Anxiety disorders

Anxiety disorders are one of the most commonly occurring psychiatric illnesses, with nearly one fourth of adults in the United States meeting criteria during their lifetime. Results from the National Comorbidity Survey (NCS) conducted in 1990-1992 and the National Institute of Mental Health (NIMH) Collaborative Psychiatric Epidemiology Studies (CPES) from 2002-2003 revealed that women were more likely than men to develop an anxiety disorder, with 30.5-33% women being diagnosed vs 19-22% men. Lifetime prevalence rates in the National Comorbidity Survey for individual anxiety disorders like Panic Disorder (PD), Agoraphobia (AG), Specific Phobia (SP), and Social Anxiety Disorder (SAD), were also greater in women.

Anxiety is a normal part of life for children, adolescents, and adults. It is usually temporary, harmless, and can help individuals cope with a tense situation, such as remaining focused while studying for an exam. But when anxiety causes irrational dread in everyday situations, it is excessive and can become a disabling condition that prevents children and adolescents from living normal lives. Anxiety feels different depending upon the individuals experiencing it. Experiencing nightmares, panic attacks and painful thoughts are different ways in which individuals express anxiety. In the case of an anxiety disorder, the feelings of fear, apprehensiveness and vulnerability will be with the individuals all the time. It is intense and in some cases debilitating. When the individuals experience anxiety disorders, they do not take pleasure in tasks and activities that they enjoyed at particular point of time. Some of the examples of anxiety disorders are, the individuals feel apprehensive in entering the elevators, crossing streets, implementing certain tasks or communicating with other individuals.

Anxiety disorders form a category of the mental health diagnosis that leads to apprehensiveness, vulnerability, worry and fear. These disorders alter how the individuals are required to behave and react to different kinds of situations. When an individual is to participate in any task or activity, such as, an exam, interview, competition and so forth, then it is likely possible that he or she may experience anxiety. Anxiety refers to the body's natural response to stress or apprehension in terms of what is to take place. When the feeling of anxiety is extreme, last for the time period of more than six months, it is possible that the individuals may experience anxiety disorder. When the individuals are feeling anxious in terms of education or job, this type of anxiety is unpleasant, but it may motivate the individuals to focus on their job duties.

The emergence of anxiety disorders is typically during childhood, adolescence or early adulthood, with a peak occurring in middle age and a subsequent decline in older individuals. Although these disorders are more prevalent in women throughout their lifespan, there is a notable narrowing in the differences among the two sexes after the age of 65. It is hypothesized that several factors can contribute to these findings including cumulative effects of anxiety related mortality, difficulty differentiating between cognitive impairment and an anxiety disorder, and the impact of female reproductive hormone cycle cessation.

The various causes of anxiety disorders are genetic factors, biochemical factors, temperament, learnt response and stress. It is comprehensively recognized that the tendency to develop anxiety disorders emerges from families. This is similar to a predisposition to other illnesses, such as, heart diseases, diabetes and so forth. The individuals may learn responses from parents as well as other family members. In one's family, when the parents, siblings or any other immediate family member experiences anxiety disorders, then the individuals are also likely to develop anxiety disorders. The genetic factors are regarded as crucial in the development of anxiety disorders. The genetic factors that lead to the development of anxiety disorders are generalized anxiety, separation anxiety, social phobia and panic attacks. Depression is one of the psychological problems that are not caused due to genetic factors. One of the unfavorable points which need to be highlighted in the case of genetic factors is, the parents as well as other family members have not paid much attention that their problems should not get transmitted to their children. When the individuals experience anxiety disorders, as well as various types of psychological problems, it is of utmost significance for them to pay attention on an immediate basis and put into operation the measures and approaches to bring about improvements. Therefore, it can be stated, genetic factors are one of the primary causes of anxiety disorders.

Stress is an integral part of the lives of the individuals. The individuals usually feel stressed in various areas and in putting into operation different tasks and activities. In some cases, stress is regarded as one of the major barriers within the course of implementation of tasks and activities in a satisfactory manner. When the individuals feel stressed within the course of implementation of tasks and activities, it impedes their concentration and they normally experience problems within the course of attainment of desired outcomes.

People with generalized anxiety disorder have excessive anxiety and worry that is difficult to control According to DSM-IV, symptoms must be present for more days than not for a six-month period, and the patient must not meet criteria for another anxiety disorder. Worrying is associated with at least three of the following: restlessness or feeling keyed up or on edge, easy fatigability, difficulty concentrating or mind going blank, imitability, muscle tension, and sleep disturbance. Person with generalized anxiety disorder worry excessively about multiple areas of life such as school or work performance, marriage, social acceptance, finances, and health. Like any psychiatric diagnosis, these symptoms must impair a person's ability to function in order to meet the diagnostic criteria. Medical causes and substance induced disorders must be ruled out.

Panic disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions to avoid panic; they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person's life.

The individuals in most cases live with anxiety disorders for years, before they are diagnosed and treated. When the individuals feel anxious in terms of acquisition of education, they either work diligently and conscientiously to acquire an efficient understanding of the lesson plans and academic concepts or they may change their subjects or they may even discontinue their education. On the other hand, when the individuals experience setbacks within the course of implementation of their job duties, they may either work diligently or provide solutions to their problems or they may change their jobs. But when the individuals experience phobia in terms of various objects or situations, then it is likely possible that they may not obtain treatment and these may continue for even long term time period. It is recommended that treatment should be obtained as soon as the phobias are identified. In this manner, they will not have detrimental effects upon the overall lives of the individuals.

Physical symptoms of an anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab tests. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation.

Using the Diagnostic and Statistical Manual of Mental Disorders (DSM) a mental health professional is able to identify the specific type of anxiety disorder causing symptoms as well as any other possible disorders that may be involved. Tackling all disorders through comprehensive treatment is the best recovery strategy.

Anxiety disorders can be effectively treated with psychopharmacological and cognitive behavioral interventions. These interventions have different symptom targets; thus, logical combinations of these strategies need to be further studied in order to improve future outcomes. New developments are forthcoming in the field of alternative strategies for managing anxiety and for treatment resistant cases. Additional treatment enhancements should include the development of algorithms that can be easily used in primary care and with greater focus on managing functional impairment in patients with anxiety.

Published : Nov 20 2023