Anxiety is the way our body responds to stress. It is an emotional state that is normal to experience up to a certain level. Normal anxiety presents with a state of alertness in response to real physical danger or social situations with an evaluative character such as before an exam or a job interview. It is a feeling of fear or unjustified worrying and anticipation. When these feelings arise without a trigger, last for more than six months or present with high and disproportionate intensity, you may have an anxiety disorder. Anxiety disorders are the most common mental illnesses worldwide. About 1 in 13 people live with at least one anxiety disorder. However, anxiety is not just one disorder but a spectrum of mental illnesses that may coexist together or trigger one another.
What are the types of anxiety?
There are seven recognised and wholly understood types of anxiety disorders:
- Specific phobia
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder
- Illness anxiety disorder
- Obsessive-compulsive disorder
- Separation anxiety disorder
An anxiety disorder diagnosis often follows a diagnosis of depression. However, this mostly happens in people who don't receive immediate care and treatment. Keep in mind that although anxiety disorders are highly treatable, only 36.9% of patients seek and receive treatment. The remaining percentage often has to deal with secondary disorders, social difficulties, or reckless and addictive behaviours.
What is the difference between normal stress and anxiety disorder?
Natural stress can be motivating. For example, feeling anxious before an exam could potentially make you study harder and finally achieve your goals. Being stressed before an interview could be unpleasant, but it could also boost your confidence and will to get the job you desire. This type of anxiety is productive and pushes you out of your comfort zone. Pathological feelings of anxiety are often unbearable. Fear might always be with you, even in situations where it is unjustified to be afraid. Its anticipatory character may interfere with your daily functioning, keeping you from trying new things or performing well in your professional life. Because of your feelings of anxiety, you might isolate yourself or abstain from activities you love. The trigger responsible for an anxiety disorder may be anything between an object, a thought, an animal, a memory, etc. Sometimes, intense and pathological anxiety occurs without any apparent trigger. Although anxiety disorders can affect anyone and at any age, women have more chances to develop them than men.
What causes anxiety disorders?
There is no definitive cause of anxiety disorders. Environmental causes, in combination with genetics, brain chemistry, the areas of the brain that respond to fear, and their interaction may play a role. Anxiety disorders may accompany other mental conditions, as well. People who are not aware of their symptoms and their interpretation may ease anxiety with substance abuse, such as alcohol or drugs. However, these substances will only worsen their condition. RBFOX1 gene may be one of the causative factors that lead to anxiety disorders. Apart from that, scientists study some specific areas of the brain, such as the amygdala and hippocampus. Amygdala processes the objects or situations that produce fear to you or which you perceive as a threat. Hippocampus stores the memories of these objects, situations, or threats. Scientists observed that people who have experienced a traumatic event have a smaller hippocampus in comparison with mentally healthy individuals.
What are the risk factors of anxiety disorders?
Scientists don't know what exactly causes anxiety disorders and attacks. However, some identifiable risk factors could significantly increase your risk of developing one or more anxiety disorders. Individuals with depression are more prone to developing secondary anxiety disorders. Irritable bowel syndrome is another risk factor that may contribute to the development of an anxiety disorder. Also, substance abuse, or even a history of substance abuse, predisposes the individual to pathological anxiety. Finally, another anxiety disorder is also a risk factor for the presentation of a new one. Except for these well-established risk factors, the following are some additional risk factors that could put you at high risk:
- Being a woman. Women have two times more chances to suffer from generalised anxiety disorder.
- Family history of anxiety disorders. Individuals with relatives who suffered from anxiety disorders are more prone to present with one in the future.
- Personality type or a personality disorder can increase your risk of developing anxiety disorders.
- Stress or previous trauma in childhood or adult life could increase your chances of developing severe and pathological anxiety later in life.
What are the symptoms of anxiety?
Anxiety is a feeling, therefore, each person experiences it differently. There are some symptoms and signs that are general and typical of anxiety disorders. However, every type has its specific symptomatology, which distinguishes it from each other. Anxiety may affect your sleep, causing nightmares or insomnia. Other people suffer from panic attacks or feelings of depersonalisation. Some objects or situations may cause people to have breathlessness or tachycardia. The following are some of the most prevalent signs and symptoms in people with general anxiety:
- Tachycardia or rapid heartbeat
- Rapid breathing
- Insomnia when trying to fall asleep
How to diagnose anxiety disorders?
You can't diagnose anxiety with a single test. The diagnosis of an anxiety disorder is a multi-factorial process. Usually, doctors rule out other possible underlying conditions by performing a physical examination and some routine testing. Several mental health evaluations and questionnaires are also necessary. To assess the levels of anxiety you are experiencing, you may undergo some accurate anxiety tests or scales. Also, it is challenging to differentiate between primary and secondary types of the condition. The following are some well-known tests and scales for the evaluation of people suspected to suffer from an anxiety disorder:
- Zung Self-Rating Anxiety Scale
- Hamilton Anxiety Scale (HAM-A)
- Beck Anxiety Inventory (BAI)
- Social Phobia Inventory (SPIN)
- Penn State Worry Questionnaire
- Generalized Anxiety Disorder Scale
- Yale-Brown Obsessive-Compulsive Scale (YBOCS)
The criteria that DSM introduces for the diagnosis of generalised anxiety disorder are the following. However, they vary in each type of anxiety disorder.
- Excessive worrying and feelings of anxiety most days of the week, for a minimum of 6 months.
- Difficulties in controlling your worrying.
- Having at least three out of the following six symptoms: restlessness, weakness, irritability, muscle tension, sleeping problems, and attention/concentration deficit.
- Symptoms are debilitating
- Symptoms appear in the absence of organic diseases or different mental diseases.
Types of anxiety disorder and their symptoms
A panic disorder is an ensemble of recurrent panic attacks. But what is a panic attack? People with panic attacks experience an intense, abrupt, and unexpected wave of fear. It peaks in a couple of minutes without a justified cause. It is overwhelming and causes discomfort. Individuals with a panic attack often experience an increased heartbeat, rapid breathing, sweating accompanied by the fear of dying. Others may report chest pain, a lump in the throat or choking, and dizziness. Also, typical of panic attacks are the feelings of derealization and depersonalization.
Intense fear is characteristic of panic disorders. It might respond to the possibility of another panic attack in the future or the likelihood of death. Panic attacks occur spontaneously without any prodromal sign. We refer to a panic disorder when panic attacks occur recurrently for a minimum of a month and with the presence of persistent fear of having another one in the future. Fearing the occurrence of a panic attack or recalling one from the past can lead to a new one.
Phobias result from a specific trigger. This trigger initiates an excessive and irrational fear response. The source of fear may be an object, a situation, an animal, a bug, or anything that exists, and we can interact with, or encounter as human beings. People with phobias have insight regarding how irrational their fear is. However, they cannot control themselves or their feelings.
Some of the most well-known types of this type of anxiety are agoraphobia and social phobia. People with agoraphobia experience intense worry and anxiety outside home, and in circumstances where escape is difficult, such as large crowds, shopping centres, etc. Social phobia refers to the fear of social situations that necessitate human interaction. Usually, people that encounter their phobia experience a panic attack or increased and debilitating discomfort. However, the diagnosis does not require the occurrence of a panic attack. There is a big variety of phobias, including aviophobia (fear of flying with aeroplanes) or arachnophobia (the fear of spiders).
Post-traumatic stress disorder (PTSD)
PTSD is an anxiety disorder that may result from a natural disaster, child abuse, military, or any traumatic experience. People with PTSD have a persistently alerted fight or flight response that leads to an increased sense of danger. There are four groups of symptoms of PTSD. These are intrusion, avoidance, arousal/reactivity, and mood/cognition. In general, individuals experience flashbacks, memories, and nightmares of the traumatic event, resulting in intense feelings of anxiety, and distress. They avoid situations that act as a trigger or remind them of the traumatic event. Consequently, they have anger bouts, attention deficit, agitation, and constant negative thoughts. These symptoms may lead to panic attacks or depression.
Anxiety and depression
Anxiety can often go hand in hand with depression. Depression presents with feelings of pathological sadness, which is persistent and doesn't go away within a couple of days. Other general symptoms of depression may be irritability, loss of libido, and negative thoughts that focus on the person's failures in the past. Suicidal ideation is the most challenging part of dealing with depression, both for patients and physicians. Depression may severely affect your sleep quality and duration. Late-onset insomnia is often a characteristic of depression. Anxiety, on the other hand, may present with early-onset insomnia. Therefore, a person with anxiety and depression may suffer from serious sleep deprivation. It is not uncommon for a person with anxiety to experience depressive signs, and vice versa. The key is to distinguish between their onsets and treat the primary disease that is responsible for the secondary symptoms.
Is anxiety common in children and adolescents?
Anxiety in children is not uncommon. As children grow, they adopt some mechanisms to cope with their stress. A child with chronic and persistent anxiety develops symptoms such as irritability, insomnia, constant fear, feelings of shame, and isolation. Also, the child will appear tensed and nervous. Teenagers are very prone to anxiety too. They present with avoidant or isolation behaviours, and nervousness. These symptoms may interfere with their social lives and performance in school or could become the gate towards substance abuse. Adolescents may experience both anxiety and depression at the same time.
Are anxiety and stress the same thing?
Anxiety and stress are not the same things. However, the one feeling brings the other in an action-reaction model. Both can result in constitutional and mental symptoms that usually overlap. Stress and anxiety are not always debilitating. On the contrary, they can both be motivating and help you achieve your short-term and long-term goals. If, however, they interfere with your normal daily activities, you should consult your doctor.
How do you treat anxiety disorders?
Anxiety disorders are treatable. In the cases in which anxiety symptoms are secondary to another condition, you should first treat the underlying disease. Anxiety can not only occur secondary to mental illnesses but to physical diseases, as well, such as diabetes or cancer. We can divide treatment methods into the following three categories:
- Home remedies and lifestyle changes
When anxiety is severe and debilitating, doctors suggest a pharmacological treatment. The most well-known, anti-anxiety medication is anti-depressants and sedatives. Doctors suggest small doses in the beginning, which increase gradually throughout the therapy. Finally, doses decrease with the completion of the treatment scheme. There are many types of sedatives and antidepressants. Your doctor will choose the most suitable for you, according to your medical history and type of anxiety disorder. These medications interfere with the functioning of your brain and prevent episodes of anxiety. Sometimes, you might receive additional drugs for symptoms such as an increased heartbeat.
Home remedies and lifestyle changes
The most important parameter in fighting anxiety and stress is taking care of your body and lifestyle. The three cornerstones of achieving a healthy body and mind are sleeping well, being fit, and eating well. Therefore, you must exercise most days per week. Scientists suggest aerobic exercise combined with high-intense regular workout is the most evidenced-based exercise plan you could follow today. Also, you should try and adopt a healthy diet, full of fruits and vegetables. Eating more fiber and less animal fat and protein is impressive when it comes to mental health.
One of the most challenging parts of anxiety disorders is getting adequate and good-quality sleep. Patients often complain of insomnia during the night and somnolence during the day. The importance of sleep is immense to most of us. Not sleeping enough could result in a very difficult day at work or school. For individuals suffering from chronic stress, this is a daily routine.
Weighted blankets for anxiety
Weighted blankets are not regular blankets, but heavier ones. Many scientists suggest that this type of comforters could serve as an alternative or adjuvant therapy to anxiety and its secondary sleep disturbances, such as nightmares, insomnia, and low-quality sleep. They are heavier than average blankets and completely safe. Researchers suggest that weighted blankets can essentially improve the symptomatology of people suffering from pathological anxiety in all age groups. They do so by allowing you to sleep more deeply through their "grounding" effect. When your stress levels drop, you produce fewer amounts of stress hormones. Research suggests that deep pressure touch by weighted blankets stimulates parts in your brain, that promote calmness and relaxation.
Talk therapy is another popular method to deal with anxiety. One of the most wide-used types of psychotherapy is cognitive-behavioural therapy (CBT). CBT's goal is to change your cognitive schema (the architecture of your thoughts and their content) and improve it. An improved and positive cognitive schema will directly affect your behaviour, resulting in fewer levels of stress. However, there are many types of psychotherapies. To choose the correct method for you, consult your doctor or mental counsellor.
Can you prevent anxiety?
To prevent anxiety, you can try and do some of the following:
- Eat healthily and exercise regularly
- Improve your sleep by modifying your sleeping hours or getting a weighted blanket
- Avoid stressors in your life
- Limit the consumption of alcohol, coffee, and sugar
- Meditate, if possible
- Find an activity you love and dedicate some time to it every day
- Stop hyperventilation using a paper bag, if you encounter a panic attack
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