Anxiety

What is Anxiety?

Fear is an immediate, automatic reaction which is like an alarm going off in your body, making it ready to either fight or run away in response to a sense of danger, whether it’s real or just perceived. Anxiety, on the other hand, is closely related to fear and is a mood that’s focused on the future. It combines thoughts, feelings, physical changes, and behaviors that prepare you for events or situations you perceive as threatening.

When someone constantly overestimates the level of threat or mistakenly sees a situation as dangerous resulting in extreme and unwarranted reactions, it’s called pathological anxiety. Anxiety is one of the most common mental disorders, but its exact prevalence is unknown. This is because a lot of people either don’t seek help or doctors often fail to recognize it.

What Causes Anxiety?

Anxiety disorders seem to originate from a mix of biological, psychological, and social influences. If someone is genetically predisposed to anxiety, they are more likely to experience it when faced with stressful or traumatic situations.

Various factors can trigger anxiety, including:

* Prescription drugs
* Herbal remedies
* Substance misuse
* Traumatic events
* Experiences during childhood
* Panic disorders

Risk Factors and Frequency for Anxiety

Anxiety is a widespread mental health condition. There are different forms of anxiety disorders, the most prevalent being specific phobia, which affects about 12.1% of the population within a year. Social anxiety disorder ranks next with a 12-month prevalence rate of 7.4%, while agoraphobia is the least common, affecting 2.5% of people within a year. Anxiety disorders tend to occur more frequently in females, with about twice as many females affected as males.

• Anxiety is a common mental health problem.
• The most common type is specific phobia, with a yearly occurrence rate of 12.1%.
• Social anxiety disorder is the second most common, affecting 7.4% of people within a year.
• Agoraphobia is the least common anxiety disorder, with an annual occurrence rate of 2.5%.
• Anxiety disorders are more common in women, with about twice as many females affected as males.

Signs and Symptoms of Anxiety

The symptoms of pathological anxiety can be broken down into four categories: cognitive, physical, behavioral, and emotional. Cognitive symptoms can include being afraid of losing control, fear of injury or death, and having scary thoughts. Physical symptoms range from rapid heartbeat and shortness of breath to tremors and dry mouth. People may show behavioral symptoms such as avoiding threatening situations, agitation, and difficulty speaking. The emotional side can include feeling nervous, scared, jittery, or impatient.

There are various disorders related to anxiety, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Here are some of them:

• Separation Anxiety Disorder: This is marked by fear and anxiety that are unusually strong for one’s age, brought on by separation from loved ones. Symptoms may persist into adulthood.
• Selective Mutism: People with this disorder avoid speaking in social settings, despite being able to talk and understanding the language.
• Specific Phobia: This involves intense fear or anxiety about specific objects or situations. There are different types of phobias, such as fear of animals, injections, or certain situations.
• Social Anxiety Disorder: Those with this disorder fear social situations where they could be judged. They worry about being embarrassed, rejected, or offending others.
• Panic Disorder: Characterized by repeated, unexpected panic attacks, and concern about future attacks. People with this disorder sometimes avoid activities due to fear of triggering an attack.
• Agoraphobia: People with agoraphobia are afraid of situations like using public transit, being in a crowd, or being alone outside.
• Generalized Anxiety Disorder: This disorder involves persistent worry about different aspects of life, such as performance at work or school. Other symptoms can include irritability, muscle tension, and sleep disturbacnes.
• Substance/Medication-Induced Anxiety Disorder: This anxiety disorder is a result of the effects of drugs or medical treatment.
• Anxiety Disorder Due to Other Medical Conditions: This type of anxiety is a physical result of another medical condition like heart disease, respiratory illness, or neurological disorders.

Testing for Anxiety

If your doctor can’t link your symptoms to a specific medical issue based on your medical history and a physical examination, they might start by running some basic lab tests. These tests could include a complete blood cell count, a chemistry profile, thyroid function tests, urinalysis, and a urine drug screen.

But suppose your anxiety symptoms are unusual, or your doctor noticed something out of the ordinary during your physical examination. In that case, they might order a more detailed set of tests to rule out other underlying health conditions. These tests could include an electroencephalography (a test that measures electrical activity in the brain), a brain CT scan, an electrocardiogram (a test that checks the heart’s electrical activity), tests for infections, an arterial blood gas analysis (a test that measures the oxygen and carbon dioxide levels in your blood), chest x-rays, and further thyroid function tests.

Treatment Options for Anxiety

Severe anxiety may need to be treated with a type of medication called a benzodiazepine. Long-term anxiety generally requires treatment using talk therapy, medication, or often a combination of both.

There are several types of medications used to treat anxiety:

* Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, paroxetine, escitalopram, and citalopram, can effectively treat all types of anxiety. They are often the first choice for treatment.

* Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine and duloxetine, are similarly effective to SSRIs. They can be particularly useful for treating a type of anxiety called generalized anxiety disorder (GAD).

* Tricyclic antidepressants, which include amitriptyline, imipramine, and nortriptyline, can also help manage anxiety. However, they may cause negative side effects.

Benzodiazepines, such as alprazolam, clonazepam, diazepam, and lorazepam, are useful for managing short-term anxiety. They work quickly, often providing relief within 30 minutes to an hour. This rapid effect makes these medications effective for sudden panic attacks. Long-term use, however, may result in needing to increase doses to achieve the same calming effect, possibly leading to issues with tolerance and dependence. Buspirone is a milder medication that takes about two weeks to start working. It’s less likely to cause drowsiness and addiction, making withdrawal easier. It mainly works for GAD.

Beta-blockers like propranolol and atenolol help control physical symptoms of anxiety, such as rapid heart rate, trembling voice, excessive sweating, dizziness, and shaky hands. They are most beneficial for people with phobias, particularly social phobia.

In addition to medication, talk therapy can also be highly effective. Cognitive-behavioral therapy (CBT) is one of the most potent forms of talk therapy. It’s a structured therapy, with specific goals, that helps people recognize and change unhelpful patterns of thought and belief that trigger and maintain symptoms of anxiety. CBT also teaches patients to respond more effectively to anxiety-provoking situations. Exposure therapy is a component of CBT that encourages people to confront situations and stimuli they usually avoid. This approach can reduce anxiety symptoms, as individuals learn that their fear or worry is disproportionate to the situation and that they have the capacity to cope successfully.

What else can Anxiety be?

The following conditions may also exhibit similar symptoms and might need to be ruled out by your doctor when determining a correct diagnosis:

• Pheochromocytoma (a rare tumor of the adrenal gland)
• Asthma (a condition that affects your airways)
• Atrial fibrillation (a heart condition that causes an irregular and often abnormally fast heart rate)
• Hyperthyroidism (a condition where your thyroid gland produces too much thyroid hormone)
• Alcoholism (serious alcohol dependence that can lead to health and social problems)
• Delirium (a sudden change in mental function)
• Diabetic ketoacidosis (a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones)
• Substance abuse (overindulgence in or dependence on an addictive substance)

Remember, your doctor needs to consider these potential conditions during an examination and use appropriate tests to ascertain the correct diagnosis.

What to expect with Anxiety

Anxiety disorders have significant impacts, including issues like substance abuse, alcoholism, and serious depression. On top of that, constant anxiety can also raise the risk of negative heart-related events. Anxiety can also hinder people’s ability to form social relationships, which can significantly harm their quality of life. In cases of severe anxiety, there’s also a higher risk of suicide.