Anxiety involves feeling uneasy, anxious or nervous, due to stress or trauma, real or imagined. Typically, anxiety is a normal health issue that goes away once a negative situation is completed. Anxiety can even be positive, helping to improve coping or alertness. But when anxiety remains, this mental illness is called an anxiety disorder. Typically lasting for at least six months, these disorders can affect mental health, relationships and quality of life.
Anxiety is actually a group of disorders that all share some level of excessive, persistent, irrational panic and dread. Generalized anxiety disorder (GAD) involves ongoing excessive worry and tension, often with no apparent reason. With obsessive compulsive disorder (OCD), irrational, reoccurring thoughts and uncontrollable compulsions can occur. Post-traumatic stress disorder (PTSD) develops after trauma or terrifying events. PTSD patients may have frightening, long-lasting thoughts and memories. Phobias, excessive, inappropriate fear of an object, situation or activity, are uncontrollable. A phobia can cause extreme stress and anxiety, as people try to avoid their fear. Those with social anxiety disorder worry and feel self-conscious about normal social situations. With separation anxiety disorder (SAD), children have anxiety when separated from loved ones. Panic disorders (anxiety attack, panic attack) are sudden episodes of intense panic or fear, often without reason. A panic attack rarely lasts more than 30 minutes, but can be severe, and you may be worried that another anxiety attack will occur.
Causes and Risk Factors of Anxiety
The exact cause of anxiety and mental illness is not completely understood. Mental health researchers suggest a combination of several factors, including environmental stress, trauma and heredity, may be at fault. Severe or long-lasting stress may actually cause chemical imbalances to the brain and its structures, altering memory and mood. But other underlying health issues shown may also cause anxiety, including: muscle cramps/spasms, thyroid conditions, tingling and burning sensations, tumors, asthma, diabetes and heart disease.
Stress is a major risk factor for anxiety, whether due to illness, big events or smaller life situations. Women are twice as likely to be diagnosed with anxiety. Children who have endured abuse or trauma have greater chances of anxiety, as well. Your risks may be higher if blood relatives, including one or both parents, have an anxiety disorder. While drug and alcohol use causes anxiety, it also masks mental health issues, and should be treated first. If anxiety goes untreated or advances, insomnia, headaches, grinding teeth (bruxism) and digestive or bowel problems can develop. Nearly half of all anxiety patients are diagnosed with depression, as well.
Symptoms, Signs and Testsof Anxiety
Often, anxiety symptoms and signs first indicate physical or mental health illnesses. Anxiety symptoms may include: feeling apprehensive or powerless, increased heart rate, rapid breathing, feeling weak or tired, sweating, dizziness, stomach discomfort, chest pain, startling easily, muscle tension, sleep issues, nightmares and sexual problems. Anxiety disorders may have specific symptoms, such as panic attacks unreal, disconnected feelings and emotional numbness, or recurring, upsetting thoughts and compulsions occurring with obsessive compulsive disorder (OCD). As anxiety may have a medical cause, doctors give physical exams and blood tests. Patients fill out psychological questionnaires, and discuss medications or alcohol/drug use. Mental health professionals diagnose stress, trauma and anxiety with criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Anxiety disorders are diagnosed, along with other mental health problems. Depression is diagnosed in about half of anxiety patients.
Treatment, Drugs and Preventionof Anxiety
When anxiety remains, it becomes a mental issue requiring treatment. Typically, anxiety is treated with psychotherapy, medications, or both. Effective drugs enable patients to lead productive, fulfilling lives, although doctors may need to determine optimal treatments. Doctors typically prescribe antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil, Pexeva). These medications, which influence brain chemicals (neurotransmitters), are thought to play a role in anxiety disorders. Doctors may also prescribe benzodiazepines (sedatives), such as clonazepam (Klonopin) or diazepam (Valium), but they can be habit-forming. Beta-blockers can prevent the physical symptoms of social phobia and other anxiety disorders, as well.
Psychotherapy with mental health professionals is effective, allowing patients to identify stress sources. Its also helpful to discuss mental health issues with trusted friends or loved ones. Anxiety and related mental illnesses can be treated through lifestyle changes. Physical activity is important, and regular exercise incorporating healthy, fun activities reduces stress. Proper sleep and relaxation, along with daily leisure time, eases anxiety and stress. A well-balanced, healthy diet, including vegetables, fruits, whole grains and fish, reduces anxiety, while fried, sugary and processed foods should be avoided. Those with anxiety should limit caffeine, and completely avoid alcohol (and other sedatives), nicotine and drugs. Discuss with your doctor whether any drugs or medications you’re taking may cause anxiety.
Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.