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Anxiety Disorder and Stress

 

 

What is anxiety?

Self-help cards

Symptoms of anxiety

What types of treatment are available?

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What is an anxiety disorder?

Anxiety is something we all feel from time to time. It is a common reaction we have to a threatening situation. An anxiety disorder, however, differs from normal anxiety in that the person can be subject to intense and prolonged feelings of fright and distress, often for no obvious reason. Feeling somewhat nervous before an exam is an example of normal anxiety. It may even enhance one's performance. When, however, one feels anxious months ahead of the exam and suffers from insomnia and, when the exam comes, one is so anxious one cannot write the exam, this can be considered an anxiety disorder. A mother, who worries excessively and continually about whether her child will return home safely from a normal day at school, could be considered to suffer from an anxiety disorder.


Self-help cards

These are tips that can be used when anxiety strikes. They are reproduced in a set 10 flash cards that one can carry in one's pocket. Show all

 

 

 

 

 

 

 

 

 

Symptoms of anxiety
Physical Symptoms Psychological Symptoms

Muscle tension

Tremors

Palpitation

Sweating

Difficulty in breathing

Dizziness

Restlessness

Urinary Frequency

Diarrhea

Worries

Fear

Uncertainty

Irritability

Tearfulness

Poor concentration

Forgetfulness

Insomnia

Feeling things are not real

Anxiety disorders can affect all areas of our functioning, and they can mimic many other medical conditions, such as a heart condition. They are the most common of emotional disorders, occurring in about 1 of every 10 persons. They are more prevalent among women and appear even in children. Experiencing an anxiety disorder does not mean that one is going crazy, unstable, or weak in character. It is a medical condition, and, like other medical conditions such as hypertension, it responds well to the appropriate treatment.

 

What types of treatment are available for anxiety disorders?

A clear diagnosis is most important. The doctor needs to rule out other medical conditions. The person needs to understand and accept the anxiety disorder. Treatment by the doctor will help but the more motivated one is to help oneself, the more successful one will be.

There are different approaches to treating anxiety disorders and they can be used singly or in combination. One may use the services of health professionals, 6 such as family doctors, psychiatrists, psychologists, counselors, and social workers. There are also ways that one can help oneself and they are described under Self-help tips.

Psychotherapy

Talking with an understanding therapist can often help tremendously, and there are many different types of therapies which have been developed. One of the more commonly used therapies is cognitive behavioral therapy. In this therapy, it is believed that anxiety disorders are related to certain ways of thinking which are dysfunctional. These thinking patterns have developed over the years and are almost automatic. Examples include:
*
All-or-nothing thinking. If one's performance falls short of perfect, one sees oneself as a complete failure.
· The "should" statement. One places rigid demands on oneself and others.
* Personal ization. One sees oneself as the main cause of any negative event.

By analyzing such thinking patterns, the therapist can help a person to change them and overcome the anxiety which is generated by them. Behavioral techniques such as exposure are often combined wherein a person is encouraged to behave in specific ways to counteract the symptoms.

Other therapies include analytical psychotherapy which looks at deeper issues from the past that have contributed to the present problem, and supportive therapy which provides support for a person to cope with his condition. A therapist will often use a combination of appropriate strategies from different schools of therapies to help the person.

Medications

At times, an anti-anxiety drug is required when there are significant symptoms. Anti-anxiety drugs include tranquilizers, but there is the potential danger of dependency when they are not used properly. It is good practice not to use tranquilizers regularly for an extended period. Anti-anxiety drugs may also impair one's alertness. The person, together with the doctor, needs to assess whether use of these drugs would compromise driving a vehicle or operating machinery.

Antidepressants are another group of medications which are of use, particularly the Selective Serotonin Reuptake Inhibitor (SSRI). While they do not have the danger of dependency, a person still needs to discuss with his doctor any side effects he may experience.

Other medications, such as beta-blockers, may also be used to reduce palpitations and other physical manifestations of the anxiety disorder.

Relaxation training

Various types of relaxation skills are available, including breathing exercises, progressive muscular relaxation, the use of imagery, and meditation. One needs to learn the techniques, and to practice for some four to six weeks for them to be effective.

A simple method is abdominal breathing: Sit comfortably with your feet planted on the ground and place you hands on your abdomen below your belly button. You may close your eyes and imagine a nice, relaxed scene. Focus on your breathing, allowing the air to come in through your nostrils and direct it to your lower abdomen. As you breathe in, your hands should rise with your abdomen as you inhale. Exhale slowly through your mouth, noting the abdomen fall. Two inches below your belly button is the special point in Chinese medicine known as the dantian. You can focus on it as the qi from each breath accumulates there.

Lifestyle

Often, the appearance of an anxiety disorder is a sign that one's lifestyle has not been the healthiest. Aside from developing more effective strategies to combat stress, one should also try to attain a balance in one's life by addressing issues of work and play, relationships and spirituality. Nutrition, exercise and one's daily routines are all areas that can be improved upon.

Lifeskills

Sometimes, anxiety may arise as a sign of certain skill deficits. Enhancing one's own skills will lead to significant improvement of the disorder. They include assertiveness training, expressing oneself appropriately, learning not to be too passive, nor too aggressive. Time management and organizational skills are also very valuable, especially in the workplace. Courses are offered in these areas from time to time in the community.

Alternative Therapies

Alternative or complementary approaches are often effective for anxiety disorders too. These include various bodywork approaches, such as massage therapy, and reflexology. Aromatherapy, such as using lavender and lemon essential oils, has been found to help a person relax in a most pleasant way. Herbs, both from the Western tradition (such as kava kava and St. John's Wort) and from the traditional Chinese medical tradition have also been used for anxiety symptoms. When using herbs and oils, consult qualified professionals and follow the proper instructions. Special therapeutic exercises like tai chi or qigong may be particularly helpful if one can find the right teachers. Acupuncture 8 and shiatsu, based on the meridian theory in Chinese medicine, may also relieve anxiety symptoms. Hypnosis and biofeedback are other techniques.

 

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Acknowledgment

Special thanks for Dr. Hung-Tat Lo, M.B. B.S., M.R.C. Psych.U.K. FRCP (C),
who was very generous to allow us to use his article on this website.