Anxiety Diagnosis and Treatment

Types of Anxiety

• Generalised anxiety disorder (GAD): Characterised by excessive, persistent worry about everyday matters like work, health, or household tasks, often leading to feelings of being overwhelmed.
• Agoraphobia: An extreme fear of situations where escape might be difficult, or help may be unavailable. This causes individuals to avoid open spaces, crowded areas, or unfamiliar environments.
• Panic disorder: Involves recurring, unexpected panic attacks that occur without warning and are not linked to another medical or mental health condition. Some individuals with panic disorder also develop agoraphobia.
• Specific phobias: A strong, irrational fear of a particular object or situation that significantly disrupts daily life. While there are countless phobias, only agoraphobia has a separate diagnosis.
• Social anxiety disorder: Previously referred to as social phobia, this condition involves an extreme, ongoing fear of negative judgement or observation in social situations.
• Separation anxiety disorder: Causes extreme distress when apart from a loved one, such as a primary caregiver. While common in young children, it can as well affect adults.
• Selective mutism: A condition where a person is unable to speak in specific situations due to fear or anxiety. This is often seen in children but also present in adolescents and adults.

Signs and Symptoms

Physical symptoms include:

• a racing heartbeat (palpitations);
• nausea or vomiting;
• trembling or shaking;
• excessive perspiration;
• dry mouth;
• pain or discomfort in the chest;
• headaches;
• dizziness;
• rapid breathing.

The nervous system receives messages from the brain that cause stress hormones like adrenaline (epinephrine) to be released, which results in these physical symptoms. This has an impact on the heart, muscles, and other organs, resulting in symptoms like sweaty hands and a pounding heartbeat.

Mental symptoms include:

• a persistent sense of exhaustion;
• restlessness or irritation;
• trouble concentrating or making choices;
• difficulty sleeping;
• ongoing anxiety about the past or possible issues in the future.

Behavioural symptoms:

• Avoiding social interactions or preferring isolation
• Selective mutism. Difficulty speaking in certain settings (like at school) despite being able to communicate in familiar environments
• Compulsions. Engaging in repetitive behaviours, like excessive handwashing, to counteract anxious thoughts like getting infected by germs.
• Agoraphobia. Fear of leaving home due to anxiety about potential dangers or overwhelming situations
• Unhealthy coping mechanisms. Relying on alcohol or substances to manage symptoms which can worsen anxiety over time

Causes

Although scientists are unsure of the precise origins of anxiety, they think a number of these elements work together to generate it:

• Brain chemistry and genetics: Some people may be genetically predisposed to anxiety, which may be related to brain chemical imbalances that intensify anxious sensations.
• Past experiences: Anxiety disorders can arise as a result of challenging or traumatic situations throughout childhood, adolescence, or adulthood.
• Current stress and trauma: Anxiety is likely to be triggered by ongoing life issues.
• Substance abuse and medication: As a side effect, alcohol, recreational drugs, and some psychiatric medicines can exacerbate or cause anxiety.
• Underlying medical conditions: Hyperthyroidism is one example of a medical disease that anxiety can occasionally be a sign of.

Diagnosis

To be diagnosed with anxiety, the following criteria must be met for at least 6 months:

• Persistent and excessive anxiety about multiple things in life (e.g., work, school, social functioning, or relationships).
• Difficulty controlling worry.
• Having at least three or more of these symptoms:
  • Restlessness or feeling on edge
  • Fatigue
  • Trouble concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep difficulties such as trouble falling or remaining asleep or unsatisfying sleep
• Significant distress or impairment in social, work, or other areas of life.
• Symptoms that are not well explained by a health condition, substance use, or another psychiatric disorder.

If a healthcare provider suspects anxiety, they will conduct a thorough medical consultation and physical examination. This may include:

• Standardised questionnaires or self-assessments to evaluate anxiety levels.
• Laboratory tests to rule out medical conditions that may cause anxiety symptoms.
• In some cases, imaging studies (such as X-rays or scans) to check for underlying health issues.

Treatment

The primary goal of treating anxiety is to relieve symptoms so that they no longer interfere with daily life. The best treatment plan is based on the severity of your anxiety and the specific condition you have.

Non-pharmacological therapies include:

• Knowledge of anxiety: Gaining knowledge about anxiety and its origins might assist lessen needless dread. Speaking with loved ones, friends, or a medical expert can help reassure you. Furthermore, anxiety can be decreased by realising that bodily symptoms (such as a racing heart) do not always indicate a major medical problem.
• Counselling: People with generalised anxiety disorder may benefit from some forms of counselling, particularly those that emphasize problem-solving techniques.
• Courses on anxiety management: These can cover coping mechanisms, problem-solving tactics, and relaxation techniques. Some people may also benefit from group assistance.
• Cognitive behavioural therapy, or CBT, is a useful treatment for phobias and anxiety disorders. It seeks to recognise harmful thought and behaviour patterns and swap them out for more constructive ones.
• Self-help strategies: Support groups (both local and online) can provide helpful information and emotional support. Also, resources like books, CDs, and relaxation exercises (such as deep breathing techniques) can be helpful in managing anxiety.

Medication treatments:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) are commonly used for anxiety. Common SSRIs for anxiety include escitalopram and sertraline. Other antidepressants recommended for anxiety include mirtazapine, venlafaxine, and paroxetine (less commonly prescribed now)
• Benzodiazepines: Used in the past as a primary treatment but prescribed with caution due to addiction risk. Short-term use (up to two weeks) may be helpful for severe or situational anxiety.
• Buspirone: Used to treat generalised anxiety disorder. It is not addictive and works by affecting serotonin levels related to anxiety symptoms.
• Beta-blockers: Helps control physical symptoms of anxiety, such as a racing heart and trembling. Beta-blockers are particularly useful for short-term anxiety, such as before an exam or presentation. A common example is propranolol.

Cognitive behavioural therapy and antidepressants are two examples of anxiety treatments that, in certain situations, may be more effective when used together than when taken separately.

Conclusion

You don’t have to live with persistent worry and fear. If you experience symptoms of an anxiety disorder, speak with a doctor right away. Being diagnosed and treated early can help prevent further complications. In many cases, a combination of medicines and counselling can effectively manage anxiety and help you feel better.

For more information or to address any concerns, book an appointment with us today.