Anxiety Disorders

Anxiety is a psychological or physical sense of discomfort often felt when one is faced with an unpleasant situation. According to psychoanalytical model, it is a warning signal when one is faced with danger. In physiological terms, it’s a manifestation of ‘Flight or Fight’ reaction.

Anxiety can be felt by all in the presence of or in anticipation of something going wrong. Anxiety can also be felt without any significant environmental stimulus. Anxiety Disorders are thus characterized by  psychological symptoms of fear, restlessness, discomfort, uneasiness and/or physical symptoms of physical restlessness, breathlessness, sweating, palpitations, trembling, increased bladder or bowel movements leading to urge to pass urine or stool, increased muscle tension leading to headache or aches or pains in other parts of body , etc.

Types of Anxiety Disorders-

Depending upon the frequency, triggers, situations and anxiety of symptoms, anxiety disorders are clinically categorized into following types-

• Generalized Anxiety Disorder
• Phobic Anxiety Disorders (Specific Anxiety Disorder/Social Anxiety Disorder /Agoraphobias)
• Panic Disorder
• Reactions to stress (Acute Stress Reaction/PTSD/Adjustment Disorder)
• Obsessive Compulsive Disorder
• Mixed Anxiety Depression
• Childhood anxiety disorders (Separation Anxiety/ Selective Mutism /School Phobia)
• Anxiety due to Medical Condition/Substance (alcohol/drug) Withdrawal

Diagnosis of Anxiety Disorders-

Diagnosis of anxiety disorders is primarily clinical and psychiatric evaluation is aimed at exploring history of symptoms, precipitation factors, duration, severity, effect on routine life and familial or genetic link, etc. Certain medical conditions related to thyroid disorders, cardiac disorder, respiratory disorders, other endocrine disorders, etc,  may mimic acute anxiety episodes which need to be ruled out before a diagnosis of anxiety is formalized.

Management of Anxiety Disorders

• Psychotherapy-

 Relaxation therapy and cognitive behaviour therapy are most common interventions for psychological treatment of anxiety disorders. Various techniques are available which can be individualized to the patient’s requirement by a trained clinical psychotherapist for optimum response.

• Pharmacotherapy-

 Medicines are aimed at reducing the nervous excitability which results from exposure to perceived threat. Unlike common perception, psychotropic medicines are not meant to put patients to sleep but act at the neuro-chemical level at which the chemical root of anxiety disorder lies. Under supervision of a psychiatrist, treatment is safe and effective and no addictive drugs are prescribed for long term. Regular physical check ups are done to ensure appropriate treatment response without any side effects.
Anxiety itself can have deleterious effects on one’s physiology making an individual vulnerable to multiple physical and metabolic problems which are avoided if patient get adequate psychiatric treatment.

Treatment may last for a minimum of 6 months or longer based on the history and prognosis. Often both psychotherapy and medicines can be combined for longer lasting response.