ANXIETY

What are Anxiety Disorders?
Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. These feelings can interfere with daily activities such as job performance, school work, and relationships.

Types of Anxiety Disorders

There are three types of anxiety disorders :-

  • Generalized Anxiety Disorder (GAD)
  • Panic Disorder
  • Social Anxiety Disorder (Social Phobia)

Generalized Anxiety Disorder

“I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”(as reported by a client…..)

Signs & Symptoms

  • People with GAD can’t seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants.
  • They can’t relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep.
  • Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

GAD develops slowly. It often starts during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress.

Who Is At Risk?
The average age of onset is 31 years old. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age.

Diagnosis
GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months.

People with GAD may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with headaches or trouble falling asleep, which can be symptoms of GAD.

Panic Disorder
“One day, without any warning or reason, I felt terrified. I was so afraid, I thought I was going to die. My heart was pounding and my head was spinning. I would get these feelings every couple of weeks. I thought I was losing my mind.”(as reported by a client…..)

Signs & Symptoms

  • Sudden and repeated attacks of fear
  • A feeling of being out of control during a panic attack
  • An intense worry about when the next attack will happen
  • A fear or avoidance of places where panic attacks have occurred in the past
  • Physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain.

Who Is At Risk?

It is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.

Diagnosis

Panic attacks can occur at any time, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may last much longer.

People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in an elevator, someone with panic disorder may develop a fear of elevators that could affect the choice of a job or an apartment, and restrict where that person can seek medical attention or enjoy entertainment. Some people’s lives become so restricted that they avoid normal activities, such as grocery shopping or driving. About one-third become housebound or are able to confront a feared situation only when accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.

Early treatment can often prevent agoraphobia, but people with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition.

Panic disorder is often accompanied by other serious problems, such as depression, drug abuse, or alcoholism.These conditions need to be treated separately. Symptoms of depression include feelings of sadness or hopelessness, changes in appetite or sleep patterns, low energy, and difficulty concentrating. Most people with depression can be effectively treated with antidepressant medications, certain types of psychotherapy, or a combination of the two.

Social Phobia (Social Anxiety Disorder)

“In school I was always afraid of being called on, even when I knew the answers. When I got a job, I hated to meet with my boss. I couldn’t eat lunch with my co-workers. I worried about being stared at or judged, and worried that I would make a fool of myself. My heart would pound and I would start to sweat when I thought about meetings. The feelings got worse as the time of the event got closer. Sometimes I couldn’t sleep or eat for days before a staff meeting.” (as reported by a client…..)

Signs & Symptoms

People with social phobia tend to:

  • Be very anxious about being with other people and have a hard time talking to them, even though they wish they could
  • Be very self-conscious in front of other people and feel embarrassed
  • Be very afraid that other people will judge them
  • Worry for days or weeks before an event where other people will be
  • Stay away from places where there are other people
  • Have a hard time making friends and keeping friends
  • Blush, sweat, or tremble around other people
  • Feel nauseous or sick to their stomach when with other people.

Who Is At Risk?
Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Social phobia is often accompanied by other anxiety disorders or depression.
Diagnosis
Social phobia usually starts during youth. A doctor can tell that a person has social phobia if the person has had symptoms for at least 6 months. Without treatment, social phobia can last for many years or a lifetime.

Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others) or may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than the family.

Treatment for Anxiety Disorders

  • Cognitive-behavioral therapy (CBT) can be highly effective in treating anxiety disorders. Psychologists use CBT to help people identify and learn to manage the factors that contribute to their anxiety.
  • Behavioral therapy involves using techniques to reduce or stop the undesired behaviors associated with these disorders. For example, one approach involves training clients in relaxation and deep breathing techniques to counteract the agitation and rapid, shallow breathing that accompany certain anxiety disorders.
  • Through cognitive therapy, patients learn to understand how their thoughts contribute to the symptoms of anxiety disorders, and how to change those thought patterns to reduce the likelihood of occurrence and the intensity of reaction. The patient’s increased cognitive awareness is often combined with behavioral techniques to help the individual gradually confront and tolerate fearful situations in a controlled, safe environment.
  • Along with psychotherapy, appropriate medications may have a role in treatment

Anxiety is a normal, but highly subjective, human emotion. While normal anxiety serves a beneficial and adaptive purpose, anxiety can also become the cause of tremendous suffering for millions of people.

We at Mumbai Psychiatry Clinics have a dedicated team of counsellors and clinical psychologists who will help you with your problems, cite interventions and assess the progress on regular intervals. There are experienced psychiatrists who will be guiding you throughout your journey and our Multidisciplinary team will try to assure you with the best help possible.

References
http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml
http://www.health.com/health/gallery/0,,20646990,00.html
http://gracepointwellness.org/1-anxiety-disorders/article/38508