Anxiety Disorders are the most common psychiatric disorders for both children and adults
We have all felt anxious at times, that is, before taking an exam, before a job interview or before delivering a public speech. Anxiety is a normal reaction to stress. It helps us prepare for significant events or warns us to get out of harm’s way or take action.
Unlike the relatively mild and brief anxiety that one may experience in these situations aforementioned, anxiety disorders are much different.
Persons with anxiety disorders suffer constant and overwhelming worry and fear. The symptoms of the underlying anxiety disorder are distressing to the person and cause significant impairment in life functioning, that is, in social, occupational, family, educational and spiritual arenas, of life.
Anxiety Disorders- Origin
Anxiety Disorders are not the result of a character flaw or personal weakness or poor parenting. Neuroscientists are learning from the ongoing research, that Anxiety disorders have a biological basis and are caused by a combination of factors, that include: brain chemistry, genetics, environmental factors, personality characteristics and life events. According to the empirical data, anxiety disorders begin in childhood, adolescence or early adulthood.
Anxiety Disorders are highly treatable by mental health professionals such as psychiatrists, psychologists and psychotherapists. Treatments are tailored specifically based on the case, for each individual. Of note, successful treatments involve medication management, talk therapy sessions and holistic treatments.
Persons with Anxiety Disorders don’t have to suffer in silence; help is available to you, now.
Examples of Normal Anxiety
Nervous feeling before a job interview
Feeling nervous, uncomfortable or awkward in a social situation
Feeling shy or awkward when entering a room of strangers
Realistic fear of a dangerous object, place or situation
Examples of Anxiety Disorder
Refusing to attend the office holiday party
Refusing a social invitation for fear of being judged, humiliated or embarrassing yourself
Turning down a promotion because it involves public speaking
Irrational fear or avoidance of an object, place or situation that poses little or no threat of danger
Types of Anxiety Disorders:
Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder (social phobia)
Substance/medication induced anxiety disorder
Anxiety due to a medical condition
Separation Anxiety Disorder
Generalized Anxiety Disorder
GAD is a common condition characterized by constant worry; fear of the future, fatigue and muscle tension that persists for several months (duration of at least six months), even when there is little or no cause. The ongoing worrying, fear, fatigue and severe muscle tension interferes with day-to-day life as persons with the disorder worry constantly and feel helpless to control these worries.
Symptoms of GAD
§ Excessive worry about everyday things
§ Inability controlling constant worries
§ Feeling tired all of the time
§ Having trouble relaxing
§ Headaches, muscle aches, stomach aches
§ Restless, difficulty concentrating
§ Irritable, hot flashes, lightheaded
§ Trouble falling asleep or staying asleep
Panic Disorder (Re-occurring Panic Attacks)
A sudden surge of overwhelming anxiety and fear, a panic attack often occurs in a familiar place, where there is seemingly nothing threatening to the individual.
During a panic attack, several of the symptoms occur simultaneously i.e. sweating, shortness of breath; rapid short shallowed breaths, racing heartbeat; chest pain or discomfort, feeling dizzy, lightheaded or faint, choking or smothering sensation, numbness or tingling, chills or hot flashes, trembling or shaking, nausea or upset stomach, feeling unreal or detached from one’s surroundings; fear of losing control or fear of dying.
Persons who experience panic attacks, often fear their own physical symptoms which can become overwhelming. The individual cannot predict when or where an attack will occur. Panic attacks can occur ‘out of the blue’ and between the attacks, the person is usually preoccupied with worry and dread of the next occurrence of symptoms.
A phobia is an unrealistic or exaggerated fear of a specific object, activity or situation that in reality presents little or no danger.
Examples of common phobias include:
8. Highway driving
11. Sight of blood
13. Medical procedures
Some phobias develop in childhood but others develop unexpectedly, usually in adolescence or early adulthood.
Persons with Phobias have emotional and physical reactions to the feared objects or situations. Symptoms of a phobia include: panic attacks (i.e. racing heartbeat, shortness of breath, chest discomfort; sweating; trembling; pin and needles sensations over finger pounds; hollow sensation in the pit of the stomach; heat over the muscles e.g. calves; thighs, biceps, triceps; feelings of impending doom or feelings of dread or terror).
Further, persons recognize that their fear goes beyond normal boundaries of reason and that their reactions are automatic and uncontrollable. They feel powerless in controlling or combating it.
Adults with phobias realize that these fears are irrational and often find that facing the object or situation or even thinking about it, brings on severe anxiety. The distress can become so great that some people, go to extreme lengths to avoid what they fear.
Unfortunately, avoidance of the object or situation or activity, only strengthens the phobia.
Social Anxiety Disorder-SAD
SAD also known as social phobia is characterized by excessive worry and self-consciousness about everyday social situations. Other symptoms of SAD include intense persistent and irrational fear of being watched and judged by others or of doing things that will embarrass them or lead to ridicule by others around them. Physical symptoms include blushing, sweating; trembling, nausea or difficulty speaking.
Common examples of SAD are seen when people suffering with the disorder, avoid at all costs, engaging in public speaking events or performing in front of audiences; of meeting new people, of eating at restaurants or going to parties or social/congregant events.
Substance/Medication-induced Anxiety Disorder
This disorder is diagnosed when panic attacks or other anxiety symptoms are brought on by the use of, or withdrawal from, alcohol or other legal and or illegal drugs, by certain prescribed medications or exposure to heavy metals or toxic substances.
Anxiety Induced by Medical Conditions
There are medical conditions which can mimic the symptoms of an anxiety disorder. In many cases, the anxiety symptoms might be the first indication that an underlying medical disorder exists, especially if the anxiety disorder develops suddenly (acutely) in a person with no prior history of anxiety or family history of anxiety disorders.
In cases of an acute onset of anxiety symptoms with no past history of anxiety disorders, the person who is experiencing the anxiety symptoms, should seek a comprehensive medical evaluation (physical examination with appropriate laboratory investigations) at a medical clinic or at the emergency room department.
The symptoms include general anxiety symptoms and panic attacks. A number of medical conditions that are known to present with anxiety symptoms include the following:
1. Endocrine Disorders i.e. thyroid gland dysfunction-hyperthyroidism; pancreas dysfuntion-hypoglycemia
2. Cardiovascular Disorders i.e. congestive heart failure; atrial fibrillation
3. Respiratory Disorders i.e. asthma; pneumonia
4. Metabolic Disturbances i.e. vitamin B12 deficiency, porphyria
5. Neurological Disorders i.e. seizure disorders, encephalitis
Treatment of Anxiety Disorders
§ Complete a comprehensive medical evaluation (physical exam with appropriate lab investigations). Treat any underlying medical disorders.
§ Complete a diagnostic evaluation with a mental health professional i.e. psychiatrist; psychologist, psychotherapist
§ Talk Therapy sessions initiated (cognitive behavioral therapy; exposure therapy; graded systematic desensitization; mindfulness; graded muscle relaxation; four second box breathing technique; positive self talking; positive affirmations; cognitive restructuring)
§ Stress Management and Coping Strategies
§ Medications (i.e. short course of benzodiazepine; antidepressant/anti-anxiety controller medication for moderate to severe symptoms)
§ Holistic treatments i.e. exercise; nutritional counseling; music therapy; aromatherapy: massage therapy; acupressure; acupuncture
§ Supportive Therapy (support group; family support; social assistance)