Anxiety disorder: Manage your anxiety naturally

Anxiety sets in when a normal emotion of worry, fear or nervousness goes overboard and becomes a hurdle in your daily life. It is a normal reaction to stress and might be helpful in some situations. But, when it starts to hinder your day to day life then it’s a sign that you have anxiety disorder. There are mainly five type of anxiety disorders. These are generalised disorder, social anxiety disorder, obsessive compulsive disorder, panic disorder and post-traumatic disorder. Anxiety varies from person to person. You might get butterflies in your stomach or a racing heartbeat. Some might experience nightmares while others may not be able to sleep well. It becomes difficult for people to concentrate and control their thoughts. You might start avoiding situations and places to prevent these feelings. You must consult a doctor if you experience any of these symptoms. Here, we give a few tips to help you deal with this disorder.

Anorexia stems from body as well as mind – study

Laura Shah

Image caption

Laura Shah was diagnosed with the disease when she was 15 years old

The origins of the eating disorder anorexia nervosa are in both the mind and the body, according to an international study.

Anorexia is seen as a serious psychiatric disease.

But doctors at King’s College London showed changes hardwired into some people’s DNA altered the way they processed fats and sugars and may make it easier to starve their bodies.

The eating disorder charity Beat said the findings were groundbreaking.

What is anorexia?

It is an eating disorder that leads people to lose as much weight as possible by eating little and sometimes exercising excessively.

People with anorexia often have a distorted image of themselves and can feel fat even if they are dangerously underweight.

It is more likely to affect young women but can affect anyone of any age or gender.

In the long term, anorexia can damage muscles, bones, the heart, fertility and can be fatal.

It can be treated and people can make a full recovery.

What is it like to have anorexia?

Laura Shah, 23, from Suffolk, was diagnosed when she was 15 and signed off school for treatment.

She was a bright high-achiever using exercise as a coping mechanism but it “spiralled out of control”.

She said the disease had had a “massive and quite horrible” impact on her family.

Her mother had had to quit her job to be her carer (her father had been working abroad at the time) and it had created “a lot of trust issues”.

She is doing much better now – but anorexia continues to be a challenge, particularly:

  • going out for a meal on a date, when “it’s embarrassing not being able to eat”
  • listening to people at work talk about dieting, which triggers anorexia thoughts and behaviours

What did the study show?

The researchers looked at 16,992 people with anorexia and 55,525 people without the disease, from 17 countries.

All their DNA – the blueprint for the human body – was analysed to find mutations in genetic instructions that were more common in anorexia patients.

The study, published in Nature Genetics, found some mutations also presented in other psychiatric disorders such obsessive-compulsive disorder, anxiety, and schizophrenia.

But they also found mutations in the instructions that control the body’s metabolism, particularly those involving blood sugar levels and body fat.

“There is something in those systems that has gone awry,” Prof Janet Treasure, from the Institute of Psychiatry at King’s College London, told BBC News.

Media captionAnnabelle developed anorexia when she was a teenager

The researchers – at King’s and the University of North Carolina at Chapel Hill – say anorexia should now be considered a “metabo-psychiatric disorder” as it is a disease of mind and body.

How does metabolism affect the risk of anorexia?

The researchers have not fully explored the role played by the genetic instructions they discovered.

However, they suspect the mutations allow people to starve their bodies for longer.

When most people lose weight, there are signals in the body that push back, stimulating the appetite..

“These are very important in controlling the set-point of weight,” Prof Treasure told BBC News.

“It’s possible that when people lose weight with anorexia nervosa, they haven’t got such strong drivers getting the set-point back to normal.”

How important are these findings?

“It’s very significant because there’s been difficulty knowing what sort of disorder anorexia is,” Prof Treasure told BBC News.

“There have been swings in our understanding

“Now, we know it’s a complex mixture of aspects from the body and the mind that interact and cause this complex disorder.”

Knowing anorexia was a mix of the physical and the mental could persuade patients to have treatment, she added.

What do the experts say?

Andrew Radford, the chief executive of Beat, said: “This is groundbreaking research that significantly increases our understanding of the genetic origins of this serious illness.

“We strongly encourage researchers to examine the results of this study and consider how it can contribute to the development of new treatments so we can end the pain and suffering of eating disorders.”

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Greater Disease Severity With Comorbid OCD, Bipolar Disorder

Patients with obsessive-compulsive disorder (OCD) and comorbid bipolar disorder (BD) appear to have more severe disease, with a higher risk for suicide, and need specific treatment strategies, according to study results published in the Journal of Affective Disorders.

Mariana S. Domingues-Castro, MD, MS, of the Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, University Estadual Paulista, Brazil, and colleagues conducted a cross-sectional study involving 955 adult patients with OCD from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. They used the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Beck Depression and Anxiety Inventories, and the Structure Clinical Interview for DSM-IV Axis I Disorders to evaluate disease characteristics and severity in patients.

The lifetime prevalence of BD in the patient cohort with OCD was 7.75% (n=74). Of patients with BD, 42% presented with type I and 53% with type II; 5% had unspecified BD. Patients who suffered from both disorders had poorer insight, experienced more frequent sensory phenomena, and had greater severity of anxiety and depressive symptoms. These patients also were more likely to report suicidal ideation, suicide plans and attempts, and to have a more extensive family history of affective symptoms. Patients with both OCD and BD reported more psychotherapy and greater use of oxcarbazepine, sodium valproate, topiramate, lithium, clozapine, and olanzapine. The OCD/BD group also presented more frequently with anxiety disorders, including generalized anxiety disorder and panic disorder with agoraphobia. In addition, they were more likely to have eating disorders; impulse control disorders such as pathologic gambling, compulsive buying, compulsive sexual disorder, and skin picking; alcohol abuse and dependence; body dysmorphic disorder; and attention-deficit/hyperactivity disorder.

After logistic regression analysis, features that remained associated with BD in these patients were panic disorder with agoraphobia, impulse control disorders, and suicide attempts.

Although the study population was large, it came from a tertiary treatment center, where patients generally had more severe disease. Thus, these results may not be generalizable to the larger population.

Researchers suggested that clinicians should investigate impulsive behaviors in patients with OCD and comorbid BD. They further recommended that in patients with OCD and panic disorder/agoraphobia comorbidity, possible symptoms of BD should be evaluated and treated appropriately. Furthermore, patients should be monitored closely for suicide risk.

Reference

Domingues-Castro MS, Torresan RC, Shavitt RG, et al.  Bipolar disorder comorbidity in patients with obsessive-compulsive disorder: prevalence and predictors. J Affect Disord. 2019;256:324-330.

People With Anxiety Disorders Can Soon Get Pa. Medical Marijuana Cards

City

And that opens the door for a whole lot of people to apply to the program.

medical marijuana anxiety

FatCamera/istockphoto.com

A whole lot more people are about to become qualified for a medical marijuana card in Pennsylvania.

On Thursday, the Pennsylvania Department of Health added anxiety disorders — as well as Tourette syndrome — to its list of approved medical conditions for the state’s medical marijuana program.

The change, which goes into effect on July 20th, comes after a research-based recommendation by the state’s Medical Marijuana Advisory Board, followed by Health Secretary Rachel Levine’s “careful review” of the medical literature available about the conditions.

“I do not take this decision lightly, and do have recommendations for physicians, dispensary pharmacists and patients in terms of the use of medical marijuana to treat these conditions,” Levine said in a statement this week. “For both conditions, medical marijuana is not first-line treatment and should not replace traditional therapies, but should be used in conjunction with them when recommended by a physician.”

According to the National Institute for Mental Health, approximately 19 percent of Americans suffer from some sort of anxiety disorder. Anxiety disorders — the most common type of mental health conditions — include generalized anxiety disorder, agoraphobia (or a fear of certain places), post-traumatic stress disorder, obsessive-compulsive disorder, separation anxiety disorder and other types of phobias, including social anxiety disorder.

Levine advised patients with these disorders to pursue (or continue pursuing) counseling and therapy to manage their conditions. She added that short-term use of medical marijuana with low THC and high CBD content has been shown to be most effective in treatment of anxiety disorders. Plus, she said medical marijuana is not recommended to treat children, adolescents, or pregnant women with anxiety disorders.

About 200,000 Americans are estimated to have the most severe form of Tourette syndrome, which is typically first noticed in childhood, according to the National Institutes of Health. As many as one in 100 people exhibit milder and less complex symptoms, like chronic motor or vocal tics, per the organization.

Pennsylvania now lists 23 qualifying conditions in its medical marijuana program, of which there are 111,000 active patient certifications. You can learn more about the program here.

Between 16 and 18% of preadolescents have ideas of suicide

The researchers studied a group of 720 boys and 794 girls who studied in 13 schools in Reus. They were monitored during three developmental periods: 10 years old, 11 years old and 13 years old. At the beginning of the study, the students answered a series of psychological tests that were used to detect which of them presented emotional symptoms related to depression, anxiety and obsessive compulsive disorder (OCD). From their responses, two groups were created: one group at risk of emotional problems and a control group.

The disorders were diagnosed with standardised international criteria and the boys and girls were monitored to see how suicidal ideation developed throughout the research period.

The figures were quite stable. During the first period, 16% of the students stated that they had thought about suicide, of whom 33% stated the same one year later. In both the second and the third period, ideas of suicide were expressed by 18% of the students surveyed. The risk of suicide was determined in a personal interview and was present in 12.2% of the children with an average age of 11 years old. Although there were no differences between the sexes, the severity of the suicidal behaviour was greater in boys.

The researchers also observed what factors predicted suicidal ideation and they found here that there were differences between the sexes. “In boys it is previous depressive symptoms which determine subsequent suicidal ideation,” says Núria Voltas, one of the researchers involved in the study. In girls, on the other hand, it is a combination of anxiety symptoms, OCD and the family’s socioeconomic situation.

The results of this research, published in the scientific journal Archives of Suicide Studies reveal the factors that can trigger ideas of suicide in this age group. “Our results will enable us to have greater control over this particular aspect and take prevention measures in preadolescents, who are going through a period of considerable vulnerability,” she concludes.

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Bibliographical reference: Voltas, N., Hernández-Martínez, C., Arija, V. Canals, J. Suicidality in a Community Sample of Early Adolescents: A Three-Phase Follow-Up Study. Archives of Suicide Research. DOI: 10.1080/13811118.2019.1588816

How you can identify an anxiety disorder

Anxiety is a normal reaction, however, it becomes a problem when it becomes constant, pervasive and interferes with our daily functioning.

The symptoms of an anxiety disorder include emotional (uneasiness and irritability), physical (palpitations, chest pain, muscle tension, headaches, nausea and faintness), and behavioural (avoidance of certain places, situations or objects). Ref: Anxiety Disorders Kit.

Anxiety disorders may include:

Panic disorder is an illness where panic attacks are experienced. The symptoms include breathing difficulties, heart palpitations, chest pains, dizziness, sweating, trembling, fear of dying or losing control and fear of choking.

Agoraphobia is an anxiety disorder where there is fear of leaving familiar surroundings. A person may be reluctant to travel or be in a crowded place.

The symptoms may be similar to that of a panic attack. In addition there may be feelings of depression, loss of self-esteem and self-confidence, frustration and anger with oneself.

In Generalised Anxiety Disorder (GAD), there is unrealistic and excessive worry about finances, health, work and/or relationships.


Symptoms include increased blood pressure, feelings of fear and apprehension, restlessness, startling easily, sleep difficulties, frequent urination, muscle tension, irritability.

A person with Obsessive-Compulsive Disorder (OCD) has constant and unwanted thoughts, which result in certain rituals to control or stop them: eg: washing hands constantly, wiping a seat before sitting.

People, who suffer from OCD, have obsessions which are intrusive and disturbing thoughts that they cannot control. Compulsions are repetitive, distressing purposeful physical behaviours relating to the thoughts.

People with Post-Traumatic Stress Disorder (PTSD) may have witnessed or a victim of trauma such as abuse, torture, vehicle accidents, fire and may continue to have nightmares of flashbacks.

Symptoms may be in the form of intrusions like nightmares and flashbacks that disturb sleep and normal activities of life.

Hyperalertness is increased sensitivity to being touched, sudden appearance of a person or phone ringing. Avoidance of places can occur. The person’s relationships are adversely affected.

Social phobia is a fear that others will judge you in a negative way. The person may avoid eating, speaking or writing in front of others. Symptoms include intense fear, racing heart, trembling, muscle twitches.

The good news is that this is a treatable condition. An assessment is made by a psychologist or psychiatrist and treatment commences. Treatment consists of therapy and possibly medication.

Study: OCD Research Needs to Focus on the Patients Themselves

In a new paper published in the journal, Clinical Psychology Review, psychology researchers assert that scientific research into obsessive compulsive disorder (OCD) has become further and further removed from the people these studies are supposed to help: OCD patients and the therapists who treat them.

On one hand, cognitive science has been extremely beneficial in furthering our understanding of mental health disorders. The interdisciplinary study of the mind and its processes embraces elements of psychology, philosophy, artificial intelligence, neuroscience and others topics. The field is rife with areas of exploration for researchers, and it has contributed enormously to the study of debilitating disorders such as OCD.

But for those living with OCD, research into their condition is not an abstract concept — it should have profound real-life implications.

Adam Radomsky, a professor in the department of psychology and the Concordia University Research Chair in Anxiety and Related Disorders, worries that for all its fascinating studies, cognitive science is becoming further and further removed from OCD patients and their therapists.

Radomsky and two of his former PhD students, Allison Ouimet and Andrea Ashbaugh, both now associate professors at the University of Ottawa, reviewed recent OCD research and found that, as interesting as it was, it did not necessarily translate into real benefits for treatment.

As Radomsky explains it, there are two hallmark symptoms of OCD.

“Obsessions are horrible intrusive thoughts people have over and over in their minds,” he explains. “Compulsions are things people do over and over again, like checking you’ve completed a task, or washing and cleaning.”

A commonly held belief among researchers suggests that memory has something to do with OCD behavior. “People are not sure if something is safe or clean or locked,” he says. An old theory was that the problem may have been cognitive in nature, or perhaps neurological.

Over the years, researchers have conducted countless studies on people with the disorder. However, after reviewing the literature, Radomsky says the overall results are equivocal.

“Research into memory, neurobiological and attention deficits probably have not helped therapists or clinicians and probably have not improved therapy,” he says.

The research did prove beneficial in another area though, that of the individual’s beliefs in their own cognitive functioning.

“It’s not that people with OCD have a memory deficit. It’s that they believe they have a memory deficit. It is not their ability to pay attention that is the problem; it is that they do not believe they can focus,” he says. “In the clinic, we can work with what people believe.”

As both an academic researcher and practicing psychologist, Radomsky says he hopes his review will be of help to colleagues inside and outside the lab.

“We think the review will help therapists focus on areas that will be of use, and hopefully help cognitive scientists look at domains that could be useful to clinicians,” he says.

Radomsky would like to see cognitive scientists and practitioners working closer together with the goal of providing better treatment for people living with OCD.

“We learn a lot from the science that researchers are doing, but we also learn a lot from clients and patients,” he says.

“In fact, in some ways, patients are the better instructors because they are living with these problems. I suspect we are going to increasingly follow their lead, because when they voice a particular concern or doubt in themselves, those are often the best ideas to take into the lab.”

Source: Concordia University

Escitalopram: Uses, side effects, warnings, and interactions

Escitalopram is the generic version of Lexapro. It belongs to a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. These drugs can help the body balance naturally occurring serotonin levels in the brain.

Doctors prescribe escitalopram to treat clinical depression or general anxiety disorder.

Generic and branded versions of escitalopram are available by prescription. The medical community generally considers escitalopram safe, but there is a risk of side effects, which can range from mild to severe.

Uses

A doctor may prescribe escitalopram for depression or generalized anxiety disorder.
Image credit: Tom Varco, 2006

Doctors typically prescribe escitalopram to treat either depression or generalized anxiety disorder. Some healthcare providers prescribe escitalopram alongside other medications and therapies to treat these conditions.

Researchers have shown that escitalopram is safe and effective for treating depression in adolescents aged 12–17, but not in children younger than 12.

Doctors do not use escitalopram to treat general anxiety disorder in people younger than 18.

Some doctors also prescribe escitalopram, off-label, for conditions such as:

  • panic disorder with or without agoraphobia
  • social anxiety disorder, sometimes called social phobia
  • obsessive-compulsive disorder, or OCD


Forms, how to take them, and dosages

Escitalopram is available as a pill or a liquid. A person can take either form orally, with or without food.

People take escitalopram at the same time each day, either in the morning or at night before bed. Escitalopram can make some people drowsy and others more energized. This effect can help determine when a person should take the drug.

It is important to take escitalopram exactly as directed, without skipping or changing doses.

Initially, a doctor usually prescribes an adult a low dosage for 1 week, then gradually increases the dosage over time if they believe that it is necessary. For adolescents, doctors will wait for 3 weeks before increasing the dosage.

As with other antidepressants, it may take some time before a person feels the effects of escitalopram. A person should continue the treatment, even after they feel better.

It is important not to stop the treatment suddenly, without consulting a doctor. Doing so can cause side effects, such as extreme sleepiness and dizziness. We discuss these effects in depth below.

If a person misses a dose, they can take it as soon as they remember. However, it is not a good idea to double up on doses. If a person realizes that they have missed a dose close to the time of the next dose, they should skip the missed dose and continue as usual.

The Food and Drug Administration (FDA) have approved two dosages of escitalopram:

  • 10 milligrams (mg), the typical starting dosage
  • 20 mg

Escitalopram is also available in pills of 5 mg. A person can also cut a pill in half to form a different dosage, as a doctor advises.

The liquid form of escitalopram comes in a strength of 1 mg per milliliter.


Side effects

Some side effects of escitalopram include yawning, sweating, and dry mouth.

In adults, some common side effects of escitalopram include:

  • yawning
  • sweating
  • dry mouth
  • constipation
  • sleepiness
  • trouble sleeping
  • changes in appetite
  • dizziness
  • anxiousness
  • nausea
  • sexual dysfunction

In adolescents and children, some common side effects of escitalopram include:

Common side effects are often mild, and they typically go away over time as the person gets used to the medication. However, if they persist or get worse, speak to the doctor.

More severe side effects can also occur. A person who experiences any of these should consult their doctor immediately or seek emergency medical assistance.

Some severe side effects include:

  • a severe allergic reaction
  • low sodium in the blood
  • possible slowed growth rate and weight change in children and adolescents
  • changes in vision
  • bleeding more easily than usual
  • manic episodes
  • serotonin syndrome
  • seizures
  • suicidal thoughts or actions

Serotonin syndrome is a reaction that occurs when the central nervous system receives too much stimulation. It is most common when a person takes additional medication that either increases their serotonin levels or decreases their metabolism.

Serotonin syndrome can result in agitation, a racing heartbeat, coordination issues, and low or high blood pressure.


Adverse effects when stopping

There are several potential adverse effects if a person stops taking escitalopram. The risk is greater when a person stops the treatment suddenly.

Some possible adverse effects of stopping escitalopram include:

To help prevent these effects, a doctor will often wean a person off of the treatment slowly.

Warnings

Escitalopram carries a warning label from the FDA indicating that the drug can increase the risk of suicidal thoughts or actions. This reaction is most common in children, teens, and young adults.

However, a doctor may still recommend the use of escitalopram in younger people if there is a need that outweighs the potential risk.


Escitalopram also comes with the following warnings, aside from those dealing with possible side effects:

  • Escitalopram may increase depression symptoms.
  • A person may experience withdrawal symptoms after stopping treatment.
  • It is unclear whether it is safe for pregnant women to use escitalopram. Laboratory studies have shown adverse effects in mice, but there have been no conclusive findings in humans.
  • Abnormal bleeding can occur while taking the drug. Anyone who also takes medication that affects the blood, such as blood thinners, should use caution.
  • People should not drink alcohol while using escitalopram.
  • Escitalopram can interact with treatment for other health conditions, particularly those that alter metabolism or blood flow.

Discuss these warnings with a doctor before starting a course of escitalopram.

Learn more about why doctors do not recommend mixing escitalopram with alcohol here.


Drug interactions

A person should tell their doctor about any other medication they are taking to avoid any negative drug interactions.

Several drugs interact with escitalopram. These interactions can be harmful and cause medications to work less well. A person should tell their doctor about any other medicines, vitamins, and supplements that they take.

Also, a doctor should monitor anyone who is taking escitalopram. The doctor can help identify changes in mood and help ensure that the person does not take any other treatments that may interact with escitalopram.

Some treatments to avoid while taking escitalopram include:

  • blood thinners
  • drugs to treat migraines
  • acid reducers
  • water pills
  • psychiatric drugs, including other antidepressants, unless a doctor prescribes them
  • drugs that also increase levels of serotonin

Cost

The cost of escitalopram depends on the dosage, whether a person has health insurance, and whether a person is taking a generic or branded version.

People without insurance may receive discounted treatment. Most insurance plans cover at least a generic version of escitalopram.


Alternatives

There are several possible alternatives to escitalopram. It is important to note, however, that all antidepressant medications carry similar risks.

Anyone who believes that they would benefit from taking an antidepressant should talk to a doctor or another healthcare provider about the options.

Learn more about antidepressant medications here.


Summary

Escitalopram is an antidepressant drug that is generally safe. Doctors typically use it to treat depression and general anxiety disorders.

Before starting a course of escitalopram, discuss any personal or family history of suicidal thoughts or actions with a doctor.

The doctor should also review all medications, supplements, and vitamins that a person is taking before they prescribe this drug.

If a person experiences any mild side effects, they should let their doctor know. If side effects are persistent or severe, seek immediate medical attention.

Anxiety: Causes, Symptoms, Treatments

There’s nothing more gut wrenching than feeling as though you have no control over anything, particularly about things that you think *could* happen in the future. You know there’s no logical reason to feel this way. And yet, that nagging voice inside your head tells you otherwise. While feeling anxious is a normal part of life and a natural response to stress, people can also fall prey to anxiety disorders. So, how can you spot an anxiety disorder from everyday anxiety?

Anxiety vs. Anxiety Disorder

Everyone will experience anxiety from time to time. Feelings of worry and fear are considered completely normal and even necessary for survival and the sensations we feel that come with anxiety are designed to alert us of potential danger or threat so that we’re able to protect ourselves. But whether it’s normal anxiety or an anxiety disorder, experiencing either is undeniably unpleasant and can go as far to jeopardize your work, relationships, and any other aspect of your life. That being said, it’s important that we acknowledge our mental health and well-being especially in this day and age. Because chances are, if you’re not suffering from an anxiety disorder, someone close to you is. Here are two key differences:

  1. Stressor – Anxiety usually occurs in response to a stressor. An important event or a job interview, for example, could give you butterflies in your stomach but it could also motivate you to do better. When you’re suffering with an anxiety disorder, you’re anxious almost all the time and are not able to pinpoint the source of the stress. Even seemingly small tasks, such as doing chores and meeting deadlines, can already make you feel anxious.
  2. Intensity and length – The main difference between normal anxiety and an anxiety disorder is that the former’s effects are fleeting. You may be anxious and on edge right before a speech you’re about to make but as soon as you finish or maybe even start, all the tension you were feeling has already left your body. With someone who struggles with an anxiety disorder, the feeling of anxiousness can already begin weeks before and are usually more intense and overwhelming right before and during the speech.

Causes Of Anxiety Disorders

There is not one specific answer to what causes an anxiety disorder as it differs from one person to another. But more often than not, a number and combination of factors can play a role:

  1. Environmental factors – Day-to-day life such as work, school, and personal relationships can take a toll on your mental health. This also includes stressful life events such as verbal, sexual, physical, and emotional abuse or trauma.
  2. Genetics or family history of mental health problems – Anxiety can sometimes run in the family. But just because someone from your immediate family is diagnosed with an anxiety disorder, doesn’t mean you’ll automatically develop it as well.
  3. Medical conditions/health problems – Chronic physical illnesses and other mental health problems can also contribute to anxiety disorders. Side effects of medications, stress from recovery or another underlying mental health problem may be causing significant changes in your lifestyle that trigger anxiety. According to research, depression and anxiety can often occur together.
  4. Brain chemistry/personality traits – Stressful and traumatic experiences can alter your brain’s functions. Some people who grow up in an abusive home the same way as people who lack self-esteem may be more susceptible to developing anxiety disorders.
  5. Substance use – Some people who are experiencing anxiety can turn to substance use as a way to cope. In some cases, people who are unable or having difficulty to manage their problems can aggravate the condition.

Different Types Of Anxiety Disorders

The five major types of anxiety disorders are:

  1. Generalized Anxiety Disorder – People with Generalized Anxiety Disorder (GAD) excessively and unrealistically worry for long periods of time over things that may be related to work, personal relationships, etc. and can differ for everyone.
  2. Obsessive-Compulsive Disorder – Anxiety that involve repetitive thoughts and behaviors fall under Obsessive-Compulsive Disorder. Although the average person can experience minor obsessions and compulsions, you can differentiate it when it’s become a medical concern once it impacts how you live your life.
  3. Panic Disorder – Panic Disorder involves recurrent and unexpected panic attacks and are often mistaken as a heart attack because of its physical effects (chest pain, palpitations, sweating, etc.). People who are diagnosed with Panic Disorder tend to try to prevent future attacks by avoiding situations and places they associate the attacks with (public transport, parties, etc.).
  4. Post-Traumatic Stress Disorder – Post-Traumatic Stress Disorders (PTSD) develop after going through something traumatic. People who are diagnosed with PTSD relive these events through flashbacks, nightmares, and even hallucinations and are usually accompanied by severe anxiety and uncontrollable thoughts.
  5. Social Anxiety Disorder – It is the anxiety that involves extreme fear and avoidance of everyday social situations. The feelings that may come with Social Anxiety Disorder may include overwhelming worry and self-consciousness of fear of being judged or embarrassed in public spaces or in front of another person.

Symptoms Of Anxiety Disorder

Your anxiety’s symptoms may be entirely different to someone else’s which is why it’s important to be knowledgeable about the different ways it can also present itself. Here are other general symptoms you can look out for:

  • Difficulty falling asleep
  • Feelings of fear, panic, and uneasiness for long periods of time
  • Increased heart rate
  • Becoming easily fatigued
  • Trouble concentrating, restlessness
  • Nausea
  • Easily irritable than usual
  • Muscle tension
  • Difficulty controlling worry
  • Avoidance behavior (can be applied to normal activities such as going to work, hanging out with friends, etc.)

Treatments

If you ever experience the symptoms mentioned above, it’s best to seek medical help. When diagnosed with an anxiety disorder, here are some forms of treatment that may work for you:

  1. Psychotherapy – This is a form of therapy that we often see in movies or tv shows. In simpler terms, it’s what we call “talk therapy” and is a treatment that uses psychological rather than medical means. It’s one of the most common forms of treatment and is highly recommended since it is specifically tailored to the person’s needs.
  2. Support groups – Those who struggle with anxiety disorders might prefer and benefit in joining a support group to share similar experiences, coping strategies, and achievements that may be fill the emotional support if needed.
  3. Medication – It’s important to note that taking prescribed medication cannot cure anxiety but should be seen as a short-term solution which is why this treatment is often accompanied by some form of psychotherapy as studies have shown that psychotherapy is more effective in terms of helping manage anxiety disorders in long-term.

Ways You Can Help Ease Anxiety

Like most mental illnesses, there’s no one-size-fits-all solution to curing and preventing anxiety. However, making small lifestyle changes can definitely help. Here are some ways you can ease it:

  1. Limiting your screen time – Millennials are arguably the most stressed and anxious generation due to the social-media driven world we live in. Though it is not proven whether more screen time leads to depression and anxiety, we can all agree that some time off can do us wonders. Whether you like it or not, spending more time on our gadgets rather than living our everyday can potentially become a red flag pointing towards anxiety.
  2. Cutting down on caffeine – Sorry to burst your bubble but caffeine can actually be contributing to your anxiety. Those jitters you are feeling after a good old cup of coffee are so similar to the “fight or flight” response which floods the body with adrenaline that one too many cups of coffee can make an anxiety worse or even trigger an anxiety attack.
  3. Strive for a more holistic lifestyle – Generally speaking, leading a healthier lifestyle is good for anybody. Exercising regularly, getting enough sleep, and eating healthier are steps you can take to make simple yet powerful changes that can overall affect your whole mood.

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Postpartum Anxiety And Depression – Symptoms To Know

If you’re a new or expectant parent, or even just thinking about starting a family, you’ve probably heard at least a little bit about postpartum depression (PPD). But what often gets glossed over in the conversation surrounding maternal mental health is the postpartum anxiety component.

Postpartum anxiety affects an estimated 15 percent of women (though that number varies a bit in the scientific research). This suggests that it’s just as common as PPD, which has been shown to affect anywhere from 10 to 20 percent of new moms.

But postpartum anxiety and postpartum depression are closely related. Historically, medical experts and resources have used “postpartum depression” as an umbrella term for a whole host of mood disorders that can occur in the postpartum period, including obsessive compulsive disorder (OCD), psychosis, and anxiety, explains Shelly Orlowsky, PsyD, a licensed clinical psychologist who specializes in perinatal mood and anxiety disorders.

The problem with grouping them all together, though, is that it may be confusing to some women who feel off during or after pregnancy but don’t feel like they have symptoms depression. There’s no one-size-fits-all diagnosis, but having a better understanding of what sets postpartum anxiety and depression apart as well as how they overlap is an important step toward getting mamas proper mental health treatment in the perinatal period.

First, a quick refresher on what postpartum depression generally looks like:

Many new moms experience what is casually referred to as the “baby blues”—a period of feeling sad, irritated, angry, annoyed, hopeless, and/or resentful during the first couple of weeks following childbirth. (Hello, you just had a baby, and it’s a LOT.) You may feel like crying for no reason, be unsure about raising your baby, or have trouble sleeping, the American College of Obstetricians and Gynecologists (ACOG) explains. These feelings can come and go in waves, but ultimately they should resolve pretty much on their own within a week or two after welcoming your baby.

So then how is PPD different from the baby blues? PPD may last up to a year after having your baby, and it generally requires more formal treatment (like therapeutic or medical interventions). Fun fact: The latest issue of the Diagnostic and Statistical Manual of Mental Disorders (which is like the medical Bible of mental health disorders), includes a “with postpartum onset” specifier in its section on major depressive disorder (MDD) to more deliberately represent postpartum depression as its own condition. It was kinda lumped in under MDD until fairly recently.

Women with PPD frequently report having an intense feeling of being overwhelmed by motherhood and may even question whether they should’ve become a mom in the first place, Orlowsky describes. Another recurring thread, she says, is just not feeling like yourself, or feeling out of control without knowing why.

She’s also had patients who report feeling nothing, or being emotionally numb; they’re simply going through the motions without any interest in their babies, or life in general. Some moms may harbor thoughts of harming herself or her baby. As you can see, postpartum depression is pretty complex and can look very different from person to person. (Oh, and it can affect new dads, too.)

It’s worth pointing out that with any pregnancy-related mood disorders, the term “postpartum” can be misleading. That’s because symptoms can pop up during your pregnancy or after you give birth. So, you may also hear “perinatal” used, which more generally implies the time before and after childbirth.

Symptoms of postpartum anxiety are a little different.

Postpartum anxiety isn’t listed as its own thing and doesn’t have a specifier in the DSM. But your doctor might still use the term to describe how you’re feeling and to diagnose you—it’s a standard term in the medical world.

Orlowsky describes PPD as a loss of heart, and postpartum anxiety—or perinatal generalized anxiety disorder—as a loss of a normal sense of balance and calm. Women with postpartum anxiety specifically aren’t necessarily dealing with depression.

Rather, women with postpartum anxiety on its own may feel as if they are in a constant state of arousal, agitation, and worry, she explains. They may feel unable to quiet their mind no matter how hard they try, or have trouble sitting still or getting to sleep.

The term “postpartum” can be misleading.

Some moms with postpartum anxiety have disturbing “what if?” thoughts about bad things happening to the baby. They may be afraid to get into the car with their child, or are uncomfortable leaving him or her with anyone else. Moms who suffer from intrusive thoughts like this may not be able to respond to reason, Orlowsky notes. (For instance, even though deep down you *know* your partner is home with the baby while you go out to run errands and everything’s okay, you might be compelled to turn back and go through a safety checklist again.)

Like it’s relative PPD, postpartum anxiety is treatable. That being said, because PPD has been studied and discussed at much greater lengths, many moms with postpartum anxiety don’t recognize they have it, and it often goes undiagnosed. Another reason moms with postpartum anxiety don’t realize they have a problem or delay seeking help is because they don’t know how much anxiety is to be expected or “normal,” versus how much is too much—even for a new mom.

You can have symptoms of postpartum depression or postpartum anxiety, or a mix of the two.

Physical symptoms of PPD are similar to those of perinatal anxiety and typically include changes in sleep and appetite, nausea, headaches, body aches, and dizziness. You can predominantly have symptoms of depression with tell-tale signs of anxiety mixed in, or the opposite.

The relationship between the two disorders isn’t fully understood, per the Massachusetts General Hospital Center for Women’s Mental Health says. It’s unclear whether having postpartum anxiety is more likely to bring on PDD, or vice versa, Orlowsky says. In one scenario, a mom can be depressed and also consumed with worrisome thoughts regarding her baby’s safety. On the flip side, a mom’s anxiety may become so cumbersome that it leads her to have depression symptoms as well.

Women with PPD or anxiety (or a combo) might feel guilty or ashamed about their inability to embrace motherhood. As a result, they might have a hard time being among other moms, friends, and family members. But social isolation can end up deepening the pain of it: “Postpartum depression and anxiety are so draining [that] moms don’t want to be around other people—but that’s precisely what they need,” Orlowsky says.

It may not seem like distinguishing between the two really matters, but it does. Perinatal mood disorders are not black and white for every person, and that’s totally okay. But being able to describe your symptoms to your doctor, whether they take the form of anxiety or depression or seem to be some hybrid, helps your physician tailor a treatment plan to fit your needs.

If you think you have postpartum depression and/or anxiety, these are your next steps.

If you just feel off, and feelings of anxiousness or depression are making you unable to function properly from day to day for longer than two weeks, you likely need to seek out professional help.

But if you’re not ready for that step (hey, no judgment), start by sharing how you’re feeling someone you trust. This can be a friend, family member, doula, or a medical professional. “You don’t have to be able to diagnose yourself, but you know when you have a cold versus the flu,” Orlowsky explains. (In other words, you have the best sense of what feels normal or not for you.)

Ideally, your pediatrician or obstetrician has screening measures in place to assess whether you are exhibiting symptoms of postpartum depression or anxiety, after which they can refer you to a clinician who specializes in perinatal mood and anxiety disorders.

What’s more, if you have dealt with anxiety and/or depression during a previous pregnancy or were diagnosed with both or either one of these conditions prior to having kids—it’s important to address that with your obstetrician. A woman who has had PPD or postpartum anxiety in a previous pregnancy is 50 percent more likely to develop it in a subsequent pregnancy, according to Orlowsky. That said, you may not have had either with your first child (or multiple children) but could still develop it during subsequent pregnancies.

Treatment absolutely exists for both postpartum anxiety and postpartum depression—and you deserve it. Some women may benefit from one-on-one therapy and/or support groups when dealing with PPD and/or anxiety, while others may also require medication. When Orlowsky thinks a patient could benefit from medication, she refers them to a reproductive psychiatrist.

Vital Signs: Don’t forget the new mom; help is available for perinatal misery

When a woman is pregnant, so much attention is on the new baby. Is it a boy or a girl? When is the baby shower? When is the due date? Family and friends will ask, “Are you ready for the baby to be here?” Baby, baby, baby — but what about Mom?

New mothers have more responsibilities, have to respond to their new babies around the clock, and must adjust to changes in their relationships with partners, friends and families. Add this to the physical recovery after giving birth, and you understand why most mothers remember this as one of the most wonderful, difficult and tiring life stages to endure. It is no wonder that some mothers struggle with these changes.

Mothers are often warned about “baby blues” — the feelings of exhaustion, anxiety, unexplained crying and mood swings that usually happen within the first two weeks after the baby is born. According to the American Academy of Pediatrics, baby blues are common — affecting about 50% to 80% of all moms — and relate to a major decrease in hormonal activity after delivery. Baby blues usually resolves on its own, but if it does not, it may be because a mother is experiencing perinatal mood and anxiety disorders.

What used to be known as postpartum depression is now recognized as perinatal mood and anxiety disorders, (PMADs). This term describes a range of symptoms that more fully capture what many mothers experience. According to the American Academy of Pediatrics, PMADs include depression, anxiety, obsessive-compulsive disorder and psychosis (one or two cases per 1,000 women).

About 20% of new mothers will experience PMADs in the first year after baby is born. It can be months until a mother has symptoms. Some PMAD symptoms include feeling overwhelmed or irritable; having sleep disturbances or anxiety; and feeling distant from one’s baby, friends and family.

Although there is no single cause for PMADs, it is important to remember that PMADs do not happen because of something a mother has or hasn’t done. Some factors that the American Academy of Pediatrics has linked to PMADs include:

» Hormone changes after childbirth

» Personal or family history of mood and/or anxiety disorders

» Stress related to going back to work or school, lack of free time, sleep issues, relationship problems and/or lack of support

» History of trauma

» History of significant reproductive health issues

» Psychological factors, including unrealistic expectations, perfectionist tendencies and difficulty with transitions.

Normally, PMADs are associated with the birth mother; however, any new parent may experience these feelings. Family members and friends can play an important role in helping their loved ones get help for PMADs.

How you or someone you know can get help for PMADs:

» Make an appointment with your doctor. Almost half of PMAD cases go undiagnosed because many women feel reluctant to talk about how they feel. Your doctor may refer you to a local therapist or prescribe medication to help.

» Surround yourself with a support system for help. Family, friends and other new parents can be a major source of support.

» Attend a local support group. Visit the Postpartum Support Virginia website (postpartumva.org) to find a local support group in your area.

» Out of the Blues – Charlottesville support group meets first and third Mondays of every month from 7:00 to 8:30 p.m. and second and fourth Thursday of every month from 10:30 a.m. to noon. Learn more at https://www.sentara.com/charlottesville-virginia/classesevents/support-groups/out-of-the-blues-a-postpartum-support-group.aspx

» Call the “Moms on Call Program” support phone line or visit http://momsoncall.com/

» Visit the Thomas Jefferson Health District’s website (TJHD.org) for information about pregnancy and parenting resources.

» Search for other resources. For example, the Improving Pregnancy Outcomes Workgroup, a local coalition that is open to the public, shares resources and discusses challenges and solutions surrounding pregnancy and birth outcomes.