Understanding Anxiety

What Is Anxiety?

Anxiety is a feeling of nervousness, worry or fear that can affect your daily life. It is normal to feel anxious in some situations, such as before a test or a job interview, but sometimes anxiety can become excessive and interfere with your ability to function. Anxiety can cause physical symptoms, such as racing heart, sweating, trembling, nausea or difficulty breathing. It can also affect your thoughts, emotions and behaviour, making you feel restless, irritable, pessimistic or avoidant.

Is it the same as Stress?

Anxiety is different from stress, although they are related. Stress is a response to a specific situation or challenge that requires adaptation or coping. Stress can be positive or negative, depending on how you perceive and manage it. Stress can also trigger or worsen anxiety in some people. Anxiety is more persistent and generalized than stress, and it often involves irrational or excessive fears that are not based on reality.

Anxiety is a feeling of fear, nervousness, or worry that persists even when there is no apparent threat or danger. For example, you might feel anxious when you have to speak in public, meet new people, or fly on a plane. Anxiety can interfere with your normal functioning and cause physical symptoms such as sweating, trembling, or palpitations.

Stress is a reaction to a specific situation or challenge that requires a response or adaptation. For example, you might feel stressed when you have a deadline at work, a big exam at school, or a fight with your partner. Stress can be positive or negative, depending on how you cope with it.

Reference: Endler, N. S., & Parker, J. D. (1990). Stress and anxiety: Conceptual and assessment issues. Stress Medicine, 6(3), 243–248. https://doi.org/10.1002/smi.2460060310

Are there different kinds?

Anxiety disorders are the most common mental health condition in the world, affecting about 18% of adults in the US [1] , and reported to be as high as 22% in India. [2] They can cause excessive fear, nervousness, and worry that are out of proportion to the actual situation. Anxiety disorders can also trigger physical symptoms, such as racing heart, sweating, trembling, nausea, and difficulty breathing.

Reference: – Anxiety and Depression Association of America. (n.d.). Facts & Statistics.  https://adaa.org/about-adaa/press-room/facts-statistics

Reference: – Sagar, R., Dandona, R., Gururaj, G., Dhaliwal, R. S., Singh, A., Ferrari, A., … & Dandona, L. (2020). The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017. The Lancet Psychiatry, 7(2), https://doi.org/148-161. 10.1016/s2215-0366(19)30475-4

There are different types of anxiety disorders, such as Generalised Anxiety Disorder (GAD), panic disorder, social anxiety disorder, phobias, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Each type has its own causes, symptoms and treatments. Anxiety disorders are common and treatable, and many people who have them can lead fulfilling lives.

Reference: American Psychiatric Association, D., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American psychiatric association. https://doi.org/10.1176/appi.books.9780890425596

There are different types of anxiety disorders, each with their own causes, symptoms, and treatments. Here’s how to identify each and get help.

Generalised anxiety disorder (GAD): This is when you feel anxious most of the time, about a variety of things, such as work, health, family, or money. You may have trouble sleeping, concentrating, or relaxing. You may also experience muscle tension, headaches, or fatigue.

Panic disorder: This is when you have sudden and intense attacks of fear that come out of nowhere and last for several minutes. You may feel like you’re having a heart attack, dying, or losing control. You may also avoid places or situations that trigger your panic attacks or make you feel trapped.

Social anxiety disorder: This is when you feel extremely self-conscious and nervous in social situations, such as meeting new people, speaking in public, or eating in front of others. You may worry about being judged, embarrassed, or rejected. You may also experience blushing, sweating, trembling, or nausea.

Obsessive-compulsive disorder (OCD): This is when you have unwanted and intrusive thoughts (obsessions) that cause you anxiety and distress. You may also feel compelled to perform certain behaviours (compulsions) over and over again to reduce your anxiety or prevent something bad from happening.

Post-traumatic stress disorder (PTSD): This is when you have flashbacks, nightmares, or intrusive memories of a traumatic event that happened in the past. You may also feel numb, detached, or angry. You may also avoid anything that reminds you of the trauma or triggers your anxiety.

Phobias: These are intense and irrational fears of specific objects or situations that pose little or no actual danger. For example, you may have a phobia of spiders, heights, flying, or blood. You may go to great lengths to avoid your phobia or endure it with extreme anxiety.

If you think you have an anxiety disorder or any other mental health issue, don’t suffer in silence. There is help available and you are not alone. The first step is to talk to your doctor or a mental health professional who can diagnose your condition and recommend the best treatment for you. Treatment may include therapy, medication, or both.

Anxiety disorders can be challenging and debilitating, but they can also be overcome with proper care and support. Remember that you are stronger than your anxiety and that you can live a happy and fulfilling life.

How does one deal with it?

According to current research on this topic, anxiety disorders are the most common type of psychiatric disorder. They often occur alongside depressive disorders or other anxiety disorders, making treatment more complicated. Benzodiazepines are not recommended as a first choice for treatment due to their potential side effects. Instead, selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SNRIs) are the preferred first-line treatments. Combining psychotherapy with medication can improve treatment outcomes. A bio-psycho-social approach is thought to be the best way to understand and treat anxiety disorders. 

Reference: Thibaut F. (2017). Anxiety disorders: a review of current literature. Dialogues in clinical neuroscience, 19(2), 87–88. https://doi.org/10.31887/DCNS.2017.19.2/fthibaut

What can therapy do?

Psychotherapy from a trained mental health professional can be an efficacious treatment for anxiety disorders. [3] Psychotherapy can be used as a standalone treatment or in combination with medication.

Different types of psychotherapy, such as cognitive-behavioral therapy (CBT), group psychotherapy, and existential phenomenological psychotherapy (EPP), have been found to be effective in treating anxiety disorders. CBT is often the initial choice of psychotherapy for anxiety disorders in children and adolescents. [4]

Psychotherapy can also be used to manage anxiety in patients with other disorders, such as schizophrenia. However, access to psychotherapy can be limited, and efforts should be made to improve access to psychotherapy for individuals with anxiety disorders. Overall, psychotherapy can play an important role in the treatment of anxiety disorders, and it should be considered as a viable treatment option.

References: Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds III, C. F. (2013). The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: A meta‐analysis of direct comparisons. World psychiatry, 12(2), 137-148. https://doi.org/10.1002/wps.20038

Nutt, D. J., & Sharpe, M. (2008). Uncritical positive regard? Issues in the efficacy and safety of psychotherapy. Journal of Psychopharmacology22(1), 3-6. https://doi.org/10.1177/0269881107086283

Reference: Zhou, X., Zhang, Y., Furukawa, T. A., Cuijpers, P., Pu, J., Weisz, J. R., … & Xie, P. (2019). Different types and acceptability of psychotherapies for acute anxiety disorders in children and adolescents: a network meta-analysis. JAMA psychiatry, 76(1), 41-50. https://doi.org/10.1001/jamapsychiatry.2018.3070

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