completion of the initial trial(s) and approval for public treatment. People usually volunteer for such trials when established treatments seem inadequate or are offered benefits that seem to outweigh the risks. Also see placebo controlled study.

Clinician - any clinical doctor or therapist.

CNS - see central nervous system

Cocaine - an alkaloid derived from the leaves of a tropical plant (Eeythroxyllum coca). The chewing of coca leaves has a long history of use in traditional medicine as an anxiolytic and analgesic. However, the white powder used as a recreational drug is far more refined and potent than coca leaves and is generally considered a dangerous narcotic. CAUTION: as a dopamine agonist, cocaine can be highly addictive.

Coffee - a tropical plant (Coffea) whose roasted and ground beans are used to make popular drinks that contain caffeine (unless decaffeinated).

Cognition - mental functions such as memory, concentration, perception and recognition. Adj. Cognitive. Also see cognitive dysfunction.

Cognitive Behavioral Therapy (CBT) - a psychotherapy which combines cognitive and behavioral therapy techniques. Also see exposure therapy, homework, paradoxical intention, rational emotive behavior therapy.

Cognitive Dysfunction - impairment of cognition, such as difficulties with memory, concentration, ability to make decisions, etc. Anxiety or fear can produce various forms and degrees of cognitive dysfunction, but such effects are typically temporary and clear up when anxiety decreases. Also see amnesia, hysterical fugue, mass hysteria, stress shutdown.

Cognitive Restructuring - a form of cognitive therapy involving discussion of thoughts, identification of questionable thoughts and encouragement of more balanced and realistic perspectives.

Cognitive Therapy (CT) - a psychotherapy which attempts to manage anxiety by modification of thinking habits. Also see automatic negative thought, catastrophize, cognitive behavioral therapy, cognitive restructuring, homework, negative thought, positive thought.

Combat Exhaustion - an alternate name for PTSD dating from WWII.

Combat Fatigue - a gradual form of battle shock which develops in four stages. The first stage includes symptoms of fluctuating fear; including muscular tremors, increased frequency and urgency of urination, intense thirst, a refusal to eat which often leads to anorexia, vomiting, great increases in sweating, vasomotor instability, and other overt physiological signs of fear. In the second stage, the earlier symptoms relax somewhat leaving a heightened sense of awareness, strength, and energy. The third stage involves growing fatigue, sleeping difficulties, irritability, and constant tremors. The forth stage involves apathy, extreme concentration and memory problems, anxiety or conviction that death is imminent, disregard for personal safety, and even a vegetative state approaching catatonia. Overall, the symptoms of these stages resemble forms of acute stress disorder or PTSD.

Combat Shock - a form of battle shock which resembles a rapid version of combat fatigue.

Combat Stress Control Team - any team of Army specialists who assess soldier mental health during deployment. Also see military psychiatry.

Comedication - the use of a medication to alleviate side effects or augment another medication.

Commercial Name - see brand name.

Co-morbid - regarding two or more disorders occurring at the same time. Some conditions that are often co-morbid with anxiety disorders include chronic fatigue syndrome, fibromyalgia, gastroesophageal reflux disease, hyperhidrosis, hypersensitivity, hyperventilation, irritable bowel syndrome, incontinence, insomnia, mutism, Raynaud's syndrome, sinusitis, tinnitus.

Complimentary Medicine - the use of herbal or alternative medicine instead of, or in addition to, medical prescriptions.

Compulsive - descriptive of thoughts or behavior which are automatic responses to anxiety or stress. A common example is compulsive hand washing caused by an obsession with cleanliness or a phobia of being unclean. Also see obsessive or phobia.

Conditioning - to train a response to a stimulus. See classical conditioning and operant conditioning.

Control Group - in clinical trials, a control group is the group of people not subjected to the therapy being tested. For example, in pharmacological studies, control groups are often given a placebo rather than the medication being studied.

Conscience - a psychoanalytic term referring to the superego.

Conscious - a state of being awake and aware, or descriptive of any thoughts we are aware of. Contrast with subconscious and unconscious.

Constitutional Inadequacy - see inadequacy.

Consultation - typically, a first visit with a doctor or therapist to discuss treatment options.

Conversion Disorder - a somatoform disorder characterized by sensory or motor symptoms associated with conflict or stress.

Conversion Reaction - a Freudian concept where repressed desire is vented in the form of an anxiety attack or other symptom.

Convulsion - the trembling or shaking associated with a seizure. Also used as a synonym for seizure. Also see tremor.

Cortex - the outer part or external layers of an internal organ. See cerebral cortex.

Corticotropin Releasing Factor (CRF) - a hormone produced by the hypothalamus which triggers the pituitary and adrenal glands to release cortisol, epinephrine and norepinephrine into the bloodstream. Amygdala activity can stimulate heightened CRF levels.

Cortisol - the body's chief stress fighting hormone produced by the adrenal gland (a glucocorticoid). Cortisol is high during periods of stress, and low when relaxing. A decrease in cortisol is associated with increase in serotonin and dopamine. Heightened levels of cortisol are associated with muscle tension, perspiration, skin conditions (psoriasis, acne, eczema), etc. Also see hydrocortisone.

Counseling - guidance by a trained social worker or religious leader. Such guidance can be helpful for various anxiety disorders, but acute or chronic cases typically require a psychiatrist and/or psychologist.

Courage - a person's ability to function despite fear or anxiety. Since fear and anxiety can be caused by internal and external sources, courage cannot be measured by an external situation alone, and social comparisons can be misleading. A person's apparent courage may vary greatly from situation to situation. Even the bravest people have limited endurance for tolerating prolonged exposure to fear or anxiety. Also see thrill.

Cowardice - refusal to confront a reasonable degree of fear or anxiety. Since fears and anxieties are extremely subjective (relative to experience, circumstance, stress and modulated by anxiety disorders) the qualifier of "reasonable degree" is highly individualized and very important. Compare with courage.

Cranial Electrotherapy Stimulation (CES) - a therapy where electrodes are placed on or near a person's ears to pass low level electricity through the brain; the person remaining awake and alert during the whole process. Apparently, CES can relieve anxiety for limited periods, though the mechanism of its efficacy is not known. CES may be used as an adjunct to anxiolytic medication and/or psychotherapy. Side effects may include headache, lightheadedness, or skin irritation by electrodes. CES is also known as Transcranial Electrotherapy (TCET) and Neuroelectric Therapy (NET), but should not be confused with Electroconvulsive Therapy (ECT) which uses higher levels of electricity to produce therapeutic convulsions. Also see Vagus Nerve Stimulator. CAUTION: CES is not recommended for people with a history of epilepsy or seizures.

Cranialsacro Somatic Therapy - apparently, a therapy that claims to treat ailments by realigning the plates of the skull. In fact, these plates become rigidly joined after birth and any attempt to actually realign them would be hazardous, to say the least. Apparently a bogus therapy.

CRF - see corticotropin releasing factor.

CT - see cognitive therapy.

Cure - any therapy that will eliminate a disorder. Regarding anxiety disorders, existing therapies can significantly reduce symptoms and promote recovery, yet not necessarily eliminate the causes of such disorders. Consequently, anxiety disorders are often described as treatable, rather than curable. Also see panacea.

Cyberchondria - use of health information found on the Internet in an excessive, uncritical or reckless manner. Also see hypochondria.

CY-BOCS - see Children's Yale-Brown Obsessive-Compulsive Scale.

Cytology - the science of individual cells. The genetic and biochemical aspects of anxiety disorders are highly dependent on the function of cells within the nervous system and endocrine system.

The ASAP Dictionary of Anxiety and Panic Disorders