Anxiety

Anxiety disorders affect 40 million people in the United States every year. However,  only 36.9% of the total patient population seeks professional help (Baldwin, Anderson, Nutt et al. 2014). According to the American Psychological Association (APA), anxiety is defined as an emotion characterized by feelings of irritation, worrisome and physical changes such as high blood pressure. It is important to differentiate between a persistent anxiety disorder and occasional feelings of anxiety in a person to diagnose and manage this disease (Baldwin, Anderson, Nutt et al. 2014).

Anxiety disorder is identified as bouts of tension and worrying triggers which are potentially harmful to the mental and physical health of the person. The consistent worry alarm set on by the anxiety disorder lead to symptoms of increased heartbeat, sweating, emotional sensitivity and feelings of fearfulness in the patient. These feelings of fearfulness and danger cause a rush in the adrenaline hormone which is responsible for triggering a fight or flight response in the patient. This chemical response generated in the brain cells prepare patients for physical confrontation and potential threat to their safety. In the present day scenario, these feelings of anxiety are often associated with work and family life imbalance, health, money matters etc. (Baldwin, Anderson, Nutt et al. 2014).

Along with day-to-day causes of anxiety, nervousness before any important life event or in difficult life situations is also natural and is not regarded as a mental disorder. Patients suffering from anxiety disorder have recurring intrusive thoughts that affect day to day functioning.

Generalized anxiety disorder (GAD) is a chronic disorder involving excessive worry about general life events and situations. Symptoms of a generalized anxiety disorder include uncontrollable feelings of worry, restlessness and being on-edge; increased irritability and concentration deficit, insomnia, nausea etc. (Katzman, Bleau, Blier, Chokka, Kjernisted, & Van Ameringen, 2014).

Panic disorder is another type of disorder which is associated with sudden attacks of intense terror and characterizes apprehension. Panic attacks produce symptoms of shaking, dizziness, confusion, nausea, dizziness and breathing difficulties. Panic  attacks tend to escalate rapidly in 10 minutes time and last for hours. Panic attacks are usually triggered by frightening experiences and prolonged stress but may also happen without any reason. People suffering from panic disorders might feel drastic behavioral changes and are threatened by any potential danger.

Specific phobias are also a type of anxiety disorder which causes irrational fear and avoidance behaviors among people. Phobias to a particular object or situation have a causative agent which is unlike other types of anxiety disorders. People suffering from specific phobia acknowledge that their fear towards a situation is irrational but are still unable to control their emotions when exposed to specific triggers (Katzman, Bleau, Blier, Chokka, Kjernisted, & Van Ameringen, 2014).

Social anxiety disorder is a fear of negative judgment from others or public embarrassment. This anxiety disorder is characterized by a transient change in feelings such as fear of intimacy, humiliation and rejection. The environmental stressors of anxiety disorders include relationship problems, difficulties at work, family issues, genetics and family history of behavioral disorders. Medical factors of anxiety are symptoms of any psychological disease, effects of a medication and stress of any intensive surgery. Cognitive-behavioral factors of anxiety include hormonal imbalance and misalignment of electrical signals in the brain (Baldwin, Anderson, Nutt et al. 2014).

Anxiety disorders are complex and need a combination of therapies for appropriate management and avoiding relapse in patients. Treatment approaches combine cognitive-behavioral therapy and medication. Mental well-being of patients is often disturbed by alcohol dependence, depression and other psychological conditions. Self-treatment can be performed by doing yoga and different exercises to cope with mild anxiety disorders. Relaxation techniques for soothing mental and physical signs of anxiety disorder include meditation, long baths, deep breathing exercises and resting in the dark (Niles, Wolitzky-Taylor, Arch & Craske, 2017).

Psychotherapy involves replacing negative thoughts with positive ones so that a positive mental image of an object or situation can be created. This exercise therapy is suitable for conquering specific phobias and symptoms of fear in GAD and panic attacks. Cognitive behavioral therapy (CBT) is helpful in recognizing and managing harmful thinking patterns and feelings of worry in patients. CBT is intended to limited distorted thinking and change the way patients react to situations which triggers anxiety in them. The psychotherapist exposes the patients to their fears in CBT and tries to reduce their emotional sensitivity in anxiety triggering situations. GAD and panic disorders are generally treated with different combination of medications according to the patient’s condition. These medications include benzodiazepines, beta-blockers and tricyclic antidepressants. Commonly prescribed benzodiazepines for anxiety disorders include Diazepam or Valium. Antidepressants include fluoxetine, citalopram and Serotonin Reuptake Inhibitors (SSRIs). Tricyclics, for example Imipramine and clomipramine, are the drug of choice in obsessive-compulsive disorder. Prevention strategies for anxiety disorders include reduced intake of caffeine, tea, cola drinks and chocolate. Alcohol and recreational drugs should also be avoided. A regular sleep pattern also helps in overcoming the symptoms of anxiety disorder (Niles, Wolitzky-Taylor, Arch & Craske, 2017).

If you are having symptoms or suspect that you need support for anxiety, please reach out and seek professional help. You will find a list of licensed professionals on the American Psychological Association website at www.apa.org

References

Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A., … & Malizia, A. (2014). Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. Journal of Psychopharmacology, 28(5), 403-439.

Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., & Van Ameringen, M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC psychiatry, 14(1), S1.

Niles, A. N., Wolitzky-Taylor, K. B., Arch, J. J., & Craske, M. G. (2017). Applying a novel statistical method to advance the personalized treatment of anxiety disorders: A composite moderator of comparative drop-out from CBT and ACT. Behaviour research and therapy, 91, 13-23.

 

Written for

Empowering People with Invisible Chronic Illness-The EPIC Foundation
29-Dec-2018

 

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HOI Solutions – Hub of Innovation