Anxiety

Anxiety disorders are the most common types of mental health conditions. Anxiety disorder is twice as likely to affect females than males. It is normal to feel a little anxious and stressed about challenging situations that arise in life. However, when the feeling of anxiety interfere with a person’s day-to-day life, such a condition is suspected to be an anxiety disorder.

Other names #

Also known as Anxiety Disorder, Panic Disorder, Phobias, Obsessive Compulsive Disorder (OCD), Generalised Anxiety Disorder (GAD)

Causes #

• Our brain produces certain chemicals which are known as neurotransmitters, which help us to deal with anxiety.

• The neurotransmitters such as norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid are related to our mood and emotions.

• Any imbalance of these neurotransmitters can lead to symptoms of anxiety and other anxiety-related disorders.

• The causes of anxiety disorder are not very clear.

• Some people experience severe anxiety in certain situations, while others take those similar conditions with ease.

• More focused studies are required to fully understand the reason.

• However, it is thought to be due to a complex interaction of genetics, environmental factors, and lifestyle choices.

• People who suffer from chronic health conditions, such as cancer, diabetes, heart illness, chronic pain, thyroid issues, may also have anxiety.

• It may also manifest as a withdrawal symptom of alcohol intoxication, drug abuse, or a side effect of certain prescription medications.

Symptoms #

• Constantly feeling restless, nervous or tense, inability to concentrate.

• The fear of losing control.

• Having frightening thoughts and mental images.

• Trouble falling asleep.

• Feeling weak or tired all the time.

• Physical symptoms such as excessive sweating, hyperventilation or raid breathing, feeling faint or dizzy & increased muscle tension.

• Extreme, irrational fear of specific things or situations.

• A tendency to avoid being in situations that cause anxiety.

Types #

Generalized anxiety disorder (GAD) #

People who experience prolonged bouts of worry, anxiousness, and irrational fear that interferes with their day-to-day activities, social life, personal health, and work for more than 6 months are considered to have a generalized anxiety disorder.

Phobias #

Intense and irrational fear of a very specific thing or situation is termed as ‘Phobia’. People who have phobias exhibit an unreasonable response to fear or anxiety to a condition that may otherwise not be considered very harmful.

These are phobias of things or situations encountered in everyday life, such as:

• Phobia of heights (Acrophobia)

• Phobia of insects (Entomophobia)

• Phobia of seeing blood (Hemophobia)

• Phobia of needles (Trypanophobia)

• Phobia of darkness (Nyctophobia)

• Phobia of water (Aquaphobia)

• Phobia of confined space (Claustrophobia)

• Phobia of interactions with others in society (Social phobia)

Panic disorder #

Panic attacks are sudden, recurrent bouts of extreme fear and anxiousness. The attack may be accompanied by physical symptoms as well, such as excessive sweating, a pounding, and fast heartbeat, trembling, shortness of breath, etc.

Post traumatic stress disorder (PTSD) #

It is a disorder that develops in some people after experiencing a shocking, scary and dangerous event. The person may reexperience intrusive thoughts about the incident in the form of flashbacks, bad dreams, and frightening thoughts which can trigger anxiety.

Bulimia nervosa #

It is a serious life-threatening eating disorder. People with bulimia secretly binge with a loss of control over the eating. This is followed by the excessive concern of living in fear of gaining weight triggering anxiety attacks.

Obsessive compulsive disorder (OCD) #

It is a common, chronic, and long-lasting disorder in which people have recurring, unwanted thoughts, ideas, or sensations (obsessions) that make them feel driven to do something repetitively (compulsions).

Risk factors #

These factors can be considered as a trigger for developing an anxiety disorder:

• Relation to a close relative in the family with an anxiety disorder.

• A chronic or serious health condition.

• Abused as a child.

• Unexpected trauma, such as the untimely death of a loved one or partner.

• Alcohol and drug abuse.

• Suffer from other mental health conditions, like depression, bipolar disorder, schizophrenia, etc.

Diagnosis #

There are no lab tests that can diagnose an anxiety disorder. Sometimes, a physician may order a few lab tests to check for the cause of symptoms and rule out other health conditions that may be causing the symptoms. These include:

• Complete Blood Count to look for signs of an infection or inflammation in the body

• Thyroid Profile Total to rule out any potential cause of thyroid disorders

• Adreno Corticotrophic Hormone (ACH) Plasma to check for the level of the ADH hormone in blood

• Alcohol Screen Blood to rule out symptoms caused due to alcohol abuse

• Drugs of Abuse (Qualitative) Panel to check if there’s any underlying side effects of medicines

• Electrocardiography (ECG) to look for any complications related to the heart

Treatments #

Antidepressants and anxiolytics #

• These medications work by regulating neurotransmitter levels and thus help improve mood.

• Selective serotonin reuptake inhibitors (SSRIs) are considered the first line of treatment for anxiety disorder. Examples include fluoxetine, sertraline, and combination drugs like clonazepam + escitalopram.

• Serotonin-norepinephrine reuptake inhibitors (SNRIs) are also effective in treating generalized anxiety. Examples are venlafaxine and duloxetine.

• Tricyclic antidepressants (TCAs) are a class of antidepressants that work by increasing levels of the hormone noradrenaline. Examples of these drugs include phenelzine and moclobemide.

• Azaperone is a class of drugs that has anxiolytic action (reduce anxiety) and works as serotonin receptor agonist. Examples of these drugs include buspirone, and gepirone.

Sedatives and tranquilizers #

They effectively promote relaxation and reduce other symptoms. They are particularly useful in managing episodes of panic attacks or phobias. Benzodiazepines like diazepam and lorazepam are used for short-term management of anxiety as they are fast-acting, whereas buspirone, a mild tranquilizer, is used in the treatment of generalized anxiety disorder.

Beta-blockers #

These medicines help control the physical manifestations of anxiety or phobias, such as fast heartbeat, palpitation, sweating, trembling, and dizziness. Examples of these types of drugs include propranolol.

Complications Of Anxiety #

Anxiety disorder, if left untreated, can worsen gradually and lead to various complications.

These may include:

• Chronic depression

• Substance abuse - smoking, alcoholism, and drug dependence

• Insomnia

• Chronic fatigue and pain

• Lack of productivity

• Suicidal thoughts

• Suicide