Anxiety is the body’s natural response to stress. It is most often characterized by a diffuse, unpleasant, vague sense of apprehension, commonly accompanied by physical symptoms such as increased heart rate, rapid breathing, restlessness, sweating, trembling, butterflies in the stomach, losing control etc.

It is quite normal and natural to feel anxious about moving to a new place, taking a test, making an important decision, or facing a challenging situation. This type of anxiety is unpleasant, but it can help a person to stay alert and focused, spur one to action, and motivate one to solve problems. Ordinary anxiety is a feeling that comes and goes but does not significantly interfere with one’s everyday life.

When anxiety becomes intense, excessive, persistent or overwhelming, one might have likely crossed the threshold from normal anxiety into the zone of an anxiety disorder. The symptoms can interfere with daily activities such as job performance, schoolwork, and maintaining relationships.

Signs and symptoms of anxiety disorders

Generalised anxiety disorder (GAD)

People with GAD display excessive anxiety or worry, about several things such as health, work, social interactions, and everyday routine life circumstances, or activities, usually accompanied by the following symptoms –

Feeling restless, or on-edge
Being easily fatigued
Having difficulty concentrating; mind going blank
Being irritable
Having muscle tension
Difficulty controlling feelings of worry
Sleep problems
Panic Disorder

Panic attacks are periods of intense fear that come on abruptly, reach their peak and subside quickly, usually within minutes. Attacks can be triggered by a feared object or situation, or they sometimes seem to happen for no apparent reason, completely “out of the blue.” When a person has unexpected panic attacks repeatedly, it is termed panic disorder.

During a panic attack, people may experience some of the following symptoms –

Palpitations, pounding heart, or an accelerated heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath, or smothering,
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, light-headed, or faint
Chills or hot sensations
Numbness or tingling sensations
Fear of losing control or going crazy
Fear of dying
Specific phobia

The term phobia refers to excessive and intense fear of a specific object, circumstance, or situation. People with a phobia have the following symptoms –

Marked anxiety about encountering a specific object or situation (e.g., flying, driving, animals, heights, receiving an injection, seeing blood, etc.)
The phobic object or situation is actively avoided or endured with intense fear or anxiety
Social phobia

People with social phobia have an intense fear of, or anxiety toward, social or performance situations. They worry that their actions or behaviours will be negatively evaluated by others, leading them to feel embarrassed. This worry often causes them to avoid social situations.

Causes of anxiety

Genetic, neurochemical and environmental factors can contribute to the risk of developing an anxiety disorder. Known risk factors are as follows –

Having first- or second-degree relatives with an anxiety disorder
Being exposed to stressful and negative life events in early childhood
Stressful life situations, e.g., death of a loved one, work stress, relationship distress, worry about finances etc.
People with certain personality types are more prone to anxiety than others
Other mental health conditions, such as depression, increase susceptibility to having an anxiety disorder
Drug or alcohol use or withdrawal can cause or worsen anxiety
Certain medical conditions, such as thyroid problems, anaemia or heart arrhythmias
Management of anxiety

Psychotherapy

This is a type of counselling, wherein a mental health specialist helps the person by talking about how to understand and deal with the symptoms of anxiety.

Cognitive behavioural therapy (CBT) – This is a type of psychotherapy that teaches how to recognize and change thought patterns and behaviours that trigger and maintain anxiety, hence resulting in symptom reduction or resolution.

Medication management

Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) are commonly used as first-line treatments for anxiety, they have known and proven efficacy in treating anxiety disorders.

Other medications such as benzodiazepines are indicated for short term use to reduce acute symptoms of anxiety, they are quite potent and effective, but carry dependence and abuse potential, if used for long term.

Other practices that might reduce anxiety include –

Deep relaxation techniques, such as progressive muscle relaxation
Deep breathing exercises, such as abdominal breathing
Meditation and mindfulness exercises
Cutting down on foods and drinks that have caffeine, such as coffee, tea, cola, energy drinks, and chocolate
Lifestyle changes such as eating right, being physically active, and getting better sleep
Brisk aerobic exercises like jogging and biking help release brain chemicals that cut stress and improve mood
Limiting nicotine, alcohol, and other substances of abuse
Taking time out, listening to music, pursuing hobbies
Accepting that one cannot control everything
Writing in a journal when one is feeling stressed or anxious, and looking for a pattern of what triggers the anxiety
Getting involved, volunteering or finding another way to be active in one’s community helps creates a support network and gives one a break from everyday stress, hence reducing anxiety

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