Chapter – One
Introduction :-
Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Everyone has feelings of anxiety at some point in their life. For example, you may feel worried and anxious about sitting an exam or having a medical test or job interview. During times like these, feeling anxious can be perfectly normal.
However, some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily life.
Anxiety is the main symptom of several conditions, including panic disorder, phobias, post-traumatic stress disorder and social anxiety disorder (social phobia).
However, the information in this section is about a specific condition called generalised anxiety disorder (GAD).
Definition :-
Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.
Signs :-
The main symptom of anxiety disorders is excessive fear or worry. Anxiety disorders can also make it hard to breathe, sleep, stay still, and concentrate. Your specific symptoms depend on the type of anxiety disorder you have.
Common anxiety signs and symptoms include:
§ Feeling nervous, restless or tense.
§ Having a sense of impending danger, panic or doom.
§ Having an increased heart rate.
§ Breathing rapidly (hyperventilation)
§ Sweating.
§ Trembling.
§ Feeling weak or tired.
§ Trouble concentrating or thinking about anything other than the present worry.
Causes :-
The causes of anxiety disorders aren’t fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.
For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.
Examples of medical problems that can be linked to anxiety include:
§ Heart disease
§ Diabetes
§ Thyroid problems, such as hyperthyroidism
§ Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
§ Drug misuse or withdrawal
§ Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
§ Chronic pain or irritable bowel syndrome
§ Rare tumors that produce certain fight-or-flight hormones
Sometimes anxiety can be a side effect of certain medications. It’s possible that your anxiety may be due to an underlying medical condition if:
§ You don’t have any blood relatives (such as a parent or sibling) with an anxiety disorder
§ You didn’t have an anxiety disorder as a child
§ You don’t avoid certain things or situations because of anxiety
§ You have a sudden occurrence of anxiety that seems unrelated to life events and you didn’t have a previous history of anxiety
Types of Anxiety :-
There are several types of anxiety disorders:
§ Generalized anxiety disorder. You feel excessive, unrealistic worry and tension with little or no reason.
§ Panic disorder. You feel sudden, intense fear that brings on a panic attack. During a panic attack you may break out in a sweat, have chest pain, and have a pounding heartbeat (palpitations). Sometimes you may feel like you’re choking or having a heart attack.
§ Social anxiety disorder. Also called social phobia, this is when you feel overwhelming worry and self-consciousness about everyday social situations. You obsessively worry about others judging you or being embarrassed or ridiculed.
§ Specific phobias. You feel intense fear of a specific object or situation, such as heights or flying. The fear goes beyond what’s appropriate and may cause you to avoid ordinary situations.
§ Agoraphobia.You have an intense fear of being in a place where it seems hard to escape or get help if an emergency occurs. For example, you may panic or feel anxious when on an airplane, public transportation, or standing in line with a crowd.
§ Separation anxiety. Little kids aren’t the only ones who feel scared or anxious when a loved one leaves. Anyone can get separation anxiety disorder. If you do, you’ll feel very anxious or fearful when a person you’re close with leaves your sight. You’ll always worry that something bad may happen to your loved one.
§ Selective mutism. This is a type of social anxiety in which young kids who talk normally with their family don’t speak in public, like at school.
§ Medication-induced anxiety disorder. Use of certain medications or illegal drugs, or withdrawal from certain drugs, can trigger some symptoms of anxiety disorder.
Diagnosis
You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.
However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).
To help diagnose an anxiety disorder, your mental health provider may:
§ Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
§ Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.
Treatment
The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.
Psychotherapy
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.
Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you’ve avoided because of anxiety.
CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.
Medications
Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:
§ Certain antidepressants are also used to treat anxiety disorders.
§ An anti-anxiety medication called buspirone may be prescribed.
§ In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.
