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AnxietySyn: Also known as Anxiety Disorder, Panic Disorder, Phobias, Obsessive Compulsive Disorder (OCD), Generalised Anxiety Disorder (GAD)
Anxiety disorders are the most common types of mental health conditions. According to a survey in 2017, 44.9 million Indians were estimated to be suffering from anxiety disorders. Anxiety disorder is twice as likely to affect females than males.
It is normal to feel a little anxious and stressed about challenging situations that arise in life. However, when the feeling of anxiety interfere with a person’s day-to-day life, such a condition is suspected to be an anxiety disorder.
People who suffer from anxiety disorders, phobias, or who have a history of panic attacks often try to avoid situations or things that precipitate their anxiety. They are unable to lead a normal life and live in fear of challenging situations. If episodes of anxiety become too frequent and severe, and start affecting a person’s quality of life and everyday behavior, it is essential to visit a doctor to seek care for anxiety. Medications, psychotherapy, and lifestyle modifications can help alleviate the symptoms of anxiety.
- Children above 11 years of age
- Adults above 20 years of age
- Both men and women but more common in women
- India: 44.9 million (2017)
- Cardiac arrhythmias
- Addison’s disease
- Complete Blood Count
- Thyroid Profile Total
- Adreno Corticotrophic Hormone Plasma
- Alcohol Screen Blood
- Drugs of Abuse (Qualitative) Panel
- Electrocardiography (ECG)
- Selective serotonin reuptake inhibitors (SSRIs): Fluoxetine & Sertraline
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): Venlafaxine & Duloxetine
- Tricyclic antidepressants (TCAs): Moclobemide
- Sedatives and tranquilizers: Diazepam & Lorazepam
- Behavior therapist
Symptoms of Anxiety
The following symptoms suggest an anxiety disorder:
- Constantly feeling restless, nervous or tense, inability to concentrate.
- The fear of losing control.
- Having frightening thoughts and mental images.
- Trouble falling asleep.
- Feeling weak or tired all the time.
- Physical symptoms such as excessive sweating, hyperventilation or raid breathing, feeling faint or dizzy & increased muscle tension.
- Extreme, irrational fear of specific things or situations.
- A tendency to avoid being in situations that cause anxiety.
Types Of Anxiety
There are several types of anxiety disorders such as:
1. Generalized anxiety disorder (GAD)
People who experience prolonged bouts of worry, anxiousness, and irrational fear that interferes with their day-to-day activities, social life, personal health, and work for more than 6 months are considered to have a generalized anxiety disorder.
Intense and irrational fear of a very specific thing or situation is termed as ‘Phobia’. People who have phobias exhibit an unreasonable response to fear or anxiety to a condition that may otherwise not be considered very harmful.
These are phobias of things or situations encountered in everyday life, such as:
Phobia of heights (Acrophobia)
Phobia of insects (Entomophobia)
Phobia of seeing blood (Hemophobia)
Phobia of needles (Trypanophobia)
Phobia of darkness (Nyctophobia)
Phobia of water (Aquaphobia)
Phobia of confined space (Claustrophobia)
Phobia of interactions with others in society (Social phobia)
3. Panic disorder
Panic attacks are sudden, recurrent bouts of extreme fear and anxiousness. The attack may be accompanied by physical symptoms as well, such as excessive sweating, a pounding, and fast heartbeat, trembling, shortness of breath, etc.
4. Post traumatic stress disorder (PTSD)
It is a disorder that develops in some people after experiencing a shocking, scary and dangerous event. The person may reexperience intrusive thoughts about the incident in the form of flashbacks, bad dreams, and frightening thoughts which can trigger anxiety.
5. Bulimia nervosa
It is a serious life-threatening eating disorder. People with bulimia secretly binge with a loss of control over the eating. This is followed by the excessive concern of living in fear of gaining weight triggering anxiety attacks.
6. Obsessive compulsive disorder (OCD)
It is a common, chronic, and long-lasting disorder in which people have recurring, unwanted thoughts, ideas, or sensations (obsessions) that make them feel driven to do something repetitively (compulsions).
Causes Of Anxiety
Our brain produces certain chemicals which are known as neurotransmitters, which help us to deal with anxiety. The neurotransmitters such as norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid are related to our mood and emotions. Any imbalance of these neurotransmitters can lead to symptoms of anxiety and other anxiety-related disorders.
The causes of anxiety disorder are not very clear. Some people experience severe anxiety in certain situations, while others take those similar conditions with ease. More focused studies are required to fully understand the reason. However, it is thought to be due to a complex interaction of genetics, environmental factors, and lifestyle choices.
People who suffer from chronic health conditions, such as cancer, diabetes, heart illness, chronic pain, thyroid issues, may also have anxiety. It may also manifest as a withdrawal symptom of alcohol intoxication, drug abuse, or a side effect of certain prescription medications.
Risk Factors Of Anxiety
Although anxiety can happen to anyone at any given point in their life, anxiety disorders are found to be associated more with certain factors. These factors can be considered as a trigger for developing an anxiety disorder:
- Relation to a close relative in the family with an anxiety disorder.
- A chronic or serious health condition.
- Abused as a child.
- Unexpected trauma, such as the untimely death of a loved one or partner.
- Alcohol and drug abuse.
- Suffer from other mental health conditions, like depression, bipolar disorder, schizophrenia, etc.
Diagnosis Of Anxiety
The diagnosis of an anxiety disorder comes after a thorough evaluation of the patient’s complaints and symptoms, family history, and history of onset of symptoms and how the symptoms affect the patient's daily life. A thorough psychological evaluation may help establish the diagnosis.
There are no lab tests that can diagnose an anxiety disorder. Sometimes, a physician may order a few lab tests to check for the cause of symptoms and rule out other health conditions that may be causing the symptoms. These include:
Complete Blood Count to look for signs of an infection or inflammation in the body
Thyroid Profile Total to rule out any potential cause of thyroid disorders
Adreno Corticotrophic Hormone (ACH) Plasma to check for the level of the ADH hormone in blood
Alcohol Screen Blood to rule out symptoms caused due to alcohol abuse
Drugs of Abuse (Qualitative) Panel to check if there’s any underlying side effects of medicines
Electrocardiography (ECG) to look for any complications related to the heart
When anxious we worry so much that everything seems to be going out of control and our mind jumps from one issue to another, leaving us more depleted than before. Here are 5 effective self-help tips to cope with anxiety.
Prevention Of Anxiety
Feeling anxious during stressful situations is a normal human response. However, the intensity of the response can act as a window to look for the symptoms of anxiety. Anxiety cannot be prevented as such, but making certain lifestyle changes can help with bouts of extreme anxiety or panic attacks.
- Meditating regularly can help focus your mind and channel positive energy.
- Listening to motivational speeches helps increase your self-confidence and boosts positivity.
- Watching videos that encourage positivity.
- Reading books on topics like understanding anxiety.
- Taking a healthy, balanced diet and cutting down on processed and sugary foods.
- Exercises are mood enhancers. Regular light exercises help prevent negative thoughts and feelings.
Specialist To Visit
When episodes of anxiety become too frequent and severe and start affecting a person’s life and everyday behavior, it is essential to visit a doctor to seek care for anxiety. The specialists who can help diagnose and treat anxiety are:
Treatment Of Anxiety
Mild or infrequent episodes of anxiety do not require any treatment. It is a normal human tendency to feel anxious in challenging and stressful situations. However, when the episodes of anxiety or panic attack become too frequent and hamper a person’s ability to lead a normal life, treatment is considered necessary to help relieve the symptoms. The following medications are used to treat anxiety:
1. Antidepressants and anxiolytics
These medications work by regulating neurotransmitter levels and thus help improve mood.
Selective serotonin reuptake inhibitors (SSRIs) are considered the first line of treatment for anxiety disorder. Examples include fluoxetine, sertraline, and combination drugs like clonazepam + escitalopram.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are also effective in treating generalized anxiety. Examples are venlafaxine and duloxetine.
Tricyclic antidepressants (TCAs) are a class of antidepressants that work by increasing levels of the hormone noradrenaline. Examples of these drugs include phenelzine and moclobemide.
- Azaperone is a class of drugs that has anxiolytic action (reduce anxiety) and works as serotonin receptor agonist. Examples of these drugs include buspirone, and gepirone.
2. Sedatives and tranquilizers
They effectively promote relaxation and reduce other symptoms. They are particularly useful in managing episodes of panic attacks or phobias. Benzodiazepines like diazepam and lorazepam are used for short-term management of anxiety as they are fast-acting, whereas buspirone, a mild tranquilizer, is used in the treatment of generalized anxiety disorder.
These medicines help control the physical manifestations of anxiety or phobias, such as fast heartbeat, palpitation, sweating, trembling, and dizziness. Examples of these types of drugs include propranolol.
A few changes to your diet can help you manage anxiety that can sometimes make a regular day tough to deal with. Here are some healthy foods that will help you fight anxiety better.
Home-care For Anxiety
Making certain lifestyle changes can help ease the symptoms of anxiety and also help reduce future episodes.
- Reduce consumption of caffeinated beverages like cola and coffee as these are known to worsen the symptoms.
- Learn and practice relaxation techniques and meditation.
- Consume a healthy, balanced diet and avoid processed, sugary, and fried foods.
- Quit smoking and reduce the consumption of alcohol
- Stay active; light-intensity exercises daily help improve mood and alleviate feelings of anxiety.
- Establish a sleep schedule for sound sleep.
- Keep a journal to log in all your thoughts. Expressing thoughts and feelings helps deal with them.
- Join a support group.
- During a panic attack, focus on breathing techniques, breathe slowly and with counts, as it will help you relax and shift focus from the source of panic.
Living with Anxiety
Living with a chronic anxiety disorder is often very challenging as it interferes with a person's day-to-day life and affects work and social interactions. People who suffer from anxiety disorders, phobias, and have a history of panic attacks often try to avoid situations or things that precipitate their anxiety. They are unable to lead a normal life and live in fear of challenging situations. Anxiety in children often hampers their performance at school and the anxiety can continue in adulthood, affecting career and social interactions.
Grounding technique for anxiety attacks
If you are having a panic attack, you can use a 5-4-3-2-1 technique to deal with anxiety. As per this technique, whenever you are feeling anxious, you should start concentrating on your breathing and try to take slow and deep regular breaths. Once your breathing is normalized, follow the 5-4-3-2-1 steps:
- Identify 5 things you see around you
- Identify 4 things you can touch around you
- Identify 3 things you can hear
- Identify 2 things you can smell
- Identify 1 thing you can taste
This will help distract your mind away from the anxious thoughts and help you cope with the anxiety attack.
Some age-old practices like meditation, tai chi (a form of exercise), and breathing exercises can help reduce stress and anxiety.
Complications Of Anxiety
Anxiety disorder, if left untreated, can worsen gradually and lead to various complications. These may include:
- Chronic depression
- Substance abuse - smoking, alcoholism, and drug dependence
- Chronic fatigue and pain
- Lack of productivity
- Suicidal thoughts
Alternative Therapies For Anxiety
Apart from medications, alternative therapies and lifestyle interventions can control anxiety to a great extent. These may include:
This involves sessions with a psychologist who helps a patient understand and deal with feelings of anxiety, modify behavior, and improve responses to particular situations.
2. Cognitive behavior therapy (CBT)
This is a structured, goal-oriented form of therapy that helps individuals modify their altered thinking patterns and beliefs, causing anxiety. It focuses on building behavioral skills that help patients adapt and react more efficiently to stress-inducing things or situations.
Speaking to a counselor may help a person express his/her feelings and overcome negative thoughts and impulses. Often, coming to terms with anxiety involves self-realization of bottled-up feelings and learning to accept them.
4. Exercise and yoga
There is plenty of evidence that suggests light exercises and yoga can help improve a person’s mood and induce feelings of happiness, positivity, and exhilaration. Regular activities, such as walking, cycling, swimming, pilates, tai-chi, yoga, etc., can help a patient struggling with anxiety tremendously.
Practicing yoga is one way to handle anxiety and depression. Here are some yoga postures to help you fight depression and anxiety.
Light massage helps rejuvenate the body, promotes relaxation, and improves overall mood. Going for regular light massages may help alleviate feelings of anxiousness.
6. Meditation and relaxation
Specific exercises focused on promoting relaxation in the body, such as breathing exercises, are particularly helpful in fighting anxiety. Meditating daily helps increase focus and concentration, it also helps increase a person’s mental strength. This boosts the person’s confidence in battling negative thoughts as well as helps improve behavioral responses.
Panchakarma therapy and herbs like Ashvagandha, Jatamansi, Bhramhi, and Mandookaparni are Ayurvedic treatment options for people suffering from anxiety disorders.
Frequently Asked Questions
- Anxiety Disorders. National Institute of Mental Health.
- What are Anxiety Disorders? American Psychiatric Association.
- Chand SP, Marwaha R. Anxiety. StatPearls Publishing; 2021 Jan
- Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015 Sep;17(3):327-35.
- Khambaty, M., & Parikh, R. M. (2017). Cultural aspects of anxiety disorders in India. Dialogues in clinical neuroscience, 19(2), 117–126.
- The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017. The Lancet Psychiatry. Volume 7. Issue 2, Pg 148-161. February 2020.
- Depression and other Common Mental Disorders. Global Health Estimates. World Health Organisation.
- Chittodvega (Anxiety Neurosis). National Health Portal India.
- Coping Technique for Anxiety. Behavioural Healthy Partners. University of Rochester Medical Center (URMC).