Anxiety Disorders : Information
|Introduction : Anxiety Disorders|
Anxiety Disorders are the most prevalent of psychiatric morbidities and are the sixth leading cause of disability worldwide with 4% of all YLD (years lived with disability). It is seen more commonly in females as compared to males. Roughly 273 million had an anxiety disorder as of 2010.
An anxiety disorder may make the person feel anxious most of the time, without any apparent reason. In some cases, the anxious feelings may be so uncomfortable that the person may stop routine activities. At times, the occasional bouts of anxiety may be so intense that they terrify and immobilize the person. Fear is another emotion with considerable similarity but with some important differences. Fear is generally considered a primary emotion, while anxiety is considered a secondary emotion that represents the avoidance of fear (including the avoidance of fear-producing stimuli). Primary emotions refer to emotions that are recognizable through facial expressions. Primary emotions can easily be interpreted by an observer and exist across different cultures. These primary emotions are: happiness, anger, sadness, fear, surprise and disgust. Secondary emotions, such as anxiety are not readily recognizable to an outside observer. Secondary emotions are generally considered an internal, private experience.
The most important distinction between fear and anxiety is the time frame. Fear is the response to a danger that is currently detected in the immediate, present moment of time. In contrast, anxiety refers to the anticipation of some potential threat that may or may not, happen in the future. In other words, fear is a response to an immediate danger in the present moment of time, while anxiety is associated with a threat that is anticipated in a future moment of time. Anxiety reflects the anticipation of fear and represents an adaptive attempt to prevent the fear-provoking circumstance from occurring. In an anxious state, people are readying themselves and preparing themselves to cope with a future problem or dilemma that they anticipate will cause some kind of harm, if not prevented from occurring. In this respect, anxiety is a normal, beneficial emotion.
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|Symptoms : Anxiety Disorders|
Signs and symptoms
Physical or bodily signs and symptoms:Trembling of the body, restlessness and muscle twitches Palpitations, increased heart rate, flushing, excessive sweating, rapid breathing, diarrhoea, increased frequency/hesitancy of passing urine, dizziness, dry mouth, dilated pupil
Psychological symptoms or symptoms of the mind may includeFearful facial expressions Poor concentration, easy distractibility, easy arousal or excitability. Inability to relax, fearfulness, irritability, feeling of impending doom, vague sense of apprehension Lack of sleep, startling in sleep A feeling that the surroundings are not real
Specific anxiety disorders with their manifestations are as follows:
|Causes : Anxiety Disorders|
The exact cause of anxiety disorders is unknown. It may be either inherited or acquired.One can trace its origins to the parents, which means, the individual possibly inherits the genes which predispose to develop anxiety responses to external changes/events of a threatening order. Repetitive past life situations from which the individual has received an unpleasant experience which becomes fixed and which makes him anticipate the worst A particular life experience which may lead to specific fears or phobias A set of response patterns which typify the personality as an anxious personality
Thus, anxiety results from faulty interactions between the individual and his life situation. It mainly includes biological, genetic, environmental and social factors. The cause must be understood entirely as it is helpful in dealing with the patient. Each patient demands a separate type of management viz-a-viz medicines and psychotherapy. Environmental factors such as a trauma or significant events may trigger an anxiety disorder in people who have an inherited susceptibility to developing the disorder.
Other causes includes :
1. Threat to self-preservation
2. Conflict arising from development of conscience and crisis of conscience
3. Loss of ideology / loss of self-esteem
4. Minor/ major stress of every day
5. Dysfunctional thoughts, beliefs, cognitive processing
6. Physical diseases
7. Social conflict
8. Difficulties in sex
9. Desire to have something for nothing
10. Psychological trauma
11. Inadequate coping mechanism
|Diagnosis : Anxiety Disorders|
The diagnosis of anxiety disorders like depression is difficult. A lot of patients visit their healthcare professionals with physical complaints as a result of which the medicine relevant to that complaint is given. This often leads to either a temporary or no relief. It is only when the physical complaints do not respond adequately or tends to recur that one investigates further and takes the help from specialists. In the meanwhile, a lot of time and energy is lost leading to expense as well and perhaps sub-optimal functioning. Once the physician is sure of the likelihood of anxiety disorder from the history, examination findings help to rule out any obvious medical condition that may be associated with anxiety.
|Management : Anxiety Disorders|
To treat an anxiety disorder, its evolution must be understood. Tracing the cause is as important as treating it and the manifestations which are troublesome. Primarily, the management consists of desensitizing the patient. It means that the patient is subjected to a milder version of the trigger and subsequently the intensity of the trigger is increased. The patient has to be helped to gain insight into her/his problem.
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