What is it and when can it be classified as a disorder?

 

The feeling of anxiety is a common one to have in everyday life. However, experiencing distress, fear and apprehension frequently (even in non-stressful situations), or having these feelings last longer than expected, may be tell-tale signs of an anxiety disorder.

 

What is an anxiety disorder?

Feelings of anxiety can be considered a ‘normal’ response to feared situations. They serve as a built-in mechanism to help us to focus on managing dangerous or difficult situations better.

However, anxiety symptoms can get out of control and can develop into a disorder when:

• It is greatly disproportionate to the risks and severity of the danger faced.
• Symptoms continue to persist even when a stressful situation has been alleviated.
• It interferes with social, occupational or physical aspects of our daily life, causing functional decline and impairment.

Amongst all disorders, anxiety disorder is the most common, with a lifetime prevalence of 28.8 percent of people globally, and a median age of onset of 11 years old.

 

What are some of the symptoms of anxiety disorder?

Symptoms can manifest in both physical and psychological responses.

Physical:

• Palpitations
• Sweating
• Headaches
• Muscle tension
• Dry mouth

Psychological:

• Sleep disturbances
• Loss of appetite
• Failure to concentrate
• Easily irritable
• Lethargy

Before an individual is diagnosed with anxiety disorder, however, it is important to rule out any other underlying conditions such as thyroid disease, anaemia, gastritis, reflux disease or respiratory diseases.

 

What are some of the common types of anxiety disorders? 

• Generalised Anxiety Disorder (GAD)
  Consists of generalised and persistent ‘free floating’ anxiety symptoms that may present itself with sweating, elevated heart rate, hyperventilation, giddiness, or gastric discomfort. GAD is usually defined as persistent worry accompanied by at least three other physical symptoms above, lasting for more than six months.
• Panic disorder or panic attacks
  This refers to recurrent attacks of severe anxiety symptoms that are not restricted to any particular situation, making them unpredictable. More often than not, panic attacks only last for a few minutes. Examples include experiencing dizziness while sitting in a train or palpitations just before delivering an important speech in front of a crowd.
• Obsessive Compulsive Disorder (OCD)
  Obsessive Compulsive Disorder is the combination of both obsessional thoughts and compulsive behaviour. Some examples include excessive fear of contamination or annoyance towards items that are not aligned properly for instance.
• Post-Traumatic Stress Disorder (PTSD)
  PTSD refers to severe psychological disturbances following a traumatic event. Symptoms usually occur after one month of trauma that include:
  • Persistent re-experiencing of the traumatic event.
  • Persistent avoidance of associated stimulus or trigger.
  • Symptoms of heightened response such as insomnia, flashbacks and nightmares.
• Phobias
  Having unrealistic fears of situations or objects which are either avoided or endured with dread. Any contact with the situation or object will result in fear and terror to a degree that is blown out of proportion. Phobias include:
  • Specific phobias: Fear of specific things such as heights, insects, flying.
  • Agoraphobia: Fear of crowded situations where immediate escape to a safe place is difficult.
  • Social phobia: Fear of social situations where one may be scrutinised by members of the public.

 

What are some of the possible causes and risk factors?

• Family history: Anxiety disorders can run in families.
• Prior emotional trauma: Those who have experienced a traumatic event prior are at a higher risk of developing an anxiety disorder later in life.
• Stressful events: Undergoing stressful events such as a change of job, moving house, or newly diagnosed health conditions can trigger bouts of anxiety.
• Underlying mental disorders: Anxiety disorders can sometimes co-exist with mental disorders such as depression or personality disorder.
• Substance abuse: Usage, misuse or withdrawals of alcohol or drugs can cause or worsen anxiety.

 

How can anxiety disorder be managed? 

For mild cases, regular counselling and psychotherapy have proven to be helpful. Exercises such as stress coping skills, muscle relaxation and breathing techniques, problem solving counselling and cognitive behavioural therapy sessions all help towards managing one’s anxiety.

In moderate to severe cases with relapsing, medication is often prescribed. Antidepressants will usually be the mainstay treatment, which can take up to two weeks for therapeutic effect to be evident. However, duration of the treatment varies greatly on several factors, such as severity of symptoms, residual symptoms, comorbidities, or level of psychosocial support.

To conclude, help is always available if you are showing any of the above symptoms, and early intervention can lead to a better prognosis.

 

Dr Goh Lit Ching is doctor of DTAP Clinic (Dr Tan & Partners). Her clinical interests include family medicine, women’s health and preventative care via health screening.

 

(** PHOTO CREDIT: Unsplash/Jeremy Wong)