WHAT IS IT?
Anxiety is an imagined fear. We can all experience some forms of anxiety in our life. For example when we get nervous before an interview. We might find ourselves wondering whether we are going to do it well or not. We might feel very uneasy and apprehensive.
WHY DO WE EXPERIENCE ANXIETY?
There is a part of our brain known as the amygdala, which is the seize of our thumb nail. It is located in the center of our brain, also known as the first brain or primitive brain. Our brain has evolved since we came into existence and it is because of this specific faculty that we are able to sense danger. You may have heard of the ‘Fight or Flight response’. This basically means that whenever we are confronted by real or perceived danger, our instinct will kick in, which will lead us to react in self-defence.
SO WHY IS THIS A PROBLEM?
Our ‘Fight or Flight response’ in itself is not a problem. Quite the opposite. Without it we would not have any sense of danger. The only time it can be a problem however is when our ‘Fight or Flight response’ kicks in even though there is no actual danger. For example, when I am sitting in my office desk and suddenly have a strong sense that I am about to die, although there is nothing dangerous happening around me. Another example could be that I start thinking that germs will contaminate me if I don’t wash my hands or my surroundings.
ARE THERE DIFFERENT TYPES ?
Although we can all experience some form of anxiety, the moment our functioning begins to become somewhat affected, this is when we call it a ‘disorder’. These disorders are also known as psychoneuroses, which causes a sense of distress and inability to function normally. There are various forms of ‘Anxiety Disorders’ that can either be mild, moderate, acute, episodic or chronic.
• Generalized Anxiety Disorder (or G.A.D.)
• Panic Disorder
• Social Anxiety Disorder (or Social Phobia)
• Other Phobias
• Post Traumatic Stress Disorder (or P.T.S.D.)
• Obsessive Compulsive Disorder (or O.C.D.)
HOW DO WE DIAGNOSE AN ANXIETY DISORDER?
A medical doctor, a psychologist or an experienced mental health practitioner will be the most qualified to assess and diagnose someone with an anxiety disorder. It is important to rule out other physical health conditions like low blood pressure or a hyperactive thyroid, along with taking certain medications that can either resemble an anxiety disorder or worsen it.
WHAT ARE THE SIGNS & SYMPTOMS ?
Generalized Anxiety Disorder
• Display excessive anxiety or worry for months
• Restless or feeling on edge
• Easily irritable
• Trouble concentrating
• Easily fatigued
• Sleeping disturbance
Panic Disorder – also known as Panic Attacks
• Pounding heart
• Trembling or shaking
• Shortness of breath
• Feeling of an impending doom
• Worries about when the next attack will happen
• Avoidance of places where the panic attack took place
Social Anxiety Disorder – also known as Social Phobia
• Fear of social places
• Fear of performance situations
• Fear of embarrassment, being judged, rejected or of
• Self-conscious and worries of being humiliated
• Hard time making friends and keeping friends
• Blushing, sweating, trembling around others
• Feeling nauseous or sick to the stomach when around
These are irrational fears or aversions to various things such as:
• Acrophobia – fear of Heights
• Agoraphobia – fear of open places
• Ailurophobia – Fear of cats
• Arachnophobia – fear of spiders
• Claustrophobia – fear of closed spaces
• Entomophobia – fear of insects
• Phagophobia – fear of swallowing
Post Traumatic Stress Disorder
When symptoms are experienced for at least a month following a traumatic incident. However, symptoms may not appear until
several months or even years. The symptoms will usually be characterized by :
• Flashbacks or re-experiencing the trauma through intrusive
recollections of the incident. Nightmares are also common.
• Increased arousal such as trouble sleeping, concentrating,
feeling jumpy, easily irritated and angered
• Emotional numbness or inability to experience positive
• Avoidance of places, activities or people that act as
reminders to the traumatic incident
Obsessions are intrusive and unwanted thoughts, images or urges that cause distress or anxiety. Compulsions are behaviors that the person feels compelled to carry out in order to ease their distress or anxiety. Some of these behaviors are visible actions while others are mental behaviors.
Some obsessions will include concerns of:
• Aggressive impulses
Some compulsions will include :
• Washing or cleaning
There isn’t always a logical explanation between obsessions and
CAN THERE BE A DUAL DIAGNOSIS?
Anxiety disorders can co-exist with other conditions such as depression, substance abuse, eating disorders. It is important to
carry out a thorough mental health evaluation.
ARE ANXIETY DISORDERS TREATABLE?
Anxiety Disorders can be treated through psychotherapy, medication or both. Psychotherapy or talk therapy can help, however to be effective it must be tailored to the specific needs of the person. Cognitive behavioral therapy or CBT is an evidence based approach that teaches a person to think, behave and feel differently towards anxiety provoking situations. The sessions are a learning opportunity to develop improved skills. Acceptance and Commitment Therapy (or A.C.T.) is effective in the treatment of anxieties, along with Mindfulness based therapy as well as Exposure with Response Prevention (or E.R.P.) which is particularly useful for the treatment of OCD. These various therapy approaches can be combined and used either individually or with a group. ‘Homework’ is typically part of this evidence based approach for people to practice between sessions.