Anxiety Disorder


All we need to know about Anxiety disorders

 

Anxiety is an unpleasant feeling of fear and apprehension in response to some perceived threat or danger. Anxiety can be normal if is in response to stressful event /experience /situation. It is required for optimal performance. However Anxiety becomes abnormal or pathological when it is excessively severe or prolonged, distressing and interferes with social, physical or occupational performance

Anxiety disorders are characterized by the presence of fear or apprehension that is out of proportion. They are called common mental disorders considering the number of people affected by it.

What are common signs and symptoms of anxiety disorders ?

Because the anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. However, irrespective of the type, all anxiety disorders share one major symptom: persistent or severe fear or worry in situations where most people wouldn’t feel threatened. Apart from this the other common symptoms are:

Emotional symptoms of anxiety

§  Feelings of apprehension or dread

§  Trouble concentrating

§  Feeling tense and jumpy

§  Anticipating the worst

§  Irritability

§  Restlessness

§  Watching for signs of danger

§  Feeling like your mind’s gone blank

Physical symptoms of anxiety

§  Pounding heart

§  Sweating

§  Stomach upset or dizziness

§  Frequent urination or diarrhea

§  Shortness of breath

§  Tremors and twitches

§  Muscle tension

§  Headaches

§  Fatigue

§  Insomnia

What are the types of anxiety disorders?

There are six major types of anxiety disorders, each with their own distinct symptom profile: generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, phobia, post-traumatic stress disorder, and social anxiety disorder.

Generalized anxiety disorder

If constant worries and fears distract you from your day-to-day activities or you’re troubled by a persistent feeling that something bad is going to happen, you may be suffering from generalized anxiety disorder (GAD). People with GAD are chronic worrywarts who feel anxious nearly all of the time


Obsessive-compulsive disorder (OCD)

It is characterized by unwanted thoughts or behaviors that seem impossible to stop or control. If you have OCD, you may be troubled by obsessions, such as a recurring worry that you forgot to turn off the oven or that you might hurt someone. You may also suffer from uncontrollable compulsions, such as washing your hands over and over. 


Panic disorder

This presents with repeated, unexpected, sudden episodes of intense anxiety, accompanied by feelings of impending doom or death as well as fear of experiencing another episode. Panic disorder may also be accompanied by agoraphobia(fear of crowded places) which is a fear of being in places where escape or help would be difficult in the event of a panic attack. If you have agoraphobia, you are likely to avoid public places such as shopping malls or confined spaces such as an airplane. 


Phobia

Phobia is unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals such as snakes and spiders, fear of flying, and fear of heights. In the case of a severe phobia, you might go to extreme lengths to avoid the thing you fear. Unfortunately, avoidance only strengthens the phobia.


Post-traumatic stress disorder (PTSD) 

PTSD is an anxiety disorder that can occur in the aftermath of an extremely traumatic or life-threatening event. Symptoms of PTSD include flashbacks or nightmares about what happened, hyper vigilance, startling easily, withdrawing from others, and avoiding situations that remind you of the event. It is often described as a sequel of natural or man-made disasters.  


Social anxiety disorder

If you have a debilitating fear of being seen negatively by others and humiliated in public, you may have social anxiety disorder, also known as social phobia. Social anxiety disorder can be thought of as extreme shyness. In severe cases, social situations are avoided altogether. Performance anxiety (better known as stage fright) is the most common type of social phobia. 

What are the treatment options?

Anxiety disorders respond very well to treatment—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with behavioral therapy, medication, or some combination of the two. New research has also revealed a number of beneficial complementary treatments for anxiety.

Medications-

A variety of medications, including benzodiazepines and antidepressants, are used in the treatment of anxiety disorders. But medication is most effective when combined with behavioral therapy. When compared to those who use medication alone, anxiety sufferers treated with both therapy and medication benefit from a greater reduction in symptoms and a lower risk of relapse.

 Psychotherapy-

Supportive tecgniques, Cognitive-behavioral therapy and exposure therapy are two effective anxiety disorder treatments. Both are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past.

How to Get Help for Anxiety Disorders?

If you think you have an anxiety disorder, the first person you should see is your family doctor. A physician can determine whether the symptoms that alarm you are due to an anxiety disorder, another medical condition, or both.

If an anxiety disorder is diagnosed, the next step is usually consulting a mental health professional. The treatment can be initiated in consultation with psychiatrist and family doctor.

Remember that once you start on medication, it is important not to stop taking it abruptly. Certain drugs must be tapered off under the supervision of a doctor. Abrupt discontinuation may lead to a relapse of symptoms, at times rebound anxiety. Make sure you talk to the doctor who prescribed your medication before you stop taking it. If you are having trouble with side effects, it’s possible that they can be eliminated by adjusting how much medication you take and when you take it.

What are the ways to make treatment more effective?

Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common. Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a mental health professional.

Stress management techniques and relaxation exercises can help people with anxiety disorders calm themselves and may enhance the effects of therapy. There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Always check with your physician before taking any additional medications.

Does anxiety disorder recover completely?

The response to treatment in an individual patient may vary with some patients responding very well to treatment while in others it may be more challenging with patients requiring more than one medicine trial or need for a combination of medicines. The recurrence of symptoms after successful treatment can be seen in nearly half the patients. Drug treatment usually needs to be continued for a longer period. Lifelong maintenance therapy may be required in some patients to prevent recurrence.

What is the role of family?

The family is very important in the recovery of a person with an anxiety disorder. Ideally, the family should be supportive but not help perpetuate their loved one’s symptoms. Family members should not trivialize the disorder or demand improvement without treatment.

 The family also need to be alert for possible complications or crisis situations that may arise during the course of illness such as  thoughts of harming others, any self-harming or suicidal ideas or behavior. In case of any of such crisis, the family should immediately report it to the doctor as this requires emergency intervention and/or hospitalization.  

Can anxiety disorder be prevented?

There are no known ways to prevent the development of the disorder. However early recognition of the illness and prompt and adequate treatment is helpful. The following techniques may help in managing stress and anxiety symptoms.

·        Adopt a healthy lifestyle including adequate rest, recreation & change

·        Learn to share your problems with family & friends

·        Never be shy to seek help when required

·        Let go of things when it is needed

·        Daily exercise, yoga & meditation are proven ways to lower anxiety

What are the Rehabilitation options for patients with chronic anxiety disorder?

 Rehabilitation involves the use of psychosocial therapies which include a variety of methods to increase social abilities, self-sufficiency, practical skills, and interpersonal communication in schizophrenia patients. The goal is to enable persons who are severely ill to develop social and vocational skills for independent living.

Living with anxiety Disorder- What can you do or help your patient do?

  1. Recognize the illness in its early stage
  2. Consult the doctor immediately
  3. Discuss the treatment options with your doctor.
  4. Avoid self medicating.
  5. Take medications as prescribed. Continuing medications will help prevent relapse or recurrence.
  6. Follow up with your doctor regularly. Regular contact with doctor and timely review are helpful.
  7. Avoid excess tea, coffee, nicotine, drugs like cannabis, alcohol.
  8. Keeping oneself engaged in activities
  9. Eat and sleep well. Adequate sleep and healthy diet is necessary for good physical and mental health.
  10. Exercise regularly. Physical activity helps reducing stress, anxiety.


( This document is compilation of information from Web and Print Media for purpose of making the scientific educative material easily available for patients and families)