According to the National Institute of Mental Health (NIMH), 18.1% of the US adult population, that is around 40 million adults, suffer from one of the anxiety disorders.

However, the true amount of sufferers, is likely to be much higher than this. It has been estimated that only around one third will receive treatment for anxiety disorders and many do not seek ANY medical advice.

Anxiety disorders respond very well to treatment in most cases. So don’t suffer in silence, if your anxiety is getting out of hand you are not alone.

 
 

What exactly are Anxiety Disorders?

The blanket term ‘anxiety disorders’ covers a range of symptoms – both emotional and physical – that are both immense and diverse.

How do you know if you are suffering with an anxiety disorder? Furthermore, When does normal worry or unease, or your natural fight-or-flight response to a dangerous situation, cross over into one of the anxiety disorders?

There are six main categorized anxiety disorders, but many of the symptoms often overlap between them so there is not always a very clear cut diagnosis. We will be looking at the main anxiety disorders, their symptoms and treatments in this post.

 
 

A Note on Anxiety

Anxiety is a natural response to stress characterized by feelings of fear, apprehension, worry and nervousness.

Usually, sensations of anxiety are  experienced both emotionally and physically and to varying degrees. For example, imagine that you are going on a first date. For some, the anxiety would be felt as a mild apprehension and maybe a few butterflies in the stomach.

To more acute anxiety sufferers, the thought could trigger a full blown panic attack with shortness of breath, sweating and an overwhelming sense of impeding doom and fear.

If your anxiety interferes with your daily activities, your work or relationships OR it feels overwhelming or constant then you are probably experiencing an anxiety disorder

 
 

The Anxiety Disorders

1. Generalized Anxiety Disorder

Everybody worries about things from time to time, but when constant worrying upsets your everyday life then you may have generalized anxiety disorder (GAD). This anxiety disorder gad is characterized by what is generally known as free-floating anxiety.

Unlike phobias, whereby the fear and anxiety is associated with a specific trigger, such as seeing a spider or a snake, generalized anxiety focuses itself on anything and everything.

The anxiety and worry is related to the constant fear that something bad might happen. Negative thoughts vary according to the individual, but usually involve fantasies of a doomed future, either on a personal or global level.

Physical Symptoms of Generalized Anxiety Disorder

Symptoms that indicate that you are suffering with Generalized Anxiety Disorder (GAD) include:-

• Muscle tension: especially in the jaw, neck, shoulders and back.  Nail biting or chewing the inside of the mouth or lips.
• Intense Fatigue: Feeling exhausted and lack-lustre a lot of the time, lacking in energy and motivation.
• Concentration problems: Experiencing mental blanks and/or trouble concentrating for any period of time on tasks.
• Ruminating: Playing over negative thoughts or scenarios over and over in your head, like a record on a loop that you have no control to stop. Worst case scenario thinking.
• Irritability: Feelings of restlessness, dissatisfaction and being out of control.
• Digestive disorders: Either constipation or diarrhea, bloating and indigestion.
• Sleep Disturbance: Unable to get to sleep due to excessive anxiety or worry OR oversleeping to ‘escape’.

 
 

2. Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is one of the more known mental health issues particularly in relation to repetitive hand washing, but this anxiety disorder can take many forms.

Firstly, to truly understand the complexity of OCD it must be understood that it is a sort of ‘magical’ type of thinking.

In childhood, a lot of us will have avoided standing on the cracks in the pavements, just for fun. However, if standing on the cracks in the pavements is related to something bad happening then this is crossing the line into the world of OCD.

 
 

Anxiety and OCD

There is intense anxiety with OCD that takes the form of obsessive, intrusive thoughts, that play over and over in the mind. These thoughts are often related to contamination, checking, performing tasks to perfection, arranging or counting objects or even harming others.

Following these overwhelming fearful thoughts is the compulsion, or the repetitive actions, which must be taken to avoid the fearful outcome.

So, for example, if an OCD sufferer fears germs and disease – that is the obsessive thought (or anxiety) and is followed by the compulsive, ritual of hand washing or cleaning to alleviate the anxiety.

Likewise, some OCD sufferers often have obsessive thoughts about hurting loved ones. The compulsive behaviours surrounding these thoughts will be to remove any objects or means of doing so.

 
 

3. Anxiety Attacks or Panic Disorder

Those who suffer from panic attacks will often experience some of the symptoms of generalized anxiety too. However, when an anxiety attack occurs, the feelings of intense fear, overwhelming panic and a sense of impending doom can happen at any time.

The fight-flight response seems to be heightened in people who suffer from anxiety attacks and is triggered seemingly out of nowhere. The irrational fear of experiencing another panic attack to sufferers may lead to avoidance of certain places and situations.

Symptoms of Panic Attacks

• A sensation of acute panic and irrational fear.
• Hyperventilation and Shortness of breath: During an attack, the breathing is often affected and the breaths become rapid and shallow, leading to tingling in the hands or feet and dizziness.
• Feeling faint or actually fainting.
• Heart palpitations and/or chest pain. Some sufferers of panic attacks may believe that they are having a heart attack as the heart rate can become very rapid during an anxiety attack. The fear of having a heart attack only serves to increase the anxiety, intense fear and panic.
• Sweating, shaking and trembling
• Tummy ache or cramps

 
 

4. Phobias

Most of us have experienced the sensations of a phobia at some time or another.

You go for a nice, long, hot bath … and there it is … A HUGE spider! If you fear spiders, you run from the bathroom, screaming and sweating. Nervously, you return, determined not to let the fear overcome you. You argue with yourself, ‘It is tiny compared to me’ ‘It is not dangerous’.  In desperation, you throw a sock at the hairy creature, it runs … very quickly and you bolt from the bathroom again, heart pounding and legs like jelly to enlist help.

The anticipated relaxing soak is replaced with high anxiety and nightmares for weeks to come.

 
 

Symptoms of Phobias

The symptoms of having a phobia are similar to other severe anxiety disorders and include:-

• Stomach ache, cramping or upset tummy including diarrhoea or nausea
• Shaking, trembling or sweating
• Palpitations or rapid heartbeat
• Hyperventilation or shortness of breath
• Feeling faint, dizzy, lightheaded or ‘wobbly’ legs

 
 

Types of Phobias

Humans are programmed to fear certain dangerous animals such as snakes and spiders.  However, for people with a specific phobia, this fear becomes exaggerated and really pronounced.

The phobic person life may become planned around avoiding the feared object, animal or activity. Sometimes just an image or thought of the feared object is enough to provoke symptoms.

The fear of exposure can become debilitating.  This is the point when a phobia is diagnosed.

There are at least 530 documented phobias.

There are common phobias such as:-

• Snakes, spiders, rats and other animals
• Fear of heights, fear of germs, fear of flying, fear of the dentist
• Claustrophobia (fear of enclosed spaces), fear of death, fear of clowns

…and there are more unusual phobias such as fear of:-

• Cheese
• The navel
• A colour
• Beards

 
 

5. Post-Traumatic Stress Disorder

This anxiety disorder is brought on by witnessing or being part of a traumatic event. The event that triggers post-traumatic stress disorder can be anything that is severe enough to deeply traumatize the sufferer.

The trauma can vary from rape and abuse to road accidents and natural disasters. However, any event that is overwhelming and triggers feelings of helplessness could trigger PTSD.

This mental illness became well known through war veterans experiencing a set of similar symptoms following military combat.  The American Psychiatric Association formally recognised post-traumatic stress disorder ptsd as a mental illness in 1980.

Symptoms of Post-Traumatic Stress Disorder

• Re-living the traumatic event: This is accompanied with all the emotional reactions of anxiety and high stress; pounding heart, shaking, trembling, sweating, shortness of breath, etc. The re-experiencing of the trauma is often involuntary. That is, it is often experienced as a nightmare or flashback.
• High Anxiety and emotionally charged: Often sufferers will experience sleep disturbances such as insomnia, nightmares and night terrors. PTSD disorder often triggers outbursts of anger and rage and being hyper vigilante to danger or perceived threats.
• Detachment: Sometimes a person suffering from posttraumatic stress disorder will feel detached from their normal life and activities. Reminders of the actual event may be obsessively avoided.
• Often sufferers of post-traumatic stress experience feelings of self-blame and guilt. Depression often accompanies this mental disorder together with some physical symptoms.
• Substance abuse:  Some sufferers may use alcohol or drugs to try and alleviate their symptoms.

 
 

6. Social anxiety Disorder

For most of us, the thought of having to give a public speech, whether it be a work presentation or the dreaded ‘best man’s speech’ fills us with dread and worries. Such as:-

 
 

For those with social anxiety disorder (sometimes known as social phobia) these thoughts are overwhelming. Intense fear of a social situation, including the apprehension and anticipation of it, can lead to a full blown anxiety attack.

For those with a social phobia, even if they manage to attend a dreaded event the experience is often ruined.

The extreme anxiety and distress caused by the underlying acute self-consciousness and fear of being criticized or judged by others ensures a negative experience.

This in turn, leads to heightened apprehension and anxiety at the thought of a similar social situation.

 
 

Situations that may cause Anxiety

There are all sorts of social situations that a sufferer from social phobia may fear and often more than one.  Here is a list of some of them:-

• Work:  Speaking in a meeting, talking with the boss, public presentations or conferences, work social functions or ‘bonding trips’.
• Children at School:  Having to answer a question in class, oral exams, social time, sports or the school canteen.
• In Public:  Eating or drinking, ordering at a restaurant, meeting strangers, shopping, going to the hairdressers, parties or dating.
• Other situations:  Talking on the telephone, responding to e-mails, logging in to social media sites or being the center of attention.

 
 

Treatments for Anxiety Disorders

Because the nature of anxiety disorders is very complex and the range of problems diverse, there is not always a ‘one cure fits all’.

If your anxiety or disorder is mild there are quite a few natural treatments that will significantly curb symptoms.

You should always contact your physician or a mental health professional before deciding on which treatment is best for you.

Talking Therapies

There are many types of talking therapies and anxiety disorders can be greatly improved in a short period of time with a professional psychotherapist.

• Cognitive-behavioral Therapy: Medical studies have shown this type of therapy to be especially effective in the treatment of anxiety disorders. Cognitive-behavioural therapy changes the way we think about events and associated feelings. The end aim of cognitive-behavioral therapy cbt
  is that once the thoughts and feelings have been changed about a situation a behavioural change will follow.
• Solution-Focused Therapy: This therapy also focuses on behavioural changes to help anxiety disorders. This is a very client-based, goal-orientated therapy. Solution-focused therapy situations are organized around a set of questions.
• Exposure therapy: Traditionally used for phobias this type of therapy gradually ‘exposes’ you to your trigger or fear in a safe controlled environment. Eventually, the sufferer will become de-sensitized to the feared object.
• Psychoanalysis: This type of therapy focuses on a person’s past and subconscious thoughts in relation to their current problem. The aim is to uncover and address the underlying ‘root’ of the anxiety.

 
 

Medications

If you have tried other methods of treatment for your anxiety disorder and nothing has helped then you may consider anti-anxiety medication.

The anti-anxiety drug does carry the risks of long and short term side effects, but if you have been suffering from an acute stress disorder you may decide this is the right option for you.

There are several types of anti-anxiety medications that you may be prescribed. These include:-

• Selective serotonin reuptake inhibitors (SSRIs): This is a newer group of anti-anxiety drug designed to increase the level of serotonin in your brain. Examples of commonly used SSRI’s are fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and fluvoxamine (Luvox).
• Selective serotonin-norepinephrine reuptake inhibitor These medications are similar to SSRI’s but increase the amount of noradrenaline and serotonin and altering brain chemistry and communication. Venlafaxine (Effexor) and duloxetine (Cymbalta). This group of anti-anxiety drugs has been shown to be slightly more effective than the SSRI’s with fewer side effects.
• Benzodiazepines (such as Diazepam, alprazolam, chlordiazepoxide, and clobazam) are another anti-anxiety medication that work by calming the nervous system. Furthermore, because these medications are tranquilizers and effective in decreasing anxiety symptoms in the short term. However, people with anxiety disorder, these too have side effects including addiction.

 
 

Recent Posts on Anxiety

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• GAD Generalized Anxiety Disorder: Free floating anxiety? No rest from the worries and anxiety about anything and everything? This post is for you.
• Social Anxiety Disorder: Also called social phobia. All the latest research on all aspects of this disorder.
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References

• Bystritsky B, Khalsa SS, Cameron ME, Schiffman J. (2013) Current Diagnosis and Treatment of Anxiety Disorders P T. 2013 Jan; 38(1): 30-38, 41-44, 57 (Retrieved August 12^th 2016) https://www.ncbi.nlm.nih.gov/pubmed/23599668
• Pull CB, Damsa C. (2008) Pharmacotherapy of panic disorder Neuropsychiatr Dis Treat. 2008 Aug; 4(4): 779–795. (Retrieved August 19^th 2016) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536545/

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