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Anxiety
Stressing about how we are going to perform in tomorrow’s exam or next week’s big meeting is fear – one of the body’s most basic emotions that activates the “fight or flight” response when there is a clear and obvious source of danger or threat. However, a lot of us will experience stress and fear when there is no such threat around.
When one cannot define what is making them feel scared or uneasy, they are feeling anxious.
Anxiety is a normal part of everyone’s life and we feel it every once in a while. But when these feelings become chronic or reach disabling intensity, you might be suffering from an anxiety disorder.
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Anxiety Disorders
Anxiety is not always bad. In fact, anxiety allows humans and animals to survive by preparing our “fight or flight” response when there is a possibility of danger but it’s not quite there yet. Mild anxiety can actually enhance learning and improve performance. Anxiety is temporary and very conditional, that is, it comes and goes depending on our surroundings. But when this anxiety persists without any reason, it takes the form of an anxiety disorder.
Anxiety disorders do not go away with time and often become worse over time, if not treated.
Prevalence of Anxiety
Despite being unreported in many cases, anxiety disorders are the most common form of mental illness among both children and adults. Estimates of prevalence rates vary from 6 percent to 20 percent globally. According to the National Institute of Mental Health, 19 percent of American adults experience some form of anxiety disorders every year, which is almost 40 million people.
Different demographics are also likely to suffer from anxiety disorder more than others. Women, for example, are twice as likely to suffer from anxiety disorders than men. Children, especially girls, are more likely to report an anxiety disorder, especially specific phobia, panic disorder, agoraphobia, and separation anxiety disorder. Panic disorder often starts in the mid-teen years.
Symptoms
Different people may experience different forms of anxiety depending on the form of anxiety disorder they have. Symptoms common for most anxiety disorders include increased heart rate, sweating, insomnia, restlessness, trouble breathing, lack of concentration, and tension.
The fifth edition of Diagnostic and Statistical Manual of Mental Disorders states the following as the key features of the most common anxiety disorders:
1. Generalized anxiety disorder: Chronic excessive, uncontrollable worry about a number of events or activities (e.g., job performance, finances)
2. Panic disorder: Recurrent, unexpected panic attacks and persistent worry/concern about additional attacks or their consequences
3. Specific phobia: Fear/avoidance of circumscribed objects or situations (e.g., heights, enclosed places, receiving injections)
4. Social phobia: Marked fear/avoidance of social situations because of the possibility of embarrassment or humiliation
5. Posttraumatic stress disorder: Persistent reexperiencing (e.g., dreams, flashbacks), distress, and avoidance of stimuli associated with prior exposure to extreme stress (e.g., rape, combat)
Causes
Like most brain disorders, it’s hard to pinpoint one factor as the direct cause of anxiety disorders. Instead, there are a number of factors that can cause the disorder to develop and also influence its progression. Some of these factors are:
1. Genetic Makeup
Our genes can affect the speed and intensity of our anxiety disorders – how fast we develop them and how strong their symptoms are. The most important factor in the development of social phobia is behavioral inhibition. Behaviorally inhibited infants often get distressed easily upon seeing unfamiliar stimuli (strange faces). These children often develop social phobia during the adolescent stage of life.
2. Learned Behavior
It’s quite common for people to develop specific phobia disorder due to previous negative stimuli. It’s been long known that traumatic experiences can be the sources of phobias. Being exposed to negative stimuli can make us generalize nearby situations or objects as well. For instance, being in a water-related incident as a child can be the cause of phobia of water. Being near water would make that person anxious even in adulthood.
3. Vicarious Conditioning
Sometimes to develop an anxiety disorder, you do not need to experience the negative stimuli yourself, merely watching others behaving fearfully can induce anxiety into us. For instance, a young man who saw his grandfather vomiting while he was dying, developed a strong phobia of vomiting. When this man was in middle age he even contemplated suicide one time when he was nauseated and feared vomiting.
4. Substance Abuse
Though not as common as other causes, alcohol abuse and substance abuse can cause anxiety symptoms. It’s a hidden cause where adults develop anxiety disorders after withdrawal.
Types of Anxiety
Generalized Anxiety Disorder
Formerly called free-floating anxiety, generalized anxiety disorder is one of the most common forms of anxiety disorders and affects about 5.7 percent of the American population at some point in their lives. People suffering from GAD worry about different aspects of life for at least 6 months. This worry is almost always unrealistic and unnecessary and in many cases becomes excessive. People suffering from GAD often live in a future-oriented mood of apprehension, tension, and uneasiness that’s out of control. In addition to the stress, people will also experience three or more problems like sleep disturbance, muscle tension, irritability, difficulty concentrating, restlessness, or fatigue, weak work performance, inattentiveness, etc.
Panic Disorder
People with panic disorder will experience panic attacks out of nowhere. These abrupt and sudden panic attacks generally last 1-10 minutes and subside within an hour. In panic disorder, panic attacks are frequent and there is a persistent fear of another panic attack, Panic disorders affect around 1 percent children and teenagers and symptoms may be different than those seen in adults. Panic disorders can also exist alongside other anxiety disorders.
In order to be diagnosed with panic disorder, a person should experience multiple panic attacks along with 4 or more other symptoms like: depersonalization (a feeling of being detached from one’s body) or derealization (a feeling that the external world is strange or unreal), fear of dying, fear of “going crazy” or “losing control”.
Phobias
A person is diagnosed with specific phobia if they show intense and long-lasting fear of a particular object or situation. These often quite unrealistic but disabling. People experience phobias will try to avoid these situations or go through with extreme discomfort. Phobias often begin in childhood and can last anywhere from one year to five years. It’s also unlikely that they will subside on their own. Specific phobias can also trigger panic attacks in some people.
Post-traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a serious mental health disorder that is almost always caused by a terrifying or traumatic event that can lead to life-long effects. It’s estimated that up to 14 percent of the general population may develop PTSD in their lifetime. However, PTSD is an underreported disorder as people having PTSD do not like talking about the illness as it reminds them of the trauma. PTSD can occur at any age and even infants can suffer from PTSD. PTSD can also occur alongside other brain disorders, major depression being the most common.
Social Anxiety Disorder
Social anxiety disorder or social phobia refers to a disabling fear of public or social situations. Social anxiety disorder is quite common and around 4 percent of children will be diagnosed with social phobia and about 12 percent of the population will qualify for a diagnosis of social phobia at some point in their lives. The disorder typically begins during early or middle adolescence or certainly by early adulthood. People with social phobia have less-effective coping skills and feel extreme uneasiness in social settings such as public speaking, urinating in a public bathroom, or eating or writing in public.
Treatment
Like other brain disorders, anxiety disorders can be treated with medication, therapy, lifestyle changes or a combination of these three. Despite being treatable, only one-third of the people suffering from anxiety disorders will actually receive treatment. Depending on the severity of the disorder, anxiety can be overcome by simple lifestyle changes such as avoiding certain. When the disorder is more severe or chronic, medication and therapy may be used.
1. Psychotherapy
Children and teenagers are usually not treated with medications since there may be more serious side effects on young bodies. The more common method is psychotherapy or talk therapy. The most common form of psychotherapy and the one backed up by most research is cognitive behavioral therapy (CBT). In CBT, patients are taught coping skills and allowed to practice these skills in controlled environments.
2. Medication
Often times medication will be prescribed alongside psychotherapy to reduce symptoms of anxiety disorders such as excess stress and panic attacks. The most common medications prescribed for anxiety disorders include antidepressants, benzodiazepnes, buspirone, hydroxyzine, and beta-blockers.
3. Support Groups
Getting the chance to talk to people going through similar problems can have extremely positive effects on the mental well-being of an individual.Support groups and interventions can also allow individuals to talk freely about their problems and achievements. Anxiety disorders are often accompanied by depression symptoms and support groups can help with that.
4. Lifestyle Changes
Simple lifestyle changes such as sleeping on time, eating healthy, exercising, avoiding alcohol or other drugs can help in relieving anxiety. Spending more time with friends and family can also help in focusing on other things and taking your mind off of stressors.