Anxiety disorders are a group of mental disorders which are characterised by general anxiety and fear. In anxiety disorders, people get frightened and distressed for no significant reason. The distress caused by this group of mental disorders may prevent the affected person from performing his/ her routine activities and can get worsen with time.
There are numerous types of anxiety disorders such as panic disorder, generalised anxiety disorder, situational anxiety and phobias and if left untreated, these disorders cause a reduction in productivity and significantly decreases an individual’s quality of life.
Types of Disorders
There are a number of anxiety disorders which exist. Often, people suffer from more than one anxiety disorder. Some of the types are as follows:
1. Situational anxiety – Anxiety is caused by new situations or changing events that make that particular individual uncomfortable.
2. Substance-induced anxiety disorder – In this condition, symptoms of extreme anxiety occur which is a result of misuse of medications, drugs or toxic substances.
3. Anxiety disorder due to a medical condition – This condition consists of symptoms of intense panic or anxiety which are directly due to the medical condition.
4. Obsessive-compulsive disorder (OCD) – Here, the anxiety problems involve uncontrollable repetitive thoughts, behaviours or urges. The person is obsessed to perform the repetitive actions.
5. Selective mutism – Selective mutism occurs when there is a failure to speak in certain social situations despite having normal language skills. This condition generally occurs before the age of 5 and is linked with extreme shyness, fear and clinging behaviour.
6. Post-traumatic stress disorder (PTSD) – In this condition, a person may develop anxiety problems after experiencing something traumatic. The patient may experience flashbacks or nightmares which may make the patient feel as if he or she is re-living all the fears and anxieties experienced during the actual event.
7. Generalised anxiety disorder (GAD) – This anxiety disorder is not focused on any one object or situation. It includes constant, exaggerated & uncontrollable worries concerning activities involved in daily life. This unrealistic worry interferes with the daily routine. This disorder is associated with physical symptoms like restlessness, irritability, feeling easily fatigued, headache, difficulty in concentrating or difficulty in sleeping.
8. Panic disorder – In this disorder there is a recurrent and regular panic attack without any evident trigger or cause. Panic attacks are attacks of extreme fear which come quickly and reach their peak within a few minutes & can last for several hours. At times the trigger is unclear. The panic attacks strike repeatedly without any warning. Physical symptoms accompanied are palpitations, sweating, chest pain, shortness of breath, dizziness, abdominal discomfort, etc.
9. Separation Anxiety Disorder – This is a childhood disorder where there is excessive anxiety in the child about been separated from those with whom the child is attached. The child may be constantly worried about losing the person closest to him or her & may also experience nightmares regarding separation. Separation anxiety disorder is commonly seen in children but then adults too can be diagnosed with this disorder.
10. Phobias and Specific phobia – Phobia is characterised by an extreme irrational fear or anxiety of a particular object or a particular situation which is usually not harmful. There are several types of phobias – specific phobia (people have fear from a specific object or situation), agoraphobia (intense fear of being in open/enclosed spaces or using public transportation) etc.
11. Social anxiety disorder – Social anxiety disorder or social phobia is characterised by extreme fear, worry or anxiety triggered by social situations. Thus, it involves avoidance of social situations. A person with social anxiety disorder experiences anxiety about being humiliated, embarrassed or rejected during social interactions. They worry that their behaviours or actions shall be negatively evaluated by others. People suffering from social anxiety disorder generally try avoiding the source of their anxiety and severe cases may lead to complete social isolation.
Anxiety disorders include a group of related conditions where each disorder expresses unique symptoms. Few signs and symptoms that are commonly experienced in majority of the anxiety disorders are as follows:
- Sleep disturbances.
- Shortness of breath.
- Difficulty in concentration.
- Palpitations or increased heart rate.
It is believed that the cause of anxiety is a combination of several factors. Some of the causative factors of anxiety disorders are as follows:
- Use of or withdrawal of an illicit substance.
- Genetics – Anxiety disorder is hereditary & runs in families.
- Brain chemistry – Problems with brain chemistry can lead to the development of anxiety disorders. There are certain neurotransmitters in the brain that are involved in anxiety.
- Medical factors – Factors such as the side effects of medicines, or stress arising from an underlying medical condition. Certain medications & medical conditions too, cause symptoms of anxiety.
- Environmental factors – Stressful or traumatic events such as the death of a loved one, conflicts in relationships, abuse, work-related stress, financial worries or prolonged illness may give rise to anxiety disorder.
Anxiety disorders usually occur with other mental illnesses hence, making the diagnosis more challenging.
Anxiety disorder can be diagnosed by:
- Psychological evaluation – Here, the thoughts and behavior of a person are evaluated.
- Physical Examination – Signs for underlying medical conditions are assessed if required laboratory investigations shall be advised.
- Comparison of symptoms – The physician shall compare the criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM) with the symptoms of the patient to identify the specific type of anxiety disorder.
- Questionnaires – Use of numerous generic anxiety questionnaires namely, Social Interaction Anxiety Scale(SIAS); State-Trait Anxiety Inventory (STAI); Social Phobia Inventory (SPIN); Generalized Anxiety Disorder 7 (GAD-7); Social Phobia Scale (SPS); Beck Anxiety Inventory (BAI); Taylor Manifest Anxiety Scale; etc.
Different types of anxiety disorders display their own characteristic symptoms hence, the treatment plan varies in each type of anxiety disorder. Below mentioned are a few common methods of treatment which are used alone or in combination.
- Based on the specific type of anxiety disorder, certain antidepressants; anticonvulsants; anxiolytics (drugs help lower anxiety) and low-dose antipsychotic drugs are used in the management of anxiety disorders.
- Medications fail to cure anxiety disorders, but significant relief in the symptoms can be obtained.
- Based on the medical condition & the need of the patient, the physician shall decide the appropriate medication, dose & treatment plan.
Psychotherapy is also known as psychological counselling. Psychotherapy addresses the emotional response of a patient to the mental illness. The psychotherapist tries to understand how the patient deals with his/her anxiety disorders. One of the most helpful forms of psychotherapy indicated in treating anxiety disorders is cognitive-behavioral therapy.
- Cognitive behaviour therapy is a type of ‘talk therapy’ which teaches a person different ways of thinking, reacting & behaving so that the person feels less anxious.
- Through CBT, the person is made to understand their thinking patterns so that they modify their reaction to different situations that cause anxiety.
Some of the lifestyle changes which help in reducing anxiety include –
- Avoiding smoking.
- Regular exercising.
- Reduction in intake of caffeine.
- Consumption of a nutritious diet.
- Regularising sleep patterns. A relaxing bedtime routine should be followed.
- Increase intake of omega-3 polyunsaturated fatty acids as it may reduce anxiety.
4. Self-Help, Coping and Managing
There are several things adapted by people to help cope with the symptoms of anxiety. Some of them are as follows:-
- Self-help books.
- Mindfulness-based programs.
- Stress management techniques.
- Support groups (in-person or online) offers people with an opportunity to share their experiences and coping strategies.
5. Alternative medicine
Alternative medicines such as Homoeopathy, yoga, aromatherapy are helpful in tackling anxiety.
- There are several homoeopathic medicines which help in tackling anxiety disorders.
- A regular yoga practice incorporating the appropriate poses aids in reducing some of the symptoms of anxiety. There are several asanas which help in anxiety & stress relief namely, Ustrasana; Balasana; Setu Bandhasana; Dhanurasana; Dandasana; Shavasana; etc.