"Anxiety Disorders Examined", by Dr. Kirk Christie Consultant Psychiatrist, Discovery Clinic, Sandyport Plaza

Anxiety Disorders are the most common psychiatric disorders for both children and adults. We have all felt nervous or anxious at times before taking a test, before a job interview, before making an important decision, or before public speaking (in the performance situation).

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 relatively mild and brief anxiety one might experience in these situations, Anxiety Disorders are much different.

While the exact cause of Anxiety Disorders is not known, they like other forms of mental disorders are not as a result of a personal weakness, or a character flaw, or poor parenting. Scientists are learning that anxiety disorders have a biological basis and are caused by a combination of factors including brain chemistry, environmental factors, personality characteristics and life events. Most often, anxiety disorders begin in childhood, adolescence or early adulthood.

The good news is that anxiety disorders are highly treatable and the vast majority of people with anxiety disorders can be helped with professional care. The most successful treatments include a combination of therapy and medications.

Generalised Anxiety Disorder (GAD) is a common condition characterized by constant worry and tension that persists for several months, even when there is little or no cause for it. The ongoing tension interferes with day-to-day living, as people worry constantly and feel helpless to control these worries.

GAD is mentally and physically exhausting, making normal life difficult

and relaxation impossible. Physical symptoms include: fatigue, headaches, muscle tension and aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, breathlessness and hot-flashes. Sufferers also have trouble concentrating, relaxing, falling asleep or staying asleep.

GAD usually develops gradually and may begin at anytime, although the risk is highest between childhood and middle age. GAD can be managed with medications and talk-therapy.

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Panic Disorder,is characterized by a sudden surge of overwhelming anixety and fear, onset of panic attacks often occurring in familiary places where there is seemlingly nothing threatening to the person. During the attack, several of the symptoms occur simultaneously. People who have panic attacks fear their own physical symptoms which can become overwhelming. They can not predict when or where an attack will occur, and, between attacks, they become preoccupied with worry or dread of the next occurrence. Panic attacks can occur at any time, and the episodes last, on average about ten (10) minutes.

Phobias are an unrealistic or exaggerated fear of a specific object, activity or situation that in reality presents little or no danger. Some of the common phobias include: to animals, snakes, spiders and insects, heights, escalators and tunnels, highway driving, trains and flying, medical procedures, needles and the sight of blood. While some phobias develop in childhood, others develop unexpectedly in adolescence or early adulthood. People with phobias have emotional and physical reactions to the feared objects or situations.

Symptoms of a phobia include: feelings of panic, dread or terror. Those who experience phobias often have sensations of rapid heartbeat, shortness of breath and trembling. They recognise that their fear goes beyond normal boundaries of reason, but their reactions are automatic and uncontrollable and they feel powerless in controlling or combating it. Treatments for phobias include medications and therapy,

Social Anxiety Disorder also know as social phobia is characterized by excessive worry and self-consciousness about everyday social situations. Far more than shyness or unease around other people, those with social phobia have an intense, persistent and irrational fear of being watched an judged by others or doing things that will embarass them or lead to ridicule. Common examples of social tanixety include public speaking or performing in front of an audience, meeting new people, eating at restaurants, or going to parties.

Physical symptoms that often accompany social anixety disorder include: blushing, sweating, trembling, nausea or difficulty speaking.

Symptoms can be extreme and eventually disrupt daily life. People with this disorder often find it difficult to make or keep friends, and it can prevent involvement in a romantic relationship, making those who suffer from the disorder feel completely isolated and even ashamed. Treatments include medication management and talk-therapy sessions.

Subtance/Medication Induced Anxiety Disorder is diagnosed when panic attacks or other anxiety symptoms are brought on by the use of and withdrawal from alcohol or other drugs, by taking medications, or exposure to heavy metals or toxins. In some cases, the onset of anxiety symptoms are immediate. For others, symptoms may develop within a month of intoxication or withdrawal.

Some of the Substances that Can Lead to Substance/Medication-Induced Anxiety

Subtances	Medications	Toxins
Alcohol	Analgesic	Carbon Dioxide
Caffeine	Anesthetics	Carbon Monoxide
Cannabis (marijuana)	Anticonvulsants	Gasoline
Cocaine	Antihistamines	Organophosphate insecticides

Anxiety Induced by Medical Conditions: a number of medical conditions can lead to anxiety disorder. In many cases the anxiety might be the first indication that a medical disorder exists, especially if the anxiety develops suddenly in a person with no history of anxiety or family history of anxiety disorders. Symptoms include general anxiety symptoms as well as the onset of panic attacks.

Medical Conditions presenting with Anxiety Symptoms

Endocrine	Hyperthyroidism, Hypoglycemia
Cardiovascular Disorders	Congestive Heart Failure, Atrial Fibrillation
Respiratory Illness	Asthma, Pneumonia
Metabolic Disturbances	Vitamin B12 Deficiency, Porphyria
Neurological Illnesses	Encephalitis, Seizure Disorders

Treatments for Anxiety Disorders Include:

1. Psychotherapy sessions or Behavioural Therapy

2. Medication Management

3. Self-Help or Support Groups

4. Support from Family, Friends, Advocates

If you have any questions, do not hesitate to contact Dr. Kirk Christie at <info@kirkchristie.com> or do call to make an upcoming appointment 327-8719/327-8718/364-9600