Anxiety in its simplest form is a feeling of being worried, afraid, or generally tense – usually in anticipation of an imminent event, or a predicted event.
Anxiety is a perfectly natural emotion, with the vast majority of people going through periods of anxiety in their life. However, for some people anxiety is a constant problem which can be hugely detrimental to their quality of life.
Anxiety can easily impact someone’s ability to live their life as they would hope to. Worrying can sometimes get out of control, making it near-impossible to live life in a healthy way. This typically leads to impairment in several different areas of life.
The term ‘Anxiety’ can be applied to a host of mental health conditions, with Generalised Anxiety Disorder and Social Anxiety Disorder just two of many conditions.
Types of Anxiety
There are several different Anxiety disorders. It is useful for patients to know what the exact type of Anxiety they suffer from is. This allows any treatment to be tailored to their needs.
Generalised Anxiety Disorder (GAD): The most common type of anxiety, this disorder encompasses a broad range of symptoms. In general, the symptoms include regular and intense worries about many different areas in life. This is a difficult condition to live with, and can lead to a marked change in behaviour, with avoidance a common response.
Social Anxiety Disorder: This form of anxiety is applicable when an individual becomes overwhelmingly anxious in social situations. Someone with Social Anxiety Disorder may dread any sort of social situation, making life complicated. Social anxiety disorder is a difficult condition to live with, though treatment is available.
Panic Disorder: This type of anxiety affects individuals who have regular panic attacks – often without a cause. Panic attacks are very distressing events to go through, and sometimes the fear of having a panic attack only acts to deepen the anxiety of an individual. Understandably, this is a very difficult condition to live with.
Phobias: A phobia is a form of anxiety that involves an intense fear that is triggered by either an object or situation. There is no shortage of phobias, with Claustrophobia among the most well-known. Agoraphobia is a well-known condition which people with Anxiety regularly suffer from. Phobias can stop an individual from living their normal day-to-day life.
Agoraphobia: Agoraphobia is a common phobia that is associated with anxiety. Agoraphobia describes the fear of being in a situation where escape might be difficult. Agoraphobia is an example of a complex phobia – which has a marked effect on the life of an individual. They may struggle to leave their home, and is often linked to panic attacks.
Selective Mutism: Selective Mutism is a severe anxiety disorder which is characterised by an individual being unable to speak in certain social situations. While predominantly seen in children, the disorder can persist into adulthood. The individual affected literally cannot speak in some situations, it isn’t out of choice. They will be able to speak regularly to some people, such as close family or friends.
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Symptoms of Anxiety
While the symptoms of each sub-type of Anxiety will vary, in general, symptoms include, but aren’t limited to:
- Intense feelings of worry, being afraid or tense
- Needing reassurance from others
- Feeling others are looking at you
- Unnecessarily worrying about future events
- Excessive sweating
- Fast heartbeat
- Shortness of breath
- Trembling or shaking
- Stomach churning
- Panic attacks
These symptoms will typically lead to many behavioural changes. An individual with an Anxiety disorder may not want to leave the house, or will aim to avoid others wherever possible.
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Causes of Anxiety
It isn’t entirely known what causes Anxiety-based conditions. It appears that any anxiety-based condition can be triggered by a multitude of factors, such as:
- Chemical Imbalance: A chemical imbalance is mooted as a possible cause for a range of mental health conditions – anxiety may be no different. Chemicals in the brain such as serotonin and noradrenaline – which are involved in the regulation of mood, may be imbalanced. This can cause mood to change frequently, and deviate from the “normal’ feelings.
- Genetics: Anxiety disorders often run in families. For instance, cases of Generalised Anxiety Disorder are six times more common in the children of someone with the condition, with similar rates throughout the other anxiety-based disorders .
- Traumatic Experience: Any sort of traumatic experience can lead to the onset of anxiety. This is especially prevalent if the experience isn’t dealt with.
- Abuse: Having been the victim of physical or emotional abuse can also lead to anxiety being triggered.
- Childhood Experiences: As childhood experiences tend to shape our personality, any sort of difficult experience in childhood can act as a trigger.
- Substance Abuse: An individual with a history of substance abuse has been proven to be more susceptible to developing mental health conditions – anxiety is no different.
- Life Event: Any life issue can lead to anxiety being triggered. Unemployment, acute stress, homelessness, loneliness or being bullied are all common triggers. In this case, anxiety can be short-lasting, or long-term.
Sometimes anxiety simply has no cause. It is often not a matter of there being one singular cause of anxiety. A range of events or factors could contribute to the development of Anxiety.
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Diagnosis of Anxiety
Anxiety cannot be diagnosed through a laboratory test or any other medical examination. Instead, doctors make a diagnosis based on a patient’s answers to a wide range of questions.
These questions will focus on the individual’s symptoms – including when they first arose. Any possible cause could be investigated.
The criteria for each individual Anxiety condition differs. Generally, the individual will need to have had their quality of life lower due to their anxiety, and not be able to live their life how they would want to due to their anxiety.
Questionnaires such as the GAD-7 can be used to assist in the diagnosis of Anxiety.
Seeking help for any anxiety condition as soon as possible is important. The illness usually won’t clear up on its own, and therefore the earlier help is sought, the sooner recovery will be possible.
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Treatment of Anxiety
Every form of anxiety treatment can be treated, and in many cases, full remission will be attained.
The treatment for each sub-type of Anxiety differs, but generally, the following treatment options are possible:
- Self-Help: Many people find that anxiety lessens with a combination of factors based around self-help. Meditation or mindfulness are great ways to relax and ease fears. Avoiding alcohol and caffeine too have proven benefits for coping with anxiety. Regular exercise, along with a healthy diet, can all help too. Regular sleep, and joining a local discussion group are two other useful methods.
- Talking Therapy: Some form of talking therapy is normally a first line of treatment. Therapy typically help individuals understand their thoughts and behaviour more. Therapy can also help individuals learn how to cope
Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.
Exposure Therapy: Exposure Therapy – also known as Desensitisation – is commonly used for cases that involve either traumas or phobias. This type of therapy involves an individual being gradually exposed to their fear/trauma. A therapist can help set up a program for this. Over time, the individual will gradually become accustomed to their problem – though this takes time. The eventual aim is to overcome the problem. Relaxation methods may also be taught as part of this therapy.
- Medication: In cases of Anxiety that feature symptoms that have a profound impact on an individual’s day-to-day life, medication could be prescribed. Normally, an antidepressant will be used, though this isn’t always the case. Sometimes, Pregablin – an anticonvulsant medication used for epilepsy – may be prescribed.
Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.
Pregabalin: Pregablin is an anticonvulsant medication used to help those who suffer from Epilepsy. Pregablin is also licensed to treat some forms of anxiety. Pregablin will generally be taken for a long-term period, and can be particularly useful when an individual doesn’t respond well to antidepressants.
For severe cases of anxiety that lead to a crisis developing, sometimes a short-term course of Benzodiazepines can be prescribed.
Benzodiazepines: Benzodiazepines are fast-acting sedatives, which can relax an individual and improve their mood. Any anxiety should fade rapidly upon consumption. The individual should therefore have an improved level of functioning. Benzodiazepines cannot be taken for more than a few weeks, due to acute risk of both physical and psychological dependence.
There are many potential treatment options for anxiety. Hopefully it will be possible to find a strong combination of treatment options, which can then result in a full recovery being made.
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Living with Anxiety
Anxiety can have a considerable effect on an individual. Those with anxiety disorders can find it difficult to function on a daily basis, including leaving their house.
It can become easy to engage in a downward spiral, of which it can be difficult to escape from. It is therefore highly recommended that treatment is sought.
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Anxiety disorders are, by nature, typically long-lasting. These disorders continue to impact the lives of many people around the world.
Treatment is available however, and may result in a full recovery being made. In most cases, someone with an Anxiety disorder will see a partial improvement in their symptoms. In the vast majority of cases, quality of life will improve significantly.
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 Patel, G., Fancher, T. L., Cotton, D., Taichman, D., & Williams, S. (2013). Generalized Anxiety Disorder. Annals of Internal Medicine. 159 (11). DOI: https://doi.org/10.7326/0003-4819-159-11-201312030-01006.