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Anxiety: Mental Health & Wellness

Anxiety is a natural human response to feelings of fear or uneasiness about something that might happen in future. It’s your body’s response to stress. We all experience a little bit of anxiety every day. For instance, the first day to school/college, attending a job interview, or giving a speech may cause nervousness in most of us.

Feelings of mild to moderate anxiety is perfectly normal as it helps to focus your energy and provides motivation to perform well. But if your anxiety lasts for some time (more than 6 months) and interferes with your daily life then it may be a case of anxiety disorder. People with anxiety disorder find it hard to lead a normal life as they are overwhelmed with worries and fear. In case of severe anxiety, you may have feelings of extreme worry, helplessness and confusion that are disproportionate to the actual feared event. Such feelings should not be ignored as it’s a health condition that needs to be diagnoses and treated for overall wellness.

Symptoms of anxiety

Outward signs and symptoms can help assess the severity of anxiety. Your body produces physical as well as emotional symptoms due to anxiety. A feared event can cause some or all of these symptoms, which usually goes away after the situation passes.

Physical symptoms:

  • Trembling or shuddering
  • Feeling of fullness in the throat or chest
  • Experiencing breathlessness or fast heartbeat
  • Dizziness
  • Sweaty or cold hands
  • Feeling jittery
  • Muscle pain & tightness
  • Physical & emotional tiredness
  • Sleeping problems

Emotional symptoms:

  • Excessive worry
  • Restlessness & irritability
  • Feeling edgy
  • Fearing future events
  • Difficulty in concentration

Anxiety affects the brain’s communication function. People with anxiety disorder find it difficult to express themselves in relationships.

Anxiety disorder

Anxiety disorder is the extreme case of feelings of fear and worry. People with anxiety disorder experience fear and helplessness that does not go away on it own, rather it gets worse with time. Symptoms of anxiety disorder interferes with every life function, like performing at the job in office, school-related work and most importantly in relationships with significant others. 

There are several types of anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, phobias, Obsessive-compulsive disorder (OCD) and Post Traumatic stress disorder (PTSD).

Generalized Anxiety Disorder (GAD)

A person with generalized anxiety disorder has excessive anxiety for days, for over 6 months, and on most days. They worry too much about several things like work, personal health, social relations and even about routine life events. Such anxiety causes significant problems in various areas of their life, for example at work, school and in social interactions.

Symptoms of generalized anxiety disorder includes:

  • Feeling restless, irritable & edgy
  • Excessive fatigue
  • Difficulties in concentration
  • Muscle tension
  • Excessive worry
  • Sleep problems

Panic disorder

Panic disorder is an anxiety disorder, where the person gets panic attacks out of fear. Panic attacks are recurrent and occurs when least expected. A person with panic disorder experiences sudden periods of intense fear; it comes on quickly and within minutes the fear reaches its peak. Such attacks can be unexpected or triggered by a feared event or object.  

Symptoms of panic attack:

  • Rapid heartbeat
  • Sweating profusely
  • Trembling or shaking
  • Breathlessness
  • Feeling helpless & out of control

A person with panic disorder is excessively worried about the next attack; and tries to prevent future attacks by avoiding events or objects that can trigger a panic attack. The focus of the person is to avoid panic attacks, which hampers the normal day-to-day activities and relations of the individual with others.

Phobia-related disorders

Phobia is persistent and excessive fear of an object or a situation. Some amount of anxiety is certain situations is okay, but the fear experienced by people with phobia is disproportionate to the actual danger.

Symptoms of phobia:

  • Irrational worry about running into the feared object or situation
  • Taking precaution to avoid the feared object or situation
  • Experiencing intense anxiety on running into the feared object or situation

Types of phobias

Specific Phobias

People with specific phobias have intense fear of specific objects or situations. For instance, fear of flying, heights, blood, injections and specific animals/insects like dogs, spiders or snakes.

Social anxiety disorder

A person with social anxiety disorder has intense fear of social situations. They worry excessively about their behaviour and feel that they would be negatively evaluated by others. Such people feel embarrassed and avoid all social situations at workplace or in the school.

Agoraphobia

People with agoraphobia have an intense fear of objects and situations that might trigger a panic attack. A person with agoraphobia disorder usually avoids:

  • Public transport
  • Open spaces
  • Enclosed spaces
  • Queues and crowded places
  • Being outside home, alone

A person with agoraphobia will avoid the above situations, as he/she feels it would be difficult to leave in the event of a panic attack. In severe forms of agoraphobia, an individual becomes housebound to avoid panic attacks.

Separation anxiety disorder

People with separation anxiety disorder have fears of being parted from a person, persons or even a pet. Such people fear that, while they are away, something unpleasant will happen to the individual they are attached. Any separation causes intense anxiety to the individual. A person with separation anxiety disorder gets nightmares about separation and may even experience physical symptoms on actual separation or on anticipation of a separation. Both children and adults can be diagnosed with separation anxiety disorder.

Selective mutism

Selective mutism is a childhood anxiety disorder that occurs before 5 years of age. A child with this anxiety is unable to speak in certain social situations like in school. However, they can communicate effectively in situations where they feel safe and relaxed. Such children display specific behaviour, such as extreme shyness, obsessive traits, fear of social embarrassment, withdrawal, clingy behaviour, and temper tantrums. A child with selective mutism usually has other anxiety disorders as well.

Obsessive-compulsive disorder (OCD)

A person with OCD displays obsessive and compulsive behaviour. They suffer from obsessive thoughts and impulses that compels them into performing repetitive behaviours.  

Some common obsessions include:

  • Contamination fear
  • Obsession with lucky/unlucky numbers
  • Excessive fear of danger
  • Need for precision
  • Unwarranted doubt

Common compulsions that follow obsessions include:

  • Ritualistic handwashing
  • Arranging things
  • Double checking
  • Counting or repeating words
  • Hoarding things

While it’s natural to experience these thoughts and behaviours sometimes. But if these symptoms are experienced for more than an hour daily, then the person is a case of OCD. This disorder interferes with normal life and causes great anxiety to both men and women. In most cases OCD starts in adolescence or early adulthood. It may also start in childhood.

Post Traumatic Stress Disorder (PTSD)

PTSD is experienced by individuals who have gone through a traumatic experience. It’s a stress disorder where the person relives a violent or tragic event that had taken place in the past. Such individuals feel intense fear and helpless. Some of the events that may lead to PTSD include war, rape, natural disasters, and violent accidents. While it’s normal to feel anxious or depressed for some time after a tragedy. But people with PTSD continue to relive the hurtful event. They get nightmares, hallucinations or flashbacks of the traumatic episode. They display avoidance behaviour and increased arousal.

Other symptoms include:

  • Sleeping problem
  • Irritability
  • Concentration problem
  • Extreme alertness or edgy behaviour

PTSD typically occurs within three months of the tragic event. But in some cases, it may occur after many years. Person diagnosed with PTSD find it difficult to function like they did before the traumatic event.

Treatment

Anxiety disorder is a mental health condition and must be treated for overall wellness of the affected individual. Medical practitioners typically treat anxiety disorders with psychotherapy, medication or both.

Psychotherapy

Psychotherapy or talking therapy is useful in treating anxiety disorders. This therapy can be effective if it is directed towards the specific anxiety or fears of the person.

Cognitive Behavioral Therapy (CBT) is a widely used psychotherapy to help individuals with anxiety disorders. It teaches the affected person, different ways of thinking, behaving and reacting to objects and situations that make them anxious. This therapy also focuses on learning and practicing social skills that are vital for dealing with social anxiety disorder.

CBT uses two methods – cognitive therapy and exposure therapy – individually or together to treat social anxiety disorder. In cognitive therapy, the therapist identifies, challenges, and neutralizes the distorted thoughts responsible for the underlying anxiety disorders. While in exposure therapy, the therapist confronts the underlying fears causing the anxiety disorder. Therapist teaches the affected person to engage in activities that they have been avoiding. In some cases, exposure therapy is paired with relaxation exercises and/or imagery.

Cognitive Behavioral Therapy is conducted individually or in groups, where people have similar problems. Participants are assigned homework that must be completed between sessions.

Medication

Anxiety disorders cannot be treated with medication, but it helps to relieve the symptoms. Medications can be prescribed by doctors, who are psychiatrist or primary care providers. In some states, even psychologists with specialized training can prescribe medications for anxiety disorders. Anti-anxiety drugs, antidepressants and beta-blockers are usually prescribed for anxiety disorder treatment. 

Anti-Anxiety Medications

Benzodiazepines is the most common anti-anxiety medication prescribed by doctors. It helps to combat the symptoms of anxiety, panic attacks, extreme fear and worry in affected individuals.  Buspirone is another commonly prescribed anti-anxiety medication. Buspirone is specifically used for treating chronic anxiety, but it may not help everyone.

Antidepressants

Antidepressants are prescribed for treating anxiety disorders, although they are mainly used to treat depression. It helps by releasing chemicals in the brain that improves mood and reduces stress. Antidepressants take time to work, so its effectiveness can be determined only after some time. Stopping anti-depressants abruptly may cause withdrawal symptoms. Always consult your doctor before discontinuing it.

Antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are used in treatments of anxiety disorders. Sometimes tricyclic antidepressants and Monoamine Oxidase Inhibitors (MAOIs) are also prescribed for treating anxiety disorders.

Beta-Blockers

Beta-blockers can be used to treat the physical symptoms of anxiety disorders, such as rapid heartbeat, trembling and blushing. They are mostly used in treating high blood pressure. If needed, it can be used to give relief from acute anxiety. Sometimes it’s used as a preventive medication to combat anxieties related to performance.

Note: All medication for treatment or for providing relief from anxiety disorder must be taken only after consulting a doctor.

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