What is Anxiety?
Anxiety is the term given to the mental, behavioural and physical changes that occur to assist the body to combat threat or danger. When the body becomes aware of danger the involuntary nervous system sends messages to areas all over the body in order to, either physically “fight” the situation or to flee from it – “flight”. This particular response is called the “fight or flight” reaction and is characterised by the following symptoms:
- Alert mind
- Increased heart rate
- Increased blood pressure
- Increased breathing rate
- Fear and apprehension
- Trembling or shaking
- Cold and clammy hands
- Hot Flushes or chills
- Feeling sick or nauseous
- Butterflies in the stomach
The “fight or flight” response can be useful in the short term when faced with dangerous or stressful situations (e.g. to get away from an attacking dog). However, this reaction can become harmful if it does not subside after the situation has passed or if the reaction your body has is out of proportion to the situation you find yourself in.
If the anxiety continues for long periods and is more severe than the individual can tolerate, it may become disabling. Prolonged anxiety is characterised by not only the physical symptoms associated with the “fight or flight” response, but also changes in an individual’s thoughts, feelings and behaviours. As a result of the anxiety, you may often feel constantly wound up or on edge, become irritable, experience difficulties concentrating, and generally have a negative outlook on life. You may also often display nervous gestures (e.g. leg tapping, fiddling), a rigid posture, and have difficulties speaking fluently.
Who gets Anxious?
Anxiety disorders are quite common amongst the general population. Studies have shown that between 2 and 4% of people experience some form of anxiety disorder, and that anxiety disorders account for about 15% of the workload of Australian psychiatrists.
What are the causes?
A number of causes for the anxiety disorders have been postulated, some include:
There is a strong link between depression and anxiety specific symptoms include headaches, restlessness, poor sleep, muscle tension and pain.
Anxiety can begin at a stressful time in your life when important changes or decisions need to be made. These stressful events may exceed your coping abilities and you may begin to suffer from anxiety.
You may have a personality that predisposes you to developing anxiety. Most people with anxiety problems describe themselves as nervous, emotional and tend to worry easily.
There is evidence that genetics play some role in the development of anxiety disorders. This suggests that there is at least some biological or biochemical basis that contribute to the disorders.
In some cases the onset of anxiety is due to the usage of elicit substances. This becomes evident that the substance misuse is the cause of the anxiety if the person has not suffered from anxiety prior to using the illicit substance.
Even though the event has passed eg. earthquake, war, siege, the person remains in an anxious state similar to when the trauma was actually occurring. Other people relive the trauma and the accompanying anxiety.
There are a number of treatments for anxiety. The treatment often depends on the type of anxiety the person is experiencing.
It is important to have the treatment designed to target the specific needs of the individual.
Medications are used to both lessen the feeling of overwhelming anxiety and to treat any underlying condition eg. depression.
Cognitive Behavioural Therapy. (C.B.T.) incorporates a number of different therapies which have proven helpful in treating disorders associated with anxiety. This is based on learning to change one’s thinking and behaviours
Psychotherapy – Talk therapy which involves the discussion of feelings and problems with a professional.
Relaxation Techniques. There are a number of different ways of learning to overcome difficulties by using this technique including using pre recorded tapes.
A brief description of the different types of Anxiety Disorders
There are a number of illnesses in which the symptoms of anxiety are present, these include:
Panic disorder is characterised by recurrent unexpected bouts of overwhelming anxiety. A panic attack occurs quickly and can last anywhere up to 10 minutes. During a panic attack you may experience a racing heart, trembling or shaking, sensations of shortness of breath, tightness in the chest area and chills or hot flushes. After experiencing such an attack the person worries about experiencing another attack and how it will affect them.
Each person’s experience is different and thus some people suffer from a mild form and other’s more severe. A mild form of the disorder would be someone who displays extreme discomfort during an attack, however in between attacks feels fine.
In more severe instances people’s social, leisure and work roles may be affected. This is usually because individual’s worry that they may experience a panic attack whilst participating in activities and so withdraw from these activities.
Is a disorder in which the person experiences anxiety about being in places or situations from which it would be difficult to escape from. Examples of situations such as these include; being in a crowd, on a bus or on a train. Because the person is extremely anxious about being in situations such as these, they tend to avoid them.
This particular disorder causes problems with people’s daily lives as they become afraid to leave the house. Due to this they find it very difficult to maintain employment and perform some activities such as shopping. Their social lives also undergo changes as they do not like being in unfamiliar situations and tend to withdraw.
Is an illness where the person has a persistent fear of social situations and the way they perform when placed in these situations. They often feel that they are under scrutiny from other people and worry that they will act in an inappropriate manner and consequently embarrass themselves. When placed in social situations the person often experiences extreme feeling of panic. Person’s with social phobia often find it difficult to maintain employment, and participate in leisure activities. They may also have problems completing some important activities such as shopping.
Generalized Anxiety Disorder:
Is a disorder in which the person experiences excessive worry and anxiety about most events and situations which they partake in. The excessive worry leads to the person often having difficulty concentrating, feeling tense and on edge, and becomes irritable. Because the person worries about most events the impact upon their everyday lives is often great.
Obsessive Compulsive Disorder:
Persons with OCD are pre-occupied with rules, regulations, achieving perfection and staying orderly and routine. Obsessions are persistent ideas, thoughts and images which cause the individual distress. The individual responds to this distress by engaging in repetitive activities in an attempt to combat their obsessive thoughts and the accompanying feelings of anxiety. These repetitive behaviours are termed compulsions. An example of this process includes; someone who believes that the dirt on their hands is contaminating them, so they perform ritual hand washing throughout the day.
If an individual suffers from only a mild form of this disorder their everyday functioning may not be affected. However, it can be disabling if people have to engage in time consuming rituals while performing activities. For example, if a person has to wash their hands in between each step of making a sandwich the process could possibly take hours. Also, because the person has set routines and behaviours that they must engage in they may become socially isolated, as they do not have time or the ability to adapt to dynamic situations.
Post-Traumatic Stress Disorder:
A person who suffers from PTSD has experienced a traumatic event in their life, and even though the event has subsided the person persistently re-experiences the event through various channels. They may experience distressing thoughts, hallucinations or disturbing dreams etc. Due to the marked distress the person feels about the situation they consistently avoid any type of situation or stimulus that could possibly remind them of the event. This particular disorder can be disabling if the person often has recollections of the event. Also, if many stimuli remind the person of the event then they will obviously withdraw from many situations.
Acute Stress Disorder:
This is the immediate response to a traumatic event. Immediately after this has taken place they may feel in a daze. After this initial phase has passed however, they re-experience the event through disturbing thoughts, images and dreams etc. They also tend to avoid any stimuli that could potentially remind them of the event.
A Phobia is an overwhelming irrational fear of a specific object, place or event eg. spiders, heights. Coming in contact with the phobic specific situation or object triggers an anxiety attack. Individuals then believe that when placed in a similar situation they would become just as anxious as the time before and thus learn to avoid these situations, or leave them the moment they experience feelings of panic. The more individuals avoid certain situations the harder and harder it becomes for them to face these situations. This can become extremely disabling.