Anxiety
An overview
Experiencing stress every now and then is a normal emotion. Some people may feel nervous before taking a test or feel worried before making an important decision. While we may feel stress or worried when under pressure, those feelings usually go away once the stressful situation has passed. However, anxiety disorder is different. Anxiety disorder is when these feelings of worry or stress just don't go away, when they are ongoing and in most cases happen without any particular reason or cause.

Anxiety disorder is essentially an inner state of turmoil, which causes constant fear and worry, thus disrupting your day to day life. People with anxiety disorders experience excessive and persistent worry and fear about everyday situations. Most importantly, the fear and worry is completely out of proportion to the actual danger. This is a serious medical condition, but with treatment, most people are able to manage anxiety and get back to a fulfilling life.
Symptoms & Signs
At times, the symptoms of anxiety disorder are not all that obvious as they develop slowly over time and, given that most of us experience some amount of anxiety at different points in time, so it is difficult to to know how much is too much. People suffering from anxiety have any or few of the following symptoms:
  • Feelings of panic and uneasiness
  • Feelings of fear and worry constantly
  • Sleeping problems
  • Shortness of breath
  • Heart palpitations
  • Unable to stay calm
  • Cold or sweaty hands and feet
  • Numbing of hands and feet
  • Nausea and dizziness
  • Restlessness and trouble concentrating
  • Feeling tense, jumpy or irritable
  • Hyperventilation
    • Causes
    It's not entirely clear what can cause anxiety disorder, though like with most mental health issues, it is not a result of personal weakness or a character flaw. It is now widely believed among the psychiatric community that anxiety is a result of complex interaction and combination of combination of factors, which include changes in the brain and environmental stress.

  • Family History of Anxiety(Genetics) - It has been observed that many people suffering from anxiety conditions also have a genetic predisposition towards anxiety and that it sometimes run in the family. However, it by no mean means that having a parent suffering from anxiety will result in the kids having anxiety.

  • Personality Factors – People with certain personality traits are more likely to experience anxiety. For example, people with low self-esteem or those who tend to be perfectionists or get easily flustered are prone to anxiety.

  • Ongoing Life Events - Experiencing difficulties such as prolonged work stress, job change, pregnancy, relationship problems, or some traumatic event such as loss of loved ones, is likely to trigger anxiety.

  • Physical Health Issues – Often chronic physical illnesses such as diabetes, asthma and heart diseases can contribute to anxiety conditions.

  • Drug Abuse - Some people suffering from anxiety end up using alcohol or other drugs to manage their condition. In most cases, this leads to people developing a substance use problem in addition to anxiety condition. Alcohol and drugs use can aggravate anxiety disorder especially when the the effects of the substance starts wearing off.

    • Everyone is different and anxiety condition is often a combination of factors that can contribute to developing anxiety. The most important thing is to recognize the anxiety symptoms and seek medical advice.
    Panic Attacks
    Panic disorder is very different from the normal fear or anxious reactions to stressful events. Panic disorder is a serious condition wherein the person experiences acute fear and nervousness along with physical symptoms such as a racing heart and sweating, for around 10 mins or so. When the panic attack strikes, the fear response is completely out of proportion for the situation, which often is non threatening. The worse part is that over time a person suffering from panic disorder starts developing a constant fear of having another panic attack, which affects the daily functioning and the quality of life.

    The key symptom of panic disorder, apart from experiencing an panic attack, is the constant fear of having future panic attacks. The fear of panic attacks can lead the person to avoid places and situations where an attack has occurred or where they believe an attack could occur.
    Social Anxiety Disorder (SAD)
    Social anxiety disorder also called social phobia, is a kind of anxiety disorder in which a person has an excessive fear of social situations. It is one of the most common anxiety disorders, and is much more than just "shyness". A person suffering from social phobia, has this constant fear that he is being closely watched and judged by others, and that he will make mistakes, which will lead to criticism from others. As a result of this fear, the person either is in extreme distress in certain social situations or ends up avoiding them.

    Most people with social anxiety disorder suffer "anticipatory" anxiety i.e. the fear of a situation much before it even happens. They would get nervous thinking about it for days or even weeks before the actual event. In a few cases, the person is even aware that his/hear fear is unreasonable but is unable to overcome it.
    General Anxiety Disorder (GAD)
    Generalized Anxiety Disorder (GAD) is the most common type of anxiety, which affects tens of millions of people across the world. It is as an ongoing state of mental and/or physical tension and nervousness, without a specific cause. In other words, if you feel you are always worried, anxious, or stressed and if it disrupts your normal life, then you may have generalized anxiety disorder. The worries may relate to several aspects of life, including work, family or financial issues, rather than just one specific issue.

    The most common symptoms associated with GAD are constant restlessness, irritation, or a feeling of being worries all the time. People suffering from GAD find it hard to stop worrying and they also feel fatigue and low energy levels. Some people may also feel muscles tension, especially on the back, neck, and shoulders. If this condition lasts for more than six months, then it is important to visit a psychologist or psychiatrist.
    Assessment & Diagnosis
    If you are experiencing symptoms of anxiety disorder, then the therapist will start the evaluation by asking you questions about your medical history. Though there are no lab tests to specifically diagnose anxiety disorders, certain assessment tests can help figure out the severity of the problems.

  • Psychological Assessment - Your psychologist or psychiatrist will ask about your symptoms, feelings and behavior patterns and might ask you to fill in specially designed interview and assessment tools to evaluate the anxiety disorder.

  • Lab Tests - In certain cases, your psychiatrist may also reccomend you to get certain lab tests to look for other medical illness as the cause of the symptoms.

    • Treatment
    There are many ways that help people recover from anxiety and these vary from person to person. However, there are a range of effective treatments that have proved to be effective in treating anxiety and they usually involve psychotherapy and/or medication.

  • Psychological Treatment (Psychotherapy) - In mild to moderate cases of anxiety, psychotherapy treatment works very well. It helps in change of thinking patterns for people suffering from anxiety, which improves the coping skills to deal with life's stresses and conflicts. While different types of psychotherapies are existing, the most effective one is Cognitive Behavioral Therapy (CBT).

  • Medication- In cases of more severe anxiety, psychotherapy along with medical treatment (prescribed by psychiatrists) can be used to treat anxiety. The main medical treatment involves prescribing antidepressant, anticonvulsant medicines and low-dose antipsychotics medication, which can be very useful in the reducing anxiety.

    • Apart from these main forms of treatment, maintaining a healthier lifestyle, finding support groups and adopting methods of relaxation techniques could also help cure anxiety.
    How Therapy Works
    There are a variety of therapeutic approaches used for the treatment of anxiety. These approaches range from cognitive behavioral therapy to behavioral therapy to interpersonal therapy. Both individual as well as group therapies are also used, depending upon the severity of the disorder and individual comfort.

    However, Cognitive-behavioral therapy remains the most commonly used and effective therapy for treating anxiety. Several research studies have proved the safety and effectiveness of CBT in treating people, of all age groups, suffering from anxiety. CBT is a structured treatment process which emphasizes on the fact that the way we think (cognition) and act (behaviour) eventually affects the way we feel. It changes the thoughts and behaviour pattern of an individual by teaching to think rationally about common difficulties and hence shifting negative or unhelpful thought patterns towards a more positive and problem-solving approach.

    CBT involves working with a professional therapist to identify and change thought/behaviour patterns that are causing anxiety and is also well-suited to be delivered online using video or audio technology.
    Anxiety disorder can also lead to complex mental and physical conditions such as depression, substance abuse, insomnia, digestive problems etc. Hence its important to identify the symptoms and start the treatment at the earliest sign of a problem to help prevent anxiety from worsening.
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