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Anxiety: When bad gets worse...

Updated: May 5


What is Anxiety?

National Health Service, defines anxiety as a feeling of unease, worry or fear that may vary in intensity from mild to severe. We all remember the butterflies in our stomach before a math test, a job interview or before giving a speech in public. Many situations make us feel uneasy. It is perfectly normal as mild levels of anxiety can boost performance. Anxiety is a complicated response for which the effects change with many factors such as beliefs. Therefore, it has been hard for researchers to study the impact of anxiety. However, much is known about it. In this blog, I will talk about what anxiety is and when to seek help.

Role of Anxiety?

Anxiety is an evolutionary response in us. As the complete absence of anxiety would mean that we would fail to make a proper assessment potentially dangerous or fatal situations, and this would certainly not be good for our odds to survive.

Assessment of danger takes place in our forebrain at all three levels, i.e., rational, emotional and instinctive, to de-escalate the threat. Anxiety is considered to be a strategic part of the de-escalation. To know further read this article.

When is it that Anxiety becomes a problem?

To identify the diagnosis of anxiety disorder, one of the most important criteria to be considered is that how the anxiety has impaired the individual's ability to function normally and its impact on their quality of life. Some symptoms experienced by patients with Generalised Anxiety Disorder are (not all symptoms are experienced. Many times, it is just 1 or 2 of them):

  1. Increased heart rate

  2. Rapid breathing

  3. Restlessness

  4. Trouble concentrating

  5. Difficulty falling or staying asleep

Diagnosis

If you believe that your anxiety is affecting your daily life and your ability to work or function, consult your medical practitioner or a psychologist. If the symptoms have lasted for six months or more, it is likely that what you are experiencing is pathological anxiety. However, anxiety and depression are very similar and may need further investigations to differentiate. Due to high comorbidity between anxiety and depression, sometimes both conditions are observed in patients. Your practitioner may advise you to undergo blood tests or suitable medical examinations to rule out potential causes such as hyperthyroidism or anaemia.

Types of Anxiety Disorders

Anxiety is a common symptom in many psychological conditions, all of which are categorised as Anxiety Disorders. 

For Example:

  1. General Anxiety Disorder (GAD)

  2. Social Anxiety Disorder (Social Phobia)

  3. Phobias

  4. Post-Traumatic Stress Disorder (PTSD)

  5. Panic Attacks

Treatment

Anxiety disorders can cause significant distress and wreak havoc in your lives. However, there are many treatment options available to help you. These primarily fall under two categories: 

Psychological Intervention: has shown significant improvement in the well-being of patients. These include but are not limited to - 

  1. Cognitive Behavioural Therapy (CBT)

  2. Mindfulness-Based Interventions

Medical Intervention:

  1. You may be advised by your psychologist/therapist to consult a psychiatrist if he/she considers medical interventions to be necessary. However, if you are having medical interventions when you come in for therapy, do not stop taking or alter the dosage of medications prescribed to you. Always consult your doctor before starting or changing the course of medicines.

  2. Selective Serotonin Re-uptake Inhibitors (SSRIs) are usually first in line as drug therapy for Anxiety Disorder. These work by preventing the surrounding nerves from up-taking serotonin and effectively increasing the concentration of it. SSRIs have been theorised as an effective intervention for both Anxiety and Depressive Disorders.

If you believe that you may have Anxiety you can get help here.

References

  1. Blanco, C., Schneier, F. R., Schmidt, A., Blanco‐Jerez, C. R., Marshall, R. D., Sánchez‐Lacay, A., & Liebowitz, M. R. (2003). Pharmacological treatment of social anxiety disorder: A meta‐analysis. Depression and anxiety, 18(1), 29-40.

  2. Bajaj, B., Robins, R. W., & Pande, N. (2016). Mediating role of self-esteem on the relationship between mindfulness, anxiety, and depression. Personality and Individual Differences, 96, 127-131.

  3. Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of anxiety disorders, 22(4), 716-721.

  4. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.

  5. Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337.

  6. Locher, C., Koechlin, H., Zion, S. R., Werner, C., Pine, D. S., Kirsch, I., ... & Kossowsky, J. (2017). Efficacy and safety of selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and placebo for common psychiatric disorders among children and adolescents: a systematic review and meta-analysis. Jama Psychiatry, 74(10), 1011-1020.

  7. Sharp, S. C., & Hellings, J. A. (2006). Efficacy and safety of selective serotonin reuptake inhibitors in the treatment of depression in children and adolescents. Clinical drug investigation, 26(5), 247-255.

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