Many individuals are struggling with anxiety here in Anguilla and other parts of the world at this time. All of us at certain points in our life have some form of anxiety at a time of stress, but this is usually transient. When it is chronic and interferes with a person’s life is when anxiety is a cause of concern. The COVID-19 pandemic is associated with increasing levels of anxiety and other mental illnesses. Anxiety is one of the most treatable mental health problems but, unfortunately, many persons with it do not seek treatment.
What is anxiety?
Anxiety is an emotion characterised by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. Everyone experiences a certain amount of apprehension when faced with a stressful situation, e.g. before an exam, or a job interview. This is adaptive and is transient in nature. Anxiety is abnormal when the response generated is the same but it is out of proportion to the threat, it is more prolonged, and it impacts the individual’s functioning. In some situations anxiety disorder is triggered by an event like death of a relative or an event like COVID-19 lockdown.
How common is anxiety disorders?
Anxiety disorders are a common illness among adults and children. People with certain personality types are more prone to anxiety disorders than others are. Women are at higher risk for getting anxiety disorders. Introverts are at higher risk as well. Anxiety disorders occur in all races and in all socio-economic groups.
What causes anxiety disorders?
It is not a result of personal weakness, a character flaw or poor upbringing. It might be caused by problems in the brain circuits that regulate fear and other emotions. Severe or enduring stress can change the way nerve cells within the circuit transmit information from one part of the brain to another. Environmental factors can trigger the stress/anxiety. There might be a genetic factor involved in some individuals.
Many individuals with anxiety have negative thoughts that can lead to chronic stress that can alter the chemical makeup of the brain. This can deplete beneficial chemicals in the brain like dopamine and serotonin. These slow the production of BDNF (Brain Deprived Neurotropin Factor), a protein required for new brain cell formation. Chronic stress can therefore shrink the size of your brain.
Symptoms of anxiety
The symptoms might vary in severity but are generally the same in all the various types of anxiety disorders. Symptoms include the following:
Increased heart rate
Increased blood pressure
Increase respiration
Increase muscle tension
Increased sweating
Dirarrhoea
Tremor or shaking
Feeling nauseous
Emotional symptoms and behavioural symptoms
Types of anxiety disorders
The main types are:
• Generalised anxiety disorder
• Panic disorder with or without agoraphobia
• Social anxiety disorder
• Specific phobias
Generalised anxiety disorder
This is characterised by persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
What is a panic disorder?
Individuals having a panic disorder can be scary to the onlooker. They often present to the accident and emergency department and can mimic a heart attack. It might present as a sudden attack that can last a few minutes or up to half an hour. It is characterised by fear of disaster or losing control even in the absence of danger. They can occur at any time. People with this disorder worry and dread the possibility of having another attack.
Agoraphobia
This is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
Social anxiety disorder (social phobia)
This involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
Specific phobias
These are characterised by major anxiety when you are exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
Diagnosis
Your primary care doctor would carry out various tests to rule out many medical disorders that can mimic anxiety disorders. You will be then referred to a mental health specialist. The clinical history is important in making the diagnosis.
Treatment
Anxiety can be successfully treated and often involve a combination of various treatment options. Types of treatment include the following:
• Cognitive behavioural therapy
• Medications
• Relaxation techniques
• Lifestyle changes
Complications
If anxiety disorders are not treated they may result in complications. Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions such as:
• Depression (which often occurs with an anxiety disorder) or other mental health disorders
• Substance misuse
• Trouble sleeping (insomnia)
• Digestive or bowel problems
• Headaches and chronic pain
• Social isolation
• Problems functioning at school or work
• Poor quality of life
• Suicide
Prevention
There is no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you are anxious:
• Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
• Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships which can lessen your worries.
• Get enough rest. Find time to relax each day even if it is only a few minutes.
• Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you are addicted to any of these substances, quitting can make you anxious. If you cannot quit on your own, see your doctor or find a support group to help you.
Conclusion
Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger, and can last a long time. If you have severe worries, and have anxiety that interferes with your life, you should see your doctor or a mental health provider before your anxiety gets worse. It is easier to treat if you get help early. Many individuals can be successfully treated once they seek professional help.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
