红字的不是太明白

ANXIETY AND PANIC

In lower animals, as well as man, anxiety is a response to danger, but in man the danger may also be anticipated or fantasized. Whatever its genesis, it may result in a person being very symptomatic. Extreme anxiety is also a hallmark of panic disorder, which is accompanied by somatic and other symptoms such as chest pain, fearfulness of dying, palpitations, sweating, and the sensation of shortness of breathe. It is differentiated from anxiety also by the fact that it is not associated with a situational trigger and therefore characteristically occurs “out of the blue.” Among people with renal failure, there are many reasons why anxiety may occur. The process of dialysis and the host of potential medical and access problems give the patient much to anticipate and worry about. The treatment of anxiety and panic is largely pharmacologic in the use of antidepressants and anxiolytics and is discussed later in this chapter (13). These pharmacologic treatments address the quelling of the symptoms of anxiety and panic but do not get to the cause of these disorders; this is where the talking psychotherapies hold promise for the motivated patient.

焦虑和恐慌

在低等动物和人中，焦虑是对（实际）危险的反应，对人而言危险也可以是可以预见或幻想的。无论起因是什么，焦虑都可能导致一个人出现非常严重的症状。极度焦虑也是恐慌症的一个特征，恐慌症具有躯体和其他症状，如胸痛、害怕死亡、心悸、出汗和呼吸短促。恐慌症与焦虑的区别还在于它与情境触发无关，因此它的特征是“突然”发生。在肾衰竭患者中，焦虑的原因有很多。透析的过程以及潜在的医疗和通路问题的数量给病人带来了许多预期和担忧。焦虑和恐慌的治疗主要是使用抗抑郁药和抗焦虑药的药物治疗，本章将稍后讨论(13)。这些药物治疗可以平息焦虑和恐慌的症状，但不能解决这些障碍的原因；这就是谈话心理疗法对有动机的患者带来希望的地方。