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Anxiety & Anxiety 'disorders'


 

Signs of Anxiety  Behavioural & Psychological Symptoms  Strategies to help alleviate Anxiety  Agoraphobia  Separation Anxiety Disorder  Panic Disorder  Phobias  Social Anxiety Disorder  Post Traumatic Stress Disorder  Generalised Anxiety Disorder  Obsessive Compulsive Disorder  Derealisation & Depersonalisation  Video - "Symptoms of Anxiety"   Anxiety Fact Sheet

Please click here for Anxiety 'Fact Sheet'.

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How anxiety affects the body

 

 

 


 

 

The term ‘Anxiety Disorder’ covers a range of disorders, fears and phobias. The illnesses or disorders under this ‘blanket’ title are abnormal & pathological and not based in reason, logic or fact. 

 

‘Anxiety’ is a normal reaction to a stress and can be described as an ‘unpleasant emotional state’. It helps us mobilize our internal forces in order to ‘deal with’ the causative factors of the stress and enable us to focus, change, adapt, rectify, alter etc.; much the same as ‘feeling down, sad & miserable’ is a response to an event, incident or experience. And just as with depression, when it becomes excessive, overpowering and debilitating, affecting our everyday functioning it becomes a disorder or illness, generally requiring intervention & treatment. 

 

‘Fear’ is defined as an ‘emotional & physiological response to a recognized external threat’. The similarity between ‘fear’ & ‘anxiety’ is rather obvious and frequently used interchangeably, though not at a scientific level. Both are unpleasant emotions and the boundaries of the two can be blurred. Anxiety states can be seen at times as fear and described thus, as can fear exhibit clear signs of anxiety. It is important for diagnostic purposes and efficacy of treatment that we are able to distinguish between them. 

 

‘Phobias’ are a type of anxiety defined as ‘a persistent or irrational fear’. He we see the clear example of two (2) specific elements – ‘fear & anxiety’. 

 

In the  United States, 18.1% of the population is affected by anxiety disorders of some type. That’s more than twice the population of Australia. When you combine this with statistics for depression & other mental illnesses you suddenly become aware of the significance & prevalence of mental ill-health. 

 

There have been classic examples of anxiety in Rugby League, but perhaps the most memorable is that of Allan Langer. His pre-match ‘jitters’ as they were termed were so intense he would be physically sick. Many others exhibit feelings & symptoms of anxiety and see it as a positive experience, utilizing it to ‘mentally prepare’ for the game. They refer to it as the ‘adrenaline rush’, ‘the hype’, ‘the buzz’, the motivation to perform. Anxiety can be seen as intrinsically linked to the 'fight or flight' response.

 

On the next page are the specific types of Anxiety Disorders. It must be noted that for each one of these, it is the excessiveness & overpowering depth of the anxiety or fear that determines whether it is a disorder or not. Each of us, at times will experience anxiety and may be able to see ourselves in each one of these definitions, though one needs to be careful not to ‘self diagnose’.  

 

 

 


  Generalised Anxiety Disorder

 

 

As the name suggests, this is anxiety that is not initiated or ‘driven’ by any specific cause. It has been described as a kind of ‘free floating’ anxiety; not focused or directed at any specific object or situation. It is a common chronic disorder that affects twice as many women as men and can lead to significant impairment in personal & social functioning. People with this disorder often describe feeling anxious or fearful of ‘something’ but cannot specify or identify what it is. They can be seen as having a ‘hang dog’, anxious expression and tend to ‘fret’ constantly, being unable to control their worries. Physical symptoms such as headache, heart palpations, insomnia & dizziness are common & are generally as a result of persistent muscle tension & autonomic fear reactions. General daily activities & functioning is impaired due to the physical symptoms combined with their long standing anxiety. They can become fatigued and feel constantly tired. 



 Panic Disorder

 

 

This can be a particularly ‘frightening’ disorder for the sufferer, particularly in relation to the overt physical symptoms that accompany and largely define it. Physical symptoms such as trembling, shaking, confusion, dizziness, difficulty breathing, nausea & heart palpitations are common. Along with the physical manifestations are feelings of ‘impending doom’, intense terror & apprehension. The American Psychiatric Association (2000) describes a ‘Panic Attack’ as a fear or discomfort arising abruptly, peaking in 10 minutes or less, and lasting occasionally for hours. A Panic Disorder is diagnosed when there have been several apparently spontaneous attacks which have lead to a persistent fear of future attacks.

 

Sometimes  ‘Panic Attacks’ come from nowhere, just suddenly occurring, though generally they happen after prolonged anxiety or stress, a frightening experience or even exercise. The physical symptoms are so severe that someone experiencing their first ‘attack’ may seek urgent medical attention, fearing they are having a ‘heart attack’ or similar life threatening ailment. Despite medical investigations & tests being negative, the continued symptoms of anxiety reinforce that there is something wrong with their body. They can continue to worry and become overly concerned & fixated that any change in physical ‘normality’ will lead to death.

 

Due to the excessive worry that they may experience another ‘panic attack’ or that minor, ‘normal’ physical changes such as increased heart rate from climbing stairs indicates something is wrong with their heart, they can often make drastic ‘life changes’ in order to avoid such an experience. They may leave their job or relationship to avoid stress, or even refuse to leave their home.



 

 

 Social Anxiety Disorder

 

Also known as ‘social phobia’ or ‘Social Anxiety’, Social Anxiety Disorder can be described as ‘excessive anxiety in social situations causing relatively extreme distress & impaired ability to function in at least some areas of daily life’. It can be a ‘specific’ disorder (where it applies to a particular situation) or ‘generalised’. Examples of a ‘specific social anxiety’ would be a fear of public performance or public speaking (often referred to as ‘stage fright’), fear of writing in public or group situations such as sitting exams or the fear of using public toilets or restrooms. Another of the ‘Social Anxiety Disorders’ is that of being ‘love shy’. This affects many more men than women and results in the inability to form or initiate intimate relationships.

 

Social Anxiety Disorder is characterized by intense, persistent & chronic fear of being judged by others or being embarrassed or humiliated by the individual’s own actions &/or behaviour. These fears can be initiated by perceived or actual scrutiny by others. For it to be classified as a ‘Social Anxiety Disorder’ the sufferer must experience anxiety when exposed to the feared situation & must recognize the fear & anxiety as irrational.

 

Physical symptoms such as sweating, shaking, nausea, blushing, increased heart rate and ‘mind going blank’ are commonly experienced. In fact the fears associated with public scrutiny & possible public humiliation is so intense as to severely affect one’s functioning in day to day life.  For a list of 'famous' people & celebrities who have suffered or suffer from this disorder, please click here.



 

 

 Post Traumatic Stress Disorder (PTSD)

 

 

Once seemingly limited to war veterans, Post Traumatic Stress Disorder (PTSD) is becoming more widely known due to the increase in stress & danger within our society. Violent crime, terrorism, military conflict, rape & sexual abuse, motor vehicle accidents, hostage situations etc. are all ‘traumatic’ experiences and that to which an increasing number of people are being exposed. As opposed to those who ‘go to war’ with the knowledge & expectation of conflict & military confrontation, trauma is becoming more prevalent amongst ‘main stream’ society.

 

PTSD is a severe anxiety disorder that occurs as the result of a traumatic experience. ‘Flashbacks’ are an integral component of PTSD. Other symptoms such as avoidant behaviour and ‘typical’ anxiety features also occur. One of the serious consequences for many afflicted by PTSD is the ‘self medicating’ that often occurs. Drugs & alcohol can temporarily ‘numb’ the anxiety and reduce the flashbacks.

 


 

 

 Obsessive Compulsive Disorder

 

This disorder has often been likened to ‘superstitions’, though is more fundamentally related to anxiety & the desire to avoid or diminish the levels of anxiety through ritualistic, repetitive & compulsive behaviours or acts.

 

Obsessions refer to strong intrusive, repetitive and distressing thoughts or images that the individual very often acknowledges as being baseless and senseless.

 

Compulsions refer to behaviour and the compulsion to repetitively perform something in order to relieve anxiety. 

 

This is where the likeness to ‘superstitions’ is evident. If I do (A), then (B) won’t happen. As the fear & anxiety of (B) occurring rises, the compulsive performing of (A) increases. Even if the likelihood is negligible that (B) will occur and the individual rationally knows this, they are still forced by their inner obsessions to carry out their inner compulsion (A). It is very easy to see why this can be such a debilitating disorder. The compulsions can be so severe, for example washing hands due to obsessive thoughts regarding germs, filth & diseases, that an individual can actually rub & scrub the skin from their hands to the point of bleeding. It can lead to being constantly late, due to the need to perform the compulsive act, to the detriment of other requirements of life. Relationships, work functioning, social activities are common areas that can be seriously affected.

 


 

 

Separation Anxiety Disorder

 

 

This disorder & the associated symptoms is a ‘normal’ experience for children, though is also seen in adolescents & adults. It can be defined as excessive & inappropriate levels of anxiety that resulting from the separation from an attachment figure or a person or place that provides comfort & security.

 

Separation Anxiety Disorder is present in all age groups and surprisingly more common in adults (approximately 7%) than in children (around 4%). It should not be confused with ‘separation anxiety’, as can be seen when a child begins school for example.

 

 

Symptoms that can be seen in this disorder are:-

 

  • Recurrent nightmares about being separated 
  • Excessive fear about being alone without the figure of attachment 
  • Persistent reluctance to sleep unless close to the figure of attachment 
  • Persistent worrying that something (event or incident) may result in separation from an attachment figure 
  • Recurrent distress when separated from the subject of attachment 
  • Persistent & excessive anxiety & worry about the prospect of losing the attachment figure 


 

Agoraphobia

 

 

Most people would believe this to be a ‘fear of wide open spaces or the outdoors’ with our impression of a lady holed up at home as being the quintessential image of the agoraphobic individual. This is actually not that accurate and does not paint the full picture or explain the fear. 

 

Agoraphobia is a common complication of a ‘Panic Disorder’. The fear is of being caught in a situation or place from where you cannot get away without causing embarrassment or without great difficulty. It therefore results in avoidant behaviour such as not leaving the house, or not attending public functions or gatherings. Should a panic attack occur whilst shopping, at school or university or driving, the person suffering agoraphobia will avoid this situation or act in order to reduce anxiety. Unfortunately, the reduction in levels of anxiety only reinforces the behaviour and makes revisiting the situation even more difficult. 

 


 

 

Derealisation & Depersonalisation

 

 

Derealisation &/or Depersonalisation cause the individual to feel detached or divorced from the world around them or themselves. They describe life as like ‘being in a dream’; as if it were not real or hazy. They can even feel detached from their own bodies. Constant worrying & persistent ‘odd’ and pervasive thoughts are also symptoms that can be seen. 

 

It is more an outcome of anxiety as opposed to a ‘stand alone’ phenomenon. It can either develop slowly as in with generalised underlying anxiety or can suddenly eventuate following a ‘panic attack’. It tends not to resolve until the anxiety has abated. As a result, avoidant behaviour develops. The sufferer of these symptoms is generally unaware of the link between them and their anxiety, becoming obsessed with attempting to explain it.

 

 

 

Phobias

 

 

Snakes, spiders, mice, horses, heights, fire, water etc…..are just a few of the specific and identifiable things of which someone may develop a phobia. You may quite probably know someone who has a particular ‘phobia’ or you may have such a disorder. 

 

Phobias differ from ‘Generalised Anxiety Disorder’ & ‘Panic Disorder’ in that there’s a specific stimulus or situation that elicits the strong fear response. The power of the Phobia can result in extreme avoidant actions & behaviour. For example a person with a fear of snakes may jump 30 feet into a river, despite being a poor swimmer, to avoid or escape from the feared creature. People with phobias realize & identify their fears as irrational, excessive & unreasonable, though can do little to reduce their anxiety. People with Phobias generally have very powerful imaginations & can vividly anticipate the terrifying consequences of their feared object or situation.

 


 

 

It is important to realize that simply experiencing episodes of anxiety in response to situations you may find yourself in from time to time does not necessarily suggest a phobia or anxiety disorder. Similarly there are occasions or objects for which fear &/or anxiety is a ‘normal’ & expected reaction.

 

‘Co-existing’ or concurrent mental illness may complicate the establishment of a diagnosis of ‘Anxiety Disorder’. For example, Depression with anxiety symptoms is common, as are some unwanted effects from drug & alcohol use & abuse. Similarly, the ‘overlapping’ of some anxiety disorders may occur or a melding or blurring of the defined boundaries. Symptoms or outcomes of a disorder may resemble another or someone suffering social anxiety for example may also have a particular phobia in another area. The diagnoses are merely a means of communicating between professionals and ‘pulling together’ the specific symptoms of a particular disorder, allowing for a more comprehensive & effective treatment regime.

 

Treatment for anxiety disorders generally covers three (3) types and/or combinations of these. They are (1) Cognitive Behavioural Therapy (CBT) (2) Pharmacological Therapy (Medications) & (3) Lifestyle Therapy. Medications prescribed are primarily anxiolytics (anti-anxiety agents) and often anti-depressants, or both. Cognitive Behavioural Therapy is the treatment of choice for ‘anxiety disorders’ and is either employed alone or in conjunction with medication. ‘Lifestyle Therapy’ involves the assessment & realistic appraisal of an individual’s lifestyle; their environment, diet, recreational pursuits, family, occupational activities, personal needs etc. Lifestyle adjustments & changes may be required and a general re-assessment of priorities; along with the implementation of relaxation techniques & strategies.

 


 

 

Signs of Anxiety can be:-

 

 

  • Sweating 
  • Trembling 
  • ‘Blushing’ 
  • Increased heart rate & palpitations 
  • Rapid, shallow breathing 
  • Dry Mouth (and sometimes difficulty in swallowing) 
  • Muscle tension & headaches 
  • Nightmares 
  • Sleep disturbances (difficulty getting to sleep or staying asleep) 
  • Diarrhoea 
  • Nausea & sometimes vomiting 
  • Difficulty concentrating 
  • Sexual dysfunction such as loss of sex drive 
  • Pre-existing illness such as asthma or dermatitis may ‘flare up’ 


 

 

Along with these symptoms, the individual may experience psychological & behavioural signs such as:-

 

 

 

  • Becoming argumentative (particularly as it relates to the attempted avoidance of the cause for the anxiety) 
  • Pessimism & negativity toward most situations 
  • Irritability – constantly in a ‘bad mood’ 
  • Often seeking reassurance & asking many unnecessary questions in order to get this 
  • Social withdrawal – becoming a ‘bit of a loner’ or a reduction in social contacts 
  • Reduction in interaction & conversation – pre-occupied & non-spontaneous 
  • Worried & constantly feeling ‘something bad is going to happen’ 
  • Becoming a bit of a perfectionist in attending to tasks – taking a lengthy time to complete due to the desire for it to be absolutely right 


 

Stress & anxiety

 

 

 

 

Should you have a problem with anxiety, though insufficient to constitute an ‘anxiety disorder’, certain strategies might be beneficial in alleviating the intensity of the symptoms. These are:

 

 

  • Relaxation techniques (such as - yoga, meditation, tai chi, controlled breathing, aromatherapy, music therapy.) 
  • Dietary changes 
  • Avoidance of stimulants such as caffeine (coffee, tea, red bull etc.) 
  • Adequate sleep & rest 
  • Walking – for relaxation, not exercise 
  • Schedule time away in a peaceful location eg. country or beach 
  • Take the phone off the hook and turn off the mobile on occasion 
  • Engage in a relaxing sport or activity; free of competitiveness & not overly challenging. Such pursuits as fishing or golf. 
  • Read a book or watch a movie 


 

These are but some suggestions of what you might do to ‘wind down’ or reduce your stress & anxiety. Should medication be necessary, be mindful of the sedative effects it most probably has and the need to use in moderation & as directed by your doctor.

 


 

Should you have concerns regarding any issue relating to your 'mental or physical well-being', 'Kick off' strongly recommend you seek professional assistance. This may entail contacting your GP or similar clinician (Psychologist, Psychiatrist, Counsellor etc.). You may also contact the appropriate agency or service that might assist you. Irrespective of your choice, ensure you see someone who might help. 

 

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