Anxiety disorder is an umbrella term used in psychiatry for different types of psychiatric disorders characterised by excessive and irrational rumination (compulsive focus on one’s distress aimed at bad feelings and experiences from the past. Opposed to worry which focuses on events potentially happening in the future), fear, worrying, uneasiness and apprehension. Anxiety is not the same as fear. Fear is evoked by a realistic danger and is an appropriate response to the situation while anxiety is an over-reaction that is only seen as a big problem subjectively.
Anxiety is a mood which can become a mental disorder when it becomes excessive, uncontrollable and disproportionate to the actual objective size of the problem. Almost everyone has experienced anxiety at one stage in their lives but most of the time this is short lived and fades away after a period of time. When the anxiety comes on a regular basis, is severe, irrational and becomes long term we can speak of anxiety disorder.
There are many subtypes of anxiety. Some examples are generalised anxiety disorder (GAD), phobias, panic disorder, OCD, post-traumatic stress syndrome, separation anxiety, situational anxiety, childhood anxiety disorders.
In brief these individual disorders mean:
GAD: quite common, chronic, long lasting and focuses on non-specific fear and worrying about objects or situations. A cause could be medical or substance abuse. A diagnosis can be made after a person suffers from excessive worrying/fear for more than 6 months.
Phobias: larges category of anxiety disorders. Fear is triggered by a specific object or situation. Worldwide about 5-12% of people suffer from a phobia. Most sufferers understand that their fear is out of proportion to the actual situation but they still get overwhelmed. Examples are claustrophobia, agoraphobia, arachnophobia, needle phobia, dental phobia etc.
Panic disorder: brief attacks of immense terror, characterised by trembling, shaking, confusion, nausea, breathing difficulties etc. These attacks can last from 10 minutes to a few hours and can come and go abruptly.
OCD: obsessive compulsive disorder. Characterised by repetitive obsessions and compulsions (urges to do certain rituals). Often the sufferer believes that acting in a certain way or performing a specific ritual, like for instance walking in a certain pattern, will prevent harm. In many cases the obsession is completely irrational and inexplicable.
Post-traumatic stress syndrome: an anxiety disorder that comes from a traumatic event. It can come from an extreme situation like rape, natural disaster, war, child abuse, etc. A symptom can be flashbacks, the person keeps returning to the terrible situation in their minds.
Separation anxiety: extreme anxiety over being separated from a person or place. Common with young children and only considered a disorder when excessive and inappropriate.
Situational anxiety: brought on by certain situation. Quite common, for instance anxiety in big crowds or to public speaking. But again it is only considered an anxiety disorder when extreme with possible panic attacks.
Childhood anxiety disorders: usually the extreme fear of new situations, their learning, decision making and concentration might be affected. When these children are left untreated a higher risk of substance abuse is present and they are more likely to suffer from eating disorders, depression, ADD and OCD.
Signs and Symptoms:
There are two types of signs and symptoms to anxiety disorders. One of them is emotional and the other is physical.
Some of the emotional signs and symptoms are persistent state of apprehension or fear, feelings of dread without valid cause, concentration problems, inner tension and nervousness, catastrophic thinking, irritability or edginess, restlessness and sleeping problems, hyper-vigilance towards signs of danger, absentmindedness and mind blanks, intense/sudden feelings of panic or doom, fear of losing control or going crazy, feelings of detachment and unreality.
Some of the physical signs and symptoms could be pounding heart/rapid heartbeat, excessive sweating, choking sensations, stomach cramps, dizziness and vertigo, frequent urination or diarrhoea, shortness of breath, hyperventilation, hot flashes or chills, light-headedness, tremors and twitches, muscle tension, headaches, fatigue, insomnia, etc.
A lot of these symptoms can also be of other medical problems. For instance shortness of breath can also be caused by a heart attack or pneumonia. Vertigo can easily be caused by being hungry but people with anxiety experience these symptoms more severely because they are particularly tuned into experiencing these feelings and this can actually make everything worse.
Early diagnosis and treatment are very important; it makes the treatment more effective and easier. There are several types of treatment, one is psychotherapy. Cognitive behavioural therapy is proven to be highly effective particularly for panic disorders and phobias. It helps the patients question their behaviour and tries to change the patient’s reaction to panic situations.
Medication can have a high risk of withdrawal and adverse effects. The most common ones are SSRI’s (selective serotonin reuptake inhibitors) which is an anti-depressant that elevates serotonin levels. Side effects are common during the first few weeks of taking the drug as the body is trying to adjust and can be headaches, nausea, insomnia and changes in sexual behaviour. An example of antianxiety drugs is benzodiazepine, which is a tranquilizer that influences the levels of certain neurotransmitters. These drugs can be highly addictive and thus can only be taken for a short period of time. Also another negative point is that these drugs can react dangerously when taken in combination with alcohol or drugs abuse. Then there are also the Beta blocker drugs, usually they are prescribed for people with high blood pressure as they inhibit the sympathetic nervous system response. They can’t help with the problems but they can alleviate symptoms.
Caffeine elimination. Caffeine can improve one’s focus and it can help clear the mind but it can also cause a hinder of one’s cognitive function. Excessive intake of caffeine can cause severe anxiety along with other effects like tremors, muscle twitching and headaches. Anxiety can increase when someone is coming off caffeine as a withdrawal effect.
There are many complementary treatments available to anxiety sufferers and most of them are designed to calm to body, mind and spirit. One of them is the ‘go crazy technique’. This technique is based on the principle where for 5-10 minutes the patient should go absolutely crazy. They can yell, shout, move; anything that will make them tired and that will get the uneasiness out of their body for a while.
What Causes Anxiety?
Anxiety can be caused by biological factors like a low level of GABA neurotransmitters. GABA neurotransmitters reduce the levels of activity of the central nervous system.
Anxiety can also be caused by sustained moderate drug or alcohol use. It commonly occurs in the withdrawal phase from the abuse and can last up to two years. A quarter of people that are recovering from alcoholism suffer from post-acute withdrawal syndrome with anxiety. Ingestion of caffeine may also increase anxiety.
Amygdalae, which are nuclei deep within the mid temporal lobes of the brain, have a function of processing memory and emotional responses and are central to processing fear and anxiety. There is evidence that the function of the amygdalae are disrupted in cases of people who suffer from anxiety.
Anxiety disorders can also be caused by stress. 4-10% of the adult population has been diagnosed with anxiety due to too much worrying about money matters or chronic illness. This figure is probably underestimated due to the fact that many adults will not seek a diagnosis for their symptoms of anxiety.
Anxiety is the most common mental disorder in Australia according to research of the Australian Bureau of Statistics. Take that together with the fact that many people will not seek a diagnosis for their symptoms the numbers will be even higher than this in reality.