ANXIETY DISORDERS

Occasional feelings of nervousness, fear or anxiety are an expected part of life.

You may feel anxious before attending an interview, making a public speech, walking down a dark alley, or before making an important decision. This kind of anxiety is useful and can make you more alert or careful. The anxiety usually ends soon after you are out of the situation that caused it.

In Anxiety Disorders, the anxiety does not always have a specific trigger and does not go away – instead can get worse over time. The symptoms can interfere with daily activities such as job performance, school performance, and interpersonal interactions.

TYPES OF ANXIETY DISORDERS

There are different types of Anxiety Disorders including:

  1. Generalised Anxiety Disorder
  2. Panic Disorder
  3. Phobias
  4. Post-Traumatic Stress Disorder
  5. Obsessive-Compulsive Disorder

 

GENERALISED ANXIETY DISORDER

People with Generalised Anxiety Disorder (GAD) experience excessive anxiety or worry, most days, everyday, for at least 6 months.

They worry about a number of things such as personal health, work, school, social interactions, and everyday routine life circumstances. The fear and anxiety causes significant interference in social, academic occupational functioning.

GAD symptoms include:

  1. Difficulties controlling the worry
  2. Feeling restless and on-edge
  3. Irritability
  4. Easily fatigued
  5. Difficulty concentrating
  6. Feeling mind going blank
  7. Muscle tension
  8. Sleep difficulties

 

PANIC DISORDER

People with panic disorder have recurrent unexpected panic attacks.

A panic attack is a sudden period of intense fear that comes on quickly and reaches a peak within minutes. Attacks can occur unexpectedly or can be brought on by a trigger, such as a “feared” object or situation.

Panic attack symptoms:

  1. Heart palpitations (racing and pounding heartbeat)
  2. Sweating (palms and underarms)
  3. Shortness of breath/Hyperventilation
  4. Feeling of pins and needles (hands and feet)
  5. A feeling of impending doom
  6. Feelings of being out of control
  7. Trembling/shaking
  8. Feeling dizzy and light-headed

People with Panic Disorder often worry about having another attack and actively try to prevent future attacks by avoiding places, situations, or behaviours they associate with panic attacks. This worry about panic attacks, and the effort spent trying to avoid attacks, causes interference in various areas of the person’s life.

 

PHOBIA-RELATED DISORDERS

A phobia is an intense fear of, or aversion to a specific object or situation. Although it can be realistic to be anxious in some circumstances, the fear associated with phobias is out of proportion to the actual danger caused by the situation or object.

People with a phobia experience:

  • Immediate intense anxiety upon encountering the feared object or situation
  • An irrational or excessive worry about encountering the feared object or situation.
  • Time spent in active steps to avoid the feared object or situation.
  • Intense anxiety when having to endure unavoidable objects and situations.

 

Types of phobias and phobia-related disorders:

  1. Specific Phobias (Simple phobias):

People who have a specific phobia have an intense fear of, or feel intense anxiety about, specific types of objects or situations.

  • Flying
  • Heights
  • Specific animals, such as spiders, dogs, or snakes
  • Receiving injections
  • Blood
  1. Social Anxiety Disorder (aka Social Phobia):

People with Social Anxiety Disorder have a general intense fear of social or performance situations. They fear being embarrassed in social situations, and so will avoid such.

  1. Agoraphobia:

People with Agoraphobia have an intense fear of two or more of the following situations:

  • Using public transportation
  • Being in open spaces
  • Being in enclosed spaces
  • Standing in line or being in a crowd
  • Being outside of the home alone

People with agoraphobia often avoid these situations, because they fear not being able to leave in the event they have panic-like reactions or other embarrassing symptoms. In the most severe form of agoraphobia, an individual can become housebound.

 

SEPARATION ANXIETY DISORDER

Separation anxiety does not only affect children, but adults can also be diagnosed with Separation Anxiety Disorder.

People who have Separation Anxiety Disorder have a fear of being separated from people to whom they are attached.

  • They often worry of harm befalling their attachment figures while they are separated.
  • This fear leads to concerted efforts to avoid separation from their attachment figures and avoidance of being alone.
  • They may have nightmares about being separated from attachment figures.
  • They may even experience physical symptoms when separation occurs or is anticipated.

 

SELECTIVE MUTISM

Selective Mutism is a rare disorder.

People with Selective Mutism fail to speak in specific social situations despite having normal language skills.

It usually occurs before the age of 5 and is often associated with extreme shyness, fear of social embarrassment, compulsive traits, withdrawal, and clinging behaviour. People diagnosed with Selective Mutism are often also diagnosed with other anxiety disorders.

 

POST-TRAUMATIC STRESS DISORDER

Post-Traumatic Stress Disorder (PTSD) is a complex psychiatric disorder that may occur in people who have been exposed to a traumatic event such as a natural disaster, a serious accident, hijacking, community violence, rape, or sexual violence.

Most people will experience some form of emotional and physical reaction to trauma, but these reactions naturally resolve fairly quickly.

People with PTSD experience persistent symptoms that interfere with normal daily tasks.

PTSD symptoms usually begin within 1 month of the trauma, but sometimes emerge years afterwards.

PTSD symptoms are generally grouped into four types:

  1. Re-experiencing
  • Recurrent and intrusive distressing memories of the traumatic event
  • Flashbacks of the traumatic event as if it were happening again
  • Unpleasant dreams or nightmares about the traumatic event
  1. Avoidance
  • Trying to avoid thinking or talking about the traumatic event
  • Avoiding places, activities or people that remind you of the traumatic event
  1. Negative changes in thinking and mood
  • Negative thoughts about yourself, other people or the world
  • Alienation and detachment from family and friends
  • Hopelessness about the future
  • Forgetfulness, including not remembering details of the traumatic event
  • Difficulty maintaining close relationships
  • Lack of interest in activities you once enjoyed
  • Difficulty experiencing positive emotions
  • Feelings of emotional numbness
  1. Hyperarousal of physical and emotional reactions
  • Hypervigilence
  • Easily startled or frightened
  • Persistent sense of impending danger
  • Trouble sleeping
  • Trouble concentrating
  • Irritability, anger outbursts or aggressive behaviour
  • Overwhelming feelings of guilt or shame

 

RISK FACTORS FOR ANXIETY DISORDERS

Genetic and environmental factors contribute to the risk of developing an anxiety disorder.

Some general risk factors for all types of anxiety disorders include:

  • Temperamental traits
  • Exposure to negative life or environmental events in early childhood or adulthood
  • Family history of anxiety or other mental illnesses
  • Co-morbid physical conditions, such as thyroid problems or heart arrhythmias can produce or aggravate anxiety symptoms
  • Caffeine or other substances/medications use

 

TREATMENT OF ANXIETY DISORDERS

Anxiety can be treated through an In-hospital or Out-of-hospital programme.

As part of a wholistic approach, we do medical investigations in order to exclude other physical illnesses. Anxiety disorders can be effectively treated with psychotherapy or a combination of psychotherapy and medication.

  • Cognitive Behavioural Therapy (CBT) and Exposure Therapy are types of psychotherapy used in the treatment of anxiety disorders. CBT focuses on identifying, challenging, and then neutralising distorted thoughts underlying anxiety disorders – thus helping people learn different ways of thinking and behaving in reacting to anxiety-producing situations.
  • Exposure therapy focuses on confronting the fears underlying the anxiety disorder to help people engage in activities they have been avoiding.
  • Medication can also be prescribed as part of treatment.
  • Support Groups