2. Anxiety - Learning About Anxiety

Learning About Anxiety

Prepare to talk with a doctor or mental health professional by educating yourself on the risks and treatment options for anxiety disorders. The following medical information is from the National Institute for Mental Health (NIMH) website, reprinted here with light editing for flow.

Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.

Risk Factors
Researchers are finding that both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Although the risk factors for each type of anxiety disorder can vary, some general risk factors for anxiety include:
• Temperamental traits of shyness or behavioral inhibition in childhood
• Exposure to negative life or environmental events in early childhood or adulthood
• A history of anxiety or other mental illnesses in biological relatives.
Some physical health conditions, such as thyroid problems or heart arrhythmias, or caffeine or other substances/medications, can produce or aggravate anxiety symptoms; a physical health examination is helpful in the evaluation of a possible anxiety disorder.

Types of Anxiety Disorders
There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, and various phobia-related disorders.

Generalized Anxiety Disorder: People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least six months, about various things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life. GAD develops slowly. It often starts during the teen years or young adulthood.

People with GAD may:

• Worry very much about everyday things
• Have trouble controlling their worries
• Know they worry more than they should
• Feel restless and have trouble relaxing
• Have a hard time concentrating
• Be easily startled, tremble, or twitch
• Have trouble falling asleep or staying asleep
• Feel easily tired or tired all the time
• Have headaches, muscle aches, stomach aches, or unexplained pains
• Have a hard time swallowing
• Be irritable or feel “on edge”
• Sweat a lot
• Feel light-headed or out of breath
• Have to go to the bathroom a lot

Adults and Children Can Be Affected:
Children and teens with GAD often worry excessively about: their performance, such as in school or sports; and catastrophes, such as earthquakes or war. Adults with GAD are often highly nervous about everyday circumstances such as: job security or performance, health and finances, being
late, or chores and responsibilities.

Both children and adults with GAD may experience physical symptoms that make it hard to function, and that interfere with daily life. Symptoms may get better or worse at different times, and they are often worse during times of stress, such as with a physical illness, during exams at school, or during a family or relationship conflict.

Panic Disorder: People with panic disorder have recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that come on quickly and reach their peak within minutes. Attacks can occur unexpectedly or can be brought on by a trigger, such as a feared object or situation. During a panic attack, people may experience:

• Heart palpitations, a pounding heartbeat, or an accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath, smothering, or choking
• Feelings of impending doom
• Feelings of being out of control

People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks. Both worry about panic attacks, and the effort spent trying to avoid attacks, cause significant problems in various areas of the person’s life, including the development of agoraphobia.

Phobia-related disorders: A phobia is an intense fear of—or aversion to—specific objects or situations. Although it can be realistic to be anxious in some circumstances, the fear people with phobias feel is out of proportion to the actual danger caused by the situation or object. People with phobias often do
quite well in life except when confronted by this situation or object. Some examples include flying, heights, snakes, or injections.

Social anxiety disorder is a common type of anxiety disorder. A person with social anxiety disorder feels symptoms of anxiety or fear in certain or all social situations, such as meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store. Doing everyday things in front of people—such as eating or drinking in front of others or using a public restroom—also causes anxiety or fear. The person is afraid that he or she will be humiliated, judged, and rejected.

The fear that people with social anxiety disorder have in social situations is so strong that they feel it is beyond their ability to control. It gets in the way of going to work, attending school, or doing everyday things. People with social anxiety disorder may worry about things for weeks before they happen. Sometimes, they end up staying away from places where they think they might have to do something that will embarrass them.

When having to perform in front of or be around others, people with social anxiety disorder tend to:

• Blush, sweat, tremble, feel a rapid heart rate, or feel their “mind going blank”
• Feel nauseous or sick to their stomach
• Show a rigid body posture, make little eye contact, or speak with an overly soft voice
• Find it scary and difficult to be with other people, especially those they don’t already know, and have a hard time talking to them even though they wish they could.
• Be very self-conscious in front of people and feel embarrassed and awkward
• Be afraid other people will judge them
• Stay away from places where there are other people

Agoraphobia: People with agoraphobia have an intense fear of two or more of the following situations:

• Using public transportation
• Being in open spaces
• Being in enclosed spaces
• Standing in line or being in a crowd
• Being outside of the home alone

People with agoraphobia often avoid these situations, in part, because they think being able to leave might be difficult or impossible if they have panic-like reactions or other embarrassing symptoms. In the most severe form of agoraphobia, people can become housebound.

Separation anxiety disorder: Separation anxiety is not something that only children deal with. Adults can also be diagnosed with separation anxiety disorder. People who have separation anxiety disorder have fears about being parted from people to whom they are attached. They often worry that something will happen to their attachment figures while they are separated. This fear leads them to avoid being separated from their attachment figures and to avoid being alone. People with separation anxiety may have nightmares about being separated from attachment figures or experience physical symptoms when separation happens or is about to occur.

Treatment for Anxiety
The good news is that anxiety is treatable. Talk to your doctor about your symptoms. Your doctor should do an exam and ask you about your health history to make sure that a physical problem is not causing your symptoms. Your doctor may refer you to a mental health specialist. Anxiety disorders are generally treated with psychotherapy, medication, or both. Don’t give up on treatment too quickly. Both psychotherapy and medication can take time to work. A healthy lifestyle and stress management techniques and meditation can also help people with anxiety disorders.

Support groups
Some people with anxiety disorders might benefit from joining a self-help or support group. Talking with a trusted friend or member of the clergy can also provide support, but it is not necessarily a sufficient alternative to care from a doctor or other health professional.

Take care of yourself
A healthy lifestyle can help combat anxiety. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends that you trust for support.