Anxiety Latest Facts: Types, Diagnosis, Symptoms, Treatment and Prognosis

What is anxiety?

Anxiety is a part of our everyday life and this temporary feeling of worry is completely normal. But when it becomes permanent or a semi-permanent feeling, it can be classified as an anxiety disorder.

Anxiety disorders last for a long time and interfere with a person’s everyday life. The feeling of fear associated with anxiety disorders can be debilitating and can reduce the quality of life greatly. They are the most common form of emotional disorder, affecting around 40 million adults in the US alone. Anxiety disorders have a predilection towards females, as it affects twice as many women as men.

Types of anxiety disorders

Anxiety is part of many other disorders like:

Panic disorder/Generalized anxiety disorder
Phobia associated anxiety
Social anxiety disorder
Obsessive-compulsive disorder(OCD)
Separation anxiety disorder
Illness anxiety disorder(hypochondria)
Post-traumatic stress disorder (PTSD)

What are the symptoms of anxiety?

Anxiety is an overwhelming sense of fear or worry that affects every person differently. The symptoms may differ from person to person but they generally are:

Increased heart rate
Rapid breathing
Restlessness
Sleep disturbances (initiating and maintaining sleep, nightmares)

Each type of anxiety disorders present with symptoms specific to the type

1. Panic Disorder:

Patients with this type of anxiety disorder suffer from recurring panic attacks that can cause a suffocating sensation in the affected individual. Symptoms of a panic attack include:

Heart palpitations
Increased heartbeat
An increased heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath, smothering, suffocating, or choking
Feelings of impending doom
Feelings of being out of control

2. Phobia-related disorders:

Patients with this type generally have an attack as a result of intense fear. This fear may be due to the person’s surroundings or a specific object, living creature, and so on. Some common phobias include flying, heights, injection, blood, and animals like snakes and spiders.

Patients with phobias actively try to avoid the thing they are scared of and if they do encounter it, the fear reaction is irrational and inappropriate considering the trigger.

3. Social anxiety disorder:

People with social anxiety disorder have extreme worries about being and behaving properly in public. They usually get embarrassed easily and constantly feel judged in a social gathering. This leads to the avoidance of socializing thus affecting their daily life severely.

4. Separation anxiety disorder:

This type is usually seen in children, but it can affect adults as well. Affected individuals suffer from nightmares about being separated from the one they are attached to. They may have an anxiety attack if they have to separate from the attached person, or even if they just expect separation.

What is an anxiety attack?

An anxiety attack is caused by a stressor and is usually shortlived. It may build slowly and can be best described as an overwhelming sense of fear and distress.

Symptoms of an anxiety attack include, but are not limited to:

Dizziness
Shortness of breath
Dry mouth
Sweating
Chills or hot flashes
Numbness
Tingling

It is important to note that an anxiety attack is not a panic attack, although they share a lot of the symptoms.
While anxiety attacks are triggered by a stressor, panic attacks occur unprovoked. Also, anxiety attacks may disappear after some time but panic attacks are completely unpredictable.

What are the causes of anxiety?

According to the National Institute of Mental health, etiology of anxiety is multifactorial including both genetic and environmental components, like diet and stress.

New studies are being conducted on the amygdala and hippocampus of the brain to determine the exact etiology of anxiety disorders. The reason why the amygdala and hippocampus are being studied is the function of both parts of the brain. Amygdala is responsible for analyzing and processing threats and the hippocampus is responsible for memories of these threatening events.

Researchers have also found the involvement of the RBFOX1 gene. However, no conclusive results are yet published.

What are the risk factors for anxiety disorders?

There are many risk factors for anxiety disorders, such as:

Depression: It can cause anxiety or anxiety can cause depression. Current studies are trying to learn the relation between them.
Irritable bowel syndrome
History of substance abuse: however, anxiety disorders are associated with a high risk of substance abuse. It is a vicious cycle.
Presence of one anxiety disorder can increase the risk for development of other types of anxiety disorders
Stress
Genetics
Personality type: Type A personalities are often associated with higher anxiety levels.
Trauma: It can be the trauma of one’s own, or trauma experienced by a loved one or even, the community. It can result in PTSD.
Gender: Women are more likely to develop anxiety disorders

How are anxiety disorders diagnosed?

An accurate diagnosis of anxiety depends on mental health evaluations and psychological questionnaires, along with a physical examination to rule out a physical cause for the symptoms.

How are anxiety disorders treated?

Anxiety is generally treated with either psychotherapy or medications. In some cases, both may be used.

Psychotherapy

It is a type of ‘talk therapy’ that is individualized per patient and their exact fears and stressors. One example of such therapy is cognitive behavior therapy. This type of therapy aims to re-train patients to think and view their fears in a different light.

It is further divided into cognitive therapy and exposure therapy. Cognitive therapy is used to focus on, identify, and neutralize the negative thoughts associated with anxiety disorders. Exposure therapy, on the other hand, is focused on facing your fears and engaging in social activities, especially for those with a social anxiety disorder.

Since exposure therapy may cause negative feelings in patients, it is often accompanied by relaxation exercises and images.

Medical Therapy

Medications can help cure the symptoms of anxiety and not the disorder itself. Generally prescribed medications include:

Anxiolytics: Most commonly used anxiolytics are benzodiazepines. However, they are associated with withdrawal symptoms if stopped abruptly, and with tolerance, if used for a long period of time.
Anti-depressants: Most commonly used antidepressants are SSRIs and SNRIs. Patients may not feel instant results and think the drug is ineffective in treating their anxiety. They may even discontinue using the drug but it is important to note that both SSRIs and SNRIs take time to show results.
Beta-blockers: They are extremely useful in treating the physical symptoms of anxiety

My opinion

Anxiety is a common disorder, the etiology of which is not properly understood. Many suffer from anxiety but due to the stigma associated with mental health disorders, they may ignore it and refuse to get diagnosed. This can lead to severe cases of anxiety which can affect their social life and relationships gravely. Furthermore, youngsters with anxiety and taking anti-depressants may suffer from suicidal thoughts and tendencies. It is important on behalf of the prescribing doctor to inform them of these side-effects and make sure they are being closely monitored.

References

https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders