ANXIETY DISORDERS

Anxiety is a feeling of uneasiness, uncertainty or fear, in response to a real or imagined danger. The body responds to anxiety by releasing a number of “stress” hormones, like adrenaline and cortisol, which have an effect on almost every organ in the body.

What are Anxiety Disorders?

Mild forms of anxiety caused by emotional conflict or life stress are common and unproblematic. Anxiety disorders are a group of conditions in which the feelings of anxiety are not associated with a real or appropriate threat, or are much more intense and long lasting than they should be. People feel frightened and distressed for no apparent reason. This condition can paralyze the individual into inactivity or withdrawal, and can dramatically reduce productivity and significantly diminish a person’s quality of life.

Anxiety disorders are common – nearly 25% of people will experience anxiety disorders at some time in their lives.

Symptoms of Anxiety Disorders

Physical symptoms of anxiety disorders are due to released stress hormones. These may increase blood pressure, cause heart palpitations, chest pain, rapid breathing or breathlessness, sweating, increased muscle tension or irritability. Intestinal blood flow decreases, resulting in nausea or diarrhoea. There is often a decreased sex drive. Children may also have a fear of being away from the family, a refusal to go to school, a fear of strangers, a fear of falling asleep or have recurrent nightmares.

Anxiety disorders

Specific anxiety disorders each have their own particular pattern of symptoms and additional behavioural characteristics.

Depression and Anxiety

The simultaneous occurrence of depression and anxiety is very common. Figures show that between 60% and 90% of people with depression also have symptoms of anxiety. The combination is well recognized and can significantly increase the disability and disruption of normal function suffered by the patient. The anxiety associated with depression can take many forms including panic attacks, obsessive compulsive disorder, post-traumatic stress disorder, social anxiety disorder or a generalized anxiety disorder. Fortunately medication is available which can effectively relieve both depression and anxiety. If symptoms of depression and anxiety are a problem to you, you should discuss them with your doctor. Appropriate treatment can then be prescribed.

Types of Anxiety Disorders

A number of anxiety disorders have been classified. It is common for one anxiety disorder to accompany another anxiety disorder, depression, eating disorders orsubstance abuse.

Panic Disorder

People with panic disorder experience recurrent, unexpected attacks of intense anxiety or terror usually lasting 15 to 30 minutes. These attacks reach peak intensity within seconds and then subside over 5 to 20 minutes. Episodes of terror are accompanied by shortness of breath, rapid heart beat (palpitations), chest pain, hot flushes or chills, nausea, dizziness, abdominal cramps, sweating, shakiness, a choking feeling, feelings of unreality, and fears of dying or going insane. Frequency of attacks can vary widely, and may occur spontaneously or in response to a particular situation.

Phobias

Phobias are persistent, irrational fears of certain objects or situations. These people are so overwhelmed by anxiety that they avoid the feared objects or situations.

Social Phobia/Social Anxiety Disorder is an extreme fear of embarrassment or humiliation in social situations. Social phobias disrupt normal life, interfering with work, social relationships and career choices, especially when they develop during adolescence which they commonly do. People give up many pleasurable and meaningful activities due to these fears.

Agoraphobia is a paralyzing fear of being in places or situations from which a person feels there is no escape or help in case of an attack. These people confine themselves to places in which they feel safe, usually at home, which may have very damaging effects on work and social interaction. It occurs typically together with panic disorder.

Post-Traumatic Stress Disorder (PTSD)

PTSD is an extremely debilitating condition that occurs after exposure to intensely frightening events or experiences in which severe physical harm was threatened or occurred. These events include violent personal assaults such as rape, mugging, disasters, car accidents or military combat. These people repeatedly re-live the ordeal in the form of mental flash backs, nightmares or disturbing thoughts or memories, especially when reminded of the trauma. Symptoms can occur weeks, months or even years after the traumatic event. Symptoms of PTSD include emotional numbness or withdrawal, hopelessness, mood swings, sleep disturbances, depression, irritability, outbursts of anger, feelings of intense guilt, inability to concentrate and an excessive startle response to noise.

Obsessive-Compulsive Disorder (OCD)

People with OCD suffer from repeated, unwanted thoughts or mental images (obsessions) which may result in compulsive behaviour – repetitive, uncontrollable routines performed in the hope of preventing the obsessive thoughts or making them go away. Rituals such as hand washing, counting or checking are common. These rituals, however, provide only temporary relief, and not performing them markedly increases anxiety. OCD is time-consuming, distressing, and can disrupt normal functioning. Read more on OCD…

Generalised Anxiety Disorder (GAD)

People with GAD suffer from an almost constant state of tension and anxiety lasting more than 6 months, without an obvious cause for the anxiety. They usually expect the worst, worrying uncontrollably about money, health, family or work. They are constantly on edge, have difficulty concentrating and typically have physical symptoms such as fatigue, sleep disturbances, trembling, muscle tension, headaches, irritability or hot flushes. They may interpret other people’s intentions or events in a negative way, and therefore feel unsafe in the world. These symptoms cause much distress and impair normal functioning.

What Causes Anxiety Disorders?

Genetic factors, environmental influences, family and childhood experiences and biochemical disorders make certain people more susceptible to stress stimuli than the normal population. Alcohol or substance abuse, other psychological problems like depression and medical conditions like thyroid disease may also play a role.

How are Anxiety Disorders Treated?

Most anxiety disorders respond well to treatment even if two or more anxiety disorders exist simultaneously. An effective approach is a combination of cognitive-behaviour therapy (CBT) and medication.

Drug Therapy will most likely be required for prolonged periods. Anti-anxiety drugs, antidepressants like the selective serotonin-reuptake inhibitors (SSRI’s), tricyclic antidepressants (TCA’s) or Monoamine Oxidase Inhibitors (MAOI’s) may be used. Drug interactions and side effects must always be monitored.

Cognitive-Behavioural Therapy teaches a patient to control their reactions to stress and stimuli, thus reducing the feeling of anxiety. Some therapies teach patients to understand their thinking patterns so they can react differently to the situations that cause them anxiety.

Other

Therapies may use techniques which either gradually or rapidly expose the patient to the anxiety- producing stimulus. Breathing exercises to prevent hyperventilation may also help.

Healthy Lifestyle. Regular exercise, adequate rest, and good nutrition can help reduce the impact of anxiety attacks. Rhythmic aerobic programs may also help to reduce the effects of anxiety.

It is important to remember that these conditions are treatable. Your length of therapy will be based on your personal needs. It is important to continue taking your medication for as long as your doctor advises, even if you are feeling better.

Helping someone with Anxiety Disorder
  • Don’t make assumptions about what the affected person needs – ask him or her.
  • Be predictable – don’t surprise them.
  • Let the person with the disorder set the pace for recovery. Be patient, but don’t allow self-pity to develop.
  • Never criticise or trivialise the condition.
  • Find something positive in every experience. Don’t allow the patient to avoid the anxiety.
  • Encourage the patient to take even a small step forward.

Courtesy of Medical Essentials, Health Information

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