Understanding Anxiety Disorders

What are Anxiety Disorders?
Anxiety is a normal reaction to stress. It can help a person to be better prepared in dealing with a tense situation. But when anxiety becomes overwhelming and interferes with your daily activities, it becomes a disorder.

Anxiety disorders can affect adults, as well as children. In fact, it is the most common psychological problem in children and adolescents. Anxiety disorders commonly occur along with other mental or physical illnesses, such as depression. Some adults may also suffer from alcohol/substance abuse, which may mask anxiety symptoms or make them worse.

In the Singapore Mental Health Survey conducted in 2010, it was found that about 100,000 Singapore residents aged 18 and above will have anxiety disorders sometime during their lifetime. The study further found that the average time for persons with obsessive-compulsive disorders to seek help from the onset of the illness was 9 years, and 6 years for persons with generalised anxiety disorders.

Anxiety disorders include social phobia, generalised anxiety disorder, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder. Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread.

People with social phobia, also known as social anxiety disorder, become overwhelmingly anxious and excessively self-conscious in everyday social situations. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school and other ordinary activities, and can make it difficult to make and keep friends.

People with generalised anxiety disorder go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. Sometimes just the thought of getting through the day produces feelings of anxiety.

Persons with GAD may experience physical symptoms like insomnia, stomach upset, restlessness, difficulties in concentrating and fatigue.

Panic disorder is characterised by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness or dizziness. During attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations.

Panic attacks usually produce a sense of unreality or a fear of impending doom. The person is unable to predict when or where an attack will occur, and between episodes many worry intensely and dread the next attack.

People with OCD have persistent and upsetting thoughts (obsessions) and use repetitive behaviours/mental acts (compulsions) to control the anxiety these thoughts produce.

For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. Other common rituals are a need to repeatedly check things, touch things in a particular sequence, or count things. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.

PTSD develops after a terrifying ordeal that involves physical harm or the threat of physical harm. The person who develops PTSD may have been the person who was harmed or the person may have witnessed a traumatic event.

Symptoms of PTSD include flashbacks or nightmares about what happened, hypervigilance, startling easily, withdrawing from others, and avoiding situations that remind the person of the event.

In general, anxiety disorders are treated with medication, specific types of psychotherapy like Cognitive-Behaviour Therapy, or both. Treatment choices depend on the problem and the person’s preference. The principal medications used for anxiety disorders are antidepressants, anti-anxiety drugs, and beta-blockers to control some of the physical symptoms.

Stress management techniques can help people with anxiety disorders calm themselves and may enhance the effects of therapy. Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Being in a supportive environment can also help the persons in their journey to recovery.