Anxiety disorders ( updated Oct 2006)


Anxiety is an uncomfortable feeling of fear, dread, or danger. Anxiety disorders are a group of psychiatric conditions that involve anxiety. The problem may be real or imaginary. Symptoms can vary in severity and length. There are several types of anxiety including:

  • acute situational anxiety
  • generalised anxiety disorder
  • panic disorder
  • post-traumatic stress disorder
  • phobias
  • obsessive compulsive disorders

Everyone feels anxious from time to time. People who are anxious may be worried about things around them. They may have an internal, mental struggle. Sometimes anxiety is so severe it causes a great deal of distress. It can interfere with the ability to function in society. In these cases, an anxiety disorder is said to be present. Anxiety symptoms are generally divided into two categories; psychological/ mental ie worries and somatic ie physical symptoms for example;

  • palpitations, an unusual awareness of the heartbeat
  • dry mouth
  • sweating
  • trembling or shaking
  • shortness of breath or a choking sensation
  • nausea
  • dizziness
  • chest pain
  • inability to sleep well ( insomnia)

Examples of mental symptoms include:

  • fear of dying or going crazy
  • fear of leaving the house
  • fear of crowds
  • difficulty concentrating
  • irritability
  • restlessness
  • fear of contamination or germs
  • constantly worrying about life
  • having the same thoughts over and over again
  • memory problems

It is not known why some people are more anxious than others. The feeling of anxiety is caused by the body's defense mechanisms. This is called fight or flight response. The body makes adrenaline, which causes the symptoms. Fatigue is a common cause for people developing anxiety symptoms especially panic attacks. So rest and relaxation are often recommended as part of the treatment. If ones lifestyle is too hectic, lifestyle changes to reduce stress may be needed.  

An anxiety disorder is diagnosed when the anxiety becomes severe. The person has problems with relationships or work because of anxiety. A history and physical examination should be done to rule out other medical conditions that may cause symptoms of anxiety. Anxiety is often linked to depression.  
 
Treatment generally include a combination of medications and psychotherapy. Medications used are often antidepressants. Anxiety however can take more time to resolve then depression. The doctor may also need to use slightly higher doses to control anxiety. People should generally avoid using sedatives. Unlike antidepressants, sedatives can be addictive if used regularly and for long periods.  
  
Treatment with Cognitive behavioural therapy (CBT) can be initially confronting for patients. CBT however teaches people tools to control their anxiety that last forever, allowing patients to eventually come off medication in most cases and stay well.