Understanding anxiety disorders

Anxiety is one of the most common mental health issues. Not only is it just an emotion that everyone experiences, but it can be a condition that is a heavy burden for those who have it. In this article, a consultant psychiatrist helps us to better understand anxiety, how it can manifest as physical symptoms and how it can mitigated.

What is anxiety?

Anxiety is the feeling of worry, distress, and apprehension that is typical of approaching new challenges or situations. Sometimes, it can be helpful to help individuals avoid that which they are not ready to confront, but it becomes an issue when the feeling is pervasive and constant, and becomes detrimental – this is when anxiety is no longer the occasional emotion, but a legitimate psychological disorder.

 In fact, there are several kinds of anxiety disorders, such as:

• Generalised anxiety disorder (GAD), which is when the anxious feeling is persistent and triggered by many different things and aspects in your life
• Panic disorder, which means that you have frequent and unexpected panic attacks
• Social anxiety disorder, which means that you are fearful of being watched and judged by others and makes socialising in different contexts very difficult
• Phobia-related disorders

Anxiety disorders can be caused by traumatic events, unaddressed issues from childhood, lifestyle, genetics and family history, and differences in the way the brain is structured.

What does anxiety look like?

Fearful thoughts and behaviour are not the only symptoms of anxiety disorders. People with anxiety are likely to suffer from attacks of panic, which happen suddenly, or anxiety, which build up and are triggered by stressors. Attacks can last around 5-20 minutes. A person undergoing a panic or anxiety attack will have some or all of the following physiological manifestations:

• Chest pain and heart palpitations
• Difficulty breathing, such as shortness of breath or hyperventilation
• Nausea
• Crying
• Chills or hot flashes
• Sweating
• Tingling or numbness in the extremities
• Hypersensitivity to the environment around them

During an attack, the person’s thoughts about their fears or worst possible outcomes are intense and exaggerated. They may feel a dire terror or trepidation, as though they are being choked or smothered even though they are not, and perhaps even think that they are going to die.

At the most extreme, anxiety can lead to weight loss, bad sleep, hair turning grey or falling out, and vomiting. Unmanaged anxiety can lead to depression as the quality of life is so greatly affected, further exacerbated by the possible inability to make or maintain friends, take positive risks at work or school, and resistance to try new things. This perpetuates a cycle of stress and unease that can become consuming.

How is anxiety managed?

To manage anxiety, therapy (such as cognitive behavioural therapy or eye movement desensitisation and reprocessing (EDMR) therapy) is highly recommended, as this will give patients a safe place to express their worries, and they can be equipped with tools and skills to cope with their feelings, and dismantle the negative associations they have with the things that are triggering the anxiety.

In some cases, anxiety may be treated with medications, such as antidepressants (like SSRIs) or mood stabilisers, but this is only considered case-by-case and can only be prescribed by a psychiatrist.

The most immediate thing one can do to manage anxiety and diffuse a panic or anxiety attack is the 333 rule:

• Name 3 things you can see
• Name 3 things you can hear
• And name 3 things you can touch

This is a grounding technique that helps draw attention away from the negative feelings, resituate yourself in the present and your environment, and regain control over your thoughts.

If you are struggling with anxiety, you can consult with a specialist via Top Doctors.