Anxiety is closely related to Stress in that they both operate within the same framework of response to stressors in a helpful manner up to an optimum level beyond which they become detrimental to the wellness, productivity and relationships of the individual. Anxiety becomes a 'disorder' when worry and dread become constant, overwhelming and crippling. It is one thing to be anxious about walking through a dark alley, taking on a new task at work or taking a major examination; it is quite another to live in dread of or constantly worry about an event that is non-existent. While the former serves as an "alarm system" that stimulates positive response, the latter is out of control, affecting the individual's ability to function normally.
Anxiety Disorder is an excessive worrying, restlessness, apprehension, arousal, fright or concern about a future negative event with a sense that the event is uncontrollable or avoidable. This should not be confused with fear which is a present emotional response to a specific threat with a way of escape in mind. This feeling passes with the event unlike the constant symptoms in anxiety disorder.
Researchers believe that anxiety disorders are caused by chemical imbalances (abnormal levels and imbalance of neurotransmitters in the brain) that generally affect mood and memory. Studies show that they may be genetic (can be inherited from one or both parents). They are also triggered by environmental factors like traumatic events including major accidents, war, abuse, separation, betrayal, death of loved ones, use of or withdrawal from addictive substances like caffeine, alcohol and nicotine etc. It must be emphasized that anxiety disorders, like other forms of mental illness are not the outcomes of personal weakness, character flaws or poor upbringing. They should hence not be approached with a sense of shame or guilt but as positively and practically as other forms of physical illnesses.
Types of anxiety disorders
- Panic Attacks - Sudden feeling of terror without any noticeable cause. It may manifest as physical symptoms like breathing difficulty, dizziness, increased heartbeat or chest pain.
- Obsessive Compulsive Disorder (OCD) - Typically manifests as repeated, upsetting thoughts called obsessions, leading to repeated actions (compulsions) to try to make the thoughts go away. An example is the fear of germs (obsession) leading to washing of hands constantly or constant cleaning (compulsions). This may take over one's life.
- Post Traumatic Stress Disorder (PTSD) - Happens after living through a traumatic event like war, rape, physical abuse, hurricane, accident etc. It manifests by way of flashbacks (reliving the event again long after it happened), nightmares, outbursts of anger, worry, guilt, sadness, loneliness etc. War veterans are particularly prone to PTSD.
- Phobias - strong and irrational fear of something that posses little or no real danger. They include Claustrophobia (fear of being in an enclosed space like an elevator), Acrophobia (fear of heights, Agoraphobia (fear of public places), Social phobia (extreme self consciousness in regular social situations. Others include flying, water, tunnels, highway driving, blood etc.
- COGNITIVE (mental) including, exaggerated thoughts of potential outcome of future events like thinking that a headache may result in brain aneurysm or death or that a chest pain is an indication of an impending heart attack, scary thoughts, hypervigillance, fear of dying etc. These thoughts may be constant and prolonged, hence crippling.
- EMOTIONAL including, feeling that your mind is blank, feeling tense or jumpy, anticipating the worst, restlessness, waiting for signs of danger, nightmares/ bad dreams etc..
- PHYSICAL (Somatic)including, tense muscles, heart palpitations, fatigue, nausea, chest pain, shortness of breath, headaches, stomach aches etc.
- BEHAVIORAL including changes in sleeping pattern, increased motor tension such as foot tapping, withdrawal from situations that bring back memories of past anxiety, avoidance, aggression, freezing etc.
A doctor should be consulted for general evaluation and possible elimination of physical illnesses. Diagnoses of anxiety disorder can then be made based on severity and length of symptoms and interference with daily activities. This may involve referral to appropriate mental illness professional.
In extreme situations of anxiety disorder, one can become so overwhelmed by personal mortality (fear of death) to the point where ones existence becomes norm (state of nonbeing). This state of existential anxiety was described by Viktor Frankl like this; "When a person is faced by extreme mortal dangers, the most basic of all human wishes is to find a meaning of life to combat the "trauma of nonbeing" as death is near". This for many is the basis for spirituality as a source of meaning or purpose in life. Paradoxically also, spirituality, hence a sense of being and meaning plus the inner peace about life after death (i.e. no more pain, no more sorrows), is that calming influence that nullifies or at least minimizes the advent of existential anxiety.
Treatment
In light of the causes and symptoms described above, anxiety disorders are treated by a combination of medication and therapy. Short term treatments involve a class of drugs called "benzodiazepines" often called tranquilizers because of their calming effects on muscles and restlessness. Examples include Xanax, Librium, Ativan and Valium. Long term treatments may involve the use of antidepressants such as Prozac, Zoloft, Lexapro, Effexor and Paxil.
Cognitive Behavioral Therapy is often the therapy of choice for Anxiety disorders. Participants learn to identify and change irrational thinking patterns that lead to anxiety based on the principle that one is likely to act differently if they think differently.
Other helpful interventions include dietary and lifestyle changes, relaxation techniques, reducing or stopping the consumption of caffeine containing products such as coffee, tea, cola and chocolate. It always helps to seek counseling and support after a traumatic or disturbing experience.