Anxiety

Symptoms: Feeling restless, irritable or tense, trouble concentrating or making decisions, trouble sleeping, trembling or shaking

Causes: Stress, depression, child abuse, diabetes

Risk Factors: Traumatic experiences in adulthood or early childhood, family history of anxiety or other mental disorders, physical tension, harmful use of alcohol

Prevalence: Currently, 4% of people worldwide are thought to suffer from anxiety disorder. In India, the total number of individuals living with anxiety is 41.8 million.

Severity: Mild to severe

Which doctor to consult: Psychiatrist, Psychologist

Overview:                                                             

Anxiety is one of the most common mental disorders. Anxiety is the body’s natural reaction to stress. Anxiety is a feeling of intense, excessive and persistent fear and worry about everyday situations. 

Anxiety may cause restlessness, tension, sweating and rapid heartbeat. Anxiety disorders can affect a person's social, personal, academic, and professional lives in addition to interfering with everyday activities. There are different types of anxiety disorders.

People with anxiety symptoms should seek medical care. There are various effective treatments for anxiety disorders, which include psychotherapy, stress management skills and medication.

The diagnosis of anxiety requires a lengthy process of mental health tests, physical tests and psychological questionnaires.

Types of Anxiety:

There are various types of anxiety disorders, which include the following:

Generalized Anxiety Disorder: It involves excessive and persistent worry about common, everyday activities or events. Physical symptoms like feeling tense, restlessness, or easily fatigued, tense muscles, difficulty concentrating, or trouble sleeping may be present along with this continuous stress and tension. 

Panic Disorder: It involves recurrent episodes of severe anxiety, terror, or worry that build to a peak in a matter of minutes (panic attacks). It may cause breathlessness, chest pain, heart palpitations (fast, fluttering or pounding heart) or impending doom (feeling that something tragic might occur). 

Phobias: Individuals who suffer from phobias experience a severe fear of things that are hardly dangerous. Their fear could be related to social anxiety, spiders, flying, crowded areas, or being in social situations.

Social Anxiety Disorder: It is an extreme fear of being watched and judged by others. It may cause sweating, trembling, racing heart, difficulty making eye contact or being around unknown people.

Agoraphobia: It is excessive worry, fear, and avoiding circumstances that could make one panic or feel helpless, embarrassed or trapped.

Separation Anxiety Disorder: People with this disorder feel excessively anxious or fearful about being separated from the people they are attached to. 

Selective Mutism: It is persistent difficulty speaking in some social situations, even though one can talk fluently in other circumstances. It mainly affects children.

Symptoms:

People with anxiety may experience excessive worry or fear about a particular situation. The common symptoms of anxiety include:

• Feeling restless, irritable or tense

• Trouble concentrating or making decisions

• Trouble sleeping

• Sweating, shaking or trembling

• Nausea or stomach pain

• Sense of impending doom, panic or danger

• Increased heart rate

• Difficulty controlling anxious thoughts or beliefs

Causes:

Like other mental health issues, anxiety disorders result from complex interactions of biological, psychological, and social factors. Anxiety disorders can affect anyone, although they are more common in those who have experienced abuse, significant losses, or other traumatic events.

For some people, anxiety may be due to an underlying health problem. Medical problems that can be associated to anxiety include diabetes, heart disease, thyroid problems, asthma, chronic obstructive pulmonary disease (COPD), irritable bowel syndrome, drug withdrawal or misuse. Sometimes, anxiety may be a side effect of certain medications.

Risk Factors:

Each type of anxiety has different risk factors. However, there are some general risk factors, including: 

Personality traits: These include nervousness and shyness in childhood.

Life history: Includes being exposed to stressful or negative live events.

Genetics: Family history of anxiety or other mental disorders.

Other health conditions: The risk of anxiety can be increased by thyroid issues and other health conditions.

Stimulants: Caffeine, alcohol, specific substances, and medicines can worsen your symptoms.

Possible Complications:

Anxiety disorders do more than just make you worry. Additionally, it can cause or worsen other physical and mental conditions like:

• Depression

• Suicide

• Substance misuse (alcohol, illegal drugs or pain medications)

• Insomnia (difficulty falling and/or staying asleep)

• Chronic pain and headaches

• Digestive or bowel problems

• Social isolation

• Poor quality of life

• Problems functioning at work or school

Prevention:

Feeling anxious is a normal part of everyday life and it does not always indicate the presence of a mental health disorder. But, the impact of symptoms can be reduced by making certain lifestyle changes.

Effective community-based strategies: Parental education and school-based programmes to improve social and emotional learning and build positive coping in children and teenagers helps to prevent anxiety.

Exercise programmes: They are also effective in preventing anxiety disorders in adults.

Stress management and mindfulness: Practicing stress management and mindfulness prevents strain.

Avoidance: You can reduce stress and anxiety by avoiding certain individuals, places, and circumstances. However, this would only be a temporary strategy. Receiving treatment will benefit you in the long run by eliminating the need for you to stay away from triggers.

Restrict caffeine: Limit Caffeine intake as it can worsen symptoms of anxiety.

Support groups: Sharing coping mechanisms and life experiences with others can happen when you speak with them.

Therapy: Having a conversation with a therapist can assist you in creating more efficient coping mechanisms for the stress and fears that cause anxiety.

Speak with a doctor about your medications: Having regular conversations with your physician regarding the dosage, effectiveness, and side effects of your drugs guarantees that any health problem is appropriately addressed and that any potential anxiety-related side effects are tracked. 

When to see a doctor?

Consult a doctor if:

• You believe that your excessive worry is getting in the way of your relationships, career, or other aspects of your life.

• Your worry, fear, or anxiety is disturbing you and is hard to manage.

• Along with anxiety, you have depression, struggle with alcohol or drug use, or have other mental health issues.

• You think there may be a connection between your anxiety and a physical health problem.

• If you are experiencing suicidal thoughts or actions, get emergency treatment immediately.

If you don't get help, your problems can not go away on their own and might even get worse over time. Consult a mental health professional or your physician before your anxiety worsens. It's easier to treat if you get help early.

Diagnosis:

To find out if there is a connection between your anxiety and your physical health, you should first consult your primary care physician. He or she can look for indications of a potentially treatable underlying medical issue. If you do not have any other health issues, you will receive a psychological evaluation. If your anxiety is severe, you may need to consult a psychiatrist.

Diagnosis of anxiety requires a lengthy process of mental health tests, physical examinations, and psychological questionnaires. Some doctors may conduct blood or urine tests and physical examinations to rule out underlying medical conditions that may be causing your symptoms.

Treatment:

There are various effective treatments for anxiety. The main treatments include psychotherapy and medicines or both.

Psychotherapy: It can assist you in identifying and changing problematic feelings, ideas, and actions. To be effective, it should focus on your specific anxieties and needs. There are several types; some of which used for anxiety disorders include:

• Cognitive behavioral therapy (CBT): It teaches you different ways of behaving and thinking. It can help you change the way you react to things that cause fear and anxiety. Exposure therapy could be a part of it. The main goal of this therapy is to help you face your fears so you can start doing the things that you have been avoiding.

• Acceptance and commitment therapy: It may help with certain anxiety disorders. It reduces discomfort and anxiety by implementing techniques like goal-setting and mindfulness.

Medicines: Anti-anxiety medicines and some antidepressants are used to treat anxiety disorders. 

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as Paroxetine, Fluoxetine, and Escitalopram can be useful in treating anxiety disorders in adults.

• Anti-anxiety medicines: Benzodiazepines such as Clonazepam and Diazepam are used for short-term treatment of anxiety due to the risk of dependence and tolerance.

• Beta-blockers: These help to relieve physical symptoms of anxiety. Examples of this class include Propranolol.

Additionally, learning stress management skills, such as mindfulness and relaxation skills, can help reduce the symptoms of anxiety disorders.