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Anxiety disorders: a complete guide

Anxiety disorders: a complete guide

Anxiety disorders: a complete guide

Anxieties are part of our day-to-day life. There may be times when you feel anxious, worried or stressed for an upcoming work project or a presentation. However, those who suffer from anxiety disorders go through periods of excessive, persistent and intense worry. This worry is not about a big project that is coming up. This worry can be about a simple day-to-day thing like whether they have locked the doors or not. Those who suffer from anxiety disorders may undergo repeated episodes where they feel extremely panicked, terrified, afraid, and anxious. Such feelings may go from a root level to a peak level within a few minutes. If this happens, this is referred to as a panic attack.

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What are anxiety disorders?

Some anxiety is normal. When things become too stressful or when there is an important presentation coming up, people feel anxious. This is absolutely normal. You can also feel anxious if you have to make an important decision suddenly or if you are appearing for exams. Anxiety is beneficial under certain circumstances. For example, the flight or fight response when used by the brain during a dangerous situation helps you focus on what’s important. Such anxiety response ensures that you stay safe. These are not anxiety disorders

However, if your anxiety just goes beyond a simple nervousness and slight fear, you may be suffering from one or more anxiety disorders depending on the symptoms. The easiest way to figure out if you are suffering from an anxiety disorder or not is to watch out for the following symptoms:

What are anxiety disorders?

Are you suffering from anxiety disorders?

If these feelings of panic and anxiety are causing interference with day-to-day life, are extremely difficult to bring under control, and are absolutely out of proportion, you are suffering from anxiety disorder. These feelings may also last for a very long time. People facing such situations stop going to places where these feelings may be triggered. The symptoms of anxiety may start during the childhood stages. They can also start during the teen years or once the person has reached the adulthood stages.

It is not uncommon to observe that a person may suffer from more than one anxiety disorder. In certain cases, anxiety disorders may also result from a medical treatment or as a side effect of drugs. I will be discussing more on these aspects in later part of this blog post.

Who is at risk for suffering from anxiety disorders?

Anxiety is a result of both environmental and genetic factors. Those who have anxiety running in the family are at higher risk of developing anxiety disorders. However, others may suffer from anxiety disorders too. If you have suffered through the following, you may be at a high risk of developing anxiety disorders:

Who is more susceptible to anxiety disorders? Men or women?

It has been observed that anxiety disorders more often affect women than men. However, why this happens is not known. Currently, research is going on to find out the causes behind anxiety affecting women more than men. One of the hypothesis states that anxiety may affect women more because of the fluctuation in hormones that occur throughout the month. Testosterone (present in higher levels in males than females) plays a role in anxiety as well. The testosterone hormone reduces anxiety and anxiousness. Since men have more testosterone, it may help to alleviate the anxiety. Furthermore, women are less inclined toward getting their anxiety disorders treated. An untreated condition only progresses and anxiety is no different. This is probably the reason why more women are diagnosed with anxiety than men.

What are the symptoms of anxiety disorders?

Anxiety disorder has a variety of symptoms. These symptoms can be classified into behavioral, mental and physical symptoms.

Physical symptoms of anxiety

Mental symptoms of anxiety disorders

Behavioral symptoms of anxiety disorders

Symptoms of anxiety disorders

The different types of anxiety disorders

As I’ve mentioned before, it is not uncommon to see a person suffer from more than one type of anxiety disorder. However, officially there are ten types of anxiety disorders. These are

Agoraphobia

Agoraphobia is it type of anxiety disorder in which people have the fear of being stuck in situations or places that can cause them to feel panicky. They also avoid going to places or situations that may induce feelings of being trapped, embarrassed, or helpless. People suffering from such type of anxiety disorders are known to avoid social settings. They generally do not prefer to go out at all.

Anxiety disorder due to an underlying medical condition

If a person is suffering from a long-term illness or a major health problem, the medical condition can also induce symptoms of anxiety. This is most often observed if the disease is particularly difficult or if there is a chance that the case may turn into a terminal one.

Generalized anxiety disorder

As the name suggests, generalized anxiety disorder is the anxiety that a person may feel about activities or events that happen in day-to-day life. Search people experience excessive and persistent anxiety regarding routine ordinary issues. They may worry about catching a bus to work, meeting colleagues at work, about what others think of them, etc. The problem with this anxiety disorder is that the person suffering from this form of

Anxiety causes the sufferer to blow the feelings out of proportion. They worry about each and everything in their life. Anything and everything can act as a trigger for generalized anxiety disorder. Furthermore, since their thoughts are way out of proportion, it becomes very difficult to bring the anxiety under control. Generalized anxiety disorder most often occurs along with other known mental health issues like depression or other types of anxiety disorders.

Panic disorder

A person is suffering from panic disorder when they have repeated episodes of panic attacks. Panic attacks occur when a person suddenly starts to feel intense levels of terror, fear, and anxiety. These feelings may start and reach peak levels within minutes. The person starts feeling a sense of doom, chest pain, shortness of breath, pounding heart (heart palpitations), headache, dizziness etc. The reason panic attacks occur is that the person is worried that they will have to face the same situation that has caused them severe stress in the past. Alternatively, some people also experience panic attacks in response to animals and places they are phobic towards.

Selective mutism

Selective mutism is an anxiety disorder that primarily occurs in children. If a kid is suffering from such an anxiety disorder, it will be impossible for the child to speak in certain scenarios. This does not mean that the child will not be able to speak anywhere. The child may be fine at home or with family members the kid trusts. However, when the same child has to speak in front of an audience or before his teacher, he may face anxiety. This can severely hamper the child’s functioning in social settings, school or work period

Separation anxiety disorder

Separation anxiety disorder is another disorder that primarily affects children. This is characterized by anxiety that the child feels when separated from parents. Most kids do not like to be away from their parents. However, kids suffering from separation anxiety disorder will display excessive anxiety when away from parents or others who have a parental position in their life.

Social anxiety disorder

Social anxiety disorder is also referred to as social phobia. This anxiety disorder involves a person experiencing a high level of fear and anxiety regarding certain social situations. The person may have felt embarrassed or self-conscious in a previous situation and this is what caused the social anxiety disorder. The primary fear that the person faces is being judged negatively by others. Thus, such a person may try to avoid being part of any type of social gathering.

Phobia

This anxiety disorder is characterized by the presence of an intense level of anxiety or panic that a person feels towards a specific object, creature or situation. Phobia may have been induced by past traumas or it may be innate to the specific person. Phobias have also been observed to provoke panic attacks in some people.

Substance-induced anxiety disorder

Some medications may induce anxiety. Alternatively, people may also experience the symptoms of anxiety like heart palpitations, dizziness, headaches, excessive sweating, etc as a response to taking the wrong type of drug or misusing drugs. Substance-induced anxiety disorder also occurs when a person faces withdrawal symptoms from drugs.

Unspecified anxiety disorder

Unspecified anxiety disorder encompasses all of those anxiety disorders and phobias that do not meet the exact criteria to fit into any of the above-mentioned categories. And these disorders are significant because they cause severe distress to the person experiencing them. However, they do not follow the specific symptoms of any of the specific categories of anxiety disorders.

Types of anxiety disorders

Are anxiety disorders common?

In the US, anxiety disorders have been identified as the most common mental health condition. They usually affect around 40 million Americans. 30% of adults go through anxiety problems at some point in their life. In most cases, anxiety disorders begin during the adolescent phases, during childhood or early adulthood. The stats I have mentioned here are specifically for the US. However, anxiety disorders have become one of the leading mental health issues worldwide.

Anywhere you go, everyone has stress. It may be because of their job, financial situation, or interpersonal relationships, etc. Everyone is facing stress. Therefore, almost everyone goes through anxiety at some point in their life. Whether they are suffering from an anxiety disorder or not is a different scenario.

Effect of anxiety disorders on children

Children are constantly being exposed to something new on a daily basis. Therefore, facing a little anxiety is very common. Some kids are afraid of Thunderstorms or the barking of a dog. These scenarios can induce anxiety in kids. This is totally normal. Some may be worried about a test that is coming up in school or whom to ask or go with for the school dance etc.

Facing mild anxiety and worry is common and perfectly alright. However, sometimes these simple activities like giving a test, asking someone to dance, etc may fill kids up with absolute dread. Under such conditions, most often, kids find it very hard to stop thinking about a specific thought. They seem to be stuck on the worry. If you notice that your child is constantly talking about only one factor that he or she is scared of, finding it hard to go to school, enjoy playtime or even fall asleep comfortably, your kid is probably suffering from an anxiety disorder.

Identifying anxiety in kids

When you look at anxiety in kids, the key to focus on is getting stuck. Kids worry too. There worry about their classmates liking them or not, the upcoming tests, and regular school activities. However, what separates a normal worry from an anxiety disorder is if your child seems to be getting stuck on a specific thought or scenario. If the worry of your kid is interfering with his or her day-to-day activities, your child needs help. The sooner you get this help for your kid, the better it is for your child’s overall mental and physical well-being.

How to understand if a child has an anxiety disorder?

This is not only for the parents. This is something that teachers should look into as well, especially teachers of young learners. Kids are not adept at talking about their problems. They are afraid of being judged by their classmates. Therefore, a child may not come up and openly discuss his or her problem with the teacher. However, a little perceptiveness and vigilance from the teacher can make a huge difference in the life of the kid. The four common features that kids display if they are suffering from anxiety disorders are

Causes behind anxiety disorders

Unfortunately, no studies have been able to identify the cause behind anxiety disorders. Most often, there are certain life experiences like traumatic events that trigger an anxiety disorder in a person. However, in certain conditions, a person may be prone to suffering from an anxiety disorder. This will happen if the person has a genetic inclination towards suffering from anxiety problems. Genetics play a huge role in the case of anxiety disorders. Let’s explore the different causes behind anxiety disorders

Medical causes behind anxiety disorders

If a person is suffering from a specific medical disorder, anxiety problems may occur. In certain cases, anxiety can even be a sign of an underlying medical illness. If your health care provider feels that you are suffering from anxiety because of a physical condition, they will order tests to find out if there is an underlying problem.

Some examples of medical health issues that may cause anxiety or are linked to anxiety disorders are

Anxiety can also be a side effect of a medication that you are currently on. Therefore, consult a health care professional if you feel that your anxiety is even remotely linked to a medical problem.

Anxiety occurrence due to an underlying medical problem

You are suffering from anxiety because of an underlying medical problem if you notice the following symptoms

Causes behind anxiety disorders

When do you need to consult a mental health professional?

Mild levels of anxiety can be treated via breathing exercises, discussing the problem with peers, colleagues or family members etc. However, if you feel that the sense of impending doom, constant worry, heart palpitations, headaches, dizziness, etc is interfering with your day-to-day life, you should consult a doctor.

Here is when you should go to a mental health professional:

How are anxiety disorders diagnosed?

If your health service provider feels that you may be suffering from an anxiety disorder, they will direct you to a psychologist or psychiatrist. Psychologists and psychiatrists are trained in diagnosing and treatment of mental health problems. Your mental health professional will use specific assessment tools and interview questionnaires to understand if you suffer from an anxiety disorder. The diagnosis of anxiety disorder will be based on

Your psychologist will also consult the diagnostic and statistical manual of mental disorders (DSM- 5 ). This is a medical disorder manual that is published by the American Psychiatric Association. This book is used as a reference manual for the diagnosis of mental illnesses.

What contributes to anxiety disorders?

There are many risk factors that can contribute to anxiety disorders. Some of them are

Trauma

Those who have been through hey past trauma or have been witness to traumatic events are at much higher risk of developing anxiety disorders later in life. This is applicable to both children, adolescents, and adults. Anxiety may develop immediately or it may set within a few months or years down the line.

Stressed because of an illness

If a person starts to feel overburdened due to a serious health issue, the person may experience anxiety disorders. This is because the person is constantly in a state of worry for his future and health.

Buildup of stress

If you are constantly under stress, whether it is from your work, or relationships or familial situations, you are at a high risk of developing anxiety disorders.

Personality

People with specific personality types are at more risk of developing anxiety.

Suffering from other mental health issues

If you are already suffering from mental health issues like depression, you are more likely to develop an anxiety disorder as well.

Genetics

If you already have family members who are suffering from anxiety disorders, it makes you more prone to developing anxiety disorders.

Misuse of drugs or alcohol

Alcohol and drug misuse can start anxiety issues. Withdrawal from these also involves anxiety as a symptom.

What contributes to anxiety disorders?

Childhood abuse

If you have suffered through emotional, sexual or physical abuse during your childhood stages, you have a higher chance of developing anxiety disorder later in life. This is also applicable if you have a psychopathic mother, narcissistic partner or a partner who suffers from histrionic personality disorder.

Negative life events

If you have been through stressful and negative life events like losing a child, or losing a parent in earlier childhood, etc. this increases your chances of suffering from anxiety disorder

Being shy as a kid

If you were shy as a kid, your tendency to withdraw from unfamiliar places, situations or people can be linked to social anxiety. Such behavior usually goes unnoticed during childhood. When you reach the age of adulthood or even during your adolescent years, social anxiety starts to be a problem.

Low self-esteem

People who have low self-esteem or negative perceptions about themselves are highly likely to develop a social anxiety disorder. This is also applicable to those who allow social media to influence their body image or do not feel right in their own skin.

Complications of anxiety disorder

Most often, when people think of anxiety, they think that the person is uselessly feeling anxious, worried, or scared. However, anxiety disorder comes with a lot of complications. It can either cause the development or worsening of other physical and mental conditions like

How to prevent anxiety disorders?

There is no standard way of preventing anxiety. There is no way to even predict if you will develop anxiety or not. However, there are certain steps that you can take to minimize the effect that your anxiety disorder may have on your daily functioning and day-to-day life. These are

Get help as soon as possible

The moment you feel that you experience excessive anxiousness, intrusive thoughts, worry and fear, consult a mental health professional immediately. As is the case with other mental health conditions, the sooner this problem is treated the better you will start to feel. If you let anxiety persist for long periods, it will only grow.

Stay active and engage in exercise

Exercises release endorphins. Endorphins make you feel good about yourself. Thus, never undermine the importance of exercising. If you suffer from anxiety, make it a point to go on daily walks and engage in breathing exercises. These may not seem like a lot. However, some fresh air can be very beneficial when suffering from anxiety. Go to the park, meet kids, and enjoy the company of animals. Do what makes you happy. When you engage in activities that make you happy, they can have a therapeutic effect on you.

Start art therapy

If you have not experienced the benefit of art therapy yet, the time to start is now. Art therapy has a ton of benefits. It can help you deal with your anxiety and make you feel better about yourself.

Stay away from drugs and alcohol

Drugs and alcohol will not help you heal. Rather, they will only increase your anxiety. Therefore, if you have an inclination toward substance abuse, do not encourage it. Stop your substance abuse and get help immediately. If you are already addicted to any of these substances, quitting suddenly can cause anxiety symptoms. If you are thinking of quitting, work with a support group or a doctor to help you through the process.

Treatment of anxiety disorders

Just like any other medical health issue, an anxiety disorder can also be treated. Treatment may not remove your anxiety completely but it can reduce the symptoms. Anxiety is not something that can just be willed away. It is not dependent on attitude or self-discipline. In the last few decades, researchers working on anxiety have made huge progress in the treatment aspects. However, you must never self-medicate. Every person who suffers from anxiety may have different symptoms. Therefore, your mental health care professional is the best person to advise you on a treatment plan. Your treatment plan may include psychotherapy and medications in a tailored approach.

Role of medications in anxiety disorders

Medications help curb the symptoms of anxiety. Medications cannot cure a person of anxiety. However, the improvement in the symptoms can help you do better in your day-to-day life. The most common medications for anxiety disorders are:

Anti-anxiety medication

The most common anti-anxiety medication is benzodiazepine. Benzodiazepine decreases the worry, panic, and anxiety. Since they work quickly, you can see the effect in a short amount of time. However, the problem with benzodiazepine is that patients tend to develop tolerance towards this drug. This makes this drug less effective if used for a prolonged duration. Thus, if your health care professional advises you to take a benzodiazepine, he may taper it after a short term and stop the medication before the tolerance starts to set in.

Antidepressants

Since, anxiety most often occurs if a person is already suffering from depression, your medical health care professional may go with antidepressants to treat anxiety disorders. Antidepressants are responsible for improving mood and reducing stress. They cause the production of certain chemicals in the brain like dopamine that make you feel better and reduce the feelings of worry. Antidepressants need some time to start showing effective results. Therefore, you must be patient. If you suddenly feel that you are ready to stop the antidepressants, consult your healthcare provider first. Never stop any medication suddenly. Medications should be tapered off and stopped in case of mental health conditions.

Treatment of anxiety disorders

Beta-blockers

Beta-blockers are used to treat high blood pressure. However, since one of the prominent symptom of anxiety is heart palpitations, beta-blockers can help curb this condition. They are also helpful in relieving trembling, shakiness, and rapid heartbeat like symptoms.

Your psychiatrist will be responsible for providing you with the medication combination that you need to treat your anxiety case. Do not change or stop the medication without consulting your therapist. Your therapist is responsible for monitoring you and deciding if the medicines are working or not to help alleviate your symptoms.

Use of psychotherapy for the treatment of anxiety disorders

Psychotherapy or counseling involves a variety of therapeutic strategies to help the patient deal with their mental health issue. Your mental health provider will talk about and discuss the different strategies available with you before they decide to go on a specific route. Some of the common approaches for treating anxiety include:

EMDR therapy for anxiety disorders

EMDR therapy uses 8 phases of treatment. This therapy involves exposure to the triggers in different stages. Most often anxiety is the result of past trauma. EMDR therapy aims to change the perception of the past trauma so that it does not induce anxiety in the patient.

Cognitive-behavioral therapy (CBT)

CBT is the most common psychotherapy used with anxiety disorders. CBT when used for anxiety focuses on teaching the patient to recognize the different behavior and thought patterns that cause the troublesome feelings and trigger anxiety. After the identification of triggers, the therapist will work with the patient to change them.

Exposure therapy

Exposure therapy is very effective in the case of phobias and panic attacks. This therapy primarily focuses on dealing with the fear that is causing the anxiety disorder. This helps the patient engage with different situations and activities that they would rather avoid. Along with the exposure, relaxation techniques and breathing exercises are used so that the triggers can be effectively neutralized

Sandplay therapy

Sandplay therapy is a therapy that is primarily used with kids who have anxiety disorders due to a past trauma. Kids find it very hard to verbalize their emotions and traumatic experiences. This is why sandplay therapy is effective. Sandplay therapy uses the nonverbal mode of communication to help kids express their feelings and experiences.

Managing symptoms of anxiety disorders

Here are some tips that can help you manage and even reduce your symptoms in case you are facing anxiety

Gain knowledge about your anxiety disorders

The more you understand your problem, the better you can deal with it. This way, you will be ready to manage the roadblocks and symptoms along the way. Do not be afraid to talk to your health care provider about any and all the questions that you may have in your mind.

Stick to the treatment

Do not stop your meds suddenly. You can face unpleasant side effects if you do so. Therefore, always taper off the medication. Suddenly stopping can increase the effects of anxiety

Cut down on the drinks and food that contain caffeine

Drinks like tea, coffee, energy drinks, cola and hot chocolate contain caffeine. Caffeine acts as a stimulator and as a mood-altering drug. These properties of caffeine cause worsening of the symptoms of anxiety.

Do not use recreational drugs or alcohol

Substance abuse will only increase your anxiety disorder. It will not help you combat it.

Eat a balanced diet

Diet has a huge role to play in dealing with her anxiety. If you are eating junk food, oily food etc. it can upset your tummy and increase your symptoms of anxiety. This is why, doctors always advise patients to go for a balanced diet.

Managing anxiety

Exercise regularly

Whether it is a brisk aerobic exercise like jogging or biking, or simply a walk or hike, exercise has a positive effect on anxiety. When you exercise, your brain releases chemicals that reduce stress and boost your mood.

Regulate your sleep patterns

Insomnia or sleep problems and anxiety go hand in hand. If you are not getting proper sleep, that might serve as a root cause for anxiety. Therefore, make sure that you make rest a priority. Follow a bedtime routine that is relaxing. If you suffer from insomnia, discuss this with your health care professional.

Breathing exercises

Breathing exercises are basically relaxation techniques. They can help if you suddenly start to experience anxiety symptoms. These can help curb Your symptoms and also help you relax in the long term and reduce anxiety.

Journaling

Start writing your thoughts down. This can help you identify the trigger for anxiety. It can also help you track your progress on your journey of healing from anxiety disorders. Putting your thoughts down in a journal provides you with an escape route. This can also help curb your anxiety.

Manage the negative thoughts

Focus on building positive thoughts in your head and removing the negative thoughts. This cannot be done overnight. It will take time. But you must learn to be patient with yourself and keep going. You can start with positive affirmations to reset your negative thoughts. This task will be challenging in certain anxiety disorders. However, CBT can help you understand how you can redirect your thoughts.

Maintain a gratitude journal

In a world where everything is sometimes going wrong, having a gratitude journal again show you things that you are thankful for. This can help reduce your anxiety and boost positive thought processes.

Use positive affirmation

As I mentioned before, positive affirmations have a huge role to play in building your confidence. One of the prime reasons, people suffer from anxiety is because they have low self-confidence. You can use positive affirmations to build on your self-confidence. When your self-confidence grows, the symptoms of anxiety will automatically reduce.

Spend time with your friends and family

It does not matter whether you are engaging with them on social media or meeting with them face to face. Spending time with you people you love releases dopamine and serotonin. These chemicals will make you feel good about yourself and about your life in general. This will help reduce anxiety.

Get support

When you feel that something is wrong with you and you are having difficulty in focusing on your day-to-day life, it is time you get the support you deserve. Contact your health care professional. If they feel that you have anxiety disorder, they will redirect you to a mental health care professional.

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Conclusion

Anxiety is not a phase. It is not going to go away if you will it. Anxiety disorders are a real problem. The sooner you address get this your anxiety problem, the better it is for your mental health. Even though society has stigmatized anxiety as it phase, it cannot be further from the truth. In this article, I have focused on the:

Armed with this information, you can easily identify if you or your loved one is facing anxiety issues. If they/you are, do not hesitate to reach out for help. DO NOT care what the society thinks or says. Your mental health is in your hands, no one else’s. Thus, it is also your responsibility to take prompt action and ensure that you are taking care of yourself. You know yourself the best. If you feel you need help, go get it. You owe it to yourself.

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Have you faced anxiety or anxiety disorders? What is your take on anxiety? How do you feel it impacts mental health? Please mention your experiences and opinions in the comment section below. You may not realize it, but your experiences may provide someone else the much needed courage to embark on the journey of better mental health.

See you in my next blog post

Dr. Shruti

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