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What is anxiety?

Picture this. You have a huge test tomorrow. Or maybe, you have to give a speech to two hundred people in two days. Does that make you a little anxious? You think of various scenarios on how the situation can go – positive or negative. Perhaps, you are sweating a little before you go on stage. Maybe you are a bit shaky or feel nauseated. These feelings of discomfort or anxiety like symptoms before a momentous occasion or stressful situation are normal human reactions. In fact these feelings may be helpful to keep you alert and focussed. 

The Diagnostic and Statistical Manual (DSM-5) describes anxiety as excessive worry and apprehensive expectations, occurring more days than not for at least 6 months, about a number of events or activities, such as work or school performance.

However, if you feel this discomfort constantly, if it is debilitating and interferes with your day-to-day life, then you may be suffering from an anxiety disorder. Anxiety disorders are pervasive, they can lead to constant turmoil, make social situations difficult, and can even prevent you from leaving your home. Anxiety disorders can have serious financial, social, and emotional repercussions. Global News reported that anxiety can cost the Canadian economy up to 17.3 billion dollars if not addressed. 

Types of Anxiety

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a reference guide used by most of the world for the classification and diagnosis of mental health disorders. The latest, revised version – of the DSM 5 lists the following under anxiety disorders – 

(While PTSD and OCD used to be under anxiety disorders, they have now been re-classified). All these anxiety disorders should be diagnosed by a registered practitioner.

- Generalized Anxiety Disorder (GAD)

As the name suggests, generalized anxiety disorder involves excessive worrying about every aspect of life, including but not limited to job stressors, family responsibilities, monetary worries, social situations, and so on. Persistent feelings of distress that hinder your daily life and can also affect sleep and appetite, usually for a period of at least six months are the hallmarks of GAD. The lifetime prevalence of GAD in Canada was estimated to be 8.7% in 2018, and it has increased since the pandemic.

- Panic disorder

A mental health condition defined by recurrent panic attacks accompanied by an intense fear of having panic attacks lasting at least one month. A panic attack is a feeling of potent anxiety that can cause physical symptoms like increased heart rate, nausea, chest pain, sweating, and a feeling of intense dread. It can also mimic organic disorders like a heart attack or a gastric ulcer.

- Specific Phobias

A specific phobia is a disproportionate fear of a certain object or action that is beyond reason. In fact, you may even be aware that your fear is irrational, and yet, you’re unable to control it. Some examples are a fear of heights (acrophobia), a fear of needles (trypanophobia), and a fear of thunderstorms (astraphobia). Phobias are the most common anxiety disorder; however, it may not always be a limiting factor to your daily life. There are several treatment options like exposure therapy that can help you overcome phobias.

- Social Anxiety Disorder 

Social anxiety disorder is an intense fear of being judged or scrutinized by people in any social situation. While a certain amount of social anxiety is normal, people with social anxiety disorder struggle with - talking to a server, interacting with a friend, or meeting new people. Since much of our work, education, and personal lives involve social interactions, living with this disorder is very challenging. It can often stem from emotional or physical abuse in one’s early life. A subset of Social Anxiety Disorder is selective mutism, where people struggle to speak only in specific situations – like meeting certain relatives or in a classroom.

- Agoraphobia

Agoraphobia is an irrational fear of being in a situation or places where escape is perceived as difficult or where help is perceived as not being easily available. A person with agoraphobia may have a persistent fear of certain situations like using public transport, using elevators, a fear of crowds, a fear of public spaces like museums or movie theatres, etc. The fear can sometimes be so intense that people may not be inclined to even leave their home.

- Separation Anxiety Disorder

A new addition to the DSM 5 classification of anxiety disorders is separation anxiety disorder. Initially, it was thought to occur only in children. Recent research has revealed a high prevalence in adults as well. While it is normal to have separation anxiety until a certain age, persistent and unyielding anxiety linked to being away from an attachment figure or from home constitutes separation anxiety disorder

Other anxiety disorders include – anxiety due to a medical condition like thyrotoxicosis, multiple sclerosis, etc., and substance-induced anxiety. 

Symptoms of anxiety

Anxiety can manifest in several different ways, with a variety of psychological and physiological symptoms. Sometimes, it can even be hard to discern if your symptoms are being caused by anxiety because of how vague it can be. However, here are the most common symptoms to look out for – so that you can help yourself and your loved ones seek help if they need it.

·  Feeling restless or nervous

·  Unable to concentrate

·  Constantly distracted

·  Always Worrying about everything

·  Tremors

·  Tingling and numbness in the extremities

·  Hyperventilation or shallow, fast breathing

·  Increased heart rate

·  Excessive sweating 

·  Nausea and abdominal discomfort

Treatment of Anxiety

Improving awareness and access to treatment for people with anxiety disorders can have a tremendous impact on society, the economy, families, and on the individual itself. Diagnoses like GAD or panic disorder are not just labels or identifiers, they are just like any other organic illness that need to be treated. There is an ardent need to break the stigma that mental health disorders are untreatable or unacceptable. With the right support and with time, people can improve their quality of life and live a fulfilling life.

What are some of the treatment options?

• Psychotherapy – Different forms of psychotherapy can be used depending upon the symptoms you are experiencing. The most common is cognitive behavioural therapy or CBT where the mental health practitioners work in conjunction with clients to help them identify their symptoms and triggers and develop concrete techniques to cope with anxiety. It is highly effective and often the first-line treatment for anxiety.

• Medication - There are several medications with different mechanisms that can be used to treat anxiety disorders. You should seek a medical practitioner for further information on drug therapy for anxiety. They are usually prescribed as a second-line treatment option after counseling and behavioral therapy.

• Lifestyle changes - All the treatment options need to be supplemented with lifestyle changes that boost the resolution of an anxiety disorder. Exercise, fitful sleep, and nutritious meals can have a very positive impact on improving the balance of neurotransmitters and therefore, also aids in treating anxiety disorders. Reducing caffeine, alcohol, and drugs, and regular meditation can also prove helpful.

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